**2. Characteristics of X-rays**

**Figure 2.** The first X-ray image (left hand of Bertha Roentgen)*.*

**Figure 1.** William Roentgen.

34 Medical Imaging and Image-Guided Interventions

Other main characteristics were revealed including:

	- **1.** X-ray passes through the patient during imaging procedures.
	- **2.** As X-rays penetrate through the body tissues, it become modified and each part of the beam is attenuated in a degree that depends on:
		- **a.** the tissue type;
		- **b.** the intensity of the beam; and
		- **c.** thickness of the tissue.

**3.** A suitable image receptor receives the signal and creates radiograph with different levels of gray scales according to the tissue attenuation.

exclusively (barium sulfate (BaSO<sup>4</sup>

), with effective atomic number 56), and gastrografin

Medical Imaging and Image-Guided Interventions http://dx.doi.org/10.5772/intechopen.76608 37

I 3 N2 O4

)) was developed [2].

(Diatrizoate Meglumine and Diatrizoate Sodium Solution, effective atomic number 53), which is an iodinated soluble contrast medium, was developed in 1954. For cardiovascular system,

Afterward, the clinical experiments on cardiac catheterization and angiography progressed extensively, and in 1956, Forssman and Cournand received the Nobel Prize in physiology and

The image-guided intervention was started as a diagnostic technique, but due to the development of recent imaging technology such as CT angiography and magnetic resonance angiography (MRA), it becomes a pure therapeutic technique. Image-guided intervention is performed usually under fluoroscopic guidance. However due to the development of other imaging modalities such as CT, MRI, and ultrasound, these techniques are progressing with some drawbacks that include radiation risk in CT imaging, metallic surgical tools as a limitation for MRI application in interventional procedures, and ultrasound poor image quality [4]. In addition to that, a combination of fluoroscopy with endoscopy provided also excellent approach to treat many clinical conditions.

Fluoroscopic equipment was developed in 1896 by Thomas Edison. At that time, very simple instruments were used without any consideration of radiation protection for patients and staff (**Figure 3B**). Since that date, fluoroscopy equipment technology developed rapidly, and

new applications are emerging continuously (**Figure 3A**; old practice in fluoroscopy).

urografin (amidotrizoate meglumine; sodium amidotrizoate (C11H9

**Figure 3.** (A) Radiologist using a fluoroscope during an examination; and (B) red goggles.

**4. Image-guided intervention instrumentation**

**4.1. Types of fluoroscopic equipment**

Fluoroscopic equipment is classified into two types:

medicine for their efforts in development of cardiac catheterization [3].
