Score Lec 9 Physics Quarter

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Almost all energy is deposited inside the organ

and very little escapes
Some of energy is deposited in the organ and
some leaves it
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Activity administrated
Fraction taken up by the organ
Effective half life of the activity in the organ
Energy of radiation emitted
Fraction of the energy escapes from the organ
Factors affecting absorbed dose

delivered to an organ
Nuclear medicine and patient

dose
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Source Organ
Target Organ
Cardiac scan
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Method of American society of nuclear medicine

Assumes that there are source organ which
accumulates the activity , and target organs which
are irradiated by the source organ
2- Medical internal radiation dose (MIRD)
1- monte carlo method

Mathematical simulation of the patient anatomy
based on CT image
Mathematical methods that consider the fate of
individual photons whose behavior determined in
terms of probabilities
Calculation of internal absorbed dose
0.05
0.05
0.01
0.025
0.05
Esophagus
Thyroid
Bone
Surfaces
Spleen
Remainder
0.21
2.85
0.24
0.03
0.1
2.74
0.1
0.04
0.23
0.2
0.07
0.005
0.071
0.0024
0.0015
0.005
0.137
0.005
0.002
0.028
0.024
0.008
0.049
0.016
Effective dose
(mSv)
Tc 99m DPTA aerosol
Tc 99m HSA
Tc 99m DPTA
Ga 67
I-123
Tl-201
bone
LUNG VENTILATION
Lung perfusion
Kidney
Infection
Thyroid
Heart
80
20
150
300
100
80
600
Activity (MBq)
18
15
0.5
Effective dose
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Notes:
Most nuclear medicine investigations deliver less than 5 mSv (in the range of annual dose
of natural radiation)
Some exams (cardiac with thallium , abscess with gallium ) deliver higher doses and should
be only undertaken when other modalities are inappropriate
agent
Tc MDP
exam
Typical activities and doses
Notes:
Calculations are approximate (exact uptake is dependant on body size , age , sex , disease..)
dose can be measured based on activity uptake measured from gamma images
After IV tracer injection most of organs receive dose (compare to x-ray)
Target organs and organs of excretion receive highest dose
Distribution of the dose is examination specific
0.05
0.05
Breast
Liver
0.12
0.12
0.05
0.12
Colon
Lung
Stomach
0.12
Bladder
0.081
0.2
Gonads (F)
Red Marrow
0.41
Absorbed
Dose (mGy)
wT
Dose after colloid scan
Target Organ
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Patient should drink good deal of water and empty

the bladder frequently (reduce dose to gonads)
Females should avoid conception for an appropriate
period following administration of long lived tracers
(t > 7ds)
females who are or may be pregnant should avoid
examinations which will result in fetal dose > 10
mSv
Interruption of breast feeding is recommended
after exam
Patients identity must be checked against type of
study and the activity to be ad ministered
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Measures to decrease patient dose
accuracy of the calibrator is checked

regularly using a long lived source (Co-57)
Used also to measure radionuclide purity
Thus radionuclide and syringe type must be

selected on the control panel
Activity of the sample

Sensitivity of the chamber to the energy of
the gamma rays assessed
Geometry of the source within the calibrator
Re-enterent ionization chamber that is

used to check the activity of radionuclide
vial before patient administration
Ionization current is dependant on
Radionuclide dose calibrator
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Preparation and storage of radioactive materials

Injections of patients
Patients waiting (should be spaced apart in the waiting
area why?)
Imaging
Temporary storage of radioactive waste
Segregation:
There must be separate areas for
Precautions include segregation and personal

protection
External radiation
Internal radiation: accidental ingestion or
inhalation of radionuclide or its entry through a
wound
Types of hazards to staff while handling

tracers
Radionuclide handling precautions
Waterproof surgical gloves are worn when

handling tracer
Abrasions must be covered
No eating or drinking inside the room
Hands and work surfaces are routinely
monitored for radioactive contamination
Air in the room must be sampled And
monitored
Staff is monitored for internal contamination
If there is slight spillage decontamination by
water , mild detergents and swabs (sealed in
plastic begs and disposed as radioactive
waste)
If contamination is obstinate special
detergent solutions
Hands is washed regularly at special hands
free designated washbasins
N.B: lead rubber aprons are ineffective against
high energy gamma radiation
Personal protection:
Staff should enter radioactivity areas only
when it is strictly necessary
Radionuclide should be contained in
shielded generators or bottles inside lead
pots
Syringes are handled with long handled
forceps, and protected by tungsten or lead
glass sleeves (decrease finger dose by 75%)
Syringes are carried to the patient into a
special container
Labeling of pharmaceuticals should be
carried out with the arms behind a lead
barrier and over a tray lined with absorbent
paper
Before injection, syringes are vented into
swabs or closed containers
Staff is monitored for external radiation
doses
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Xe-133 & Tc-99m aerosols: to the exterior of the building

