The application of x-rays in radiology: from difficult and dangerous to simple and safe.

OBJECTIVE: This article will provide an assessment of the application of x-rays in the early days of radiology, which is an excellent way to come to value the convenience and safety of modern x-ray systems. CONCLUSION: The gas tubes that were originally applied for x-ray production were very unstable because of variations in the tube's vacuum. In an effort to understand some of the problems of these tubes and the high occupational exposure that was indirectly caused by the tubes' erratic behavior, we measured x-ray output rates as a function of the gas pressure inside the tube. The pressure range for the optimal production of x-rays, using an original Ruhmkorff inductor as a high-voltage generator, was found to be narrow. With the vacuum changing over time, this might explain the many photographs from the first years of radiology with operators watching their unshielded tube, either with bare eyes or with a fluoroscope, and their own hand as a test object. This practice often led to severe damage of the hands and to many early deaths due to cancer. Today, after a century of technologic development of x-ray tubes and associated equipment, the total average effective dose of workers in radiology can be close to natural background levels.

Characteristics of a first-generation x-ray system.

PURPOSE: To compare the antiquated x-ray system of Hoffmans and van Kleef (circa 1896) with modern x-ray equipment in terms of radiation dose, x-ray beam properties, image quality, and electrical parameters. MATERIALS AND METHODS: The antiquated x-ray system consisted of a Ruhmkorff inductor, battery, and Crookes tube. The radiation dose rate, x-ray beam properties, and electrical characteristics of this system were determined. A modern computed radiography plate was used to compare images of a hand specimen obtained by using the antiquated system with images obtained by using the modern system. RESULTS: A peak voltage of 73 kV was obtained with an 8-V battery. With Crookes tube number 9, the half-value layer of the generated x-rays was 0.56 mm Al. Pinhole images showed that the x-rays originated from an extended area of the glass wall, causing image blurring. When measured on the skin of a hand specimen, the radiation dose of the antiquated system was about 10 times greater than that of the modern system for the same detector signal. The estimated skin dose was about 74 mGy for the antiquated system and 0.05 mGy for the modern system. The corresponding exposure times were 90 minutes and 21 msec. CONCLUSION: Radiation dose and exposure time of the antiquated system were greater than those of the modern system by about three and five orders of magnitude, respectively. Images of the hand specimen obtained with the antiquated system were severely blurred but were still awe inspiring, considering the simplicity of the system. SUPPLEMENTAL MATERIAL: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11101899/-/DC1.