Detailed explanation of X-ray Transmission Imaging (Fluoroscope) technology

Fluoroscopy is a real-time dynamic imaging technique based on the principle of X-ray attenuation, which uses a continuous X-ray beam to penetrate human tissue to form a real-time "video stream" image for observing organ movement and instrument operation processes. The following introduces the core principles, system composition, application scenarios, and development trends:

I. Core Principles and Imaging Mechanisms

Dynamic attenuation imaging

When X-rays penetrate human tissue, tissues of different densities (such as bones, muscles, and fats) absorb photons to varying degrees, resulting in differences in the intensity of the radiation received by the detector, forming grayscale contrast images. For example, bones appear bright white due to high electron density, while lung tissue containing air appears dark gray.

Real time performance and low latency

Traditional fluoroscopy captures signals with image intensifiers, while modern systems have been upgraded to flat panel detectors (such as amorphous silicon/selenium) that support continuous imaging at over 30 frames per second and can track dynamic processes such as heart beats and gastrointestinal peristalsis.

Dual energy and phase enhancement technology

Dual energy imaging: By using high-energy and low-energy X-ray beams to separate different tissue components, eliminate thickness interference, and generate classified colored images.

Phase contrast: For low atomic number tissues such as mammary glands, enhance edge contrast to compensate for the limitations of traditional absorption imaging.

II. System composition and technological evolution

Component Function Description Technology Innovation

X-ray source emits controllable energy radiation (conventional 10-120 kV) through pulsed exposure, reducing radiation dose by 60%

Detector indirect conversion (scintillator → photodiode) or direct conversion (photoconductive material → electrical signal) Flat panel detector resolution of 512 × 512 pixels, dynamic range>12 bits

Real time image denoising and artifact correction AI algorithms for processing systems optimize contrast and reduce motion blur

III. Core application areas

Clinical diagnosis

Digestive system: Real time observation of esophageal peristalsis and intestinal obstruction during barium meal/barium enema imaging.

Cardiovascular intervention: guiding catheter placement, monitoring vascular stenosis or stent deployment (such as cardiac catheterization).

Surgical navigation

Assist in fracture reduction during orthopedic surgery, and use interventional radiology to accurately locate biopsy instruments.

Functional evaluation

Quantify the range of diaphragm movement and joint range of motion to provide a basis for respiratory diseases and sports injuries.

IV. Advantages and Risk Management

Dimension advantage risk control measures

Time sensitive millisecond level dynamic capture pulse fluoroscopy reduces exposure time

Flexible operation, real-time adjustment of observation position from multiple angles, lead shielding protection for sensitive organs

The single dose of radiation exposure is lower than that of CT, but the cumulative risk is higher. Dose monitoring system+AI automatic beam limiting

Typical risk: Prolonged operation may induce skin erythema (>2 Gy dose), and heavy metal protection and operation training are the safety core.

V. Future development direction

Intelligent integration

AI real-time analysis: automatically marks abnormal movements (such as polyp tremors in gastrointestinal imaging).

Low dose protocol: Deep learning reconstructs low signal-to-noise ratio images, reducing the dose to 1/5 of traditional methods.

Multimodal fusion

Combining ultrasound or MRI to supplement soft tissue information and improve the detection rate of complex lesions.

Remote medical support

5G transmission of real-time images enables cross regional surgical guidance.

Fluoroscopy is evolving from a single diagnostic tool to an intelligent intervention platform, playing an irreplaceable role in precision medicine and minimally invasive surgery.