Kr-81m (very short t): Ventilation to exterior is desirable but
not always necessary (adequate room ventilation is a must)
Ventilation to atmosphere
Used with wastes of lung ventilation studies
principles:
Containment and decay
Dilution by dispersal to the environment
Roots:
Disposal of gaseous waste:
Disposal of radioactive waste
If necessary cordon off the area or cover

it with impervious sheeting until
sufficient decay has occurred
Clear area from non essential persons

Wear gloves aprons and overshoes
Mop the floor with absorbent pads and
seal swabs as radioactive waste
Continue until monitoring show the
activity to be satisfactorily of low level
Dealing with radioactive spill
Ultrasound physics
Used generators are kept in a secure

shielded store until returned to
manufacturer
Contaminated clothing; stored in
protected area until the activity is
sufficiently decayed , then released to
laundry
authorized incinerators
With ordinary waste if suitably diluted
Placed into designated sacs for disposal

in:
Disposal of solid waste (swabs

,syringes and bottles):
Well diluted with water via designated

sinks draining into foul drains (as long
as levels are within authorized levels)
Disposal of liquid waste:
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Wave Travel
Motion of
Individual
Coil
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i.e. Particle motion parallel to direction of wave travel
Sound waves is Longitudinal Waves
Sound Properties and

Parameters
Motion of Individual
Air Molecule
Particle moves perpendicular to wave travel

Example: Electromagnetic waves
N.B. In Transverse Waves:
Wave Travel
Regions of alternating low and high pressure

move through air
Particles oscillate back & forth parallel to
direction of sound travel
Sound Waves are Compression Waves
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20 - 20,000 Hz
sound frequency corresponds to pitch
Human hearing range
cycles per second

1 Hz = 1 cycle per second
1 kHz = 1000 cycles per second
1 MHz = 1,000,000 cycles per second
Units
# of complete cycles of sound waves per unit

time
Sound Frequency
Medium not required for electromagnetic

waves
sound does not travel through vacuum
medium is required for sound
Medium
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Magnitude
of acoustic
variable
time
period
1
Period = ---------------Frequency
As frequency increases, period decreases
Sound Period & Frequency are determined only by the
sound source. They are independent of medium
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Time between a given point in one cycle & the

same point in the next cycle (time of single cycle)
Period
1 - 10 MHz
1,000,000 - 10,000,000 Hz
Clinical ultrasound frequency range
> 20,000 Hz
not audible to humans
Ultrasound definition
Sound Frequency
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Velocity also depends on temperature

soft tissues sound take 7 sec to travel for 1 cm (1.54mm/
sec )
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Notes:
Density: velocity
Compressibility: Compressibility stic modulus)
velocity
Speed is only a function of medium

Speed is dependant on material through which it
travels
Speed is (nearly) constant for a given material
(independent on frequency)
Material properties affecting sound velocity:
Sound Speed
If frequency = 50 Hz then soWuwnwd.ScopreeTrariniiongd

.netis 1/50 = 0.02 sec
If frequency = 10 kHz then sound period is 1/10 = 0.1 msec
If frequency = 2 MHz then sound period is 1/2 = 0.5 msec
if frequency in MHz, period in msec/cycle
if frequency in kHz, period in msec/cycle
if frequency in Hz, period in seconds/cycle
Period = 1 / Frequency
4000
PZT
7500
1650
1000
1.29
Density
30 x1
5.3x 1
1.5X1
430
Acoustic impedance (Z)
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= distance between a given point in a cycle &

corresponding point in next cycle
Unit = length per cycle
usually in millimeters or fractions of a millimeter
for clinical ultrasound
distance in space over which single cycle occurs
Wavelength
Note that:
Air sound velocity is despite ha density (because it has compressibility)
Frequency of ultrasound in different media is constant (= frequency of transducer) , so that
changes in velocity from one medium to another will change ..
acoustic impedance is independent of frequency
Differences in acoustic impedance deterWmwiwn.SecofreraTrcaitniiongn.neotf ultrasound echoed at an interface
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3200
1540
Soft tissue
Bone
330
Velocity (m/s)
Air
Material
Acoustic Impedance = Density X Prop. Speed
Definition
Acoustic Impedance (Z)
(dist./cycle)
(cycles/time)
Quantity of ultrasound
Unit = Watts/mm
Proportional to square of wave amplitude
Under operator control
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Note:
Ultrasound can undergo reflection ,refraction and focusing (unlike X & rays)
Sound intensity
Wavelength is a function of both the sound source

and the medium! (why?)
because speed is constant
As frequency increases, wavelength decreases
(dist./time)
Speed = Wavelength X Frequency

[c=l Xn]
Wavelength Equation
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Two flat faces of the disc is made electrically

conducting with a very thin coating of silver
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compressed microcrystalline lead zirconate titanate (PZT)

Or plastic polyvinylidine difluoride (PVDF)
Made of piezoceramic disc that consists of either:
Uses: ultrasound transducer
conversion of electrical signals to mechanical energy

(ultrasound beam) and vice versa
Definition:
Piezoelectric effect
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The reverse is also possible:

