CHAPTER Luminescent Screens The x-ray photons making up the radi esraphic image cannot be seen by the Int pan cye. This information is converted {mo a visual image by one of two methorly A photographic emulsion can he exposed to the x rays directly. More com nonly, the cnergy of the x rays is converted into ra diation in the visible light spectrum, acd this light may be used to expose x-ray film radiography or photofluorography), or the light may be viewed directly (fluores Copy). The sensitivity of film to direct x-ray exposure is low. Direct exposure of film would require pro! large patient x-ray doses for most examinations. There. fore, almost all radiographic film exami. nations require that the radiographic image be converted into light at some stage by a luminescent screen. FLUORESCENCE Luminescence refers to the emission of light by a substance. It can be caused by varying kinds of stimuli (e.g., light, chem- ical reactions, o ionizing radiation). ‘The term fluorescence is applied to that form of luminescence produced when light is emitted instantaneously (within 10-4 coe of the stimulation). If the emission of light is delayed beyond 10. sec, the term phos- Phorescence is used Fluorescence, as used in radiology, is the ability of crystals of certain inorganic salts (called phosphors) (o emit light when excited by x rays. For many years the crys tals, or phosphors, of importance in rad ology were calcium tungstate (the phos- phor in intensifying screens) and zinc cadmium sulfide (the phosphor in fluores- 118 ic screens). Re~ cent ancl photofluoragraphic scree cent advances in technology ha’ rew in the introduction of a numb eee phosphors, such as cesium fodide in image ntensifer tubes and several new intersi- fying screen phosphors, including s rs the rire strontium sulfate, yttrium, and and the carths gadolinium and lanthanum, rare earth tantalates. INTENSIFYING SCREENS Intensifying screens are used becawe they decrease the x-ray dose to the patient, yet still afford a properly exposed x-ny film, Also, the reduction in exposure allows use of short exposure times, which be- comes important when it is necessary 10 minimize patient motion The x-ray film used with intensifying, screens has photosensitive emulsion on both sides. The film is sandwiched between two intensifying screens in a cassette, «© that the emulsion on each side is expose to the light from its contiguous screen. Re membes, he screen functions to absorb the energy (and information) in the x-ray beam that has penetrated the patient, and to ¢ vert this energy intoa light pattern that has {as nearly as possible) the same information the original x-ray beam. The light, then, forms a latent image on x-ray film. The transfer of information from x-ray beam to screen light to filtm results in some loss of information. In this and subsequent chapters we will discuss some factors in volved in the degradation of information and describe what can be done to keep this toa minimum~-+-@ee LUMINESCENT SCRE ERE 9 Const An intensil 1 has four layers 1 arbase, on support, made of plastie os cardboand a reflecting layer (1iO,) a phosphor layer a plastic protective coat The total thickness ofa typical intensifying screen is about 15 or 16 mils(1 mil = 0,001 in, = 0.0254 min). Base. The screen support, or bast be made of high-grade cardboard or polyester plastic, The base of Du Pont in- tensifying screens isa polyester plastic (My- lar¢) that is 10 mils thick (10 jum). Kodak X-Omatic and Lanex screens have a similar (Estart) base 7 mils thick. Reflecting Goat. The light produced by the interaction of x-ray photons and phos- phor crystals is emitted in all directions. Much of the light is emitted from the screen in the direction of the film. Many light photons, however, are also directed toward the back of the screen (ie., toward the base layer) and would be lost as far as photographic activity is concerned. The re- flecting layer acts to reflect light back to- ward the front of the screen. The reflecting coat is made of a white substance, such as titanium dioxide (£i0,), and is spread over the base in a thin layer, about 1 mil thick Some screens do not have a reflecting layer (e.g., Kodak X-Omitic fine and regular). Phosphor Layer. ‘The phosphor layer containing phosphor crystals, is applied over the reflecting coat or base. ‘The crys- tals are suspended in a plastic (polymer) containing a substance to keep the plastic flexible. We will discuss the phosphor in more detail later. The thickness of the phosphor layer is about 4 