COMPUTED

RADIOGRAPHY
▪ Computed Radiography (CR) is a process of
capturing radiographic data from
conventional X ray machine and processing
data digitally to produce high quality
radiographic images.
 Components

1.Imaging plate (IP)

2.Imaging plate reader
3.Image display system
4.Image storage system
 Imaging Plate

• Most critical part of CR imaging system.

• It is made up of several layers:

I. PROTECTIVE LAYER : Thin tough ,clear plastic that protects the

phosphor /active layer of IP .
II. PHOSPHOR / ACTIVE LAYER:It is a layer of photostimulable
phosphor that traps electrons during exposure ,this layer has the
peoperty of storing radiation energy for a while
III. REFLECTIVE LAYER: Reflects the light to the reader.
IV. CONDUCTIVE LAYER: Absorbs light as well as any electrical
charge.
V. SUPPORTIVE LAYER:Made of polyester and gives strength.
 PRINCIPLE

• The IP is coated with the photostimulable phosphor , also called storage

phosphor.
• The phosphor material is generally a kind of Bariumfluorohalide .
• Incident X rays excite electrons into a higher energy level i.e. from
valence band to conduction band.
• A latent image is created in the form of stored energy .
• Stimulation with a scanning laser beam releases electrons from
conduction band to again in valence band.
• During this energy is released in the form of blue green light which is
captured with an optical array and photomultiplier in reader system and
digitalized into an image.
 IMAGE PLATE READER / DIGITIZER
• Plate is inserted into the digitizer where it is
scanned with a high power laser .
• Typical wavelength of the stimulating laser is
633 nm.
• The laser light causes the storage phosphors to
release the energy they have captured in the
form of blue light .
• In the digitizer ,this blue light energy is
converted into electrical signals which are then
digitized to produce digital images.
• After exposure and scanning ,the phosphor
plate is erased by exposing to a bright light and
previous image stored in the phosphors is
removed and plate is ready to be exposed
again.
 IMAGE DISPLAY AND STORAGE SYSTEM
READER

ELECTRONIC SIGNAL

DIGITAL SIGNAL

DISPLAYED ON COMPUTER AND

STORED
DIGITAL RADIOGRAPHY
 ▪ It is a technique in which conventional silver halide film or
imaging plate of CR are replaced by photo electronic
receptor which is connected directly to computer.
▪ COMPONENTS :
I. X ray equipment
II. Detector
III. TFT(Thin Film Transistor)
IV. CCD (Charge couple devices )
V. Computer system
 PRINCIPLE
• X-ray signals can be detected X-RAYS
by using detectors
• X-rays falls on detectors
which convert x-ray signals DETECTOR –DIRECT/INDIRECT
into electronic signals. ELECTRONIC
• These electronic signals falls SIGNALS

on TFT/CCD where they are TFT/CCD

converted into digital DIGITAL SIGNAL
signals.
COMPUTER
 DETECTOR

• Converts X ray signals into electronic signals.

• Types of detector:

1. DDR- Direct Digital Detector

2. IDR- Indirect Digital Detector
 DDR
• Amorphous Selenium-Photoconducting X RAY TUBE
material.
SELENIUM
ELECTRONIC
• Function- SIGNAL
TFT
Directly converts the X RAY signals into
DIGITAL SIGNAL
Electronic signals
COMPUTER
 IDR
X RAY
It consist of- SCINTILLATION
PHOSPHOR CRYSTALS
1) Scintillation crystals 2) Photo diode
LIGHT PHOTONS
1) SCINTILLATION CRYSTALS: Cesium iodide or
SILICON
Gadolinium oxysulphide PHOTODIODE

Function : Converts X ray signals into a Light ELECTRONIC SIGNALS

signals
TFT

DIGITAL SIGNAL
2)PHOTO DIODE : Amorphous Silicon (Light sensitive)

