X-ray Radiation

He was experimenting with cathode rays when he discovered that a type of paper that shines under ultraviolet light and cathode rays also shone in his dark laboratory in the presence of a new material. Thus, he discovered a source of an as yet unknown radiation , which he named X-ray radiation . He soon discovered that the radiation passes differently through different structures and materials. Soon, physicians applied this radiation in diagnostics and as a form of therapy for cancer and tuberculosis patients. In 1901 Röntgen was the first person to win the new Nobel prize (in physics). He refrained from applying for a patent as a gift to society, and soon afterwards X-ray radiation found applications in many forms (e.g. in shoe shops, to check the correct position of the foot in the shoe). There was even a proposal to use X-rays for shaving after the discovery that X-ray radiation can cause hair loss . However, after discovering more and more side effects, people became cautious when using X-rays. Indeed, there were many sceptical voices criticising doctors for X-raying too often instead of asking the patient about symptoms and taking the whole person into consideration .

What does „X-ray“ mean, exactly? X-ray imaging is an imaging procedure that screens bones and tissue. The images are based on X-rays, which are electromagnetic waves formed by changes in the velocities of charged particles. The X-ray image makes density differences in the examined body region visible . This allows X-ray diagnostics. The diagnostician is a radiologist. Depending on the structure through which the X-radiation is shone, there is a different shadow image. A dense structure such as a bone blocks much of the radiation, thus producing a light coloration. On the contrary , smooth tissues, for example muscles or organs, let more radiation pass through, therefore appearing as dark structures.

How is the examination conducted ? Before the X-ray, clothes covering the target region, as well as piercings or jewelery, must be removed. The patient either sits, stands or lies down.

It is important not to move while the picture is taken (which only takes a couple of seconds). If regions in the lower abdomen are examined, the patient is required to wear a lead apron to protect the reproductive organs from X-radiation.

When is X-ray used? The most common reason to do an X-ray is if a bone fracture is suspected. However, X-ray can also detect a herniated disc , osteoporosis, diseases of the blood vessels or organs, heart problems or a heart valve defect (since the size and shape of the heart can be determined) as well as breast cancer by conducting a mammography. Using contrast agents, even soft tissues can be visualized using X-rays.

Which types of X-ray exist? Conventional X-ray: The radiation is pointed at the respective body part for milliseconds, which produces a black-and-white image. A contrast agent can be drunk or injected in order to increase the visibility of structures such as hollow organs (e. g.: blood vessels or gastrointestinal tract). Standard Computed Tomography: It is performed in a hospital or radiologist’s clinic. It is typically used for diagnoses of the circulatory system such as blood vessel aneurysms, blood clots, and coronary artery disease. Fluoroscopy: For observing swallowing or heart movements, a series of pictures are taken. Digital subtraction angiography: To depict vessels in even higher detail bones and tissues are eliminated from the image. Digital volume tomography (Teeth and bones X-ray): Dentists use this method to produce a three-dimensional image. Orthopantomography: The X-ray moves in a semicircle around the head producing a panoramic image of the teeth and the jaw. What are the risks of X-rays? The most important factors determining the risks are the frequency and intensity of the X-radiation. The radiation can cause genetic damage when passing through tissues. Thus, it is possible that the radiation may cause cancer. However, nowadays the technology relies on modern, sensitive systems that reduce exposure to radiation to a minimum. Nevertheless, a study conducted in 2012 and published in the magazine “Cancer” showed that patients who are exposed to a dental X-ray more than once a year are three times more likely to develop a meningioma.

Additionally, various organs react differently to radiation. The most sensitive organs are the brain, the lungs, the stomach, the female breast and the colon. Lower risk organs are the bladder, the liver, the oesophagus and the thyroid . The skin and muscles, meanwhile, are the least sensitive to radiation exposure.

X-ray examinations should be avoided during pregnancy. If necessary, the physician and the patient should thoroughly discuss the necessity and alternatives of the procedure. However, it has been proven that it is non-critical during the lactation period, since the radiation does not affect breast milk. Recently, the Society of Uroradiology also declared contrast agents to be unobjectionable during lactation.

Contrast agents may cause allergic reactions. These agents contain iodine and are therefore not suited for people with hyperthyroidism, impaired kidney function (since the kidney might not be able to excrete the iodine on its own) and diabetics who take medicine containing metformin (possible overload of the kidney).

It is always important to balance out the risks and benefits before doing an X-ray examination.

EXERCISE: 1. Which organs are the most sensitive to X-ray? a) liver b) brain c) lung d) stomach e) thyroid

2. X-ray is used to detect osteoporosis, blood vessel diseases or heart insufficiency.

a) True b) False

3. In the beginning, X-ray radiation saw use in various forms, such as in shoe shops to fit shoes.

a) True b) False

You’ll find the answer on the next page.

BIBLIOGRAPHY Herring W: Learning Radiology, 4th edition, Elsevier 2020. http://dict.leo.org www.dict.cc www.webster-dictionary.org CARMEN LOBITZ Carmen Lobitz ist freie Trainerin, Lehrerin und MTA. Sie gründete 1998 in Berlin lobitz seminare, die unter anderem Englischseminare für Health Professionals anbieten. Kontakt: mail@lobitz-seminare.de www.lobitz-seminare.de

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Lösung für Exercise:

1. B, C, D

2. A

3. A

X-ray Radiation

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