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INTERACTION OF X-RAY WITH MATTER
AND EFFECTS OF RADIATION
Presented by ;
Niroj Sandha
B.Sc. MIT 1st year
NAMS, BIR HOSPITAL
CONTENTS
ATOM
TYPES OF INTERACTION
DIFFERENTIAL ABSORPTION
EXPONENTITAL ATTENUATION
EFFECTS OF RADIATION
SUMMARY
REFERENCES
ATOM
Matter is anything that occupies space , is made
up of atom which is composed of nucleon (i.e.
neutron and proton) and electron.
Neutrons are electrically neutral and protons have
positive charge ,both are found in nucleus.
Electrons are negatively charge and circulate
around the nucleus .
The Atomic numer (Z) is the no. of protons in the
nucleus , it is equal to the no. of electrons .
Total no. of protons and neutrons in the nucleus is
known as Mass number(A).
ATOMIC STRUCTURE
According to Bohr’s atomic model :
1. Positively charged nucleus surround and revolve by
the negatively charged electrons in a fixed orbits
2. Electron orbit shells are given the codes for
identification K,L,M,N, and so forth from closest to
nucleus to farthest from nucleus .
3. Maximum number of electrons that can exist in each
shell increases with increase in distance from the
nucleus i.e. 2n^2 where ‘n’ is the shell number .
Binding energy
It is energy acquired by the electrons due to
strong electrostatic pull of attraction by the
nucleus
Energy required to remove an electron from an
atom is called electron binding energy
It is unique for each shell of each element
It depend on the distance of an electron from
5ye nucleus i.e. inner shell electrons have high
binding energy than outer shell electron
Binding energy of tungsten atom
Ionization
Removal of one or more electrons form the neutral
atom leaving behind a positive ion .
Electromagnetic radiation with sufficient energy to
eject atomic electron is called ionizing radiation
EXICITATION
Electrons of an atom move from inner shell to outer shell
when energy is supplied to neutral atom is called
excitation
Beam interaction picture
Photon beam interctaction
Attenuation : removal of intensity of the radiation
when it passes through the matter
Absorption:transfer of energy from radiation to the
medium
Scattering :refers to change indirection of photons
Transmission : x ray energy that penetrate through
matter without any of above process
DUAL NATURE OF LIGHT
X ray belongs to a group of radiation called
Electromagnetic radiation .
Electromagnetic radiation has dual characteristics i.e. it
comprises both particle and wave
Wave concept
Propagate through space in the form of wave
Waves of all type have wavelength and frequency
C = / . V Where v= frequency , /= wavelength, c=
speed of light
Electromagnetic wave ko gif fig
Wave theory of light explains phenomenon like
interference , diffraction, polarization and coherent
scattering
Particle concept
When metal surface is irradiated with light , an
electron is ejwcted
Depends on its energy( frequency) not its
intensity
The phenomenon of photoelectric effect and
compton effect is explained on the basis of light
consisting photons or quanta.
Gif of duality
Interaction of x ray with matter
x ray interacts with matter through 5 different
mechanism .
They are :
1. Coherent scattering
2. Compton scattering
3. Photoelectric scattering
4. Pair production
5. photodisintegration
COHERENT SCATTERING
Incident x ray energy below 10kev interacts with the
target atom causing it to become excited and release
the excess energy as a scattered x ray
Also called classical scattering or Thompson scattering
There are two types of coherent scattering
1. Thomson scattering
2. Rayleigh scattering
Scattered x ray is change in direction and wave length
is equal to that of the incident x ray and therefore equal
energy
No ionization occurs as no transfer of energy of occurs
/no ejection of the electrons .
It is little importance to the diagnostic radiology
Figure of coherent scatteing
Compton scattering
COMPTON SCATTERING
Incident x ray interact with the outer shell electron
target atom , thereby ionizing the atom .
Ejected electron is called Compton electron
Energy of Compton scattered x ray is equal to
difference between the energy of incident x ray and
ejected electron .
This reaction produces an ion pair , a positive atom
and a negative electron known as recoil electron
It contributes around 20% in diagnostic radiography
Scatter photon has less energy than the
incident photon .
Wavelength is longer than the incident
photon
Scatter photon undergo additional tissue
interaction
Direction of scatter radiation
Scatter radiation travel in a new direction
depending upon deflection angle with the
electron.