If disc is compressed voltage is generated
If pressure is reversed voltage is reversed
Voltage produced is proportional to the pressure
applied
DC application to the piezoceramic disc:

DC voltage is applied to the flat faces of the dis
it expands
If the voltage is reversed contracts
The movement of the faces is proportional to the
voltage
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Notes:
Curie temperature: temperature above which
transducer lose its piezoelectric properties
Transducer should not be autoclaved
Thin slices of naturally occurring quartz
crystals also show piezoelectric effects (used
in digital timers)
AC application to the piezoceramic disc:

Disc will alternately expands and contracts with
the same frequency of the Aroduction of
sound waves
also: When the disc is subjected to alternating
pressure , an alternating voltage is produced of
the same frreceiving of sound waves
This means that: The same transducer can act as
transmitter and receiver of the sound
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AC voltage is applied to the crystal

The crystal face pulses forward & backwards (through
distance <1m), producing successive compressions &
rarefactions waves
Density (& pressure) of the material rise & fall above its
normal atmospheric value (can reach several atmospheres)
Frequency with which compression waves pass through
material = frequency of AC voltage applied = frequency of
ultrasound produced
Continuous mode ultrasound
Continuous and pulsed Ultrasound
silence
sound
OFF
This means that the same transducer used for

transmitting sound
receiving echoes
ON
Sound is Pulsed on & off

On Cycle (speak)
Transducer produces short duration sound
Off Cycle (listen) = dead time
Transducer receives echoes
longer duration
sound
Few hundred volts DC are suddenly applied to the

disc
It expands , compressing a layer of material in
contact with it
The compressed layer then expands compressing
layer of the material in contact with it
So that: wave of compression travels with velocity
(v) through the material followed by corresponding
wave of decompression
Short regular sound pulses are produced
Every pulse produce spectrum of frequencies
(compare to continuous mode)
ON
Pulse Mode Ultrasound
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OFF
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Silence period
Sound pulse
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pulse repetition frequency

pulse repetition period
pulse duration
duty factor
spatial pulse length
cycles per pulse
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Parameters of pulsed ultrasound
The ultrasound frequency is dependant on the transducer

material (= resonant frequency) not on the current applied
(compare to continuous mode)
one sound pulse

and
one period of silence
one pulse cycle =
Sound pulse
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Pulse Repetition Period
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time from beginning of one pulse until beginning of

next
= time between corresponding points of adjacent
pulses
1 - 10 KHz
clinical range (typical values)
determined by the source (the scanner) (= frequency of

applied voltage pulses)
Number of sound pulses per unit time

= number of times ultrasound beam turned on & off per
unit time
sound frequency
Pulse Repetition Frequency
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Higher sound Frequency

Same Pulse
Repetition Frequency
Same sound Frequency

Higher Pulse
Repetition Frequency
Pulse repetition frequency & period

independent sound frequency & period
pulse repetition period & frequency

determined by source
as pulse repetition frequency increases, pulse repetition period

decreases
PRF = 1 / PRP
Pulse repetition period is reciprocal of

pulse repetition frequency
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(cycles/pulse)
Pulse Duration
Period
typically 2-3 cycles per pulse (3 x t)
(time/pulse) (time/cycle)
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pulse duration = sound Period X # sound cycles per pulse
equation
Pulse Duration
time per pulse
When transducer is pulsed continues to

vibrate for a short while with diminishing
amplitude as it lose energy
Pulse Duration= Length of time for each
sound pulse
units
Pulse Duration
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This is minimized by dampening transducer element
Transducer tends to continue ringing
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Pulse duration (ring down time) is a controlled by

the sound source
Pulse Duration
Number of sound cycles/pulse is changed
Shorter Pulse Duration
Same frequency; pulse repetition frequency,

& pulse repetition period
Longer Pulse Duration
Pulse Duration
Piezoelectric
Element
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N.B: if the block is omitted (disc is packed with air) pulse will last
for 20 or more periods
N.B: Additional damping may be performed electronically by applying a
second reverse voltage pulse very shortly after the first
air
no
Dampin
g
Material
attached to near face of piezoelectric

element (away from patient)
Place:
reduce cycles / pulse by damping out

vibrations after voltage pulse ringdown
Goal:
Damping Material
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Frequency
Frequency = ..
Intensity
Continuous mode
Intensity
Frequency
Bandwidth
Pulsed mode
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Operating
Frequency
range of frequencies present in an ultrasound pulse

=FWHM of frequency spectrum
Bandwidth
the shorter the pulse, the higher the range of frequencies

produced
Range of frequencies produced called bandwidth
Reduces beam intensity

produces less pure frequency (tone)
Disadvantages of Damping
Frequency
Bandwidth
Mean
Frequency
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Intensity
Frequency
Bandwidth
Mean
Frequency
Compare between pulsed and continuous ultrasound

according to Q & received frequencies
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N.B: Same graphs represent the resonance curve

i.e. the response of the transducer as a receiver to waves of
different frequencies
i.e. transducer with Y produce a pure note and respond
only to that note
Intensity
Q is a Quantitative Measure of Spectral Purity Q narrower

bandwidth)
mean (resonance)frequency
Quality Factor = ----------------------------------------bandwidth
Quality Factor (Q) = mechanical coefficient
Intensity
Conclusion
Same Operating Frequency!
Intensity
shorter pulses
more frequencies
higher bandwidth
lower quality factor
lower intensity
More damping results in
Frequency
Frequency
Which has a Higher Quality Factor?

