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MEDICAL PHYSICS PUBLISHING
RT X -RAY
RT X-RAY PHYSICS REVIEW

PHYSICS REVIEW
RT X-Ray Physics Review is designed to help the x-ray technologist prepare for
the Physics component of the American Registry of Radiologic Technologists
(ARRT) examination. This book addresses the AART examination content areas
directly related to Physics, the material that gives most students the greatest
difficulty.
Key aspects of the proposed RT X-Ray Physics Review are: Walter Huda
n Compactness/Content Kerry Greene-Donnelly
Identifies the important Physics concepts that all students need to know.
Areas included are Radiation Protection, Equipment Operation & Quality
Control, Image Production & Evaluation.
n Organization
Presents the material in three units subdivided into five chapters. Unit I
includes basic physics concepts, Unit II contains imaging systems, and
Unit III addresses quality, dose, protection, and safety. Explanatory tables
and figures are included in each topic.
n Questions
Includes 450 questions, 30 pertaining to each of 15 chapters, and
two comprehensive tests of 100 questions each at the end of the book.
Answers, explanation, and references are provided.
Huda and Greene-Donnelly

n Appendixes
Useful tables of radiologic quantities and units. Comprehensive
Radiological Physics bibliography.
Huda_RT_XRay_softcover_final.indd 1 7/11/11 10:51 PM

RT X-Ray Physics Review
Walter Huda, Ph.D.

Department of Radiology and Radiological Science
Medical University of South Carolina
Charleston, South Carolina
and
Kerry Greene-Donnelly, R.T.(R)(M)(CT)(QM)

Department of Medical Imaging Sciences
SUNY Upstate Medical University
Syracuse, New York

Madison, Wisconsin
Notice: Information in this book is provided for instructional use only. The authors have taken care that the
information and recommendations contained herein are accurate and compatible with the standards generally
accepted at the time of publication. Nevertheless, it is difficult to ensure that all the information given is
entirely accurate for all circumstances. The authors and publisher cannot assume responsibility for the
validity of all materials or for any damage or harm incurred as a result of the use of this information.
Copyright © 2011 by Walter Huda and Kerry Greene-Donnelly
All rights reserved. No part of this publication may be reproduced or distributed in any form or by any
means without written permission from the publisher.
15 14 13 12 11 1 2 3 4 5 6
Library of Congress Control No.: 2011933323
ISBN 13: 978-1-930524-54-5

ISBN 13 2014 eBook edition: 978-1-930524-75-0
Medical Physics Publishing

4513 Vernon Boulevard
Madison, WI 53705-4964
Phone: 1-800-442-5778, 608-262-4021
Fax: 608-265-2121
Web: www.medicalphysics.org
Printed in the United States of America

Dedication
Walter Huda dedicates this book to Joyce.
Kerry Greene-Donnelly dedicates this book to Dennis.

Acknowledgments
RT X-Ray Physics Review would not have been possible without the assistance of many colleagues.
Kent Ogden, Ph.D., and Marsha Roskopf, R.T.(R) were instrumental in the acquisition of images and
creation of graphics, in addition to offering their years of experience and knowledge with the authors.
Thank you to the following individuals who offered their clinical expertise and aided in image acqui-
sition: Andrew Smith, Ph.D., Janet Bentley, R.T.(R), Jennifer McBurnie, R.T.(R)(CT), Robyn
Ouderkirk, R.T.(R)(CT), Richard Thompson, R.T.(R)(CT), and Donna Fritz.
A special thank you to those who reviewed all or part of the draft manuscript: Dominick DeMichele,
R.T.(R)(CT), Charles Drago, R.T.(R)(CT), Colleen Donahue, R.T.(R)(MR), and Rosemary Morin,
R.T.(R).
Contents
PART I. BASIC PHYSICS
Chapter 1 MATTER AND RADIATION

1.1 ENERGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.2 MATTER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
1.3 ELECTROMAGNETIC RADIATION . . . . . . . . . . . . . . . . . . . . . . . . 6
1.4 IONIZING RADIATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Chapter 2 PHYSICS LAWS

2.1 BASICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
2.2 ELECTROSTATICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
2.3 ELECTRICITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
2.4 MAGNETISM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
2.5 GENERATORS/TRANSFORMERS . . . . . . . . . . . . . . . . . . . . . . . . . 33
Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Chapter 3 X-RAY PRODUCTION

3.1 X-RAY GENERATORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
3.2 PHYSICS OF X-RAY PRODUCTION . . . . . . . . . . . . . . . . . . . . . . . 50
3.3 X-RAY QUANTITY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
3.4 TUBE HEATING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Chapter 4 X-RAY INTERACTIONS

4.1 X-RAY INTERACTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
4.2 SCATTER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
4.3 GRIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
4.4 BEAM ATTENUATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
4.5 X-RAY BEAM QUALITY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
vii
viii CONTENTS
Chapter 5 X-RAY TUBES

5.1 CATHODE/ANODE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
5.2 HOUSING/MOUNTINGS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
5.3 COLLIMATION/FILTRATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102
5.4 PERFORMANCE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
PART II. IMAGING WITH X-RAYS
Chapter 6 DETECTING X-RAYS

6.1 FILM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
6.2 FILM PROCESSING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
6.3 SCREENS/CASSETTES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
6.4 DIGITAL DETECTORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131
Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143
Chapter 7 ANALOG AND DIGITAL IMAGES

7.1 ANALOG IMAGES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147
7.2 COMPUTERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
7.3 DIGITAL IMAGES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152
7.4 IMAGE DISPLAY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156
Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167
Chapter 8 PROJECTION RADIOGRAPHY

8.1 RADIOGRAPHIC TECHNIQUES . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
8.2 RADIOGRAPHY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 172
8.3 MAMMOGRAPHY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177
8.4 SPOT IMAGING/DA/DSA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180
8.5 SPECIALIZED RADIOGRAPHY . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184
Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195
CONTENTS ix
Chapter 9 FLUOROSCOPY
9.1 IMAGE INTENSIFIERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199
9.2 TELEVISION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201
9.3 IMAGING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204
9.4 MISCELLANEOUS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 210
Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213
Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219
Chapter 10 COMPUTED TOMOGRAPHY

10.1 CT BASICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 223
10.2 CT IMAGES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 226
10.3 IMAGING CHAIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 230
10.4 TECHNOLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 232
10.5 CLINICAL ASPECTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235
Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239
Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245
PART III. DOSE, QUALITY, AND SAFETY
Chapter 11 RADIATION DOSIMETRY

11.1 RADIATION UNITS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251
11.2 INCIDENT RADIATION. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255
11.3 ABSORBED DOSES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 258
11.4 CT DOSIMETRY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 261
11.5 EFFECTIVE DOSES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 264
Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269
Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275
Chapter 12 IMAGE QUALITY

12.1 RESOLUTION (THEORY) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279
12.2 RESOLUTION (PRACTICE) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 282
12.3 CONTRAST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 285
12.4 NOISE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 289
x CONTENTS
12.5 RADIOGRAPHIC ARTIFACTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 292

Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 297
Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 303
Chapter 13 QUALITY CONTROL

13.1 OVERVIEW . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 307
13.2 IMAGE RECEPTORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 311
13.3 X-RAY SYSTEMS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 314
13.4 COMPUTED TOMOGRAPHY (CT) . . . . . . . . . . . . . . . . . . . . . . . . . 318
Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 323
Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 329
Chapter 14 RADIATION BIOLOGY

14.1 CELL BIOLOGY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 333
14.2 RADIATION AND CELLS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 335
14.3 HIGH-DOSE EFFECTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 338
14.4 STOCHASTIC EFFECTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 341
14.5 PREGNANCY AND RADIATION . . . . . . . . . . . . . . . . . . . . . . . . . . 344
Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 349
Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 355
Chapter 15 RADIATION PROTECTION

15.1 RADIATION MEASUREMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . 359
15.2 PROTECTION DEVICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 361
15.3 PROTECTING PATIENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 364
15.4 WORKERS AND PUBLIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 367
15.5 POPULATION EXPOSURES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 370
Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 375
Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 381
TEST A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 387
Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 403
TEST B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 413
Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 429
CONTENTS xi
APPENDIX A – Summary of Prefix Names and Magnitudes . . . . . . . . . . . . . . . . . . . . . . . . . 437

APPENDIX B – Radiologic Quantities and Units . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 437
APPENDIX C – SI and Non-SI Units for Quantities Used in Radiological Physics. . . . . . . . . 438
APPENDIX D – Units for Photometric Quantities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 438
APPENDIX E – Selected Radiological Physics Web Sites . . . . . . . . . . . . . . . . . . . . . . . . . . . . 439
BIBLIOGRAPHY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 441
ABOUT THE AUTHORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 443

Preface
I. Radiological Physics
Radiology is an ever-changing field in health care. Since the discovery of x-rays by Roentgen in 1895,
many aspects of image production have improved. Advancement in the use of computers and imag-
ing equipment has led to improvement in the detection of disease processes, more efficient patient
care, and increased occupational safety. Radiological Physics is involved in every aspect of medical
imaging, from image acquisition to display and storage.
Understanding and application of Radiological Physics is essential for the production of quality
medical images using Radiography, Fluoroscopy, Mammography, Interventional Radiology, and
Computed Tomography. Members of the imaging team include the radiologist, the medical physicist,
and the technologist. The imaging team, by working together, provides quality imaging services
while maintaining a high level of patient care.
Associated with most imaging modalities is the issue of radiation exposure for both the patient
and the operators. Technologists must be aware of the radiation dose to the patient and personnel.
One of the most important goals of imaging professionals is to ensure that radiation levels are kept
As Low As Reasonably Achievable (i.e., ALARA principle). Exposure levels to operators and
patients must also meet regulatory and accreditation limits.
II. Review Book Structure

This review book will assist the student technologist with preparation for the registry/licensing exam-
ination. As a review book, it is not intended to cover all Radiological Physics concepts fully, rather,
it is to be used as part of a comprehensive registry preparation plan. Use of this review book will
complement the student’s understanding and application of radiological physics.
This review book is separated in to three units of study. Unit I presents basic concepts in physics,
production/interaction of x-rays, and the x-ray tube. Unit II discusses radiographic detectors, the
computer in imaging, projection radiography, fluoroscopy, and computed tomography. Unit III con-
cludes the review book with radiation dosimetry, image quality, quality control practices, radiation
biology, and protection. Each chapter has 30 questions for content review, and two 100-question
comprehensive examinations are included at the end of this book.
The ARRT examination currently uses traditional radiation units, i.e., R, rad, and rem. The radi-
ation quantities provided herein are generally provided using SI units, with traditional units to follow.
In the text, the term “exposure” is not used, in favor of “Air Kerma.” An Air Kerma of 10 mGy is
taken to be approximately equal to an exposure of 1 R.
III. ARRT Exam

The American Registry of Radiologic Technologists (ARRT) oversees imaging-related credentialing
examinations in the United States. The ARRT credentialing examinations are available for many
modalities, such as Radiography, Mammography, and Computed Tomography. This review book has
xiii
xiv PREFACE
been produced for those taking the Radiography credentialing examination. The ARRT examination
includes the following content areas: (1) radiation protection, (2) equipment operation and mainte-
nance, (3) image production and evaluation, (4) radiographic procedures, and (5) patient care.
ARRT examinations are computer based and given at secure testing centers across the country.
The exam contains 200 questions and must be completed in 3.5 hours. A scientific calculator is pro-
vided, as well as a writing surface and a pen. As each ARRT examination is unique, a scaled score
exam is used, in that examinations are scaled on their level of difficulty to account for any variation.
A (scaled) test score of 75 is required to pass the ARRT exam. Further information on the
American Registry of Radiologic Technologists can be obtained at the ARRT web site (www.arrt.org).
Chapter 11
RADIATION DOSIMETRY
11.1 Radiation Units