mils for par speed screens. The thickness of the phos: phor layer is increased 1 or 2 mils in high- speed screens, and is decreased sli detail screens ‘Mylar is a trademark of k. 1. dus Pont de Nemours and Company, Inc. tEstar is a trademark of Eastman Kodak Cor Protective Layer Che protective layer Applied aver the phosphor is made of a plist omposed of a cellulose ta Hit is ened with other ply. Kangeely nn 8H forms a layer about 0.7 10 0.8 anils thick, ‘This layer serves three functions: it helps to prevent static electricity; it gives physical protection to the delicate. phos- phor layer; and it provides a surface that can be cleaned without damaging the phos- phor layer. ure 9-1 shows cross section of a typ- ical par speed intensifying screen with a plastic base. Unlike the highly mechanized operation of x-ray film production, screens are largely a product of hand labor, Phosphor he original phosphor used in x-ray in tensifying screens was crystalline calcium tungstate (CaWO,). New (since about 1973) screen phosphor technology is being developed w increase screen speed over that available with calcium ungstate, and has resulted in the introduction of a be- wildering variety of screens and corre- sponding films. Let us first consider cal- cium qungstate and then review some of the new phosphors. Natural calcium tungstate (scheelite) is no longer used because synthetic calcium tungstate of better quality is produced by fusing sodium tungstate and calcium chlo- ide under carefully controlled conditions. The first commercial calcium tungstate screens were made in England and Ger- many in 1 it made in the United States in 1912. The calcium tung- state crystal must be absolutely free of any contaminant if itis to fluoresce properly. It wore fi prorecrive UAVEH 07-08) Frassvon Im PaSTIC 1103 REFLECTING LVF It PLASTIC BASE a6 om Figure 9-1 Par speed x-ray intensifying screen (cross section)Luna with 9 wave Hee OF SOO 1s GAO Ay ane O.0001 4. 8.900000 Gn ant Peak wavelengths af about 400 sey him), which is seem by the eye iis a voter colo Although t Sensitive us light of this wavele emul sion exhibits maximum sensitivity to light from calcium tungstate sercens, Figure 9-2 diagrams the spectrum of state Muorescene Heium ting + the response of the eye to light of different wavelengths, sensitivity of x-ray film. Filmy sensitivity is scen to be high throughout most of the range of light emitted by the sercen, a fact that ensures maximum Photographic ef- fect. Note that the film does not exhibit Photosensitivity to red light, so red light can be used in the darkroom without pro- ducing any photographic effect on the filn Intensifying Action of Screens. An in. tensifying screen is used because it c vert_a few absorbed x-ray photons into many light photons, ‘The efficiency with which the phosphor converts x rays to light is termed the intrinsic conversion efficiency of the phosphor; this is more accurately defined as the ratio of the light energy liberated by the crystal to the x ray cnergy absorbed. The intrinsic conversion cHficiency of calcium tungstate is about 5% Hihe energy of the absorbed x-ray photon, the wavelength of the emitted light nd the 1 con. X00 4000 se00 ind 7000 wuima- Skuta whom Meo Figure 9-2 The spectral emission of a calcium snsifying screen compared to ity of x-ray film and of the tungstate x-ray the spectral sen eve SULT SCREENS {the phosphor the conversion efficiency 0! photons ber of light ine know, the Bot Fag Aenerated is easily calculated rest eV) asset 50 keV -zay photo reen state nin cungsta a wavelength Jectron volts lated by is absorbed in a ¢ that emits most of its light at of 4300 A, ‘The energy in el (c¥) of this light photon is € 124 eve 3 1 bluelight The energy of a 4300 A (430 nm) blue photon is about 3 eV. At 100% efficiency, a 50,000 eV x-ray photon would produce about 17,000 light photons of 3 eV energy: 90.000 «$7,000 3 Because the conversion efficiency of cal- cium tungstate is only 5%, the actual num: ber of light photons emitted by this phos- phor is about 850 (17,000 x 0. ‘One reason some new intensifying screen phosphors are faster than calcium tung. state is that the new phosphor has a higher conversion efficiency (up to 20%). The ability of light emitted by the phos- Phor to escape from the screen and expos the film is termed the “screen efficiency. For typical screens about half the gene: ated light reaches the film; the rest is ab sorbed in the sereen and is wasted. In the previous example, only half the 850 light photons generated