Which have less pulse duration?
Which have less damping?
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(cycles / pulse)
depends on source & medium (why?)
(dist. / pulse)
(dist. / cycle)
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Spat. Pulse Length = # sound cycles per pulse X wavelength
distance in space traveled by ultrasound

during one pulse
Spatial Pulse Length
Pulse Duration
Duty Factor = Pulse Duration X Pulse Repetition Freq.
Duty Factor = Pulse Duration / Pulse Repetition Period
Equations
Fraction of time sound generated

Determined by source
Duty Factor
Sound interference
Spat. Pulse Length = 3 less
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as wavelength increases, spatial pulse length

as # cycles per pulse increases, spatial pulse length
..
as frequency increases spatial pulse length ..
Spatial pulse length determines axial resolution (see
later)
Wavelength = Speed / Frequency
Spat. Pulse Length = # cycles per pulse X wavelength
Spatial Pulse Length
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Frequency at which the transducer vibrates most

violently and produce largest output of sound (AC)
Frequency at which transducer is most sensitive as
receiver
Resonant Frequency at which the transducer
vibrate when given DC pulse
= frequency which produce wave length = 2 x
transducer thickness
Ultrasound Resonant Frequency
If they are exactly out of

phase reduced intensity
If they are exactly in-phase

their amplitudes add up
If two sound waves of the same

wavelength cross each other , the
pressure waves combine
Notes:
Resonant Frequency is the
frequency at which the
transducer vibrate when given
DC pulse , other frequencies
produced die away quickly
because of the destructive
interference (what happens if
we apply AC?)
The thicker the transducer , the
lower is the natural frequency
Natural period = 1/f at = 2t
A 3.5 MHz transducer has disc
of about 0.5 mm thick
Front face of the transducer emits sound in both the

forwards and the back direction
The back-wave is reflected at the back face of the disc
By the time it joins the front wave , it has traveled
distance = 2oth are exactly constructive
interference
If ultrasound frequency changome destructive
interference will occur
Explanation of resonant frequency
2t
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90o
Incident
Angle
Boundary
between
media
Sound beam
travels
perpendicular to
boundary
between two
media
Perpendicular Incidence
Ultrasound Reflection
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IRC + ITC = 1
Fraction of sound intensity

transmitted through interface
<1
ITC
Fraction of sound intensity

reflected at interface
<1
IRC
Medium 2
Medium 1
Intensity Reflection Coefficient (IRC)

&
Intensity Transmission Coefficient (ITC)
sound continues in
same direction
transmitted
sound returns
toward source
reflected
at boundary part
of the sound
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z2 + z1
----------
z2 - z 1
Z1 is acoustic impedance of medium #1

Z2 is acoustic impedance of medium #2
incident intensity
IRC = ------------------------ =
reflected intensity
For perpendicular incidence
Medium 2
Medium 1
IRC Equation
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Acoustic Impedance =
Density X Speed ofWww.ScoreTraining.net
Sound
Fraction of intensity
reflected depends on
difference in acoustic
impedances between
the two media
reflected intensity
z2 + z 1
----------
Air
Soft Tissue
400
1,630,000
Acoustic
Impedance
(rayls)
Fraction Reflected: 0.9995
Acoustic Impedance of air & soft tissue very different

Acoustic Impedance of gel & soft tissue very similar
Without gel virtually no sound penetrates skin
incident intensity
z2 - z 1
z2 + z1
----------
z2 - z 1
IRC = ------------------------ =
1- ultrasound gel:
Applications
incident intensity
IRC = ------------------------ =
reflected intensity
Example: soft tissue and air

virtually all reflected
Impedances are so different
little reflected
Impedances are similar
no reflections
materials are acoustically matched
Z1=Z2:
Probabilities:
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Notes:
There is subtle differences in Z between different soft
tissues fraction is reflected at interfaces
between soft tissues (e.g. 1% at fat kidney interface)
Reflections less than 0.01% are unlikely to be detected
At interface between bone and tissues 30% is reflected
, yet , it is not possible to image through the bone
Characteristic: made of plastic (Z is intermediate

between transducer and tissues)
Place: at the front face of the transducer
plate thickness:
Z of transducer and tissues are mismatches

only 20% of sound waves are transmitted in
either directions
Solution: insertion of matching plate
2 matching plate:
Oblique
Incident
Angle
(not equal
to 90o)
2) rarefaction:
snells law: ratio of sines of the
incident and rarefaction angles is
equal to ratio of sound velocity in
the two materials
i.e. Sin/Sin1= C/C1
Angle of reflection = angle of incidence
1)reflection similar to light reflection

from mirror
Occur when the beam strikes a

large smooth interface at an angle
The sound undergoes reflection
and rarefaction
Specular Reflections
Boundary
between
media
Sound beam travel not

perpendicular to
boundary
Three probabilities:
1- specular reflection
2-diffuse reflection
3- scattering
Oblique Incidence
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Shorter
Rougher surface
Tissue interface is rough and has undulations