Function: Converts Light signal into Electronic

Signals
COMPUTER
 THIN FILM TRANSISTORS
• It can be used with direct as well as indirect digital detectors.
• It converts electronic signals to digital signals.
• TFT is basically an electronic switch that can be made ON and OFF
-ve voltage applied to gate – OFF
+ve voltage applied to gate - ON
• During the X ray exposure ,-ve voltage to gate – TFT in OFF position –
charge accumulated in each detector element is stored in capacitor
• During the read out process,+ve voltage to gate – charge in each
detector element is read out sequentially
• Finally ,electronic signal is digitalized and stored.
 CHARGED COUPLED DEVICES
• CCD forms images from visible light.
• It is only used with IDR
• CCD is an integrated circuit made up of metal oxide crystalline silicon
capacitor.
• CCD has individual pixel elements ,when visible light falls on each pixel
,electrons are liberated charges from pixels
• Electrons in every pixel are shifted to another pixel and the charge is
generated.
• This produces an elctronic signal.
 COMPUTER SYSTEM
• In the computer system ,the digital image is
manipulated by different means like contrast
enhancement ,brightness control etc.
• From this computer system ,the digital image will go
either printer systems or in the storage system.
MAMMOGRAPHY
• Mammography remains the cornerstone of breast imaging .
• It can offers the necessary reliability to diagnose the curable
forms of breast cancers.

• X rays strike on electrically charged plate of selenium coated

aluminium.
• The loss of charge at sites of X ray interactions leads to latent image
formation which is converted to visible image by reading the charge
pattern.
• This technique gives a very sharp but low contrast image.
 MAMMOGRAPHY
EQUIOMENTS
• Generator
• X ray tube – fine focus of 0.2-0.5 mm
with an additional 0.1 mm focus for
magnification.
• Target – Molybdenum and Rhodium
• Beryllium window –Minimises
absorption of radiation within the tube.
• Molybdenum filter – By transmitting
only characteristic radiation ,absorbs
unwanted radiation and forms a
monoenergetic beam.
• Compression device :1-4 mm thick
plastic plate.
 GENERAL X RAY TUBE MAMMOGRAPHY TUBE

1. Both Bremsstrahlung x ray and 1. Only characteristic x- ray produced.

characteristic x ray produced.
2.High kVp 50-120 is used. 2.Low kVp 20-35 is used.

3.Target/Filter: W/Cu,Al 3. Target /Filter: Mo /Rh

4.Window:Glass 4.Window:Beryllium or very thin

Borosilicate glass.
5.SID: 100-180 cm 5.SID: 60-80 cm

6.Anode angulations :6-20 degree 6.Anode angulation : 6 degree

Tube angle :Nil Tube angle:23-25 degree
 TARGET

• X ray tubes are designed with Tungsten ,

Molybdenum, Rhodium targets.
• Molybdenum target with Mo/Rh filter is more suitable
for mammography.
• Rhodium target with Rh filter gives a similar spectrum
as molybdenum.
• Since the atomic number is higher, the radiation is
also higher than molybdenum.
 FILAMENT (ANODE)
• Positioned within a focussing cup with two focal spot sizes.
• Filament types are either double wound/flat ribbon /circular
filament.
• Focal spot size is very critical in mammography where high
resolution is required.
• Small focal spot is used with small anode angle (mc-0 to 20),which
permit the use of high mA factors.
• Usually the cathode is positioned towards the chest wall.
 FILTERS

• It narrows energy range pass,cut off low energy radiations which

are highly absorbable.
• Thin beryllium window or borosilicate glass window is used to
reduce inherent filtration ,since it offers low attenuation.
• For a tungsten target X ray tube ,Mo or Rh filter is recommended.
• In case of Rhodium target X ray tube ,Rhodium filter of 0.025 mm
is used which gives high quality X rays with higher penetration.
• Combination is suitable for thicker and dense breast imaging.
 GRIDS

• Grids improve the image quality.