would be able to escape from the screen and expose the film. To examine the manner in which the screen amplifies the photographic effect of x rays, let us consider the case of a film- screen combination compared to a filn alone, each irradiated by one thousand 50. keV x-ray photons. Of the 1000 photons, aa high-speed calcium tungstate screen will absorb 40% (we will discuss this aspect in more detail later), or 400. Each of the 400 y photons will produce 850 light pho- xuname ser s total of 110,000 fight photons tons, | Hall of these hight photons (170,000) wil eseape the screen and expose the fli Ler usassinone that 100 fight phot needed ty form one latent we cout The screen-film system in our example h caused the formation of 1700 latent image centers, (We will discuss the concept of the latent image in Chapter 10.) At this poi Jet us simply define a latent image center as the end product of the photog fect of light or x rays.on the film tis possible t0 measure the magnitude of the photographic effect of an expostne by counting the number of latent image cen ters formed as.a result of that exposure, [n the case of x rays exposing film directly, only about 5% of the x-ray photons are absorbed by the film, so our example wi cause 50 x-ray photons to react with th film emulsion. 11 is usually considered tha one latent image center is formed for each x-ray photon absorbed by a film em ‘The result of the same 1000 x-ray photons acting directly on film is to produce only 50 latent image centers, versus 1700 latent mage centers resulting from the use of in tensifying screens. In our example, the tio of the photographic effect of sercen ver- Ision sus nonscreen, or direct, exposure is 34:1 If kVp remains constant, direct film ex- posure will require 34 times as many mAs asa film-screen exposure. A review of the example of the intensi- fying effect of screensis presented in Table 9-1. Stated another way, patient exposure is decreased greatly when intensifvine screens are used. A measure of this de- crease in exposure is termed the “intensi- fication factor” of the screen. The inten- Table 9-1 Without intensifying Screens Hse 124 sification fac the weray oxy sity of a sereen is the ratio of needed to praduce the with and yt factor is com sity of 1.0), ‘xpos toquled whon scroons nro not used ‘xposure roquirod with sean intensification factor of CaWO, as will increase with kVp of the x-ray beam (Fig. 9-3). The K-absorption edges of silver and bromine in the film are 26, keV and 15 keV, respectively, while the K- absorption edge of tungsten is 69.5 keV. Photoelectric absorption of low-kVp x rays will be relatively greater in film because of the low-keV. K-absorption edge of silver and bromine. High-kVp x rays will be more abundantly absorbed by the photoelectric process in calcium tungstate screens. For this same reason, a heavily filtered x-ray beam will increase the screen intensifica- 2 factor by removing the low-energy components of the beam. Thus, CaWO, in- tensifying screens are relatively faster in radiography of a thick body part, such as the lumbar spine, than when an extremity is examined. ‘That is, only higher energy x Tays can penetrate the thick part and reach the screen, ‘There will actually be a small number (3 or 4%) of x-ray photons directly absorbed by the film when a screen-film combination is exposed. ‘This direct action of x rays would create so few latent image centers compared to those caused by the fluores: cence of the screen that it may be ignored as having no detectable influence on total film response to the exposure. smonly determined ata fil de Intonsitication factor Comparison of the Photographie Elect of 1000 X-Flay Photons Used With and ‘TENT XRAY PHOTONS RAY PHOTONS uch MAGE ‘ABSORBED SY ABSORBED BY PHOTONS ‘CENTERS ‘SCREEN rum GENERATED FonWeo Intensifying screen 400 340,000 1700 Direct exposure 50 50122 « S 2 S a z 2 5 3 a gS 2 io g z 20-40 60801000 KILOVOLTS PEAK Figure 9-3 Variation of the intensification factor with kVp Speed of Calcium Tungstate Intensify- ing Screens, Several factors determine how “fast” or “slow” a calcium tungstate screen will be. These include thickness of the Phosphor layer, size of the phosphor crys- tals, presence or absence of light-absorb- ing dye in the phosphor layer, and phos. phor conversion efficiency. Of course, the faster screen will allow a lower x-ray ex- posure to the patient, but a price for this speed must be paid. The speed of a cal- cium tungstate screen and its ability to record detail are in reciprocal