The reflected beam spread out over an angle
Same effect seen with light and frosted glass
The spread become wider with:
specular reflection very angle dependent

backscatter not angle dependWewnwt.ScoreTraining.net
N.B:
higher frequency results in more backscatter
Why does Doppler require high frequency?
Condition: structure size is just <

Result: sound is scattered equally in all directions
This allows even small structures to be visualized
(some scatter will reach the transducer)
Examples:
echo signals produced inside tissue
parenchyma (e.g. liver), which is about 1-10%
as strong as those produced at organ
boundaries
RBCs (basis of Doppler)
Scattering
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Result: transducer will receive some reflections even if the

beam does not strike the interface exactly at a right angle
Diffuse reflection
reflection
Scattering
sound energy converted to heat by frictional forces
absorption
Causes
Reduction in amplitude & intensity as sound

travels through medium
Sound is Attenuated exponentially with the
depth the sound travels
Definition:
Attenuation
Sound Attenuation
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Tissue
(attenuation)
Power Out
-20
1/100
20
10
10
100
dB
0
Power ratio
1
Decibel calculation
dB =10 X log10 [power ratio]
Power Ratio = Power Out / Power In
Notes:
+ve dB means sound amplification
-ve dB means sound attenuation (dB
indicates fraction of intensity lost)
Decibel values are additive
Power In
Power Ratio = Power Out / Power In
decibels (dB)
No. of decibels = 10 x log power ratio
Unit of attenuation
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39
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N.B: Beam penetration (cm) = 40/Frequency

= depth at which the beam intensity has fallen too low to
be useful
As frequency increases, attenuation increase

high frequency = poorer penetration
Medium (see next)

frequency
Attenuation affected by
HID
180
150
100
Notes:
Every decrease of 10 dB indicates another
factor of 10 times attenuation
Thickness of tissues that reduce sound
intensity to half of its original value (result in
-3dB) = half value layer = half intensity depth
Ultrasound attenuation limits maximum
imaging depth
dB =10 X log10 [power ratio]
40 dB /cm at 1 MHz
Attenuation In air
35 dB /cm at 2.5 MHz
Attenuation In bone
There are little attenuation of ultrasound in water

Q. why pelvic U/S is done with full UB?
Attenuation In water
Attenuation = Attenuation Coefficient X Path Length
Attenuation Coefficient =
1
* Freq.
(dB/cm)
(dB/cm/MHz) * (MHz)
N.B:
Attenuation Coefficient: indicates fraction of beam
intensity lost per unit distance of sound travel
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For 1MHz U/S : half value layer of soft tissues = ..

for 3.5 MHz U/S: sound loss is .. dB/cm
for 3.5 MHz U/S: total sound loss during imaging an
object at 15 cm depth = .. dB
Sound lose 1 dB / cm depth / MHz
Attenuation In Soft Tissue
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Waves are in phase (with constructive interference) in the forward direction

Waves are out of phase (with destructive interference) in any other direction
If transducer has diameter 0.5mm) sound would spread out equally

in all directions
If probe has diameter D (e.g. 10 ) sound is projected forwards , with the
beam diameter D (HUYGENS principle)
Explanation:
Probe diameter and beam shape:
1- Unfocussed beams
Beam geometry
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1) crystal diameter (D):

near zone length D
Far zone Angle of divergence 1/D
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Factors affecting location of focal region
Near (frensel) zone:

The portion of the beam close to the face of the transducer
has rystal width
Width of the field changes little in it
Far (fraunhofer) zone: zone in which the field diverge
(interference effect is lost)
Focal region: junction of the two zones
Side lobes: small low intensity beams outside the main beam ,
due to vibration of the edge of the disc (cause artifacts)
Zones of unfocused beams
NZL= near zone length

D= crystal diameter
= ultrasound wavelength
Equation:
i.e. &re collimated

beam)
2) ultrasound frequency :
near zone length &
Angle of divergence 1/F
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Ultrasound modes
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Goal of focusing: focusing the beam at a particular depth corresponding to region

of diagnostic interest will cause:
Improvement in lateral resolution
Concentration of intensity to that region , so that producing strongest echoes
Methods of focusing:
1using concave piezoelectric element: the greater the curvature , the shorter the
focal lens
2mechanical focusing : see later
3- electronic focusing: see later
Focused beams
B
a
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U/S pulse reach interface (2) at time t (at the same time light spot is at point p)
Echo pulse take another time t to return to probe (light spot at point B)
A short vertical blip is produced at point B in response to the received echo (its
height echo strength)
Other interfaces (3&4) produce blips at C & D respectively
Position of the blip indicates the depth of the corresponding interface (a ruler is
used to superimpose on the horizontal trace)
Ultrasound pulse travel in the patient by certain velocity