It may be as great as 180 degree ( back
scattering )
I. Back scatter can cause artefacts ,such as
cassette strap image .
II. These photons pose major radiation hazard
to the staff ( especially during fluoroscopic
examination )
Probabilty of occurrence
Most likely to occur
With outer shell electron and loosely bound electron
As x ray energy increases
Reduce probability of Compton effect
 As atomic number of matter increases
 No effect
 As mass density of matter increase
 More Compton scatter
PHOTOELECTRIC EFFECT
• Incident x ray interact with the innershell electron
and is fully absorbed thereby ejecting an electron
from its shell
• the ejected electron escapes with the KE equal to
difference between energy of incident x ray and the
binding energy of the electron.
• Earned albert einstein the 1921 nobel prize in physics .
• For low atomic number atom , photoelectron eject
with KE is equal to the energy of incident x ray .
• For high atomic number atom , KE of photoelectron is
proportionately lower in compared to binding energy
of target atom .
The photoelectric effect yields
1. photo electron (-ve ion )
2.Positive atom(+ve ion)
3.Characteristic x ray
- •Energy of characteristics x ray are produces when
the void in the k-shell is filled by the subsequent
shell electrons , generally L- shell electrons .
•Energy of characteristics x ray is equal to the
difference of binding energy of both shells
• It acts as secondary radiation and contributes
nothing of diagnostic
Characteristic x ray after photelectric
Probabilty of occurrence
Incident x ray must have energy equal or
greater than the binding energy of k shell
electron
Inversely proportional to the third power of x
ray energy
Directly proportional to the third power of
the atomic number of an atom.
Advantages of photoelectric effect
Contributes around 75% to the medical
imaging .
Does not produce scattered radiation
Enhances natural tissue contrast
I. Since the probability of interaction is proportional
to the third power of atomic number , it
magnifies the difference in tissue composed of
different atomic numbers
II. For example bone and soft tissue
Disadvantage of photoelectric
Increase in patient radiation dose , since all
the energy of incident photon is absorbed by
the patient in the photoelectric interaction.
Pair production
Production of an electron and positron pair after
complete absorption of the x ray photon.
The energy equivalence of the mass of both
particle is equal of 0.51MeV
That’s why it only Occurs when incident photon
has energy of atleast 1.02MeV
Energy in excess of 1.02MeV is distributed
equally as a kinetic energy
It is unimportant in x ray imaging but is very
much of important in PET imaging in nuclear
imaging
Picture of pair production
Photodisintegration
X ray of energy greater than 10Mev escapes
interaction with the electron and nuclear
electrostatic field and absorbed directly by
the nucleus
nucleus is raised to excited state and emits
nucleon or nuclear fragments .
It does not occur in diagnostic radiology
Picture of photodisintegration
DIFFERENTIAL ABSORPTION
• X rays that undergo photoelectric interaction provides
diagnostic information as they do not reach the IR and
produces light areas
• whereas x ray transmitted through the patient without
interaction produces the dark areas of a radiograph
• this difference in absorption of x ray interacrion is called
Differential absorption .
• Both, x rays that are transmitted to the IR and that are
absorbed photoelectrically are equally important
• If all the x rays are transmitted then iimage would be
uniformly black and also if all the x ray photons are
absorbed then it will cause uniformly white . Neither of
cases are appreiciated in diagnostic radiology .
• Differential absorption depends on following factors ;
1.Atomic number (Z)
2.Mass density
1. Atomic number
• Probabilty of an x ray undergoing photoelectric is
proportional the third power of At no. of the tissue and
inversely proportional to the third power of x ray energy
• So decrease in compton scattering is not as rapid as
photoelectric with increase in energy .
•
Contd ...
2.Mass density
• Interaction of x ray with tissue is proportional to the
mass demsity of the tissue regardless of type of
interaction .
• Mass denity is quantity of matter per volume.
• We could image bone even if differential absorption
is not (Z) related because bone has higher mass
density than soft tissue .
EXPONENTIAL ATTENUATION
When x ray interact with any type of tissue ,
interaction occurs through any 5 mechanism but in
diagnostic radiology only 2 types of interaction are
important .
these interaction depend on atomic no of tissue
atoms , mass density and x ray energy.