11.2 Incident Radiation
11.3 Absorbed Doses
11.4 CT Dosimetry
11.5 Effective Doses
11.1 RADIATION UNITS

A. Air Kerma
• The International Commission on Radiation Units and Measurements (ICRU)

developed standard units based on the SI system.
• SI units are utilized by all countries except the United States.
• Air Kerma is the SI unit that is currently used to quantify the x-ray beam
intensity.
• Kerma stands for the Kinetic Energy Released per unit Mass.
• Intensity is directly related to the number of x-ray photons in a beam.
• Air Kerma is the kinetic energy transferred from x-ray photons to electrons.
• Air Kerma is measured in joules per kilogram (J/kg):
1 J/kg is 1 Gray (Gy).
• The Air Kerma value from x-ray sources obeys the inverse square law.
B. Exposure
• Exposure is the total charge of electrons liberated per unit mass of air by the
x-ray photons.
• Exposure is the non-SI unit used to quantify the x-ray beam intensity.
• One roentgen (R) is equal to the 2.58×10−4 C/kg.
251
252 RADIATION DOSIMETRY
• 1 R is equal to 1000 mR, and is still used in some radiology departments in the
United States.
• The roentgen applies to photons (x-rays and gamma rays) but not particles such as
electrons.
• An exposure of 1 R corresponds to an Air Kerma of 8.7 mGy.
• Scientific publications have replaced exposure (R) with Air Kerma (mGy).
• 1 R is often approximated as ~10 mGy Air Kerma, and 10 mGy Air Kerma is
approximated as ~1 R.
C. Absorbed dose
• Absorbed dose (D) measures the amount of radiation energy (E) absorbed per unit
mass (M) of a tissue (i.e., D = E/M).
• Absorbed dose is specified in gray (Gy) in SI units.
• One gray is equal to 1 J of energy deposited per kilogram.
• In the non-SI system, the rad was the unit of absorbed dose.
• The rad was derived from the expression radiation absorbed dose.
• 1 Gy = 100 rad and 1 rad = 10 mGy.
• It is helpful to specify the absorbing medium explicitly (i.e., absorbed dose to skin
entrance, absorbed dose to liver, etc.).
D. Integral dose (energy imparted)
• The integral dose is simply the total energy (mJ) that a patient absorbs.
• Integral dose and energy imparted have the same meaning.
• A chest x-ray radiograph imparts about 2 mJ of energy to the patient.
• Head radiographs impart about 5 mJ and abdominal radiographs impart about
20 mJ.
• By contrast, a 500-W microwave oven produces 500,000 mJ every second.
• Energy imparted in a microwave oven is much greater than in a radiograph, and
increases the food temperature.
• X-rays deposit very little energy, but this energy is ionizing, which breaks apart
biologically important molecules such as DNA.
RADIATION DOSIMETRY 253
E. Equivalent dose
• Equivalent dose quantifies biological damage by different types of radiation.

• For the same absorbed dose, alpha particles cause much more biological damage
than x-rays.
• The equivalent dose (H) is the absorbed dose (D) multiplied by a radiation
weighting factor (wR).
• Mathematically, H = D × wR .
• Equivalent dose is expressed in sieverts (Sv).
• Use of wR permits comparisons of effects of different types of radiation on a
common scale.
• For x-rays, gamma rays, and electrons wR = 1.
• An absorbed dose to the skin of 1 Gy (100 rad) from x-rays corresponds to a skin-
equivalent dose of 1 Sv (100 rem).
• For alpha particles and neutrons, wR may be as high as 20.
• Equivalent dose is primarily used for radiation protection purposes as an
approximate indicator of biological harm.
• Dosimetry units are shown in Table 11.1. Examples of measurement devices used
in dosimetry are shown in Figure 11.1.
Table 11.1
Summary of dosimetry units used in x-ray imaging
Quantity Units Comments

Air Kerma mGy Quantifies the intensity of x-ray beams
Exposure C/kg or roentgen Has been replaced by Air Kerma
Absorbed dose mGy or rad Quantifies how much any tissue absorbs from any
incident x-ray beam
Integral dose mJ Total energy absorbed by a patient undergoing
any x-ray examination
Equivalent dose mSv or rem Obtained by multiplying absorbed dose to an
organ by radiation weighting factor and used to
predict the likelihood of biological harm
(a) (b)
(c)
Figure 11.1
Examples of radiation measurement/detection devices.
(a) Ionization chamber; (b) Solid-state detector; (a) and (b) are used
for the measurement of the primary x-ray beam.
(c) Geiger-Mueller tube used to detect radioactive isotope
contamination in nuclear medicine.
11.2 INCIDENT RADIATION

A. Entrance Air Kerma (EAK)
• Entrance Air Kerma (EAK) is a measure of the amount of x-ray radiation intensity
incident on the patient undergoing an x-ray examination.
• The EAK value is measured at the point where the x-ray beam would enter the
patient, but is obtained in the absence of the patient.
• Values of EAK are thus measured “free in air” and do not include backscatter
radiation from the patient.
• The EAK is measured “free in air” by placing an ionization chamber at the
appropriate distance from the x-ray tube and using the patient technique factors
(kVp and mAs).
• Values of the EAK are easy to measure but do not quantify the amount of
radiation received by the patient.
• Patient doses (e.g., skin dose, embryo dose, organ dose) can be derived from EAK
values via appropriate conversion factors (see below).
B. Radiography
• For a lateral skull radiograph, a typical EAK value is 1.5 mGy.

• An AP (or PA) skull would likely double the EAK value for a lateral skull.
• For a PA chest radiograph, the EAK is generally 0.1 to 0.2 mGy.
• A lateral chest has EAK values about four times higher than a PA chest radiograph.
• For an AP abdominal radiograph, the EAK value is about 3 mGy.
• EAK values for extremities are very low (< 0.1 mGy).
C. Fluoroscopy
• Because fluoroscopy involves continuous exposure, Air Kerma rates in

mGy/minute are the units used.
• Entrance Air Kerma rates in fluoroscopy typically range from 10 to 100 mGy/min.
• An average-sized patient entrance skin Air Kerma rate in fluoroscopy is 30 mGy/min.
• Larger patients require more radiation in fluoroscopy, which is achieved either by
increasing the x-ray tube voltage (kV) and/or increasing the tube current (mA).
• Figure 11.2 shows a typical variation of EAK rates as a function of patient
thickness.
• Magnification imaging in fluoroscopy will cause an increase in entrance Air Kerma
rate as shown in Figure 11.3.
Figure 11.2
Entrance Air Kerma (EAK) rates in fluoroscopy
as a function of patient thickness.
Figure 11.3
Effect of magnification in fluoroscopy on Entrance
Air Kerma (EAK) rate. Using a magnification mode of 1.5 and 2.0
increases the EAK by a factor of 2.4 and 4.4, respectively.
D. Regulations
• In the United States, the legal limit for entrance skin kerma rate is 100 mGy/min
(10 R/min).
• No regulatory limits apply when a fluoroscopy imaging chain acquires diagnostic
images.
• Diagnostic images include cardiac cine, DSA, and photospot.
• High-dose modes in fluoroscopy may be activated to maintain image quality in very
large patients.
• Special activation mechanisms as well as visible/audible indicators are present to
indicate when high-dose mode is being used.
• The maximum Air Kerma rate in high-dose mode is 200 mGy/min (20 R/min).
E. Kerma Area Product (KAP)
• The entrance Air Kerma is independent of the x-ray beam area.

• At constant techniques, a 10 cm × 10 cm beam area and 20 cm × 20 cm beam area
have similar EAK values.
• Compared to a 10 cm × 10 cm field, the 20 cm × 20 cm field results in four times
more energy deposition in the patient.
• The best quantity that takes into account the total amount of radiation incident on
the patient is the Kerma Area Product (KAP).
• KAP is the product of the entrance Air Kerma and cross-sectional area of the
x-ray beam.
• KAP is independent of the measurement location because increases in beam area
are offset by the reduction of beam intensity (inverse square law).
• KAP can be used to compare doses from different imaging systems (or facilities) for
similar types of examinations on similar-sized patients.
• KAP values indicate relative radiation risks for similar types of examinations
performed on similar-sized patients.
• Table 11.2 shows typical KAP values in radiography and fluoroscopy.
• Kerma Area Product is also known as the Dose Area Product (DAP), and the terms
KAP and DAP are interchangeable.
Table 11.2
Typical KAP values in radiography, fluoroscopy, and IR
Entrance Air Kerma Kerma Area Product

Image acquisition (mGy) (Gy-cm2)
Skull radiograph 1.5 0.5
AP chest x-ray 0.2 0.2
Abdominal x-ray 3 3
Fluoroscopy (1 min) 20 10
Spot image (Ba study) 1 0.5
DSA image* (abd) 6 2
*Taking into account that two frames are required to generate one DSA frame
11.3 ABSORBED DOSES

A. Air Kerma (free in air) and doses
• For the same Air Kerma (intensity), absorbed dose depends on the material or
tissue that is placed into the x-ray beam.
• The radiation absorbed by a medium is determined by the characteristics of the
absorber (density, atomic number, etc.), as well as the x-ray beam energy.
• An Air Kerma of 1 mGy (100 mR) will result in an absorbed dose in soft tissue
of approximately 1.1 mGy (110 mrad).
• An Air Kerma of 1 mGy (100 mR) will result in a bone dose of 4 mGy (400 mrad).
• Doses in radiology also need to account for backscatter.
• An x-ray beam incident on a patient will also result in x-ray photons from within
the patient being backscattered.
• Backscatter is the ratio of the radiation intensities with and without the patient
being present.
• Values of backscatter in diagnostic radiology are about 1.4.
• Skin doses will be higher than entrance Air Kerma because tissue absorbs more
×1.1), and because of backscatter (×
radiation than air (× ×1.4).
• An entrance Air Kerma of 1 mGy results in skin doses of about 1.5 mGy.
B. Skin doses
• Skin doses are generally specified at the location where the x-ray beam enters the
patient.
• Skin doses are numerically about 50% higher than the entrance Air Kerma.
• Skin doses in radiography are generally very low.
• Pediatric skin doses will generally be lower than for adults.
• An average-sized patient (23 cm) undergoing fluoroscopy will have a skin dose rate
of about 45 mGy per minute.
• An average-sized patient undergoing 10 minutes of fluoroscopy may result in a skin
dose of 450 mGy.
• Skin doses can be substantially increased for larger patients.
• Interventional Radiology (IR) is complex, has long fluoroscopy times, and can
generate many images.
• Because of this, IR may result in deterministic effects.
• Fewer than 1 in 10,000 patients undergoing IR by qualified personnel suffer from
serious deterministic effects.
C. Organ (embryo) doses
• Entrance Air Kerma may be converted into absorbed doses to any organ located
within the patient.
• Organ doses are generally much lower than skin doses.
• If the x-ray beam does not directly irradiate the embryo, the embryo dose may be
taken to be very low.
• Embryo doses may be estimated from entrance Air Kerma values.
• The x-ray projection is important when determining embryo doses.
• Table 11.3 provides typical values of entrance Air Kerma and the corresponding
values of embryo dose in abdominal radiography.
Table 11.3
Entrance Air Kerma (EAK) and embryo doses in abdominal/pelvic
radiography when the embryo is directly irradiated
Projection EAK (mGy) Embryo dose (mGy)

AP 3 1
PA 3 0.6
Lateral 6 0.3
• Patient size is an additional factor that needs to be taken into account when
estimating embryo doses.
• Larger patients require more radiation for adequate penetration, but this will also
result in more attenuation between the entrance and the location of the embryo.
• Estimating embryo doses generally requires input from a Qualified Medical
Physicist.
D. Gonad doses
• Gonad doses refer to the radiation received by the testes in males and the ovaries
in females.
• The genetic risk in any exposed individual is generally deemed to be low and of no
direct clinical concern.
• Gonad doses have been used to quantify the genetically significant dose (GSD),
which is an index of potential genetic damage in exposed populations.
• GSD accounts for gonad dose and the number of offspring likely to be produced.
• When a population receives a gonad dose equal to the GSD, the genetic harm equals
that from current medical exposures.
• The National Council on Radiation Protection and Measurements (NCRP)
reported the U.S. GSD at about 0.3 mGy in 1980.
• Gonad doses are now of little concern in diagnostic radiology, and GSD values are
rarely subject to scientific investigation.
• Nonetheless, use of gonad shields is still common practice and useful as a
precautionary principle.
E. Mammography
• In mammography, the average glandular dose (AGD) is obtained from a

measurement of the entrance Air Kerma using a breast phantom.
• AGD values depend on x-ray beam techniques (kV and mAs), beam filtration, breast
thickness, and composition.
• AGD are obtained using a phantom simulating a 4.2-cm thick breast with 50%
glandularity.
• Increasing the x-ray tube voltage when the image receptor intensity is kept constant
will reduce AGD because of increased x-ray beam penetration.
• AGD values are about 1.5 mGy (150 mrad) per image.
• Digital mammography has slightly lower AGD values than screen-film because of
the use of higher beam qualities (i.e., increased kV and/or filtration).
• Patient doses can differ markedly from the AGD obtained using a breast dosimetry
phantom because of differences in breast size and composition.
11.4 CT DOSIMETRY
A. Computed Tomography Dose Index (CTDI)
• Manufacturers specify CT doses by the CT dose index (CTDI).