Light spot start to move from the left edge of the display screen at a constant speed
When probe is pulsed , 2 simultaneous processes occur:
Idea: simply show positions of tissues interfaces

Process:
A-Mode (amplitude mode)
Before
TGC
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A sound amplifier (+ve dB gain)

automatically increasing echo
intensity in proportion to time elapsed
(distance traveled)
TGC is varied typically from 0 50 dB
Gain is not applied until the region of
interest is reached at threshold depth
(d1) , then increased linearly until
depth (d2)
Threshold and slope of TGC can be
changed manually
Solution: Time gain compensation

(TGC):
d1
After
TGC
d2
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Problem: deeper interfaces in the body produce weaker echo

than identical interface near the surface
Explanation: Amplitude of sound pulses decrease as it travel in
tissues (due to attenuation) , and echo pulse is also
attenuated
Pulse repetition frequency of 1KHz is used ( pulse

duration = 1 ms)
Transducer is in transmit mode for 1 s , and in
listening mode for 99s
Uses: eye examination , identifying breast cyst

and brain midline displacement
To provide sustained image:
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Seen as bright dots (not blip)

brightness echo strength
Trace itself will be suppressed
TGC is also used
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2-echoes from interfaces at each scan lines will

be displayed Just like A-mode, but:
compare to A mode
1) A slice of the patient is imaged

Method:
U/S pencil beam (scan line) scans back and forth
across 2D section of the patient
Complete sweep (complete set of scan lines) = one
displayed frame
B-Mode (brightness mode)
probe construction and types
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3- Succession of frames is sufficiently rapid to demonstrate

tissue motion (real time imaging)
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1) mechanical probes: probe has moving parts

that oscillate
2) electronic or phased probes: no moving
parts
Types of probes
Decrease U/S reflection

Protect the disc
Matching layer
made of epoxy resin in which are suspended fine particles of tungsten

Matched to the transducer (admit backwards travelling waves which is then absorbed
within the block) . Pulse , and Q
Backing block:
Signal produced by the returning echo is led away along a wire
In the receiving mode:
The energizing voltage is applied between the back face of the piezoelectric disc (via
insulated wire) and the front face (via earthed metal case)
Probe construction:
Piezoelectric element:
In the transmitting mode:
Earthed metal case
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2) rotating head transducer

One or several transducers crystals are
mounted on a cylinder that is rapidly rotated
over 360 using a motor
1) mechanical sector probe:

Contains single piezoelectric
element
Crystal is attached to a motor
that mechanically move it back
and forth
Each sweep = image frame
Rate of oscillation (and frame
rate) can be varied
Ultrasound beam geometry is
that of a sector
Sector angle (and so field size)
can be varied
Mechanical probes
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mechanical probes Focusing (mechanical focusing):

Using acoustic lens or curved mirror
Creates a beam with fixed focal length specific for each probe
Transducers may have strong , intermediate or weak focusing
The price of short focal length is increased divergence of far
field
3) mechanical probes with rotating mirrors:

Transducer crystal is steady
Rotating mirror reflect the sound beam and
direct it out of the probe
At each given time a well defined

ultrasound beam scan a rectangular area
in the body
Formation of rectangular
shaped images
1) sequential (stepped) linear array:

Elongated transducer divided into
large number of separate narrow
transducer elements (about a
wavelength in width)
Individually they produce poor beam
with short near field and widely
divergent far field
They are energized in overlapping
groups in succession (1-6 , 2-7 , 3-8.)
Results
Types of electronic probes
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Each crystal can transmit or receive

individually
Sweep ,focusing and steering of the beam is
controlled by timing patterns
i.e. row of several small transducers
Crystals are arranged in arrays
Electronic probes = annular arrays
2) steered or phased sector

linear array:
Similar but shorter transducer
(contains fewer elements)
Transducers work all together
(compare to the previous
type)
if all elements energized
simultaneously travel
forwards
p
p
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Focal depth can be alter by the operator: the greater the time delay
between energizing successive pairs of elements , the shorter is the
focal length
All pulses arrive at the point p (focal point) at the same time and
reinforce
Electronic focusing in stepped linear array:

Each group of crystals are not energized in exactly the same time
Outermost pair is energized first , then after a very short delay the
next pair , and finally the innermost pair
Result
Beam steered upward
Beam steered downward
appropriate timing variations

applied to echoes received by
various elements of a group
listening focus depth can be
changed electronically
between pulses by applying
timing variations as above
N.B: Listening direction can be

also steered & focused
similarly
Focal point can be changed by the adjustment

of phase delay pattern
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By changing the time delay in the successive sequenccan line is swept across
the patient covering a sector field (remember mechanical scanning?)
timing variations.
If this process is reversed steering in the opposite direction
timing variations.
If Elements energized separately in rapid sequence (1,2,3) ulses reinforce only in

one direction ( interfere destructively in all other planes) = beam steering
Better
Wide
Relatively narrow
Abdomen , thyroid
obstetrics
Image quality
Field of view need skin
Field at Depth
Uses
Large
Patient contact area

