Dosage is an important factor in the use of ionization radiation as well as in application of contrast agents or radiopharmaceuticals and the dosage should be comply with the ALARA principle (As Low As Reasonably Achievable).
Ionizing radiation comes from natural and artificial sources. Radiation effects depend on the type of radiation, and various units are used for measurement of dosages including gray, sievert, radiation absorbed dose (RAD), roentgen equivalent in man (REM), and roentgen. The amount of radiopharmaceutical given to a patient is measured in becquerels (Bq).
The dosage of contrast media in radiographic or computer-tomographic procedures should be tailored according to the diagnostic indications, the iodine concentration, and the patient's body size and age.

See also Administrative Dose Guidelines.

Fluoroscopy is used to study moving body structures in real time. A fluoroscope is used to produce a continuous (advanced fluoroscopy machines provide pulsed techniques to lower the amount of radiation) x-ray beam, passing through the body part being examined and transmitted to a monitor so that dynamic images of deep tissue structures can be visualized. Fluoroscopy is primarily used for gastrointestinal exams, genitourinary studies, cardiovascular imaging and for invasive procedures performed by interventional radiologists and angiographers under fluoroscopic guidance. Fluoroscopy can also produce a static record of an image formed on the output phosphor of an image intensifier. The image intensifier is an x-ray image receptor that increases the brightness of a fluoroscopic image by electronic amplification and image minification. Modern fluoroscopy systems combine less radiation with better image quality due to digital image processing and flat-panel technology.
Roentgen's discovery of x-rays related directly to fluoroscopy, because fluorescence on the material in the room draws his attention to the x-ray's properties. In 1896, Thomas A. Edison created the first fluoroscope, consisting of a zinc-cadmium sulfide screen that was placed above the patient's body in the x-ray beam and provides a faint fluorescent image. In first-generation units, the exam room required complete darkness. The users wear red goggles for up to 30 minutes prior to the examination, to adapt the eyes to darkness. After this, the radiologist stared directly at a yellow-green fluorescent image through a sheet of lead to prevent the x-ray beam from striking the eyes.

Iodinated contrast agents (typically iodine-substituted benzene derivatives) are bound either in nonionic or ionic compounds. Ionic contrast agents consist of the negatively charged anion and the positively charged cation. Used components of the anion are for example diatrizoate, iodamide, iothalamate or metrizoate and of the cation the sodium or meglumine ion. The osmotic pressure depends on the number of particles in solution. Ionic contrast agents have a greater osmolarity; double that of nonionic contrast agents due to delivering more iodine atoms per molecule.
Ionic contrast agents were developed first and are still in use depending on the examination. Iodine based contrast media are water soluble and as harmless as possible to the body. However, ionic agents have more side effects compared to nonionic contrast agents due to their high osmolarity.

See also Ionic Dimer.

The first-generation contrast agents were all ionic monomers, consisting of a tri-iodinated benzene ring with 2 organic side chains and a carboxyl group. Diatrizoate or iothalamate are common iodinated anions, conjugated with a cation, sodium or meglumine. The ionization at the carboxyl-cation bond makes the agent water soluble.
Ionic monomers have the highest osmolality (high-osmolar contrast media (HOCM) possess an osmolality seven to eight times higher than plasma) of the different groups of contrast agents (CM ratio=1.5) and the lowest viscosity. The osmolality in solutions of ionic monomers ranges from 600 to 2100 mOsm/kg (human plasma = 290 mOsm/kg). These high osmolality is related to some of the adverse reactions. HOCM's have been widely replaced by newer contrast agents with improved tolerability and safety profiles.
Examples of HOCM's are Renografin®-60, Hypaque 76, Hypaque Meglumine, Hypaque Sodium and Conray®.

See also Ionic Contrast Agents.

If available, some graphic aids can be helpful to show image orientations.
1) A graphic icon of the labeled primary axes (A, L, H) with relative lengths given by direction sines and system of coordinates as if viewed from the normal to the image plane can help orient the viewer, both to identify image plane orientation and to indicate possible in plane rotation.
2) In graphic prescription of obliques from other images, a sample original image with an overlaid line or set of lines indicating the intersection of the original and oblique image planes can help orient the viewer. The location in the R/L and P/A directions can be specified relative to the axis of the scanner.
The F/H location can be specified relative to a convenient patient structure.
The orientation of single oblique slices can be specified by rotating a slice in one of the basic orientations toward one of the other two basic orthogonal planes about an axis defined by the intersection of the 2 planes.
Double oblique slices can be specified as the result of tipping a single oblique plane toward the remaining basic orientation plane, about an axis defined by the intersection of the oblique plane and the remaining basic plane. In double oblique angulations, the first rotation is chosen about the vertical image axis and the second about the (new) horizontal axis. Angles are chosen to have magnitudes less than 90° (for single oblique slices less than 45°); the sign of the angle is taken to be positive when the rotation brings positive axes closer together.