• CTDI is obtained from the dose distribution that occurs when the x-ray tube
performs one single 360° rotation with no table motion.
• CTDI values are measured using a pencil-shaped ionization chamber in terms of
Air Kerma, and are specified in mGy.
• An acrylic cylinder with a 16-cm diameter is normally taken to represent an adult
patient head.
• The head CT dosimetry phantom can also represent a pediatric abdomen.
• An acrylic cylinder with a 32 cm diameter is normally taken to represent an adult
body.
• Most patients are smaller than a 32 cm acrylic phantom, and dose measurements
made in this phantom will underestimate patient doses.
B. Clinical CTDI
• CTDI measurements may be made at the periphery and at the center of the phantom
are called CTDIp and CTDIc, respectively.
• A weighted CTDI (i.e., CTDIw) is defined as 2/3 CTDIp + 1/3 CTDIc .
• Doses in helical scanning modes with a pitch of 1.0 are similar to those resulting
from contiguous axial scanning.
• When pitch is less than 1.0, doses increase because of overlap. When pitch is greater
than 1.0, doses decrease because scan energy is deposited in a larger volume.
• A pitch of 2 will halve dose, and a pitch of 0.5 will double the dose.
• CTDI is inversely proportional to pitch.
• To account for different pitch values in helical scanning, the volume CTDIvol has
been introduced as CTDIw /Pitch.
• CTDIvol is expressed in mGy.
• Figure 11.4 shows CTDIvol for head and body phantoms, illustrating that body doses
are about half head CTDI due to increased attenuation.
Figure 11.4
Average values of CTDIvol as a function
of x-ray tube voltage (per 100 mAs).
C. Dose-Length Product (DLP)
• CTDIvol is independent of the total scan length.

• The total amount of radiation received by the patient, however, is directly
proportional to the scan length.
• The Dose-Length Product (DLP) is the product of CTDIvol and scan length.
• The DLP is proportional to the total dose (energy) imparted to the patient.
• DLP is a good measure of the total amount of radiation incident on a patient.
• A typical head CT examination has a DLP of 1000 mGy-cm, where CTDI is
measured in 16-cm phantoms.
• A chest, body, or pelvic CT examination would have a DLP of 600 mGy-cm,
where CTDI is measured in 32-cm phantoms.
• A chest abdomen pelvic CT scan would have a DLP of 1500 mGy-cm.
• CTDI and DLP measures are shown in Table 11.4, and it is very important that the
phantom size (16 cm or 32 cm) is always specified.
Table 11.4
Common Computed Tomography Dose Index (CTDI) measures used in CT dosimetry
Quantity Units Comments

CTDIair mGy CTDI measured at the CT scanner isocenter in the absence of
any patient or dosimetric phantom
CTDIp mGy CTDI measured at the periphery (i.e., 1 cm from edge) of an
acrylic dosimetric phantom
CTDIc mGy CTDI measured at the center of an acrylic dosimetric phantom
CTDIw mGy Equal to 1/3 (CTDIc ) + 2/3 (CTDIp ), and measured in either
16-cm (head) or 32-cm (body)
CTDIvol* mGy Equal to CTDIw divided by pitch
Dose-Length mGy-cm Product of CTDIvol and the scan length L (cm)
Product (DLP)*
*Metrics easily available to the technologist
D. Adult CTDI
• The American College of Radiology (ACR) runs a CT Accreditation Program,

including CT dosimetry data.
• Mean values of CTDIvol for an adult head are 58 mGy (16-cm phantom), and for an
adult abdomen, 18 mGy (32-cm phantom).
• CT doses are directly proportional to the mA and to the scan rotation time.
• Increasing the x-ray tube voltage from 80 kV to 140 kV, increases doses fivefold.
• Performing multi-phase studies can substantially increase patient doses.

• For constant techniques, performing four phase examinations (pre-contrast, arterial,
venous, and equilibrium) would quadruple the patient dose.
• Multi-detector CT (MDCT) has radiation doses similar to those of axial CT for
similar image quality.
E. Pediatric
• Pediatric doses depend on both patient characteristics and selected techniques.

• Doses in infants and young children are much higher than for adults when
performed using the same techniques.
• The Food and Drug Administration (FDA) issued an advisory in 2001 to reduce
radiation doses to pediatric patients.
• Increasing the patient size from 20 to 100 kg reduces x-ray beam penetration by
a factor of 30.
• Reduced techniques are possible because x-ray penetration is much greater in
children than in adults.
• The American College of Radiology (ACR) CT Accreditation Program includes
specific CT dosimetry requirements for pediatric examinations.
• The ACR provides resources to assist in dose reduction techniques, such as the
Image Gently™ web site, www.imagegently.org.
• Pediatric body examinations should be performed with a reduction in dose by a
factor of ~3 compared with adult examinations.
11.5 EFFECTIVE DOSES

A. Effective dose
• Skin doses are poor predictors of patient stochastic radiation risk.

• Problems with skin doses include the fact that they fail to account for the exposed
body region, x-ray beam area, and x-ray penetration.
• The effective dose (E) is obtained by taking into account the equivalent dose to all
exposed organs, as well as each organ’s relative radiosensitivity.
• E is obtained by multiplying equivalent dose (H) to an organ by the organ
weighting factor (w), and summed for all irradiated organs.
• The organ weighting factor (w) is a measure of the relative organ radiosensitivity
for the induction of stochastic effects.
• The most radiosensitive organs are the red bone marrow, colon, lung, breast,
and stomach.
• The effective dose is expressed in terms of the equivalent dose (mSv).

• The effective dose (E) is the uniform whole-body dose that results in the same
stochastic detriment as any non-uniform pattern of dose.
• A major benefit of the effective dose is that it permits all radiological examinations
that use ionizing radiations to be directly compared using a single common scale.
B. Computing effective doses
• KAP may be converted to effective dose by taking into account irradiation geometry
and x-ray beam quality.
• PA chest radiographs have E/KAP of ~0.2 mSv/Gy-cm2.
• Effective dose per unit skin dose for AP chest radiographs is ~0.3 mSv/Gy-cm2,
and for lateral chest radiographs is ~0.15 mSv/Gy-cm2.
• For AP abdominal radiographs, the effective dose per unit skin dose is
~0.2 mSv/Gy-cm2.
• E/KAP conversion factor for newborns is an order of magnitude higher than for adults.
• CT DLP doses can be converted into an effective dose using E/DLP conversion
factors.
• E/DLP values for 32-cm diameter phantoms are generally twice as high as
E/DLP values for 16-cm diameter phantoms.
C. Radiography
• The effective dose of a chest radiographic examination (PA + lateral views) is

typically 0.05 mSv (5 mrem).
• The effective dose of a complete skull radiographic examination is ~0.1 mSv
(10 mrem).
• The effective dose of a complete abdominal radiographic examination is ~0.5 mSv
(50 mrem).
• Radiation doses in projection radiography are low in comparison to GI studies,
Interventional Radiology, and CT.
D. Fluoroscopy and IR
• Effective doses in GI studies depend on total fluoroscopy time as well as the number
of photospot images.
• Table 11.5 summarizes common fluoroscopy examinations, highlighting increased
effective dose as fluoroscopy time and spot images increase.
Table 11.5
Common fluoroscopy exam time, images, and dose information
Type of Typical fluoroscopy Number of Effective dose

examination time (minutes) spot films (mSv)
Barium swallow 1 to 2 9 to 15 1 to 2
Upper GI 2 to 3 12 to 15 2 to 4
Barium enema 3 to 5 6 to 12 4 to 8
• Effective doses for a cardiac catheterization examination are ~7 mSv (700 mrem).
• Therapeutic catheterization of the heart vessels is likely to result in higher radiation
doses.
• Cerebral angiography has effective doses that range from 1 to 10 mSv
(100–1000 mrem).
• Abdominal interventional radiography includes hepatic, renal, mesenteric studies, as
well as those of the aorta.
• Typical effective doses in abdominal angiography are ~20 mSv (2000 mrem).
• Peripheral angiography studies have effective doses of ~5 mSv (500 mrem).
E. CT
• Effective doses in head CT scans are 1 to 2 mSv (100–200 mrem).

• Effective doses in chest CT scans are 5 to 10 mSv (500–1000 mrem).
• For a single-phase exam, effective doses in pelvis + abdominal CT scans are 5 to
10 mSv.
• A three-phase exam (pre-contrast, arterial phase, venous phase) would likely triple
the patient effective dose.
• Effective doses for CT of the extremities would be less than 1 mSv (100 mrem).
• Figure 11.5 shows how CT effective doses vary with age when the amount of
radiation used (i.e., DLP) is kept constant.
Figure 11.5
Relative effective dose for CT examination as a function
of patient age, showing a large increase when CTDI and DLP
are kept constant for a small patient size.
QUESTIONS
Chapter 11: Radiation Dosimetry
11.1 In the SI system of units, the intensity of an x-ray beam is best measured as:
A. air kerma.
B. exposure.
C. air dose.
D. equivalent dose.
11.2 An exposure of 1 roentgen may be taken to be an Air Kerma of about ______ mGy.
A. 0.1
B. 1
C. 10
D. 100
11.3 Absorbed dose is the energy absorbed per unit:

A. density.
B. mass.
C. time.
D. power.
11.4 The units of equivalent dose are:

A. C/kg.
B. dimensionless.
C. Gy.
D. Sv.
11.5 The radiation weighting factor for x-rays is ______ .

A. 1
B. 2
C. 10
D. 20
11.6 When the skin dose in an x-ray examination is 10 mGy, the skin equivalent dose
is ______ mSv.
A. 1
B. 2
C. 10
D. 20
11.7 The Entrance Air Kerma (EAK) is least affected by the x-ray:
A. tube potential (kV).
B. tube current (mA).
C. exposure time (ms).
D. beam area (cm2).
11.8 Entrance Air Kerma would most likely be measured using:

A. ionization chambers.
B. Geiger Mueller tubes.
C. NaI crystals.
D. photomultiplier tubes.
11.9 Then entrance Air Kerma for a normal-sized adult undergoing abdominal fluoroscopy (PA)
is most likely ______ mGy/min.
A. 0.3
B. 3
C. 30
D. 300
11.10 The maximum Air Kerma rate (mGy/minute) in high-dose fluoroscopy is currently:
A. 50.
B. 100.
C. 200.
D. No limit.
11.11 The units of Kerma Area Product (KAP) are:

A. Gy/cm2
B. Gy-cm2
C. Gy-cm
D. Gy
11.12 An Air Kerma of 1 mGy would likely correspond to a soft-tissue dose of ______ mGy.
A. 0.5
B. 0.9
C. 1.1
D. 1.5
11.13 An Air Kerma of 1 mGy would likely correspond to a bone dose of ______ mGy.
A. 0.5
B. 1
C. 2
D. 4
11.14 The backscatter factor in diagnostic radiology is most likely ______ .

A. 0.7
B. 1.1
C. 1.4
D. 2.0
11.15 An entrance Air Kerma (free in air) of 1 mGy will most likely result in a skin dose
of ______ mGy.
A. 0.75
B. 1.0
C. 1.25
D. 1.5
11.16 Skin dose for a chest radiograph is most likely ______ mGy.
A. 0.15
B. 1.5
C. 15
D. 150
11.17 For an AP projection, the ratio of the embryo dose to the entrance Air Kerma is most
likely ______.
A. 1:1
B. 1:2
C. 1:3
D. 1:4
11.18 In 1980, the Genetically Significant Dose (GSD) in the United States was reported to
be ______ mGy.
A. 0.003
B. 0.03
C. 0.3
D. 3
11.19 Mean Glandular Doses per image in mammography are most likely ______ mGy.
A. 0.5
B. 1.5
C. 5
D. 15
11.20 Using Automatic Exposure Control (AEC) increasing which x-ray tube parameter is most
likely to reduce the mean glandular dose?
A. Current (mA)
B. Exposure time
C. Voltage (kV)
D. Focus size
11.21 Head CTDI doses are measured using an acrylic cylinder with a diameter of ______ cm.
A. 8
B. 16
C. 24
D. 32
11.22 The volume CTDI (CTDIvol) is obtained by dividing the weighted CTDI (CTDIw)
by the CT:
A. pitch.
B. table speed.
C. gantry rotation time.
D. beam width.
11.23 Volume CTDI (CTDIvol) and weighted CTDI (CTDIw) are equal for a pitch ratio of:
A. 0.5.
B. 1.
C. 2.
D. All pitch values.
11.24 A typical adult head CTDIvol would likely be ______ mGy.