The reduction in beam intensity after penetration
through a given thickness of tissue is called
attenuation i.e. they are reduced in number by a
certain percentage of each increment in thickness of
the tissue they go through
Deterministic effect of the radiation
The effect which have threshold value below
which the effect doesn’t occur
Once the threshold value has been reach the
severity of an effect increase with radiation
dose
It includes
1. Acute radiation lethality
2. Local tissue damage
3. hematologic depression
4. Cytogenic depression
Acute radiation lethality
sequence of events followed by high
radiation exposure leading to death within
days or weeks is called acute radiation
syndrome .
Three lethal syndrome associated with acute
radiation lethality are ;
I. Prodromal period (immediate response )
II. Latent period ( no response )
III. Manifest illness ( haematologic, GI ,CNS syndrome )
Table 33-2
LD50/60 is the dose of radiation that will result in
death of 50% of irradiated subjects within 60 days
 Table 33-3
Mean survival time decreases as the
radiation dose increase
Local tissue damage
skin
Depends on the intrinsic radiosensitivity , cell
proliferation and maturation .
Local tissues that are affected immediately
are skin, gonads and bone marrow
Damage to basal cells results in earliest
manifestation of radiation injury to the skin .
The resultant skin damage is seen as
erythema and desquamation
Fig of erythema and desquamtion
Gonads
Human gonads are critically important target
and responds to doses as low as 100mGyt
Even such low dose can reduce the number of
spermatozoa in male testes and suppress
menstruation in female
Dose of approximately 2Gyt causes temporary
infertility and 5Gyt cause permanent infertility
Moderate such as 250mGy is sufficient to
cause genetic mutation
Haemopoietic system
highly radiosensitive system ,consists of bone
marrow ,circulating blood and lymphoid tissue
Derived from pluripotent stem cells which
produce many stem cells like lymphocytes
,granulocytes ,thrombocytes ,erythrocytes.
Graph of haemopoeitic system
Cytogenetic effects
Cytogenetic is the study of cell ,particularly
cell chromosome .
Radiation induced chromosome aberrations
follow non threshold dose response
relationship
Radiation may damage chromosome by
following
i. chromatid deletion –single hit
ii. Dicentric / ring chromosome – multi hit
iii. Reciprocal translocation –multi hit
Ring chromosome are produced if two hits occur on the same
chromosome.
Dicentrics are produced when adjacent chromosome sustain
one hit amd recombine .
It results in no loss of genetic material, simoly rearrangement
of genes in incorrect sequence .
Stochastic effect
Effects of radiation that may occur by chance
and are result of low dose delivered over a
long period of time
It follows linear ,non-threshold dose response
relationship
The principle stochastic effects are radiation
induced malignancy and genetic effects .
Local tissue effects
Chronic irradiation of skin can result in severe
non-malignant changes such as development
of very callaused , discolored ,weathered
apperances in the skin
Even a low dose can produce chromosome
aberration that may not be visible even after
many years of exposure
usually the radiation protection guides are
based on the stochastic effects of radiation
and on linear non threshold dose relationship
Consequently the precise dose response
relationship are often not possible to
formulate .
hence, we resort Risk Estimates. They are :
1. Relative risk
2. Excess risk
3. Absolute risk
1. Relative risk
If one observe a large population for stocjastic
radiation effects without having precise
knowledge of radiatiom dose which they are
exposed .
It is computed by comparing the number of
irradiated populations showing stochastic
effect by the number of unexposed population
showing the same stochastic effect
Relative risk =observed case /expected
cases
2. Excess risk
It is difference between observed risk and
expected risk
Observed risk-Expected risk =Excess risk
Leukemia is known to occur in non irradiated
population but if leukemia incidence in
irradiated population exceeds more than
expected then difference betn observed cases
and expected cases would be excess risk .