(acoustic window required)
Stepped Linear scanner
Outermost ring is
energized first , followed
by subsequent rings , and
finally the central
element
3) phased annular array:

Five to ten Circular
shaped crystals arranged
concentrically
Focusing of annular
arrays:
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Neonatal brain, scanning

the heart through
intercostal space
wide
Narrow
Less
Small
Sector (phased) scanner
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better
Trans-vascular transducer:
very small crystal array at the end of the vascular
catheter
Operate at 10-20 MHz
N.B: Endoscopic ultrasound:

advantage: avoid effects of bone or gas
Types : single high frequency transducer rotating
through 36
Examples: trans-esophageal ECHO , Trans-rectal
prostatic ultrasound
Yes
resolution
Moving parts
cheaper
cost
Mechanical scanners
no
less
more
Electronic scanners
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N.B: Convex linear stepped array:

Same as linear stepped array but the face of the probe is curved
into arc shape sector type image (wide view at depth)
advantage: no complications of beam steering (no loss of focus at
edge) because scan lines are perpendicular to the array surface
Disadvantage: at depth there are diversions with reduced line
density
2) Elevation plane:
The plane perpendicular to the long
axis of the probe
Focusing in that plane Define the
slice thickness
linear array: Electronic focusing in
this plane is Not possible (done by
shaping each transducer or by lens)
Annular array: can be done
1) azimuthal plane:
The plane parallel to the
length of the probe
Electronic Focusing is
Possible with both linear and
annular arrays
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Ultrasound electronic focusing in different planes
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Problem: focusing of the beam improve the image in

the focal region , but make it worse beyond it
Solution: Multiple zone focusing
New 1.5D transducers:

Seven rows of small elements replace single row
of conventional linear array
Focusing in the 2 planes can be done
Element selection is used rather than beam
steering
Produce better resolution of small lesions
Produce greater uniformity at depth
Inter row spacing =
Inter-element spacing =
Multiple zone focusing
Number of scan lines per

frame
Depends on the number of
elements in the array
can line density
image quality and
resolution
100 lines/frame is usually
sufficient (as lateral
resolution is dependant on
other factors)
Scan line density
Decrease frame rate
Disadvantage:
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focal zones overlap producing good resolution at deep and superficial

area
Advantage:
along each scan line , more than one pulse are sent in succession
In each pulse, the phase delays are altered to focus at different depth
This is done for both transmission and receiving)
Method:
Which has less frame rate?
Number of frames displayed per second

rame rate etter following of moving
structures
Frame rate
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When the next pulse is generated , the previous

pulse must make the complete return journey
(from and to the transducer)
Explanation:
Depth of view = 0.5 x sound velocity / PRF
Depth of view
Example: to achieve
Frame rate = 30 frames/s
With 100 lines per frame
We need PRF of MHz
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Pulse repetition frequency (PRF) =

Frame rate x scan line density
Important equation
Ultrasound contrast agents
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high scan line density (need high PRF), and in the same
time scan at large depth
i.e. one aspect must be compromised
i.e. it is not possible to achieve both high frame rate with
Depth of view x scan line density x frame rate = constant
Depth of view = 0.5 x sound velocity / PRF
Pulse repetition frequency (PRF) =

Frame rate x scan line density
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increase reflections from tissues containing the contrast

agent
Although smaller than U/S , they can resonate at U/S
frequency and at harmonic frequencies, enhancing
echoes from the tissue of interest
After exam.: normal static diffusion leads to total
bubble destruction within few hours
Mechanism of action:
micro-bubbles: less than 4

Nanoparticles: less than 1
Size:
of low toxicity
Readily eliminated from the
body
Advantage: improve
ultrasound image quality
Must be:
Ultrasound contrast agents
Advantage: increased contrast of

ultrasound image (2nd harmonic is
retlre
ainsin
)g.net
received only from place ofwwbwu.sbcob
Echo returns normally