A. 2
B. 6
C. 20
D. 60
11.25 Units of Dose-Length Product (DLP) are:

A. mGy
B. mGy/cm
C. mGy-cm
D. (mGy-cm)2
11.26 The ACR suggests a dose reduction by a factor of ______ from adult to pediatric body
CT protocols.
A. 2
B. 3
C. 4
D. 5
11.27 The typical adult effective dose from a chest examination is most likely ______ mSv.
A. 0.05
B. 0.5
C. 5
D. 50
11.28 The typical adult effective dose from an upper GI examination is most likely ______ mSv.
A. 0.03
B. 0.3
C. 3
D. 30
11.29 The typical adult effective dose from a diagnostic cardiac catheterization is most
likely ______ mSv.
A. 0.07
B. 0.7
C. 7
D. 70
11.30 The typical adult effective dose from a head CT examination is most likely ______ mSv.
A. 0.2
B. 2
C. 20
D. 200
ANSWERS1
Chapter 11: Radiation Dosimetry
11.1 A Air Kerma is the SI unit used to measure exposure in air p. 34 Bushong
or intensity. p. 140 Carlton/Adler
11.2 C One roentgen of exposure is equivalent to approximately p. 34 Bushong

10 mGy Air Kerma. p. 140 Carlton/Adler
11.3 B Absorbed dose is the amount of energy deposited per unit p. 34 Bushong
mass (J/kg). p. 140 Carlton/Adler
11.4 D Equivalent dose is measured in sieverts (Sv). p. 618 Bushong

p. 140 Carlton/Adler
11.5 A Radiations used in diagnostic radiology all have a radiation p. 34 Bushong

weighting factor of 1. p. 141 Carlton/Adler
11.6 C The skin equivalent dose is equal to the skin dose because p. 635 Bushong
the x-ray radiation weighting factor is 1. p. 141 Carlton/Adler
11.7 D Entrance Air Kerma values are measured free in air at the p. 34 Bushong
entrance skin distance. Any factor that affects beam quantity p. 140 Carlton/Adler
or quality would affect the EAK, but not the x-ray beam
area.
11.8 A An ionization chamber would be placed free in air at the p. 589 Bushong
same location as the entrance skin. p. 142 Carlton/Adler
11.9 C Entrance Air Kerma in fluoroscopy ~30 mGy/min for an n/a Bushong
average adult. p. 579 Carlton/Adler
11.10 C High-dose mode fluoroscopy is limited to an Air Kerma of p. 311 Bushong

200 mGy/min in the United States. p. 202 Carlton/Adler
11.11 B Kerma Area Product is given in Gy-cm2. n/a Bushong

n/a Carlton/Adler
11.12 C Tissue doses are slightly higher than air doses, so an p. 35 Bushong
Air Kerma of 1 mGy results in a tissue dose of 1.1 mGy. p. 186 Carlton/Adler
1
As a study aid, page numbers for additional study are given for the following references:
Bushong SC: Radiologic Science for Technologists, 9th ed. St. Louis, MO: Mosby, 2008.
Carlton RR, Adler AM: Principles of Radiographic Imaging: An Art and a Science, 4th ed. Albany, NY: Delmar
Publishing Inc., 2005.
11.13 D Bone doses are much higher than air doses, so an p. 168 Bushong
Air Kerma of 1 mGy results in a bone dose of 4 mGy. p. 186 Carlton/Adler
11.14 C Diagnostic radiography has a backscatter factor of ~1.4. n/a Bushong

n/a Carlton/Adler
11.15 D Skin doses will be higher than the entrance Air Kerma due n/a Bushong
to higher absorption in skin and backscatter. p. 202 Carlton/Adler
11.16 A A skin dose of ~0.15 is typical in chest radiography and n/a Bushong
an entrance Air Kerma of 1 mGy will result in a skin dose p. 202 Carlton/Adler
of 1.5 mGy.
11.17 C Attenuation in the soft tissues results in the embryo dose p. 610 Bushong
that is numerically one-third of the entrance Air Kerma. n/a Carlton/Adler
11.18 C In 1980 the Genetically Significant Dose was estimated p. 601 Bushong
at 0.3 mGy by the NCRP. p. 139 Carlton/Adler
11.19 B A mean glandular dose of 1.5 mGy (150 mrad) is common p. 602 Bushong
in mammography. p. 621 Carlton/Adler
11.20 C Increasing the kVp allows for a decrease in mAs and an p. 322 Bushong
overall dose savings. p. 614 Carlton/Adler
11.21 B A 16-cm acrylic phantom is used for CTDI measurements n/a Bushong
in adult head protocols. n/a Carlton/Adler
11.22 A The volume CTDI is obtained by dividing the weighted n/a Bushong
CTDI by the pitch. n/a Carlton/Adler
11.23 B A pitch of 1 results in equal values of weighted and volume n/a Bushong
CTDI. n/a Carlton/Adler
11.24 D A CTDIvol of ~60 Gy is typical for an adult head CT. p. 603 Bushong
p. 667 Carlton/Adler
11.25 C The DLP is calculated by multiplying the CTDIvol by p. 635 Bushong

scan length, resulting in a value measured in mGy-cm. n/a Carlton/Adler
11.26 B Pediatric body scans typically use 3 times less radiation n/a Bushong
than adult scans. n/a Carlton/Adler
11.27 A A chest exam, PA and lateral, has an effective dose of n/a Bushong
~0.05 mSv. n/a Carlton/Adler
11.28 C An effective dose of ~3 mSv is typical. n/a Bushong

n/a Carlton/Adler
11.29 C A cardiac catheterization (diagnostic) has an effective dose n/a Bushong

of ~7 mSv. n/a Carlton/Adler
11.30 B Head CT scans in adults have effective doses of ~2 mSv. n/a Bushong
n/a Carlton/Adler
APPENDIX A
SUMMARY OF PREFIX NAMES AND MAGNITUDES
Prefix Name Symbol Magnitude

exa E 1018
peta P 1015
tera T 1012
giga G 109
mega M 106
kilo k 103
hecta h 102
deca da 10
deci d 10–1
centi c 10–2
milli m 10–3
micro µ 10–6
nano n 10–9
pico p 10–12
femto f 10–15
atto a 10–18
APPENDIX B
RADIOLOGIC QUANTITIES AND UNITS
SI to Non-SI Non-SI to SI
Quantity SI Unit Non-SI Unit Conversion Conversion
Exposure C/kg roentgen 1 C/kg = 3876 R 1 R = 2.58 × 10–4 C/kg
Air Kerma gray (J/kg) roentgen 1 Gy = 115 R 1 R = 8.73 mGy
Absorbed dose gray (J/kg) rad (100 erg/g) 1 Gy = 100 rad 1 rad = 10 mGy
Equivalent dose sievert rem 1 Sv = 100 rem 1 rem = 10 mSv
437
438 APPENDIX C/APPENDIX D
APPENDIX C
SI AND NON-SI UNITS FOR QUANTITIES USED

IN RADIOLOGICAL PHYSICS
Quantity SI Unit Non-SI Unit

Length meter (m) centimeter (cm)
Mass kilogram (kg) gram (g)
Time second (s) minute (min)
Electrical current ampere (A) electrostatic unit (ESU) per second (s)
Frequency hertz (Hz) revolutions per minute (rpm)
Force newton (N) dyne
Energy joule ( J) erg
Power watt (W) erg/s
Electrical charge coulomb (C) ESU
APPENDIX D
UNITS FOR PHOTOMETRIC QUANTITIES
To Convert Non-SI Units

Quantity SI Unit Non-SI Unit to SI Units
Luminance* cd/m² foot-lambert foot-lambert × 3.4261 = cd/m²
(nit)
Illuminance** lumen/m² foot-candle foot-candle × 10.761 = lumen/m²
(lux)
*Light scattered or emitted by a surface.

**Light falling on a surface.
APPENDIX E 439
APPENDIX E
SELECTED RADIOLOGICAL PHYSICS WEB SITES

American Association of Physicists in Medicine (AAPM) www.aapm.org
American College of Radiology (ACR) www.acr.org
American Journal of Roentgenology (AJR) www.ajronline.org
American Registry of Radiologic Technologists (ARRT) www.arrt.org
American Roentgen Ray Society (ARRS) www.arrs.org
American Society of Radiologic Technologists (ASRT) www.asrt.org
Conference of Radiation Control Program Directors (CRCPD) www.crcpd.org
CTISUS Advanced Diagnostic Imaging www.ctisus.com
Health Physics Society (HPS) www.hps.org
Huda Physics Review www.HudaPhysicsReview.com
Image Gently www.imagegently.org
Image Wisely www.imagewisely.org
International Commission on Radiation Units
and Measurements (ICRU) www.icru.org
International Commission on Radiological Protection (ICRP) www.icrp.org
Joint Commission for Accreditation of Healthcare Organizations www.jcaho.org
(JCAHO) (now Joint Commission)
National Council on Radiation Protection and Measurements
(NCRP) www.ncrponline.org
Radiological Society of North America (RSNA) www.rsna.org
Society for Imaging and Informatics in Medicine (SIIM) www.siim.web.org
U.S. Food and Drug Administration (FDA) www.fda.gov
U.S. Nuclear Regulatory Commission (NRC) www.nrc.gov
BIBLIOGRAPHY
GENERAL RADIOLOGIC IMAGING

AAPM Report No. 15: Performance Evaluation and Quality Assurance in Digital Subtraction
Angiography. New York: American Institute of Physics, 1985. www.aapm.org/pubs/reports/
RPT_15.pdf.
AAPM Report No. 70: Cardiac Catheterization Equipment Performance. Report of AAPM Task
Group No. 17. Madison, WI: Medical Physics Publishing, 2001. www.aapm.org/pubs/reports/
RPT_70.pdf.
Ball J, Moore AD, Turner S: Ball and Moore’s Essential Physics for Radiographers, 4th ed. Hoboken,
NJ: Wiley-Blackwell, 2008.
Bushong SC: Radiologic Science for Technologists, 9th ed. St. Louis, MO: Mosby, 2008.
Carlton RR, Adler AM: Principles of Radiographic Imaging: An Art and a Science, 4th ed. Albany,
NY: Delmar Publishing Inc., 2005.
Carter C: Digital Radiography and PACS. St. Louis, MO: Mosby, 2008.
Cullinan AM, Cullinan JE: Producing Quality Radiographs, 2nd ed. Baltimore, MD: Lippincott
William & Wilkins, 1994.
Daniels C: Fundamentals of Diagnostic Radiology (CD-ROM). Madison, WI: Medical Physics
Publishing, 1996.
Fosbinder R, Kelsey CA: Essentials of Radiologic Science. New York: McGraw-Hill, 2011.
Graham TG: Principles of Radiological Physics. 5th ed. New York: Churchill Livingstone, 2007.
Papp J: Quality Management in the Imaging Sciences, 4th ed. St. Louis, MO: Mosby, 2010.
Samei E, Badano A, Chakraborty D, Compton K, Cornelius C, Corrigan K, Flynn MJ, Hemminger
B, Hangiandreou N, Johnson J, Moxley M, Pavlicek W, Roehrig H, Rutz L, Shepard J, Uzenoff
R, Wang J, Willis C: Assessment of Display Performance for Medical Imaging Systems. Report
of the American Association of Physicists in Medicine (AAPM) Task Group 18, Medical
Physics Publishing, Madison, WI, AAPM On-Line Report No. O3, April 2005. www.aapm.org/
pubs/reports/OR_03.pdf.
Selman J: The Fundamentals of Imaging Physics and Radiobiology: For the Radiologic Technologist,
9th ed. Springfield, IL: Charles C Thomas, 2000.
Stevens AT: Quality Management for radiographic imaging. New York: McGraw-Hill, 2001.
EXAMINATION REVIEW BOOKS

Carlton RR: Delmar’s Radiography Exam Review. Albany, NY: Delmar Cengage Learning, 2010.
Bonsignore K, Maiellaro D, Kudlas M, Thengampallil A, Thengampallil S: Kaplan’s Radiography
Exam with CD-ROM, 2nd ed. New York: Kaplan Publishing, 2009.
Huda W: Review of Radiologic Physics, 3rd edition. Philadelphia: Lippincott Williams & Wilkins,
2010.
441
442 BIBLIOGRAPHY
Leonard WL: Radiography Examination Review, 10th ed. Holly Springs, NC: JLW Publications, 2004.
Saia DA: Appleton and Lange’s Review for the Radiography Examination, 7th ed. New York:
McGraw-Hill, 2008.
Saia DA: Radiography PREP: Program Review and Exam Preparation, 5th ed. New York: McGraw-
Hill, 2008.
BREAST IMAGING
American College of Radiology (ACR). Mammography Quality Control Manual. Reston, VA:
ACR, 1999.
Andolina V, Lillé L: Mammographic Imaging: A Practical Guide, 3rd ed. Philadelphia: Lippincott
Williams & Wilkins, 2010.
Myers CP: Mammography Quality Control: The Why and How Book. Madison, WI: Medical Physics
Publishing, 1997.
Peart O: Lange Q&A: Mammography Examination, 2nd ed. New York: McGraw-Hill, 2008.
Wagner JR, Wight EK: Mammography Exam Review. Philadelphia: Lippincott Williams & Wilkins,
2007.
COMPUTED TOMOGRAPHY
Blanck C: Understanding Helical Scanning. Baltimore, MD: Williams & Wilkins, 1998.
Phlipot-Scroggins D, Reddinger W Jr, Carlton R, Shappell A: Lippincott’s Computed Tomography
Review. Philadelphia: JB Lippincott, 1995.
Romans LE: Computed Tomography for Technologists: A Comprehensive Text. Baltimore, MD:
Williams & Wilkins, 2010.
Seeram E: Computed Tomography: Physical Principles, Clinical Applications, and Quality Control,
3rd ed. Philadelphia: WB Saunders, 2008.
RADIOBIOLOGY AND RADIATION PROTECTION