relation: ship; that is, high speed means less detail This statement is also true for new screen phosphors, but the subject is more complex because higher speed does not always re quire a thicker sereen, These screens are classified as fast, medium (par speed), and slow (detail), with intensification factors in tne range of 100, 50, and 25, respectively. A thicker phosphor layer will result in a faster screen because the thick layer will absorb more x-ray photons than a thin layer. Thick screens will be faster but will cause a decrease in the clarity of the image recorded on the film. This decrease in mage clarity is primarily caused by diffu n of light in the phosphor layer. Ia thick phosphor layer is employed, an x-ray photon may be absorbed in the phosphor at some distance from the film. The fight LUMINESCENT SCREENS: witheaa wa ” Figu 4 Screen unshar| a Berto, eg tm vee ry this absorbed mae photon are emitted in all ee Pee all the light will reach the ar be lye which does will expose an area of (he 0 0" that is much larger than the size of Te calcium tungstate crystal that emit light (Fig. 9-4), In addition, st ee scattering takes place in the screen, 1n¢ further increases of iluminatiy The resultant light diffusion obviously causes images to have less sharp border Consider Figure 9-5. If an x-ray beam is cted onto a film-screen combination that has a thick lead block covering half the film, one would expect half the film tobe exposed and half to be entirely unexposecl. with the line betweén the two areas being very sharp. If the x-ray beam were to ex- photons generated b; x-ray__| BEAM rium-scrcen_ \€*®axoce COMBINATION — FAST SCREEN |__| buaenennc SLOW SCREEN Te sue Figure 9-5 Unsharp image borders produc. by light diffusion in ‘~rensifying area cedLURINESCENT COREENS the tine hon sere anid unexposed areas Hi ale flan as sant pose fila al between exposed would be very shty eicivedd between rarenstfy ing sects, HON ever the border ts fess sharp becanse sone Tighe will diffuse edge of the lead I of film in an are stay expos under the edge of the available to expose the portion of the fil that is not covered by the block. ‘The final result is the production of a more gradual change in density, which is unlike the ideal abrupt transition from black to unexposed (clear) film, (Attempts to measure the mag. nitude of this problem of ght diffusion and scattering will lead us to consideration of the concepts of line spread function and modulation transfer function in Chapter 12) A thin screen causes less light diffusion than a thick one bc. .ause light photons are produced closer to the to decrease light diffusion is to incorpo a substance that absorbs light in the screen. ‘The substance is commonly a yellow d but the question of which color is most ef- fective has not heen resolved. ‘The tight photons that concige from the crystal ir mediately adjacent 10 the film will obviously travel the shoriest distance hefore leavin and cause expostr tually receive Int, which diffused sad block, is: not the phosphor layer Seattered phonons must travel longer distances in the phor phor layer, and thus they have a beter chance of being absorbed by the dye. The ye will decrease the seed of the screen because it decreases the amount of light emitted. Lightabsorbing dyes are included ned to produce greater in screens de detail. Resolvi The Power aximuin number of line paits per millimeter + solved by the screen-film system is called the resolving power. A line pair means a line and a space. For example, two lines (or two line pairs) perma means that there are ovo mn can h min wele, n idle: (A wove detated discussion of resets ing power is presented in Chapter Hy. Xray fil is able to record up te 100 fine pries per mm, but the slowest screens can record only alittle over 10, ‘sri wide Fone making eae Finve po each spy ilm Contact Cassette in which the intensifying screens are mounted provides a light-tight container for the film. It also serves to hold the film in tight contact with the screens over its entire surface. With good film- a dot of light produced in the sereen will be recorded as a comparable dot on the film. If contact is poor, this dot of light will diffuse before it reaches the its radiographic image is un- film, so th sharp, Tiere is a simple method for testing film-screen comact. A piece of wire screen is placed on the cassette, and a radiograph of the wire screen is made. The sharpness of the image of the wire in all regions of the film is compared, and any areas of poor filu-sereen