• Stationary grids or grids placed in between the screen and the
film are no longer used as the thin grid lines compromised on the
quality of the image.
• Hense oscillating grids are used.
• Grid ratio of 4:1 or 5:1 is used .
• The grid lines are eliminated by the motion of the grid.
 HEEL EFFECT

• Shape of the breast requires higher intensity of radiation near the chest
wall ,to create uniform exposure to the screen-film.
• The cathode is positioned towards the chest wall and the anode is toward
the nipple.
• Permits easy positioning of the patient
• Increases the intensity of radiation near the chest wall,where greater
penetration is needed .
• The anode is often grounded with zero potential and the cathode is given
higher potential .
 COMPRESSION PEDDLE
❑ Decreases the thickness of the breast , thus reduces the
scattered radiation –improves the contrast .

❑ Decreases the kinetic blur .

❑ Reduces geometric unsharpness by homogenously bringing

the object close to the film .

❑ Makes breast thickness uniform in film density.

❑ Differentiates the easily compressible cysts and fibro-

glandular tissue from the more rigid carcinomas.

❑ Separates the super imposed breast lesions .

❑ Reduces radiation dose to the breast tissue .

DIGITAL MAMMOGRAPHY
• Stages in digital mammography:
I. Image captured by digital detector.
II. Conversion of latent image into
digital data.
III. Processing of image data.
IV. Display of processed image .
V. Transmission and archival of data.
 CHARGE COUPLE DEVICE TECHNOLOGY

• Digital detectors consist of a phosphor ,which is optically

coupled to the CCD.

• ADVANTAGE: The slit collimation of the X ray beam

results in a significant reduction in scatter.
• This eliminates the need for a grid ,leading to potential
dose savings.
 CRANIO-CAUDAL VIEW
▪ The casette is placed under the breast at
the level of the inframammary fold .

▪ The breast is then pulled until the

inframammary fold is taut .

▪ Compression is applied and Xray beam is

directed vertically from above .

▪ Postero medial aspect should also be

included .
 MEDIO-LATERAL VIEW
▪ Best view to image all of the breast tissue
and the pectoral muscle .

▪ The C-arm of the mammographic unit is

rotated to 45 degree so that the cassette is
parallel to the pectoral muscle .

▪ The film holder is kept high up in the axillary

fossa and the patient’s arm is abducted at
the elbow by 80degrees.

▪ The xray beam enters the breast from the

medial side –compression is applied to the
pectoralis major muscle .
FLUOROSCOPY
➢The primary function of a fluoroscope is to
perform dynamic studies ;that is the fluoroscope
is used to visualize the motion of internal
structures and fluids.
➢The purpose of this technique is to get real-time
and moving images of the insides of a person by
way of the fluoroscope
Components of Fluoroscope
▪ X- ray generator
▪ X-ray tube
▪ Collimator
▪ Filters
▪ Patient table
▪ Grid
▪ Image intensifier
▪ Optical coupling
▪ Television system
▪ Image recording
 Image Intensifier
➢The image intensifier is a complex electeronic device that receives the
remnant X-ray beam ,converts it into light,and increases the light
intensity.
 Input phosphor:

▪ X- Rays that exit the patient and are incident on the image
intensifier tube are transmitted through the glass envelop and
interact with the input phosphor ,which is cesium iodide.
▪ When X-rays interacts with the input phosphor, its energy is
converted into a burst of visible light photons as occur on the
intensifying screen.
 Photocathode:

• It is bonded directly to the input phosphor with a thin

,transparent ,adhesive layer.
• The photocathode is a thin metal layer ,usually composed of
cesium and antimony compounds , that respond to stimulation
by light with the emission of electron. This process is known as
photoemission.
Output phosphor:
The output phosphor is usually made up of zinc cadmium
sulphide crystals. Each photoelectron that arrives at the
output phosphor results in approximately 50-70 times.

Optical coupling :
It accepts the light from the output phosphor and converts it into
a parallel beam.
Video camera:
The video signal is amplified and is transmitted by cable to
the television monitor ,where it is transformed back into a
visible image.
 ARTIFACTS

Motion artifacts Double Exposure Clothing Artifacts

Image Reader artifacts Grid line artifacts Dust particle artifacts
 ARTIFACTS IN MAMMOGRAPHY

Motion Artifacts Belly Fold Artifacts Hand Artifacts