American College of Radiology: Radiation Risk: A primer. Reston, VA: ACR, 1996.
Bushong SC: Radiation Protection. New York: McGraw-Hill, 1998.
Hall EJ, Giaccia AJ: Radiobiology for the Radiologist, 6th ed. Philadelphia: Lippincott Williams &
Wilkins, 2005.
National Council on Radiation Protection and Measurements (NCRP) Report No. 147. Structural
Shielding for Medical X-Ray Imaging Facilities. Bethesda, MD: NCRP, 2004.
Seeram E: Radiation Protection. Philadelphia: Lippincott, 1997.
Statkiewicz Sherer MA, Visconti PJ, Ritenour ER: Radiation Protection in Medical Radiography,
6th ed. St Louis: Mosby, 2010.
Wagner LK, Lester RG, Saldana LR: Exposure of the Pregnant Patient to Diagnostic Radiations: A
Guide to Medical Management, 2nd ed. Madison, WI: Medical Physics Publishing, 1997.
About the Authors
Walter Huda studied Physics at Corpus Christi College, Oxford University, in the United
Kingdom, followed by a doctorate degree in Medical Physics at the Royal Postgraduate Medical
School (Hammersmith Hospital) at the University of London. From 1976 to 1981, Dr. Huda worked
as a physicist at Amersham International, a commercial company specializing in radioactive prod-
ucts. In 1982, Dr. Huda moved to the Manitoba Cancer Treatment and Research Foundation in
Winnipeg, MB, Canada, where he worked as a medical physicist in the fields of diagnostic imaging
and medical radiation dosimetry. Dr. Huda has worked at the University of Florida, Gainesville, FL
(1990 to 1997), SUNY Upstate Medical University at Syracuse (1997 to 2007), and the Medical
College of South Carolina (MUSC) in Charleston, SC (2007 to present). His research interests are in
medical imaging and radiation dosimetry. He has published one other book1, approximately 200 sci-
entific papers, and is board certified by the Canadian College of Physicists in Medicine and by the
American Board of Medical Physics.
Dr. Huda has extensive experience in teaching x-ray physics, including to physicists, radiology
residents, and x-ray technologists. Dr. Huda also offers review courses in North America directed at
residents and other medical practitioners in Boston, Chicago, Ottawa, and Charleston, attracting over
400 attendees each year.
Kerry Greene-Donnelly holds a Master of Business Administration degree from SUNY

Oswego, a Bachelor of Professional Studies degree in Health Service Management from SUNY
Institute of Technology at Utica/Rome, and an Associate in Applied Science degree in Medical
Radiography from SUNY Health Science Center at Syracuse. Kerry has 16 years of professional expe-
rience, with 11 of those years teaching in the Department of Medical Imaging Sciences at SUNY
Upstate Medical University Syracuse. Kerry continues to work clinically, consulting on accreditation
and CT protocol development.
Kerry teaches a variety of courses including: fundamentals of imaging, fundamentals of com-
puted tomography, quality management, management principles, and imaging in radiation oncology,
and coordinates computed tomography clinical rotations. Kerry is nationally certified in the follow-
ing modalities: Radiography, Mammography, Computed Tomography, and Quality Management.
Kerry participates in several professional societies: American Society of Radiologic Technologists
(ASRT), Central New York Society of Radiologic Technologists, Western New York Health Physics
Society, and the Upstate New York chapter of the American Association of Physicists in Medicine.
1
Huda W: Review of Radiologic Physics, 3rd edition. Philadelphia: Lippincott Williams & Wilkins, 2010.
443
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departure from Malden, at about four hundred troops, and “nearly a
115
thousand Indians.” The Indians dispersed until those with Proctor
116
at Fort Stephenson probably numbered two or three hundred,
the rest having returned to Detroit and Malden. Harrison reported
the British force as five thousand strong, on the authority of General
117
Green Clay.
Whether the British force was large or small, Harrison’s
arrangements to meet it did not please Secretary Armstrong. “It is
118
worthy of notice,” he wrote long afterward, “that of these two
commanders, always the terror of each other, one [Proctor] was now
actually flying from his supposed pursuer; while the other [Harrison]
waited only the arrival of Croghan at Seneca to begin a camp-
conflagration and flight to Upper Sandusky.”
The well-won honors of the campaign fell to Major George
Croghan, with whose name the whole country resounded. Whatever
were the faults of the two generals, Major Croghan showed courage
and intelligence, not only before and during the attack, but
afterward in supporting Harrison against the outcry which for a time
threatened to destroy the General’s authority. Immediately after the
siege of Fort Stephenson every energy of the northwest turned
toward a new offensive movement by water against Malden, and in
the task of organizing the force required for that purpose,
complaints of past failures were stifled. Secretary Armstrong did not
forget them, but the moment was not suited for making a change in
so important a command. Harrison organized, under Armstrong’s
orders, a force of seven thousand men to cross the Lake in boats,
under cover of a fleet.
The fleet, not the army, was to bear the brunt of reconquering
the northwest; and in nothing did Armstrong show his ability so
clearly as in the promptness with which, immediately after taking
office, he stopped Harrison’s campaign on the Maumee, while Perry
was set to work at Erie. Feb. 5, 1813, Armstrong entered on his
duties. March 5 his arrangements for the new movements were
119
already made. Harrison did not approve them, but he obeyed.
The Navy Department had already begun operations on Lake Erie,
immediately after Hull’s surrender; but though something was
accomplished in the winter, great difficulties had still to be overcome
when February 17 Commander Perry, an energetic young officer on
gunboat service at Newport, received orders from Secretary Jones to
report to Commodore Chauncey on Lake Ontario. Chauncey ordered
him to Presqu’isle, afterward called Erie, to take charge of the
vessels under construction on Lake Erie. March 27 he reached the
spot, a small village in a remote wilderness, where timber and water
alone existed for the supply of the fleets.
When Perry reached Presqu’isle the contractors and carpenters
had on the stocks two brigs, a schooner, and three gunboats. These
were to be launched in May, and to be ready for service in June.
Besides these vessels building at Erie, a number of other craft,
including the prize brig “Caledonia,” were at the Black Rock navy-
yard in the Niagara River, unable to move on account of the British
fort opposite Buffalo and the British fleet on the Lake. Perry’s task
was to unite the two squadrons, to man them, and to fight the
British fleet, without allowing his enemy to interfere at any stage of
these difficult operations.
The British squadron under Commander Finnis, an experienced
officer, had entire control of the Lake and its shores. No regular
garrison protected the harbor of Presqu’isle; not two hundred men
could be armed to defend it, nor was any military support to be had
nearer than Buffalo, eighty miles away. Proctor or Prevost were likely
to risk everything in trying to destroy the shipyard at Erie; for upon
that point, far more than on Detroit, Fort Meigs, Sandusky, or
Buffalo, their existence depended. If Perry were allowed to control
the Lake, the British must not only evacuate Detroit, but also
Malden, must abandon Tecumthe and the military advantages of
three or four thousand Indian auxiliaries, and must fall back on a
difficult defensive at the Niagara River. That they would make every
effort to thwart Perry seemed certain.
Superstition survived in nothing more obstinately than in faith in
luck; neither sailors nor soldiers ever doubted the value of this
inscrutable quality in the conduct of war. The “Chesapeake” was an
unlucky ship to the luckiest commanders, even to the British captain
who captured it. The bad luck of the “Chesapeake” was hardly
steadier than the good luck of Oliver Perry. Whatever he touched
seemed to take the direction he wanted. He began with the
advantage of having Proctor for his chief enemy; but Harrison, also a
lucky man, had the same advantage and yet suffered constant
disasters. Commander Finnis was a good seaman, yet Finnis failed
repeatedly, and always by a narrow chance, to injure Perry.
Dearborn’s incompetence in 1813 was not less than it had been in
1812; but the single success which in two campaigns Dearborn
gained on the Niagara obliged the British, May 27, to evacuate Fort
Erie opposite Buffalo, and to release Perry’s vessels at Black Rock.
June 6, at leisure, Perry superintended the removal of the five small
craft from the navy-yard at Black Rock; several hundred soldiers,
seamen, and oxen warped them up stream into the Lake. Loaded
with stores, the little squadron sailed from Buffalo June 13; the wind
was ahead; they were five days making eighty miles; but June 19
they arrived at Presqu’isle, and as the last vessel crossed the bar,
Finnis and his squadron came in sight. Finnis alone could explain
how he, a first-rate seaman, with a strong force and a fair wind, in
such narrow seas, could have helped finding Perry’s squadron when
he knew where it must be.
From June 19 to August 1 Perry’s combined fleet lay within the
bar at Presqu’isle, while Proctor, with a sufficient fleet and a military
force superior to anything on the Lake, was planning expeditions
from Malden against every place except the one to which military
necessity and the orders of his Government bade him go. August 4,
Perry took out the armaments of his two brigs and floated both over
the bar into deep water. Had the British fleet been at hand, such a
movement would have been impossible or fatal; but the British fleet
appeared just as Perry’s vessels got into deep water, and when for
the first time an attack could not be made with a fair hope of
success.
These extraordinary advantages were not gained without labor,
energy, courage, and wearing anxieties and disappointments. Of
these Perry had his full share, but no more; and his opponents were
no better off than himself. By great exertions alone could the British
maintain themselves on Lake Ontario, and to this necessity they
were forced to sacrifice Lake Erie. Sir George Prevost could spare
only a new commander with a few officers and some forty men from
the lower Lake to meet the large American reinforcements on the
upper. When the commander, R. H. Barclay, arrived at Malden in
June, he found as many difficulties there as Perry found at
Presqu’isle. Barclay was a captain in the British Royal Navy, thirty-
two years old; he had lost an arm in the service, but he was fairly
matched as Perry’s antagonist, and showed the qualities of an
excellent officer.
Perry’s squadron, once on the Lake, altogether overawed the
British fleet, and Barclay’s only hope lay in completing a vessel called
the “Detroit,” then on the stocks at Amherstburg. Rough and
unfinished, she was launched, and while Perry blockaded the harbor,
Barclay, early in September, got masts and rigging into her, and
120
armed her with guns of every calibre, taken from the ramparts.
Even the two American twenty-four pound guns, used by Proctor
against Fort Meigs, were put on board the “Detroit.” Thus equipped,
she had still to be manned; but no seamen were near the Lake.
Barclay was forced to make up a crew of soldiers from the
hardworked Forty-first regiment and Canadians unused to service.
September 6 the “Detroit” was ready to sail, and Barclay had then
no choice but to fight at any risk. “So perfectly destitute of
provisions was the port that there was not a day’s flour in store, and
the crews of the squadron under my command were on half
allowance of many things; and when that was done, there was no
121
more.”
Early on the morning of September 9 Barclay’s fleet weighed and
sailed for the enemy, who was then at anchor off the island of Put-
in-Bay near the mouth of Sandusky River. The British squadron
consisted of six vessels,—the “Detroit,” a ship of four hundred and
ninety tons, carrying nineteen guns, commanded by Barclay himself;
the “Queen Charlotte” of seventeen guns, commanded by Finnis; the
“Lady Prevost” of thirteen guns; the “Hunter” of ten; the “Little Belt”
carrying three, and the “Chippeway” carrying one gun,—in all, sixty-
three guns, and probably about four hundred and fifty men. The
American squadron consisted of nine vessels,—the “Lawrence,”
Perry’s own brig, nearly as large as the “Detroit,” and carrying
twenty guns; the “Niagara,” commander Jesse D. Elliott, of the same
tonnage, with the same armament; the “Caledonia,” a three-gun
brig; the schooners “Ariel,” “Scorpion,” “Somers,” “Porcupine,” and
“Tigress,” carrying ten guns; and the sloop “Trippe,” with one gun,—
in all, fifty-four guns, with a nominal crew of five hundred and thirty-
two men, and an effective crew probably not greatly differing from
the British. In other respects Perry’s superiority was decided, as it
was meant to be. The Americans had thirty-nine thirty-two pound
carronades; the British had not a gun of that weight, and only fifteen
twenty-four pound carronades. The lightest guns on the American
fleet were eight long twelve-pounders, while twenty-four of the
British guns threw only nine-pound shot, or less. The American
broadside threw at close range about nine hundred pounds of metal;
the British threw about four hundred and sixty. At long range the
Americans threw two hundred and eighty-eight pounds of metal; the
British threw one hundred and ninety-five pounds. In tonnage the
Americans were superior as eight to seven. In short, the Navy
Department had done everything reasonably necessary to insure
success; and if the American crews, like the British, were partly
made up of landsmen, soldiers or volunteers, the reason was in each
case the same. Both governments supplied all the seamen they had.
Between forces so matched, victory ought not to have been in
doubt; and if it was so, the fault certainly lay not in Perry. When, at
daylight September 10, his look-out discovered the British fleet,
Perry got his own squadron under way, and came down with a light
wind from the southeast against Barclay’s line, striking it obliquely
near the head. Perry must have been anxious to fight at close range,
where his superiority was as two to one, while at long range his ship
could use only two long twelve-pounders against the “Detroit’s” six
twelves, one eighteen, and two twenty-fours,—an inferiority
amounting to helplessness. Both the “Lawrence” and the “Niagara”
were armed for close fighting, and were intended for nothing else.
At long range their combined broadside, even if all their twelve-
pounders were worked on one side, threw but forty-eight pounds of
metal; at short range the two brigs were able to throw six hundred
and forty pounds at each broadside.
Perry could not have meant to fight at a distance, nor could
Commander Elliott have thought it good seamanship. Yet Perry alone
acted on this evident scheme; and though his official account
showed that he had himself fought at close range, and that he
ordered the other commanders to do the same, it gave no sufficient
reasons to explain what prevented the whole fleet from acting
together, and made the result doubtful. He did not even mention
that he himself led the line in the “Lawrence,” with two gunboats,
the “Ariel” and the “Scorpion,” supporting him, the “Caledonia,”
“Niagara,” and three gunboats following. The “Lawrence” came
within range of the British line just at noon, the wind being very
light, the Lake calm, and Barclay, in the “Detroit,” opposite. Perry’s
report began at that point:—
“At fifteen minutes before twelve the enemy commenced