contact become obvious be- ‘cause the image of the wire appears fuzzy. The wire screen should be made of iron, dass, or copper (aluminum and_ plastic screens fail (0 absorb enough x rays), and should have a heavier wire than that used 1n ordinary window screen. It is best:to nowt the test wire screen between two pieces of plastic, composition board, or cardboard, Poor film-screen contact will ‘occur quickly if the cassette is handled roughly, but eventually any cassette will wear out with routine use. Cleaning Intensifying screens must be kept clean. Any foveign material on the screen, such paper or blood, will block light photons 1d produce an area of underexposure on the film corresponding to the size and shape of the soiled area. Cleaning will elim- inate the “high spots” on a screen; these high points are the major source of exces-124 sive wear. “The cause af screen failure ig mechanical attrition, Under normal con didions of use, xray photons will not dan KE screens. Screens are best ch # solution containing tistatic com Pound anda detergent; the solution should be applied gently (never ruby vigorouey) with a soft lint-free cloth, ‘The cassette shoult never be closed after cleaning tn itis absolutely dry: “with NEW PHOSPHOR TECHNOLOGY ICs usually agreed that the maximum Useful speed of calcium tungstate screens has been achieved. New screen phosphors have permitted greater speed, but this changing technology is complex and per- plexing Increasing Screen Speed We must first consider how intensifying screen speed can be increased. There are three possible ways. The phosphor layer n be made thicker to absorly more of the X-ray beam. The phosphor may have a higher conversion efficiency of x rays to light. ‘The phosphor may be able to absorb the x-ray beam more effectively. To review, there are three possible ways to increase screen speed: 1. thicker phosphor layer 2. higher conversion efficiency phos- phor 3. higher absorption phosphor Hefore entering this long discussion of new phosphor technology, please review Table 9-2, which catalogs the noncalcium tung- state screens available from Du Pont and Kodak, listing phosphor composition and color of light emitted by the phosphor. Thicker Phosphor Layer. Thick phos- phor layers absorb more of the x-ray beam than thin layers. This is the major way in which the speed of calcium tungstate screens is increased. A pair of Du Pont Par Speed CaWO, screens absorbs about 20% of the x-ray beam. A pair of Du Pont Hi Plus screens absorbs about 40% of the x-ray UOMINESCENT screens as par spec) hick as fa is twice a ; not twice as tl we about 2 san 1s, Why is this? Hf 0 pair of par screcysy emitted through Asecond ct h of the 80° rb 20% 97 he Phe Hi Plus ser as pat sereens: they 2 thick asthe sctay photons struck a 80 photons would be 7 the sereens (20 are absorbed). of par screens placed in fie pal transmitted photons would ab: 16 photons, allowing, 64 10 pass throug Thus, a double thickness of par spec screens absorbs 36% rather than 40% 91 the x-ray beam. It is possible to contin fa ase ed of CaWO, scree to increase the speed of C a thidk increasing screen thickness, but un: ness cause! by light diffusion in the thie phosphor layer becomes unacceptable. calcium tungstate screens a compromiseis made between speed and sharpness. Conversion Efficiency. In 1972, repor's describing rare earth oxysulfide phospho. for use in intensifying screens were pul- lished.1° This work was supported by a com tract from the Atomic Energy to the Lockheed Corporation, and this clas. of phosphors is sometimes referred to 3 the Lockheed rare earth phosphors. Rare earth | 1g screens have been com ‘mercially available since about 1973. Chemists divide the periodic table of the elements into four Lusi groups: alkaline earths, rare earths, transition elements, and nonmetals. The term “rare earth” de veloped because these clements are diffi cult and expensive to separate from the earth and each other, not because the el ements are scarce, ‘The rare earth group consists of elements of atomic numbers 57 (lanthanum) through 71 (lutetium), and in cludes thulium (atomic number 69), ter bium (atomic number 65), gadolinium (atomic number 64), and europium (atornic number 63). Because lanthanum is the firs, element, the rare earth group is also known as the lanthanide series. Lanthanum (La) and gadolinium (Gd) are used in the rare earth phosphors. A related phosphor, yt. trinm (¥), with atomic number 39, is not 4LUMINESCENT screens faq ave wear. The cause of sreen f