3. Absolute risk
If at least two dose levels are known , it may
be possible to determine the possible risk
factors
It consist unit of case / population / dose
According to the National committee on
biological effects of Ionizing radiation , this
value is 8*10^2
This is the risk coefficient used by the scientist
to predict stochastic radiation response in
exposed populations
Radiation Induced Malignancy
All the radiation induced malignancy follow
linear non threshold dose response
relationship expect the radiation induced skin
cancer
Radiation induced malignancy like leukemia
,cancer increases with the increase in
radiation dose
References
Text book of Radiology for Residents and
Technicians
Radiologic science for technologist
Thank You
 Interaction of x-ray and radiation effects

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Interaction of x-ray and radiation effects

  • 1. INTERACTION OF X-RAY WITH MATTER AND EFFECTS OF RADIATION Presented by ; Niroj Sandha B.Sc. MIT 1st year NAMS, BIR HOSPITAL
  • 2. CONTENTS ATOM TYPES OF INTERACTION DIFFERENTIAL ABSORPTION EXPONENTITAL ATTENUATION EFFECTS OF RADIATION SUMMARY REFERENCES
  • 3. ATOM Matter is anything that occupies space , is made up of atom which is composed of nucleon (i.e. neutron and proton) and electron. Neutrons are electrically neutral and protons have positive charge ,both are found in nucleus. Electrons are negatively charge and circulate around the nucleus . The Atomic numer (Z) is the no. of protons in the nucleus , it is equal to the no. of electrons . Total no. of protons and neutrons in the nucleus is known as Mass number(A).
  • 4. ATOMIC STRUCTURE According to Bohr’s atomic model : 1. Positively charged nucleus surround and revolve by the negatively charged electrons in a fixed orbits 2. Electron orbit shells are given the codes for identification K,L,M,N, and so forth from closest to nucleus to farthest from nucleus . 3. Maximum number of electrons that can exist in each shell increases with increase in distance from the nucleus i.e. 2n^2 where ‘n’ is the shell number .
  • 5.
  • 6. Binding energy It is energy acquired by the electrons due to strong electrostatic pull of attraction by the nucleus Energy required to remove an electron from an atom is called electron binding energy It is unique for each shell of each element It depend on the distance of an electron from 5ye nucleus i.e. inner shell electrons have high binding energy than outer shell electron
  • 7. Binding energy of tungsten atom
  • 8. Ionization Removal of one or more electrons form the neutral atom leaving behind a positive ion . Electromagnetic radiation with sufficient energy to eject atomic electron is called ionizing radiation
  • 9. EXICITATION Electrons of an atom move from inner shell to outer shell when energy is supplied to neutral atom is called excitation
  • 11. Photon beam interctaction Attenuation : removal of intensity of the radiation when it passes through the matter Absorption:transfer of energy from radiation to the medium Scattering :refers to change indirection of photons Transmission : x ray energy that penetrate through matter without any of above process
  • 12. DUAL NATURE OF LIGHT X ray belongs to a group of radiation called Electromagnetic radiation . Electromagnetic radiation has dual characteristics i.e. it comprises both particle and wave Wave concept Propagate through space in the form of wave Waves of all type have wavelength and frequency C = / . V Where v= frequency , /= wavelength, c= speed of light
  • 13. Electromagnetic wave ko gif fig Wave theory of light explains phenomenon like interference , diffraction, polarization and coherent scattering
  • 14. Particle concept When metal surface is irradiated with light , an electron is ejwcted Depends on its energy( frequency) not its intensity The phenomenon of photoelectric effect and compton effect is explained on the basis of light consisting photons or quanta. Gif of duality
  • 15. Interaction of x ray with matter x ray interacts with matter through 5 different mechanism . They are : 1. Coherent scattering 2. Compton scattering 3. Photoelectric scattering 4. Pair production 5. photodisintegration
  • 16. COHERENT SCATTERING Incident x ray energy below 10kev interacts with the target atom causing it to become excited and release the excess energy as a scattered x ray Also called classical scattering or Thompson scattering There are two types of coherent scattering 1. Thomson scattering 2. Rayleigh scattering Scattered x ray is change in direction and wave length is equal to that of the incident x ray and therefore equal energy No ionization occurs as no transfer of energy of occurs /no ejection of the electrons . It is little importance to the diagnostic radiology
  • 17. Figure of coherent scatteing
  • 19. COMPTON SCATTERING Incident x ray interact with the outer shell electron target atom , thereby ionizing the atom . Ejected electron is called Compton electron Energy of Compton scattered x ray is equal to difference between the energy of incident x ray and ejected electron . This reaction produces an ion pair , a positive atom and a negative electron known as recoil electron It contributes around 20% in diagnostic radiography
  • 20. Scatter photon has less energy than the incident photon . Wavelength is longer than the incident photon Scatter photon undergo additional tissue interaction
  • 21.