firing; at five minutes before twelve the action commenced on
our part. Finding their fire very destructive, owing to their long
guns, and its being mostly directed to the ‘Lawrence,’ I made sail
(at quarter-past twelve) and directed the other vessels to follow,
for the purpose of closing with the enemy. Every brace and
bowline being shot away, she became unmanageable,
notwithstanding the great exertions of the sailing-master. In this
situation she sustained the action upwards of two hours, within
canister-shot distance, until every gun was rendered useless,
and a greater part of the crew either killed or wounded. Finding
she could no longer annoy the enemy, I left her in charge of
Lieutenant Yarnall, who, I was convinced from the bravery
already displayed by him, would do what would comport with
the honor of the flag. At half-past two, the wind springing up,
Captain Elliott was enabled to bring his vessel, the ‘Niagara,’
gallantly into close action. I immediately went on board of her,
when he anticipated my wish by volunteering to bring the
schooners, which had been kept astern by the lightness of the
wind, into close action.... At forty-five minutes past two the
signal was made for ‘close action.’ The ‘Niagara’ being very little
injured, I determined to pass through the enemy’s line; bore up,
and passed ahead of their two ships and a brig, giving a raking
fire to them from the starboard guns, and to a large schooner
and sloop, from the larboard side, at half pistol-shot distance.
The smaller vessels at this time having got within grape and
canister distance, under the direction of Captain Elliott, and
keeping up a well-directed fire, the two ships, a brig, and a
schooner surrendered, a schooner and sloop making a vain
attempt to escape.”
From this reticent report, any careful reader could see that for
some reason, not so distinctly given as would have been the case if
the wind alone were at fault, the action had been very badly fought
on the American side. The British official account confirmed the
impression given by Perry. Barclay’s story was as well told as his
action was well fought:—
“At a quarter before twelve I commenced the action by a

few long guns; about a quarter-past, the American commodore,
also supported by two schooners, ... came to close action with
the ‘Detroit.’ The other brig [the ‘Niagara’] of the enemy,
apparently destined to engage the ‘Queen Charlotte,’ kept so far
to windward as to render the ‘Queen Charlotte’s’ twenty-four
pounder carronades useless, while she was, with the ‘Lady
Prevost,’ exposed to the heavy and destructive fire of the
‘Caledonia’ and four other schooners, armed with heavy and
long guns.... The action continued with great fury until half-past
two, when I perceived my opponent [the ‘Lawrence’] drop
astern, and a boat passing from him to the ‘Niagara,’ which
vessel was at this time perfectly fresh. The American
commodore, seeing that as yet the day was against him, ...
made a noble and, alas! too successful an effort to regain it; for
he bore up, and supported by his small vessels, passed within
pistol-shot and took a raking position on our bow.... The
weather-gage gave the enemy a prodigious advantage, as it
enabled them not only to choose their position, but their
distance also, which they [the ‘Caledonia,’ ‘Niagara,’ and the
gunboats] did in such a manner as to prevent the carronades of
the ‘Queen Charlotte’ and ‘Lady Prevost’ from having much
effect, while their long ones did great execution, particularly
against the ‘Queen Charlotte.’”
Barclay’s report, agreeing with Perry’s, made it clear that while

Perry and the head of the American line fought at close quarters, the
“Caledonia,” “Niagara,” and the four gunboats supporting them
preferred fighting at long range,—not because they wanted wind,
but because the “Caledonia” and gunboats were armed with long
thirty-two and twenty-four pounders, while the British vessels
opposed to them had only one or two long twelve-pounders.
Certainly the advantage in this respect on the side of the American
brig and gunboats was enormous; but these tactics threw the
“Niagara,” which had not the same excuse, out of the battle, leaving
her, from twelve o’clock till half-past two, firing only two twelve-
pound guns, while her heavy armament was useless, and might as
well have been left ashore. Worse than this, the persistence of the
“Caledonia,” “Niagara,” and their gunboats in keeping, beyond range
of their enemies’ carronades nearly lost the battle, by allowing the
British to concentrate on the “Lawrence” all their heavy guns, and in
the end compelling the “Lawrence” to strike. On all these points no
reasonable doubt could exist. The two reports were the only official
sources of information on which an opinion as to the merits of the
action could properly be founded. No other account,
contemporaneous and authoritative, threw light on the subject,
except a letter by Lieutenant Yarnall, second in command to Perry on
the “Lawrence,” written September 15, and published in the Ohio
newspapers about September 29,—in which Yarnall said that if Elliott
had brought his ship into action when the signal was given, the
battle would have ended in much less time, and with less loss to the
“Lawrence.” This statement agreed with the tenor of the two official
reports.
Furious as the battle was, a more furious dispute raged over it
when in the year 1834 the friends of Perry and of Elliott wrangled
over the action. With their dispute history need not concern itself.
The official reports left no reasonable doubt that Perry’s plan of
battle was correct; that want of wind was not the reason it failed;
but that the “Niagara” was badly managed by Elliott, and that the
victory, when actually forfeited by this mismanagement, was saved
by the personal energy of Perry, who, abandoning his own ship,
brought the “Niagara” through the enemy’s line, and regained the
advantage of her heavy battery. The luck which attended Perry’s
career on the Lake saved him from injury, when every other officer
on the two opposing flagships and four-fifths of his crew were killed
or wounded, and enabled him to perform a feat almost without
parallel in naval warfare, giving him a well-won immortality by
means of the disaster unnecessarily incurred. No process of
argument or ingenuity of seamanship could deprive Perry of the
fame justly given him by the public, or detract from the splendor of
his reputation as the hero of the war. More than any other battle of
the time, the victory on Lake Erie was won by the courage and
obstinacy of a single man.
Between two opponents such as Perry and Barclay, no one
doubted that the ships were fought to their utmost. Of the
“Lawrence” not much was left; ship, officers, and crew were shot to
pieces. Such carnage was not known on the ocean, for even the
cockpit where the sick and wounded lay, being above water, was
riddled by shot, and the wounded were wounded again on the
surgeon’s board. Of one hundred and three effectives on the
“Lawrence,” twenty-two were killed and sixty-one wounded. The brig
herself when she struck was a wreck, unmanageable, her starboard
bulwarks beaten in, guns dismounted, and rigging cut to pieces. The
British ships were in hardly better condition. The long guns of the
gunboats had raked them with destructive effect. Barclay was
desperately wounded; Finnis was killed; Barclay’s first lieutenant was
mortally wounded; not one commander or second in command could
keep the deck; the squadron had forty-one men killed and ninety-
four wounded, or nearly one man in three; the “Detroit” and “Queen
Charlotte” were unmanageable and fell foul; the “Lady Prevost” was
crippled, and drifted out of the fight. Perry could console himself
with the thought that if his ship had struck her flag, she had at least
struck to brave men.
CHAPTER VI.
General Harrison, waiting at Seneca on the Sandusky River,
received, September 12, Perry’s famous despatch of September 10:
“We have met the enemy, and they are ours.” The navy having done
its work, the army was next to act.
The force under Harrison’s command was ample for the required
purpose, although it contained fewer regular troops than Armstrong
had intended. The seven regular regiments assigned to Harrison fell
short in numbers of the most moderate expectations. Instead of
providing seven thousand rank-and-file, the recruiting service ended
122
in producing rather more than twenty-five hundred. Divided into
two brigades under Brigadier-Generals McArthur and Lewis Cass,
with a light corps under Lieutenant-Colonel Ball of the Light
Dragoons, they formed only one wing of Harrison’s army.
To supply his main force, Harrison had still to depend on
Kentucky; and once more that State made a great effort. Governor
Shelby took the field in person, leading three thousand
123
volunteers, organized in eleven regiments, five brigades, and two
divisions. Besides the militia, who volunteered for this special
purpose, Harrison obtained the services of another Kentucky corps,
which had already proved its efficiency.
One of Armstrong’s happiest acts, at the beginning of his service
124
as War Secretary, was to accept the aid of Richard M. Johnson in
organizing for frontier defence a mounted regiment of a thousand
125
men, armed with muskets or rifles, tomahawks, and knives.
Johnson and his regiment took the field about June 1, and from that
time anxiety on account of Indians ceased. The regiment patrolled
the district from Fort Wayne to the river Raisin, and whether in
marching or fighting proved to be the most efficient corps in the
Western country. Harrison obtained the assistance of Johnson’s
regiment for the movement into Canada, and thereby increased the
efficiency of his army beyond the proportion of Johnson’s numbers.
While the mounted regiment moved by the road to Detroit,
Harrison’s main force was embarked in boats September 20, and in
the course of a few days some forty-five hundred infantry were
safely conveyed by way of Bass Island and Put-in-Bay to Middle
126
Sister Island, about twelve miles from the Canadian shore.
Harrison and Perry then selected a landing place, and the whole
force was successfully set ashore, September 27, about three miles
below Malden.
Although Proctor could not hope to maintain himself at Malden
or Detroit without control of the Lake, he had still the means of
rendering Harrison’s possession insecure. According to the British
account, he commanded at Detroit and Malden a force of nine
hundred and eighty-six regulars, giving about eight hundred
127
effectives. Not less than thirty-five hundred Indian warriors had
flocked to Amherstburg, and although they greatly increased the
British general’s difficulties by bringing their families with them, they
might be formidable opponents to Harrison’s advance. Every motive
dictated to Proctor the necessity of resisting Harrison’s approach. To
Tecumthe and his Indians the evacuation of Malden and Detroit
without a struggle meant not only the sacrifice of their cause, but
also cowardice; and when Proctor announced to them, September
18, that he meant to retreat, Tecumthe rose in the council and
protested against the flight, likening Proctor to a fat dog that had
carried its tail erect, and now that it was frightened dropped its tail
128
between its legs and ran. He told Proctor to go if he liked, but
the Indians would remain.
Proctor insisted upon retiring at least toward the Moravian town,
seventy miles on the road to Lake Ontario, and the Indians yielded.
The troops immediately began to burn or destroy the public property
at Detroit and Malden, or to load on wagons or boats what could not
be carried away. September 24, three days before Harrison’s army
landed, the British evacuated Malden and withdrew to Sandwich,
allowing Harrison to establish himself at Malden without a skirmish,
and neglecting to destroy the bridge over the Canards River.
Harrison was surprised at Proctor’s tame retreat.
129
“Nothing but infatuation,” he reported, “could have
governed General Proctor’s conduct. The day that I landed
below Malden he had at his disposal upward of three thousand
Indian warriors; his regular force reinforced by the militia of the
district would have made his number nearly equal to my
aggregate, which on the day of landing did not exceed forty-five
hundred.... His inferior officers say that his conduct has been a
series of continued blunders.”
This crowning proof of Proctor’s incapacity disorganized his

force. Tecumthe expressed a general sentiment of the British army in
his public denunciation of Proctor’s cowardice. One of the inferior
British officers afterward declared that Proctor’s “marked
inefficiency” and “wanton sacrifice” of the troops raised more than a
doubt not only of his capacity but even of his personal courage, and
130
led to serious thoughts of taking away his authority. The British
at Sandwich went through the same experience that marked the
retreat of Hull and his army from the same spot, only the year
before.
Harrison on his side made no extreme haste to pursue. His army
marched into Malden at four o’clock on the afternoon of September
131
27, and he wrote to Secretary Armstrong that evening: “I will
pursue the enemy to-morrow, although there is no probability of my
overtaking him, as he has upwards of a thousand horses, and we
132
have not one in the army.” The pursuit was not rapid. Sandwich,
opposite Detroit, was only thirteen miles above Malden, but Harrison
required two days to reach it, arriving at two o’clock on the
afternoon of September 29. From there, September 30, he wrote
again to Secretary Armstrong that he was preparing to pursue the
133
enemy on the following day; but he waited for R. M. Johnson’s
mounted regiment, which arrived at Detroit September 30, and was
obliged to consume a day in crossing the river. Then the pursuit
began with energy, but on the morning of October 2 Proctor had
already a week’s advance and should have been safe.
Proctor seemed to imagine that the Americans would not
134
venture to pursue him. Moving, according to his own report, “by
easy marches,” neither obstructing the road in his rear nor leaving
detachments to delay the enemy, he reached Dolson’s October 1,
and there halted his army, fifty miles from Sandwich, while he went
to the Moravian town some twenty-six miles beyond. He then
intended to make a stand at Chatham, three miles behind Dolson’s.
“I had assured the Indians,” said Proctor’s report of October

