radiography History 400
radiography History 400
By Brian Nett, PhD History
Highlights of X-ray radiology from the discovery of x-rays through its multiple uses including: radiography, fluoroscopy, mammography, cardiac catherization, digital subtraction angiography, and bone densitometry.
1875

Crookes Cathode Ray Tube Invented
crookes 640 1

Modern X-ray Tube Predecessor
The cathode ray tube was invented by English physicist William Crookes before scientists had discovered x-rays or electrons. 
After later research it was discovered that the cathode rays were actually electrons being drawn across a positive potential. 

1875
1895

X-Rays Discovered
Anna Bertha Ludwig

X-Ray Imaging Predecessor
Rontgen discovered the unknown particles and hence called them x-rays as x typically is an unknown variable. 
He did so by using a cathode ray tube and covering it in paper so as to block the electrons from escaping. However, the x-rays penetrated the paper and were detected using a phosphorous screen.
The first human x-ray was of Rontgen’s wife hand (print of this x-ray shown above).

1895
1900

Fluroscopy Invented
fluoroscopy min

The first imaging devices used to provide realtime feedback for guiding medical procedures was invented by Thomas Edison. 

1900
1901

Nobel Prize Physics
rontgen

Discovery of X-rays
Rontgen given the first Nobel prize in physics for the discovery of X-rays.

1901
1913

First Anti-scatter X-ray Grid
scatter min 1

Gustav Bucky invented the first x-ray grid. He is still the namesake for the Bucky factor which is a measure of the efficiency of a grid as it is the ratio of x-rays that are stopped in the grid to those that pass through the grid.

1913
1913

Modern x-ray tube developedIcon for X Ray Tube

The hot cathode x-ray tube which uses thermionic emission was patented in 1913 and produced in 1917 by GE lead by William D. Coolige. Thus, the design of the modern tube is often still referred to as the Coolige tube.

1913
1913

First Dedicated Radiograph of Breast Tissue
albertSalmonBW min

Mammography Predecessor
German surgeon Albert Salmon took a radiographs of breast tissue after it was excised from a mastectomy. He studied over 3000 mastectomies and found: micro-calcifications and different types of breast cancer.  Salmon was later discharged from the University of Berlin during the Hitler regime and after forced time in a concentration camp he left Germany for Holland. 

1913
1918

X-ray Film Introduced
eastman min

Eastman introduces film to radiography, which replaced the glass plates previously used.

1918
1920-1970s

X-ray imaging used for fitting shoesfootoscope min

Beginning before but continuing long after the genetic effects of radiation were known. This practice was used to fit shoes with brands such as Foot-o-scope and Pedoscope. 

1920-1970s
1926

First Demonstration of Genetic Effects of x-rays
fruit flies min

Hermann Joseph Muller found a strong relationship between the x-ray dose fruit flies were exposed to and legal genetic damage. This was the first direct evidence of genetic effects from radiation.

1926
1929

Cardiac Cath
Werner Forssmann

Cath lab predecessor
The first clinical cardiac catheterization was performed by Werner Forssmann. 

1929
1930

First Clinical Breast x-ray ImagingstaffordWarren


Mammography Predecessor
Stafford Warren, a radiologist a Rochester Memorial Hospital, conducted the first clinical mammography trial with 119 patients.

1930
1932

First X-ray tomography
tomography



Tomosynthesis predecessor
Ziedes des Plantes demonstrated the technique that by moving the x-ray source and image receptor (film) that a tomographic image can be generated. In this image structures above and below the focal plane are blurred out whereas those lying in the focal plane remain in focus. 

1932
1934

Image Intensifier
imageIntensifier



 G. Holst from Phillips developed an early image intensifier. After about a decade of development an image intensifier was then produced for medical applications.

1934
1946

Nobel Prize for demonstrating the Genetic effects of radiation
Hermann Joseph Muller min



 Hermann Joseph Muller received the Nobel prize in Physiology or Medicine for being the first to link radiation and genetic damage. 

1946
1949

Breast Compression Introducedcompression min

Raule Leborgne from Uruguay introduced breast compression to breast x-ray imaging to reduce x-ray scatter, anatomical clutter and x-ray attenuation.

1949
1953

Subtraction imaging
hand subtraction min

DSA predecessor
Bernard George Ziedes des Plantes who trained in Utect (Netherlands) used two consecutive x-ray exposures: one with contrast and one without contrast to highlight just the contrast enhanced region.  

1953
1956

Nobel Prize for cardiac catheterization
forssmannCournand


The Nobel prize in physiology or medicine was awarded to Werner Forssmann, Andre Frederic Cournand and Dickinson Richards for the cardiac cathereterization. The first cath lab being at Bellevue Hospital in New York City, which is associated with Columbia University.  

1956
1964

First Angioplasty
catheter alpha min 1

Interventional Radiography Predecessor
Charles Dotter proposed and demonstrated the first use of percutaneous angioplasty such that a clot could be removed from within rather than performing imaging only to inform the recommendation of invasive surgery. 

1964
1972

First Tomosynthesis Imagingtomosynthesis


Tomosynthesis predecessor
D. G. Grant expanded on earlier x-ray tomography approaches by proposing a method that enables reconstruction of planes above and below the focal plane. 

1972
1977

Percutaneous coronary angioplasty
cath image min


 Andreas Roland Gruntzig, a German Radiologist and Cardiologist, was the first to perform a coronary angioplasty on a human that was awake. The procedure was performed in Zurich Switzerland.

1977
1980

Digital Subtraction Angiographydsa mistretta min


 Chuck Mistretta from UW Madison was granted the US patent for realtime subtraction imaging. This is particularly helpful to suppress the background tissue such that only the contrast agent will be present in the images.

1980
1981

Dual Energy X-ray Absorption (DEXA)  demonstrated in bone density measurements
dexaScan min 1


Following previous work at UW Madison using Gd sources, the Mazess lab demonstrated that bone densitometry is possible using x-ray projections acquired with a standard x-ray tube at tube at two different energies. Mazess founded a company in his nighttime hours based on this concept, hence Lunar. Which was subsequently acquired and is now GE Lunar. 

1981
1983

Computed Radiography (CR) system used clinically
computedRadiology min


As an intermediate improvement from film processing a reusable phosphor stimulated detector was used. This was termed Computed Radiography (CR). This wins the award for most deceptive naming used on this page as there is no actual computing as in computed tomography.  

1983
2000

Digital X-ray Detectors used commerciallydigital detector min


Radiography and mammography specific detectors were introduced and began clinical use.

2000
2011

First Breast Tomography FDA cleared
mammographyTomo min


Hologic received FDA clearance for breast tomosynthesis, i.e. commercially referred to as 3D breast imaging. In reality tomosynthesis is ~2.5D where standard projection imaging is 2D and true breast CT is 3D.

2011

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