  • 22. Direction of scatter radiation Scatter radiation travel in a new direction depending upon deflection angle with the electron. It may be as great as 180 degree ( back scattering ) I. Back scatter can cause artefacts ,such as cassette strap image . II. These photons pose major radiation hazard to the staff ( especially during fluoroscopic examination )
  • 23. Probabilty of occurrence Most likely to occur With outer shell electron and loosely bound electron As x ray energy increases Reduce probability of Compton effect  As atomic number of matter increases  No effect  As mass density of matter increase  More Compton scatter
  • 24. PHOTOELECTRIC EFFECT • Incident x ray interact with the innershell electron and is fully absorbed thereby ejecting an electron from its shell • the ejected electron escapes with the KE equal to difference between energy of incident x ray and the binding energy of the electron.
  • 25.
  • 26. • Earned albert einstein the 1921 nobel prize in physics . • For low atomic number atom , photoelectron eject with KE is equal to the energy of incident x ray . • For high atomic number atom , KE of photoelectron is proportionately lower in compared to binding energy of target atom .
  • 27. The photoelectric effect yields 1. photo electron (-ve ion ) 2.Positive atom(+ve ion) 3.Characteristic x ray - •Energy of characteristics x ray are produces when the void in the k-shell is filled by the subsequent shell electrons , generally L- shell electrons . •Energy of characteristics x ray is equal to the difference of binding energy of both shells • It acts as secondary radiation and contributes nothing of diagnostic
  • 28. Characteristic x ray after photelectric
  • 29. Probabilty of occurrence Incident x ray must have energy equal or greater than the binding energy of k shell electron Inversely proportional to the third power of x ray energy Directly proportional to the third power of the atomic number of an atom.
  • 30.
  • 31. Advantages of photoelectric effect Contributes around 75% to the medical imaging . Does not produce scattered radiation Enhances natural tissue contrast I. Since the probability of interaction is proportional to the third power of atomic number , it magnifies the difference in tissue composed of different atomic numbers II. For example bone and soft tissue
  • 32. Disadvantage of photoelectric Increase in patient radiation dose , since all the energy of incident photon is absorbed by the patient in the photoelectric interaction.
  • 33. Pair production Production of an electron and positron pair after complete absorption of the x ray photon. The energy equivalence of the mass of both particle is equal of 0.51MeV That’s why it only Occurs when incident photon has energy of atleast 1.02MeV Energy in excess of 1.02MeV is distributed equally as a kinetic energy It is unimportant in x ray imaging but is very much of important in PET imaging in nuclear imaging
  • 34. Picture of pair production
  • 35. Photodisintegration X ray of energy greater than 10Mev escapes interaction with the electron and nuclear electrostatic field and absorbed directly by the nucleus nucleus is raised to excited state and emits nucleon or nuclear fragments . It does not occur in diagnostic radiology
  • 37. DIFFERENTIAL ABSORPTION • X rays that undergo photoelectric interaction provides diagnostic information as they do not reach the IR and produces light areas • whereas x ray transmitted through the patient without interaction produces the dark areas of a radiograph • this difference in absorption of x ray interacrion is called Differential absorption . • Both, x rays that are transmitted to the IR and that are absorbed photoelectrically are equally important • If all the x rays are transmitted then iimage would be uniformly black and also if all the x ray photons are absorbed then it will cause uniformly white . Neither of cases are appreiciated in diagnostic radiology .
  • 38. • Differential absorption depends on following factors ; 1.Atomic number (Z) 2.Mass density 1. Atomic number • Probabilty of an x ray undergoing photoelectric is proportional the third power of At no. of the tissue and inversely proportional to the third power of x ray energy • So decrease in compton scattering is not as rapid as photoelectric with increase in energy . • Contd ...
  • 39.
  • 40. 2.Mass density • Interaction of x ray with tissue is proportional to the mass demsity of the tissue regardless of type of interaction . • Mass denity is quantity of matter per volume. • We could image bone even if differential absorption is not (Z) related because bone has higher mass density than soft tissue .
  • 41.