23, “that we would not desert them, and it was my full
determination to have made a stand at the Forks (Chatham), by
which our vessels and stores would be protected; but after my
arrival at Dover [Dolson’s] three miles lower down the river, I
was induced to take post there first, where ovens had been
constructed, and where there was some shelter for the troops,
and had accordingly directed that it should be put into the best
possible state of defence that time and circumstances would
admit of; indeed it had been my intention to have opposed the
enemy nearer the mouth of the river, had not the troops
contrary to my intention been moved, during my absence of a
few hours for the purpose of acquiring some knowledge of the
country in my rear.”
The British army, left at Dolson’s October 1, without a general or
135
orders, saw the American army arrive in its front, October 3, and
retired three miles to Chatham, where the Indians insisted upon
fighting; but when, the next morning, October 4, the Americans
136
advanced in order of battle, the Indians after a skirmish changed
their minds and retreated. The British were compelled to sacrifice
the supplies they had brought by water to Chatham for establishing
their new base, and their retreat precipitated on the Moravian town
the confusion of flight already resembling rout.
Six miles on their way they met General Proctor returning from
the Moravian town, and as much dissatisfied with them as they with
him. Pressed closely by the American advance, the British troops
made what haste they could over excessively bad roads until eight
o’clock in the evening, when they halted within six miles of the
137
Moravian town. The next morning, October 5, the enemy was
again reported to be close at hand, and the British force again
retreated. About a mile and a half from the Moravian town it was
halted. Proctor had then retired as far as he could, and there he
must either fight, or abandon women and children, sick and
wounded, baggage, stores, and wagons, desert his Indian allies, and
fly to Lake Ontario. Probably flight would not have saved his troops.
More than a hundred miles of unsettled country lay between them
and their next base. The Americans had in their advance the
mounted regiment of R. M. Johnson, and could outmarch the most
lightly equipped British regulars. Already, according to Proctor’s
report, the rapidity of the Americans had destroyed the efficiency of
138
the British organization: —
“In the attempt to save provisions we became encumbered

with boats not suited to the state of navigation. The Indians and
the troops retreated on different sides of the river, and the boats
to which sufficient attention had not been given became
particularly exposed to the fire of the enemy who were
advancing on the side the Indians were retiring, and most
unfortunately fell into possession of the enemy, and with them
several of the men, provisions, and all the ammunition that had
not been issued to the troops and Indians. This disastrous
circumstance afforded the enemy the means of crossing and
advancing on both sides of the river. Finding the enemy were
advancing too near I resolved to meet him, being strong in
cavalry, in a wood below the Moravian town, which last was not
cleared of Indian women and children, or of those of the troops,
nor of the sick.”
The whole British force was then on the north bank of the river
Thames, retreating eastward by a road near the river bank. Proctor
could hardly claim to have exercised choice in the selection of a
battleground, unless he preferred placing his little force under every
disadvantage. “The troops were formed with their left to the river,”
his report continued, “with a reserve and a six-pounder on the road,
near the river; the Indians on the right.” According to the report of
officers of the Forty-first regiment, two lines of troops were formed
in a thick forest, two hundred yards apart. The first line began where
the six-pound field-piece stood, with a range of some fifty yards
along the road. A few Canadian Light Dragoons were stationed near
the gun. To the left of the road was the river; to the right a forest,
free from underbrush that could stop horsemen, but offering cover
139
to an approaching enemy within twenty paces of the British line.
In the wood about two hundred men of the British Forty-first took
position as well as they could, behind trees, and there as a first line
they waited some two hours for their enemy to appear.
The second line, somewhat less numerous, two hundred yards
behind the first, and not within sight, was also formed in the wood;
and on the road, in rear of the second line, Proctor and his staff
stationed themselves. The Indians were collected behind a swamp
on the right, touching and covering effectually the British right flank,
while the river covered the left.
Such a formation was best fitted for Harrison’s purposes, but the
mere arrangement gave little idea of Proctor’s weakness. The six-
pound field-piece, which as he afterward reported “certainly should
have produced the best effect if properly managed,” had not a round
140
of ammunition, and could not be fired. The Forty-first regiment
was almost mutinous, but had it been in the best condition it could
not have held against serious attack. The whole strength of the
Forty-first was only three hundred and fifty-six rank-and-file, or four
141
hundred and eight men all told. The numbers of the regiment
actually in the field were reported as three hundred and fifteen rank-
142
and-file, or three hundred and sixty-seven men all told. The
dragoons were supposed not to exceed twenty. This petty force was
unable to see either the advancing enemy or its own members. The
only efficient corps in the field was the Indians, who were estimated
by the British sometimes at five hundred, at eight hundred, and
twelve hundred in number, and who were in some degree covered
by the swamp.
A. B. Advance Guard on foot at head of 5 Collumns—the
1st Battalion of the mounted Regiments.
C. D. Capt. Slecker’s Comp. of 100 men on foot at head
of 2 Collumns
Note: five Brigades & Reserved Corps, Governor Shelbys
troops
G. D. E. represents the whole of the 2d Battalion after I
was wounded & finding it impracticable on account of
logs & the thickness of the woods to break through
the Indian line & form in their rear, I ordered the men
to dismount & fight the Indians in their own way, part
of the time the Indians contended for the ground at
the 2d Swamp.
ACCOMPANYING COL. R. M. JOHNSON’S LETTER OF NOV. 21st
1813, DETAILING THE AFFAIR OF THE 5th AT THE RIVER
THAMES, ETC.—WAR DEPARTMENT ARCHIVES, MSS.
Harrison came upon the British line soon after two o’clock in the
afternoon, and at once formed his army in regular order of battle. As
the order was disregarded, and the battle was fought, as he
reported, in a manner “not sanctioned by anything that I had seen
143
or heard of,” the intended arrangement mattered little. In truth,
the battle was planned as well as fought by Richard M. Johnson,
whose energy impressed on the army a new character from the
moment he joined it. While Harrison drew up his infantry in order of
battle, Johnson, whose mounted regiment was close to the British
144
line, asked leave to charge, and Harrison gave him the order,
although he knew no rule of war that sanctioned it.
Johnson’s tactics were hazardous, though effective. Giving to his
brother, James Johnson, half the regiment to lead up the road
against the six-pound gun and the British Forty-first regiment, R. M.
Johnson with the other half of his regiment wheeled to the left, at
an angle with the road, and crossed the swamp to attack twice his
number of Indians posted in a thick wood.
James Johnson, with his five hundred men, galloped directly
145
through the British first line, receiving a confused fire, and
passing immediately to the rear of the British second line, so rapidly
146
as almost to capture Proctor himself, who fled at full speed. As
the British soldiers straggled in bands or singly toward the rear, they
found themselves among the American mounted riflemen, and had
no choice but to surrender. About fifty men, with a single lieutenant,
contrived to escape through the woods; all the rest became
prisoners.
R. M. Johnson was less fortunate. Crossing the swamp to his
left, he was received by the Indians in underbrush which the horses
could not penetrate. Under a sharp fire his men were obliged to
dismount and fight at close quarters. At an early moment of the
battle, Johnson was wounded by the rifle of an Indian warrior who
sprang forward to despatch him, but was killed by a ball from
Johnson’s pistol. The fighting at that point was severe, but Johnson’s
men broke or turned the Indian line, which was uncovered after the
British defeat, and driving the Indians toward the American left,
brought them under fire of Shelby’s infantry, when they fled.
In this contest Johnson maintained that his regiment was alone
engaged. In a letter to Secretary Armstrong, dated six weeks after
147
the battle, he said: —
“I send you an imperfect sketch of the late battle on the

river Thames, fought solely by the mounted regiment; at least,
so much so that not fifty men from any other corps assisted....
Fought the Indians, twelve hundred or fifteen hundred men, one
hour and twenty minutes, driving them from the extreme right
to the extreme left of my line, at which last point we came near
Governor Shelby, who ordered Colonel Simrall to reinforce me;
but the battle was over, and although the Indians were pursued
half a mile, there was no fighting.”
Harrison’s official report gave another idea of the relative share

taken by the Kentucky infantry in the action; but the difference in
dispute was trifling. The entire American loss was supposed to be
only about fifteen killed and thirty wounded. The battle lasted, with
sharpness, not more than twenty minutes; and none but the men
under Johnson’s command enjoyed opportunity to share in the first
and most perilous assault.
The British loss was only twelve men killed and thirty-six
wounded. The total number of British prisoners taken on the field
and in the Moravian town, or elsewhere on the day of battle, was
four hundred and seventy-seven; in the whole campaign, six
hundred. All Proctor’s baggage, artillery, small arms, stores, and
hospital were captured in the Moravian town. The Indians left thirty-
three dead on the field, among them one reported to be Tecumthe.
After the battle several officers of the British Forty-first, well
acquainted with the Shawnee warrior, visited the spot, and identified
his body. The Kentuckians had first recognized it, and had cut long
strips of skin from the thighs, to keep, as was said, for razor-straps,
148
in memory of the river Raisin.
After Perry’s victory on Lake Erie, Tecumthe’s life was of no value
to himself or his people, and his death was no subject for regret; but
the manner chosen for producing this result was an expensive mode
of acquiring territory for the United States. The Shawnee warrior
compelled the government to pay for once something like the value
of the lands it took. The precise cost of the Indian war could not be
estimated, being combined in many ways with that of the war with
England; but the British counted for little, within the northwestern
territory, except so far as Tecumthe used them for his purposes. Not
more than seven or eight hundred British soldiers ever crossed the
Detroit River; but the United States raised fully twenty thousand
men, and spent at least five million dollars and many lives in
expelling them. The Indians alone made this outlay necessary. The
campaign of Tippecanoe, the surrender of Detroit and Mackinaw, the
massacres at Fort Dearborn, the river Raisin, and Fort Meigs, the
murders along the frontier, and the campaign of 1813 were the price
paid for the Indian lands in the Wabash Valley.
No part of the war more injured British credit on the American
continent than the result of the Indian alliance. Except the capture
of Detroit and Mackinaw at the outset, without fighting, and the
qualified success at the river Raisin, the British suffered only
mortifications, ending with the total loss of their fleet, the
abandonment of their fortress, the flight of their army, and the
shameful scene before the Moravian town, where four hundred
British regulars allowed themselves to be ridden over and captured
by five hundred Kentucky horsemen, with hardly the loss of a man to
the assailants. After such a disgrace the British ceased to be
formidable in the northwest. The Indians recognized the
hopelessness of their course, and from that moment abandoned
their dependence on England.
The battle of the Thames annihilated the right division of the
British army in Upper Canada. When the remnants of Proctor’s force
were mustered, October 17, at Ancaster, a hundred miles from the
149
battlefield, about two hundred rank-and-file were assembled.
Proctor made a report of the battle blaming his troops, and Prevost
issued a severe reprimand to the unfortunate Forty-first regiment on
the strength of Proctor’s representations. In the end the Prince
Regent disgraced both officers, recognizing by these public acts the
loss of credit the government had suffered; but its recovery was
impossible.
So little anxiety did General Harrison thenceforward feel about
the Eighth Military District which he commanded, that he returned to
Detroit October 7; his army followed him, and arrived at Sandwich,
October 10, without seeing an enemy. Promptly discharged, the
Kentucky Volunteers marched homeward October 14; the mounted
regiment and its wounded colonel followed a few days later, and
within a fortnight only two brigades of the regular army remained
north of the Maumee.
At Detroit the war was closed, and except for two or three
distant expeditions was not again a subject of interest. The Indians
were for the most part obliged to remain within the United States
jurisdiction. The great number of Indian families that had been
collected about Detroit and Malden were rather a cause for
confidence than fear, since they were in effect hostages, and any
violence committed by the warriors would have caused them, their
women and children, to be deprived of food and to perish of
starvation. Detroit was full of savages dependent on army supplies,
and living on the refuse and offal of the slaughter-yard; but their
military strength was gone. Some hundreds of the best warriors
followed Proctor to Lake Ontario, but Tecumthe’s northwestern
confederacy was broken up, and most of the tribes made
submission.
CHAPTER VII.
The new Secretaries of War and Navy who took office in January,
1813, were able in the following October to show Detroit recovered.
Nine months solved the problem of Lake Erie. The problem of Lake
Ontario remained insoluble.
In theory nothing was simpler than the conquest of Upper
Canada. Six months before war was declared, Jan. 2, 1812, John
Armstrong, then a private citizen, wrote to Secretary Eustis a letter
containing the remark,—
“In invading a neighboring and independent territory like