mechanical attrition, Under wey i ditions of use. reek OF use, x-ray photons will not ans senaeens: Sticens are best cleaned with a solu i Pound and a detergey tistatic: con ‘nt; the solution sho be applied gently (ever rub vignrouay Wil a soft lint-free cloth. ‘The camer, should never be closed atier elem ng until itis absolutely dry. NEW PHOSPHOR TECHNOLOGY 11 is usually agreed that the maximum hscful speed of calcium tungstate screens has been achieved. New screen Phosphors have permitted greater speed. bur the changing technology is complex and per- plexing. Increasing Screen Speed We must first consider how intensifying screen speed can be increased, There are three possible ways. The phosphor layer can be made thicker to absorb more of the x-ray beam. The phosphor may have a higher conversion efficiency of x rays to light. The phosphor may be able to absorb the x-ray beam more effectively. To review, there are three possible ways to increase sereen speed: 1. thicker phosphor layer 2. higher conversion efficiency phos- phor 3. higher absorption phosphor Nefore entering this long discussion of new Phosphor technology, please review Table 9-2, which catalogs the noncalcium tung- state screens available from Du Pont and Kodak, listing phosphor composition and color of light emitted by the phosphor. Thicker Phosphor Layer. Thick phos- phor layers absorb more of the x-ray beam than thin layers. This is the major way i which the speed of calcium tungstate screens is increased. A pair of Du Pont Par Speed CaWO, screens absorbs about 20% of the x-ray beam. A pair of Du Pont Hi Plus screens absorbs about 40% of the x-ray tas par speel). oo ave as ick sloount 28 timeesit 8 Iheaun (ane is twine as fo : The Hi Plus sereens are not twee fas pat serrens: they re oth tht he par sereens. Why is this? HF DO Jf par serecas, Xray phos ruck 2p of par ser 40 photons would be transmitted through the screens (20 are absorbed). A second Of par sereens placed in the path of ie ° transmitted photons would absorb 20% 9) 16 photons, allowing 64 to pass eee Thus, a double thickness of par sperc screens absorbs 36% rather than 40% of the x-ray beam. It is possible to continie to increase the speed of CaWO, screens by increasing screen thickness, but unsharp- ness caused by light diffusion in the thik Phosphor layer becomes unacceptable. In calcium tungstate screens a compromiseis made between speed and sharpness. Conversion Efficiency. In 1972, repors describing rare earth oxysulfide phospho: for use in intensifying screens were pul- lished. This work was supported by a con- tract from the Atomic Energy Commission tothe Lockheed Corporation, and this clas, of phosphors is sometimes referred to 3 the Lockheed rare earth phosphors. Rare earth imensifying screens have been com mercially available since about 1973 Chemists divide the periodic table of the ¢lements into four Lasic groups: alkaline earths, rare earths, transition elements and nonmetals, The term “rare earth” de veloped because these elements are diff cult and expensive to separate from the earth and each other, not because the eb ements are scarce. The rare earth group consists of elements of atomic numbers 57 (lanthanum) through 71 (lutetium), and in: cludes thulium (atomic number 69), ter- bium (atomic number 65), gadolinium (atomic number 64), and europium (atomic number 63). Because lanthanum is the first clement, the rare earth group is also known as the lanthanide series. Lanthanum (La) and gadolinium (Gd) are used in the rare earth phosphors. A related phosphor, yt. m (¥), with atomic number 39, is not 4LUMINESCE Table 9-2. MF SCREENS 125 Now Catenm Lungs tate Intenslyng Sereons Manufactured ty {4 Pont and Kodak Du Pont jones Quanta I Lanthanum oxybromid thalium act Bic oe ‘ vated (LaOBr Ten) Quonta Detail Vivi fantalate thulwmn activated Utrawototbton (¥1,0,.1m) Quanta Fast Detail Ytrium tantalate:niobium activated ——Uilravilet blue (YTaO,Nb) Cronex Quanta V- Lanthanum oxybromide:thutium act- Bus vated plus gadolinium oxysul- and fido:torbium activated (LaOBr:Tm grean plus Gd,0,S:Tb) Kodak X-Omatic Fine Barium load Sulfate, yellow dyo Blue (BaPbSO,) X-Omatic Regular Barium strontium sultate:europium Blue activated, neutral dye (BaSrSO.Eu) Lanex Fine Gadolinium oxysulfide:terbium acti- Green vated, neutral dye (Gd,0,S:Tb) Lanex Medium Gadolinium oxysulfide:terbium acti- Green vated, yellow dye (Gd,0,S:Tb) Lanex Regular Gadolinium oxysulide:terbium acti- Green rare earth but has some properties situa: to those of the rare earths. The