  • 42. EXPONENTIAL ATTENUATION When x ray interact with any type of tissue , interaction occurs through any 5 mechanism but in diagnostic radiology only 2 types of interaction are important . these interaction depend on atomic no of tissue atoms , mass density and x ray energy. The reduction in beam intensity after penetration through a given thickness of tissue is called attenuation i.e. they are reduced in number by a certain percentage of each increment in thickness of the tissue they go through
  • 43. Deterministic effect of the radiation The effect which have threshold value below which the effect doesn’t occur Once the threshold value has been reach the severity of an effect increase with radiation dose It includes 1. Acute radiation lethality 2. Local tissue damage 3. hematologic depression 4. Cytogenic depression
  • 44. Acute radiation lethality sequence of events followed by high radiation exposure leading to death within days or weeks is called acute radiation syndrome . Three lethal syndrome associated with acute radiation lethality are ; I. Prodromal period (immediate response ) II. Latent period ( no response ) III. Manifest illness ( haematologic, GI ,CNS syndrome )
  • 46. LD50/60 is the dose of radiation that will result in death of 50% of irradiated subjects within 60 days  Table 33-3
  • 47. Mean survival time decreases as the radiation dose increase
  • 48. Local tissue damage skin Depends on the intrinsic radiosensitivity , cell proliferation and maturation . Local tissues that are affected immediately are skin, gonads and bone marrow Damage to basal cells results in earliest manifestation of radiation injury to the skin . The resultant skin damage is seen as erythema and desquamation
  • 49. Fig of erythema and desquamtion
  • 50. Gonads Human gonads are critically important target and responds to doses as low as 100mGyt Even such low dose can reduce the number of spermatozoa in male testes and suppress menstruation in female Dose of approximately 2Gyt causes temporary infertility and 5Gyt cause permanent infertility Moderate such as 250mGy is sufficient to cause genetic mutation
  • 51.
  • 52. Haemopoietic system highly radiosensitive system ,consists of bone marrow ,circulating blood and lymphoid tissue Derived from pluripotent stem cells which produce many stem cells like lymphocytes ,granulocytes ,thrombocytes ,erythrocytes.
  • 54. Cytogenetic effects Cytogenetic is the study of cell ,particularly cell chromosome . Radiation induced chromosome aberrations follow non threshold dose response relationship Radiation may damage chromosome by following i. chromatid deletion –single hit ii. Dicentric / ring chromosome – multi hit iii. Reciprocal translocation –multi hit
  • 55.
  • 56.
  • 57. Ring chromosome are produced if two hits occur on the same chromosome. Dicentrics are produced when adjacent chromosome sustain one hit amd recombine .
  • 58. It results in no loss of genetic material, simoly rearrangement of genes in incorrect sequence .
  • 59. Stochastic effect Effects of radiation that may occur by chance and are result of low dose delivered over a long period of time It follows linear ,non-threshold dose response relationship The principle stochastic effects are radiation induced malignancy and genetic effects .
  • 60. Local tissue effects Chronic irradiation of skin can result in severe non-malignant changes such as development of very callaused , discolored ,weathered apperances in the skin Even a low dose can produce chromosome aberration that may not be visible even after many years of exposure
  • 61. usually the radiation protection guides are based on the stochastic effects of radiation and on linear non threshold dose relationship Consequently the precise dose response relationship are often not possible to formulate . hence, we resort Risk Estimates. They are : 1. Relative risk 2. Excess risk 3. Absolute risk
  • 62. 1. Relative risk If one observe a large population for stocjastic radiation effects without having precise knowledge of radiatiom dose which they are exposed . It is computed by comparing the number of irradiated populations showing stochastic effect by the number of unexposed population showing the same stochastic effect Relative risk =observed case /expected cases
  • 63. 2. Excess risk It is difference between observed risk and expected risk Observed risk-Expected risk =Excess risk Leukemia is known to occur in non irradiated population but if leukemia incidence in irradiated population exceeds more than expected then difference betn observed cases and expected cases would be excess risk .
  • 64. 3. Absolute risk If at least two dose levels are known , it may be possible to determine the possible risk factors It consist unit of case / population / dose According to the National committee on biological effects of Ionizing radiation , this value is 8*10^2 This is the risk coefficient used by the scientist to predict stochastic radiation response in exposed populations
  • 65. Radiation Induced Malignancy All the radiation induced malignancy follow linear non threshold dose response relationship expect the radiation induced skin cancer Radiation induced malignancy like leukemia ,cancer increases with the increase in radiation dose
  • 66. References Text book of Radiology for Residents and Technicians Radiologic science for technologist