Bubble vibrates in response to the shock
from the pulse this will generate a
second harmonic a twice frequency of
the original pulse (2f)
When U/S pulse (with frequency f)

encounter a bubble , there are two
types of response:
Definition:
imaging of harmonic frequencies =
2f , 3f, ..
Generation of harmonics:
Not generated by U/S scanner itself
Generated in the body by two
methods:
1)Interaction with contrast agents
Harmonic imaging
conjugated with Abs immunowlowgwi.sccaorlelytraining.net

targeted
Examples:
1 ultrasound-targeted microbubble:
contrast agent with attached bioactive
substance will distribute in capillaries of
target organ.
U/S then destroy microbubbles , releasing
the substance into surrounding tissue.
2 air filled microspheres encapsulated in a
thin shell of albumin:
Increase backscatter from ventricular
border increase visualization
adhere to thrombi , assist in DVT
diagnosis
3 Low solubility gas encapsulated in lipid shell:
Used in all vascular applications (assist in
visualization of small vessels)
4 per-fluoro carbon nano-particles:
Slowly uptake by liver mprove
metastasis visualization
5 Gold bound colloid micro-tubes:
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This means that harmonic imaging

effect is most pronounced in the
mid-field
Near field: no harmonics (signal has

not traveled enough to distort)
Near mid field: harmonics increasing
(begin to be produced)
Mid field: harmonics unchanging
(generation = attenuation)
Far mid field: harmonics decreasing
(attenuation generation)
Far field : fundamental frequency
only is present
Harmonics are seen to varying degree

throughout U/S field of view:
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When ultrasound pass through the tissue , it compress and expand the tissue
When the tissue is compress sound speed
When tissue is expanded speed
Result: top of the waveform is pulled forwards as the wave pass through the
tissues stortion with generation of harmonics (change in U/S frequency)
These changes become more pronounced with depth, and degrade the normal
imaging process
Distortion is more pronounced in fat tissues (especially in obese persons)
The resultant a waveform contains both fundamental frequency (first harmonic
= f) and subsequent harmonics (integral multiples of first harmonic i.e. 2f, 3f ,
4f)
2) Interaction with tissues (tissue harmonics):
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Disadvantage: motion artifacts (frame rate is two times

slower)
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Fundamental harmonics disappear (two received echoes cancel

each other)
Amplitude of harmonics is do^EZ of harmonic)
B- pulse inversion:
Two pulses are sent with reversed polarity
Echoes received from each pair of pulses are summed
Methods of isolation of 2nd harmonic to form the image:

A) harmonic band filtering:
Fundamental frequency is removed using filter , leaving the tissue
generated harmonics to form the image
transmitted pulse should not contain higher frequencies (this could corrupt
the received signal) , and the Pulse produced must have narrow bandwidth
at lower frequency
receiving bandwidth of the transducer cover frequencies of harmonics
Disadvantage: decreased axial resolution (transmitted pulse has narrow
f) , but this is compensated by the high quality of harmonic imaging
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C) reverberation artifacts (caused by subcutaneous fat), fatty

tissue distortion and scattering are reduced :
because 2nd harmonic pass through fat layer once only
(during receiving) , not twice as fundamental frequency
d) Low acoustic noise sualization of low contrast lesions
c & d increase contrast resolution
Advantages of harmonic imaging:

a) Harmonic beam is narrower than conventional
beam
b) Side lobes are lower than conventional beam
A rease lateral resolution and contrast
resolution
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Almost all energy is deposited inside the organ

Factors affecting absorbed dose

Nuclear medicine and patient

Method of American society of nuclear medicine

2- Medical internal radiation dose (MIRD)

1- monte carlo method

Calculation of internal absorbed dose

Tc 99m DPTA aerosol

Typical activities and doses

Dose after colloid scan

Patient should drink good deal of water and empty

Measures to decrease patient dose

accuracy of the calibrator is checked

Thus radionuclide and syringe type must be

Activity of the sample

Re-enterent ionization chamber that is

Radionuclide dose calibrator

Preparation and storage of radioactive materials

Precautions include segregation and personal

Types of hazards to staff while handling

Radionuclide handling precautions

Waterproof surgical gloves are worn when

Xe-133 & Tc-99m aerosols: to the exterior of the building

Disposal of radioactive waste

If necessary cordon off the area or cover

Clear area from non essential persons

Dealing with radioactive spill

Used generators are kept in a secure

Placed into designated sacs for disposal

Disposal of solid waste (swabs

Well diluted with water via designated

Disposal of liquid waste:

i.e. Particle motion parallel to direction of wave travel

Sound waves is Longitudinal Waves

Sound Properties and

Particle moves perpendicular to wave travel

N.B. In Transverse Waves:

Regions of alternating low and high pressure

Sound Waves are Compression Waves

Human hearing range

cycles per second

# of complete cycles of sound waves per unit

Medium not required for electromagnetic

sound does not travel through vacuum

medium is required for sound

Time between a given point in one cycle & the

Clinical ultrasound frequency range

Velocity also depends on temperature

Speed is only a function of medium

If frequency = 50 Hz then soWuwnwd.ScopreeTrariniiongd

If frequency = 10 kHz then sound period is 1/10 = 0.1 msec

If frequency = 2 MHz then sound period is 1/2 = 0.5 msec

if frequency in MHz, period in msec/cycle

if frequency in kHz, period in msec/cycle

if frequency in Hz, period in seconds/cycle

Acoustic impedance (Z)

= distance between a given point in a cycle &

distance in space over which single cycle occurs

Acoustic Impedance = Density X Prop. Speed

Acoustic Impedance (Z)

Wavelength is a function of both the sound source

because speed is constant

As frequency increases, wavelength decreases

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