X-rays can also be produced by fast protons or other positive ions. The proton-induced X-ray emission or particle-induced X-ray emission is widely used as an analytical procedure. For high energies, the production cross section is proportional to Z12Z2−4, where Z1 refers to the atomic number of the ion, Z2 to that of the target atom. An overview of these cross sections is given in the same reference.
Main article: X-ray detector
X-ray detectors vary in shape and function depending on their purpose. Imaging detectors such as those used for radiography were originally based on photographic plates and later photographic film, but are now mostly replaced by various digital detector types such as image plates and flat panel detectors. For radiation protection direct exposure hazard is often evaluated using ionization chambers, while dosimeters are used to measure the radiation dose a person has been exposed to. X-ray spectra can be measured either by energy dispersive or wavelength dispersive spectrometers.
Main article: Medical imaging
A chest radiograph of a female, demonstrating a hiatus hernia
Since Röntgen's discovery that X-rays can identify bone structures, X-rays have been used for medical imaging. The first medical use was less than a month after his paper on the subject. Up until 2010, 5 billion medical imaging studies have been conducted worldwide. Radiation exposure from medical imaging in 2006 made up about 50% of total ionizing radiation exposure in the United States.
Main article: Radiography
An arm radiograph, demonstrating broken ulna and radius with implantedinternal fixation.
A radiograph is an X-ray image obtained by placing a part of the patient in front of an X-ray detector and then illuminating it with a short X-ray pulse. Bones contain much calcium, which due to its relatively high atomic number absorbs x-rays efficiently. This reduces the amount of X-rays reaching the detector in the shadow of the bones, making them clearly visible on the radiograph. The lungs and trapped gas also show up clearly because of lower absorption compared to tissue, while differences between tissue types are harder to see.
Radiographs are useful in the detection of pathology of the skeletal system as well as for detecting some disease processes in soft tissue. Some notable examples are the very common chest X-ray, which can be used to identify lung diseases such aspneumonia, lung cancer, or pulmonary edema, and the abdominal x-ray, which can detect bowel (or intestinal) obstruction, free air (from visceral perforations) and free fluid (in ascites). X-rays may also be used to detect pathology such as gallstones(which are rarely radiopaque) or kidney stones which are often (but not always) visible. Traditional plain X-rays are less useful in the imaging of soft tissues such as the brain or muscle.
Dental radiography is commonly used in the diagnoses of common oral problems, such as cavities.
In medical diagnostic applications, the low energy (soft) X-rays are unwanted, since they are totally absorbed by the body, increasing the radiation dose without contributing to the image. Hence, a thin metal sheet, often of aluminium, called an X-ray filter, is usually placed over the window of the X-ray tube, absorbing the low energy part in the spectrum. This is calledhardening the beam since it shifts the center of the spectrum towards higher energy (or harder) x-rays.
To generate an image of the cardiovascular system, including the arteries and veins (angiography) an initial image is taken of the anatomical region of interest. A second image is then taken of the same region after an iodinated contrast agent has been injected into the blood vessels within this area. These two images are then digitally subtracted, leaving an image of only the iodinated contrast outlining the blood vessels. The radiologist or surgeon then compares the image obtained to normal anatomical images to determine whether there is any damage or blockage of the vessel.