Author: Isabella De Soriano, Museum Blog

A Note from the Collection: X-Rays, Coolidge Tubes, and Breast Cancer (Part 1)

Picture 1. c.1901. An original X-ray print of two human hands in the International Museum of Surgical Science collection. Image by Emil Grubbe of the Illinois X-ray and Electric Therapeutic Laboratory, Chicago, IL. Grubbe was one of the first people to use X-rays to treat breast cancer.

October 17, 2024

Written by Isabella De Soriano

X-rays revolutionized medical imaging. The X-ray made it possible to examine inside the body without the need for surgery and, while we might often associate the X-ray with broken bones, its discovery and implementation made a profound impact on our ability to diagnose  – and therefore treat – breast cancer. 

When it comes to breast cancer, X-rays are used to create an image of the breast known as a mammogram through a technique known as mammography, a diagnostic test which uses a low-dose X-ray technique to produce imaging of the breast. These X-ray images help to detect small lumps in the breast which may be cancerous. This early detection is crucial for effective treatment of breast cancer, which is the most common cancer among U.S. women. Mammograms have significantly improved the rate of diagnosis compared to pre-X-ray methods.

What are X-Rays?

In the world of medical imaging, few discoveries have had such an impact as the X-ray. Wilhelm Röntgen accidentally discovered X-rays in 1895 while experimenting with vacuum tubes known as Crookes tubes. He named them X-rays because their nature was unknown. X-rays are a type of electromagnetic energy that the human eye cannot see and sits on the same spectrum as visible light which the eye can see. You can read more about electromagnetic energy from NASA

Using X-rays in machines and devices allow us to take images of the inside of the body as the rays can pass through objects, including human tissue. In the images produced by X-rays, denser objects such as bones absorb less of the energy while less dense objects absorb more. This creates an image with different contrasts. For X-ray images, the greater the contrast the better the quality of image.

The X-ray image below demonstrates this contrast. In the image of the right hand, we can clearly see the contrast between the density of the bones and the metal of the rings. In the image of the left hand we can clearly see the contrast between the density of the bones in the arm, the radius and ulna, and the jacket sleeve and buttons.

When X-rays were first found, the harmful effects were unknown. This led doctors to use X-ray machines to take pictures of their own bodies frequently and without safety precautions. These repeated and unmitigated exposures to X-rays caused skin and eye damage but led physicians to believe that X-rays could be used in the treatment of various diseases leading to the first instances of cancer treatment, including breast cancer using X-rays. Now, we know much more about the side effects of X-rays and make sure to use safety measures such as wearing lead clothing and keeping X-ray exposure time short. 


Wilhelm Röntgen (1845-1923): Photo from the Nobel Foundation archive.

What are Coolidge Tubes in X-Rays?

William Coolidge invented these tubes in 1913. They are the main part of X-ray machines as they are the part of the machine that produces the actual X-rays. To do this, an electrical current heats a thin wire of tungsten metal which makes electrons. This heat causes the electrons to move very quickly and it is this fast movement that makes X-rays. Before Coolidge tubes were invented, Crookes tubes were used which used a gas instead of metal.

Picture 2. An early 20th century ‘Universal’ Coolidge Tube manufactured by General Electric. From the International Museum of Surgical Science collection.

What made Coolidge’s invention such a big deal was its ability to produce consistent, controllable, and low-energy X-rays. These low energy X-rays create high contrast images and high contrast is what makes images high quality. High quality images make it easier to see and find objects in the body, including breast cancer. 

For more on breast cancer and X-rays, see Part 2: X-Rays in Breast Cancer, coming soon!


Isabella De Soriano is the Fall 2024 Marketing Intern at the IMSS. She is a medical history and oddities enthusiast with a love of taxidermy. Based in Chicago with an education in anthropology and public health from the University of Iowa, she’s interested in how medical narratives reflect understandings of society.



References:

History of Medicine: Dr. Roentgen’s Accidental X-Rays. (n.d.). Columbia University Irving Medical Center, Department of Surgery. https://columbiasurgery.org/news/2015/09/17/history-medicine-dr-roentgen-s-accidental-x-rays

Vardeu, M. F., Larentis, O., Vecchio, I., Gorini, I., Martini, M., Bragazzi, N., D’Ambra, A., Ruggieri, M., & Tornali, C. (2020). History of use and abuse of X-ray: the early 20th century Italian pediatrics school. Acta bio-medica : Atenei Parmensis, 91(1), 113–117. https://doi.org/10.23750/abm.v91i1.8646

Coolidge X-Ray Tubes. (n.d.). ORAU Museum of Radiation and Radioactivity. https://www.orau.org/health-physics-museum/collection/x-ray-coolidge/index.html

Narratives: Radiology in Illinois. (n.d.). Chicago Radiological Society. https://chicagoradiology.org/history/narratives/narratives-radiology-in-illinois/

Wan, S., Arhatari, B. D., Nesterets, Y. I., Mayo, S. C., Thompson, D., Fox, J., Kumar, B., Prodanovic, Z., Hausermann, D., Maksimenko, A., Hall, C., Dimmock, M., Pavlov, K. M., Lockie, D., Rickard, M., Gadomkar, Z., Aminzadeh, A., Vafa, E., Peele, A., Quiney, H. M., … Taba, S. T. (2021). Effect of x-ray energy on the radiological image quality in propagation-based phase-contrast computed tomography of the breast. Journal of medical imaging (Bellingham, Wash.), 8(5), 052108. https://doi.org/10.1117/1.JMI.8.5.052108