Canada, having a frontier of immense extent; destitute of means
strictly its own for the purposes of defence; separated from the
rest of the empire by an ocean, and having to this but one
outlet,—this outlet forms your true object or point of attack.”
The river St. Lawrence was the true object of attack, and the
Canadians hardly dared hope to defend it.
“From St. Regis to opposite Kingston,” said the Quebec

“Gazette” in 1814, “the southern bank of the river belongs to the
United States. It is well known that this river is the only
communication between Upper and Lower Canada. It is rapid
and narrow in many places. A few cannon judiciously posted, or
even musketry, could render the communication impracticable
without powerful escorts, wasting and parcelling the force
applicable to the defence of the provinces. It is needless to say
that no British force can remain in safety or maintain itself in
Upper Canada without a ready communication with the lower
province.”
Closure of the river anywhere must compel the submission of the

whole country above, which could not provide its supplies. The
American, who saw his own difficulties of transport between New
York and the Lakes, thought well of his energy in surmounting them;
but as the war took larger proportions, and great fleets were built on
Lake Ontario, the difficulties of Canadian transport became
insuperable. Toward the close of the war, Sir George Prevost wrote
150
to Lord Bathurst that six thirty-two-pound guns for the fleet,
hauled in winter four hundred miles from Quebec to Kingston, would
cost at least £2000 for transport. Forty twenty-four-pounders hauled
on the snow had cost £4,800; a cable of the largest size hauled from
Sorel to Kingston, two hundred and fifty-five miles, cost £1000 for
transport. In summer, when the river was open, the difficulties were
hardly less. The commissary-general reported that the impediments
of navigation were incalculable, and the scarcity of workmen,
151
laborers, and voyageurs not to be described.
(Larger)
UPPER CANADA
NEW YORK
EAST END OF
LA K E O N TA R I O
AND
RIVER ST. LAWRENCE
FROM
Kingston to French Mills
REDUCED FROM AN
ORIGINAL DRAWING IN THE
NAVAL DEPARTMENT
BY JOHN MELISH.
STRUTHERS & CO., ENGR’S, N.Y.
If these reasons for attacking and closing the river St. Lawrence
had not been decisive with the United States government, other
reasons were sufficient. The political motive was as strong as the
military. Americans, especially in New England, denied that
treasonable intercourse existed with Canada; but intercourse needed
not to be technically treasonable in order to have the effects of
treason. Sir George Prevost wrote to Lord Bathurst, Aug. 27,
152
1814, when the war had lasted two years,—
“Two thirds of the army in Canada are at this moment eating

beef provided by American contractors, drawn principally from
the States of Vermont and New York. This circumstance, as well
as that of the introduction of large sums of specie into this
province, being notorious in the United States, it is to be
expected Congress will take steps to deprive us of those
resources, and under that apprehension, large droves are daily
crossing the lines coming into Lower Canada.”
This state of things had then lasted during three campaigns,

from the beginning of the war. The Indians at Malden, the British
army at Niagara, the naval station at Kingston were largely fed by
the United States. If these supplies could be stopped, Upper Canada
must probably fall; and they could be easily stopped by interrupting
the British line of transport anywhere on the St. Lawrence.
The task was not difficult. Indeed, early in the war an
enterprising officer of irregulars, Major Benjamin Forsyth, carried on
a troublesome system of annoyance from Ogdensburg, which Sir
153
George Prevost treated with extreme timidity. The British
commandant at Prescott, Major Macdonnell, was not so cautious as
the governor-general, but crossed the river on the ice with about five
hundred men, drove Forsyth from the town, destroyed the public
property, and retired in safety with a loss of eight killed and fifty-two
154
wounded. This affair, Feb. 23, 1813, closed hostilities in that
region, and Major Forsyth was soon ordered to Sackett’s Harbor. His
experience, and that of Major Macdonnell, proved how easy the
closure of such a river must be, exposed as it was for two hundred
miles to the fire of cannon and musketry.
The St. Lawrence was therefore the proper point of approach
and attack against Upper Canada. Armstrong came to the
Department of War with that idea fixed in his mind. The next subject
for his consideration was the means at his disposal.
During Monroe’s control of the War Department for two months,
between Dec. 3, 1812, and Feb. 5, 1813, much effort had been
made to increase the army. Monroe wrote to the chairman of the
155
Military Committee Dec. 22, 1812, a sketch of his ideas. He
proposed to provide for the general defence by dividing the United
States into military districts, and apportioning ninety-three hundred
and fifty men among them as garrisons. For offensive operations he
required a force competent to overpower the British defence, and in
estimating his wants, he assumed that Canada contained about
twelve thousand British regulars, besides militia, and three thousand
men at Halifax.
“To demolish the British force from Niagara to Quebec,” said

Monroe, “would require, to make the thing secure, an efficient
regular army of twenty thousand men, with an army of reserve
of ten thousand.... If the government could raise and keep in
the field thirty-five thousand regular troops, ... the deficiency to
be supplied even to authorize an expedition against Halifax
would be inconsiderable. Ten thousand men would be amply
sufficient; but there is danger of not being able to raise that
force, and to keep it at that standard.... My idea is that provision
ought to be made for raising twenty thousand men in addition to
the present establishment.”
Congress voted about fifty-eight thousand men, and after
deducting ten thousand for garrisons, counted on forty-eight
thousand for service in Canada. When Armstrong took control, Feb.
5, 1813, he began at once to devise a plan of operation for the army
which by law numbered fifty-eight thousand men, and in fact
numbered, including the staff and regimental officers, eighteen
thousand nine hundred and forty-five men, according to the returns
in the adjutant-general’s office February 16, 1813. Before he had
been a week in the War Department, he wrote, February 10, to
Major-General Dearborn announcing that four thousand men were to
be immediately collected at Sackett’s Harbor, and three thousand at
Buffalo. April 1, or as soon as navigation opened, the four thousand
troops at Sackett’s Harbor were to be embarked and transported in
boats under convoy of the fleet across the Lake at the mouth of the
St. Lawrence, thirty-five miles, to Kingston. After capturing Kingston,
with its magazines, navy-yards, and ships, the expedition was to
proceed up the Lake to York (Toronto) and capture two vessels
building there. Thence it was to join the corps of three thousand
156
men at Buffalo, and attack the British on the Niagara River.
In explaining his plan to the Cabinet, Armstrong pointed out that
the attack from Lake Champlain on Montreal could not begin before
May 1; that Kingston, between April 1 and May 15, was shut from
support by ice; that not more than two thousand men could be
gathered to defend it; and that by beginning the campaign against
Kingston rather than against Montreal, six weeks’ time would be
157
gained before reinforcements could arrive from England.
Whatever defects the plan might have, Kingston, and Kingston
alone, possessed so much military importance as warranted the
movement. Evidently Armstrong had in mind no result short of the
capture of Kingston.
Dearborn received these instructions at Albany, and replied,
February 18, that nothing should be omitted on his part in
158
endeavoring to carry into effect the expedition proposed. Orders
were given for concentrating the intended force at Sackett’s Harbor.
During the month of March the preparations were stimulated by a
panic due to the appearance of Sir George Prevost at Prescott and
Kingston. Dearborn hurried to Sackett’s Harbor in person, under the
belief that the governor-general was about to attack it.
Armstrong estimated the British force at Kingston as nine
hundred regulars, or two thousand men all told; and his estimate
was probably correct. The usual garrison at Kingston and Prescott
was about eight hundred rank-and-file. In both the British and
American services, the returns of rank-and-file were the ordinary
gauge of numerical force. Rank-and-file included corporals, but not
sergeants or commissioned officers; and an allowance of at least ten
sergeants and officers was always to be made for every hundred
rank-and-file, in order to estimate the true numerical strength of an
army or garrison. Unless otherwise mentioned, the return excluded
also the sick and disabled. The relative force of every army was
given in effectives, or rank-and-file actually present for duty.
In the distribution of British forces in Canada for 1812–1813, the
garrison at Prescott was allowed three hundred and seventy-six
rank-and-file, with fifty-two officers including sergeants. To Kingston
three hundred and eighty-four rank-and-file were allotted, with sixty
officers including sergeants. To Montreal and the positions between
Prescott and the St. John’s River about five thousand rank-and-file
159
were allotted. At Prescott and Kingston, besides the regular
troops, the men employed in ship-building or other labor, the sailors,
and the local militia were to be reckoned as part of the garrison, and
Armstrong included them all in his estimate of two thousand men.
The British force should have been known to Dearborn nearly as
well as his own. No considerable movement of troops between
Lower and Upper Canada could occur without his knowledge. Yet
Dearborn wrote to Armstrong, March 9, 1813, from Sackett’s
160
Harbor, —

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RT X-RAY PHYSICS REVIEW

Huda and Greene-Donnelly

MEDICAL PHYSICS PUBLISHING

Huda_RT_XRay_softcover_final.indd 1 7/11/11 10:51 PM

Walter Huda, Ph.D.

Kerry Greene-Donnelly, R.T.(R)(M)(CT)(QM)

MEDICAL PHYSICS PUBLISHING

Copyright © 2011 by Walter Huda and Kerry Greene-Donnelly

Library of Congress Control No.: 2011933323

ISBN 13: 978-1-930524-54-5

Medical Physics Publishing

Printed in the United States of America

Walter Huda dedicates this book to Joyce.

Kerry Greene-Donnelly dedicates this book to Dennis.

PART I. BASIC PHYSICS

Chapter 1 MATTER AND RADIATION

Chapter 2 PHYSICS LAWS

Chapter 3 X-RAY PRODUCTION

Chapter 4 X-RAY INTERACTIONS

Chapter 5 X-RAY TUBES

PART II. IMAGING WITH X-RAYS

Chapter 6 DETECTING X-RAYS

Chapter 7 ANALOG AND DIGITAL IMAGES

Chapter 8 PROJECTION RADIOGRAPHY

Chapter 10 COMPUTED TOMOGRAPHY

PART III. DOSE, QUALITY, AND SAFETY

Chapter 11 RADIATION DOSIMETRY

Chapter 12 IMAGE QUALITY

12.5 RADIOGRAPHIC ARTIFACTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 292

Chapter 13 QUALITY CONTROL

Chapter 14 RADIATION BIOLOGY

Chapter 15 RADIATION PROTECTION

APPENDIX A – Summary of Prefix Names and Magnitudes . . . . . . . . . . . . . . . . . . . . . . . . . 437

ABOUT THE AUTHORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 443

II. Review Book Structure

III. ARRT Exam

11.1 Radiation Units

11.1 RADIATION UNITS

• The International Commission on Radiation Units and Measurements (ICRU)

1 J/kg is 1 Gray (Gy).

D. Integral dose (energy imparted)

• Equivalent dose quantifies biological damage by different types of radiation.

Quantity Units Comments

11.2 INCIDENT RADIATION

• For a lateral skull radiograph, a typical EAK value is 1.5 mGy.

• Because fluoroscopy involves continuous exposure, Air Kerma rates in

E. Kerma Area Product (KAP)

• The entrance Air Kerma is independent of the x-ray beam area.

Entrance Air Kerma Kerma Area Product