X-ray radiography and fluoroscopy
The plain X-ray is the oldest and cheapest medical image: a single shadow picture of bone and lung. Fluoroscopy is the live-video version, used to steer needles, catheters and stents during cancer procedures.
Overview
A radiography room has an X-ray tube on one side of the patient and a flat-panel digital detector on the other; a single exposure records how much each tissue blocked the beam. In cancer care the chest X-ray still finds many lung tumours by accident, the skeletal survey remains a fallback for myeloma bone disease where whole-body CT or MRI is not available, and mobile units image inpatients. Fluoroscopy runs the tube continuously at low current to give a live picture, and a C-arm or fixed angiography suite is the room where interventional radiologists perform chemoembolisation and radioembolisation of liver tumours, place ports and drains, treat vertebral fractures with cement and take image-guided biopsies.
Against CT, radiography is far cheaper, faster and lower in dose, but it projects a three-dimensional body onto one plane, so overlapping structures hide small tumours and it cannot stage disease. Modern angiography suites add cone-beam CT on the same C-arm so the operator can check a catheter position or an embolisation in three dimensions without moving the patient.
- Rotating X-ray tube
- Lung nodule
How it works
X-rays from a tube pass through the body and are absorbed in proportion to tissue density and thickness; a digital detector records the transmitted pattern as a projection image, continuously in fluoroscopy.
- Cheapest and most widely available imaging
- Low radiation dose per image
- Live guidance for interventional procedures
- Overlapping structures hide small lesions
- Cannot stage cancer or measure soft tissue
- Fluoroscopy time adds dose to staff and patient
Latest papers
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