rare earth phosphors are produced as crystalline powders of terbium-activated gadolinium oxysulfide (Gd,0,8:Tb) and thulium-activated lanthanum oxybro- mide (LaQBr:Th), Unlike CaWO,, the rare th phosphors do not fluoresce properly in the pure state For example, maximum Mluorescence of Gd,0,8 occurs when about 01.89 of the gadolinium atoms are replaced by terbium. ‘The x ray to light conversion efficiency of rare earth phosphor: ntly greater than that of CaWO,. It is generally 119 state that the x ray to light con- version efficiency of CaWO, is about 5%, ‘as that of the rare earth phosphors bout 20%, Stated another way, one ab- sorbed x-ray photon in a CaWO, intensi- fying sereen will produce about 1000 light photons, and the same photon absorbed in ‘nwill produce about 4000 cersion efficiency of strane earth ser light photons. The eo yttrium oxysullide screens is about the same as that of gadolinium, In the litera- ture, actual conversion efficiency figures __vated (Gd,0,S:Tb) quoted are CaWO, 5%, LaOBr:Th 18%, Gd,0,8:Tb 18%,-and Y,0;5:Tb 18%. A fairly new addition to the family of Tare earth screens are the rare earth tan- talates, designated by the generic formula LnTaO, where Ln is any of the lanthanide series. Tantalate phosphors can be made with most of the lanthanides, but the com- mercial screens that have been made use im tantalate (YTaO,). ‘able 9-2 lists two tantalate screens of Du Pont manufacture. In the YTaQ,:Tm (Quanta Detail) some of the ¥ ions have been replaced by Tm ions. In the YTaO¢Nb (Quanta Fast Detail) some of the TaO, ions have been replaced by NbO, ions. The brightest phosphor involves Nb substitution (YTaO,:Nb), which has an ¢s- timated x ray to light conversion efficiency of 11%. Higher Absorption. The fraction of the x-ray beam absorbed by a pair of par speed CaWO, screens is about 20%, high-speed CaWO, screens about 40%, and rare earth screens about. 60%. The increased absorp- tion in the faster CaWO, screens occurs because a thicker screen is used; the in- creased absorption in rare earth screens is126 LUMINESCENT HC Ries, absorption, UL by the photocte in the high atomic mamiber ele ments of the phosphor As discussed in Chapter 4, a photoelectric reaction is most likely to occur in clements with high atomic numbers, and when the x-ray photo ergy and the binding energy of the K-shell electron h a higher atomic ber would have higher absorption. Because the atomic numbers of tungsten (74) and lead (82) at » almost at the end of the pe- riodic table, the potential for this type of improvement is limited. It is interesting to note that the improvement in the input Phosphor of image intensifier tube: volved a change from zine sulfide (atomic numbers 30 and 16) to cesium iodide (atomic numbers 55 and 53). Actually, each of the phosphors used in the new fast i tensifying screens has an atomic number lower than that of tungsten Table 9-3 lists some of the elements found in intensifying screens, together with their atomic number. (2) and K-shell binding energy. Figure 9-6 diagrams the approximate x- ray absorption curve of a calcium tungstate screen, Notice that the screen is less ab- sorbing as radiation energy increases until the 70 keV K edge of tungsten is reached In Figure 9-7 the approximate absorp- tion curve of Gd,O,5:Tb is added to the CaWO, curve. Up to 50 keV, both phos- phors absorb about the same. But, a the 50.2-keV K edge of Gd, the rare earth screen develops a four- or five-fold advan- Table 9-3. Atomic Number and K-Shell Binding Energy of Some Screen Phosphors_ eg Tow BRON ELEMENT NUMBER (2) _ ENERGY tov) Yttrium (Y) 39 17.05 Barium (Ba) 56 37.4 Lanthanum (La) 57 38.9 Gadolinium (Gd) 64 50.2 Tungsten (W; wolfram) _74 69.5 ener i & aio, gL a 50, 8 enn ener ate x-ray absor} Figure 9-6 Approximate x-ray absorption 23 3 function of xray ploton energy ia cal tungstate intensifying screen tage over CaWO,, which persists until the 70-keV K cdge of W is reached. It is ap- which has a lower atomic parent that Gd, i number than W, enjoys an absorption ad- vantage over W in the x-ray energy range of 50 ta 72 keV because of the differences in photoelectric absorption related to the K-shell electron binding energies of these two elements. In diagnostic radiology. however, a large percentage of x rays in the beam will have au energy less than ‘:209¢ Gatotaiam 64058 oih0p 1 Tungsten RELATIVE SCREEN PHOSPHOR ABSORPTIC' eee ee es s0 nay Enency Figure 9-7 Comparison of the approximate xray absorption a8 function of scray phous energy in CaWO, and Gd,0,$LUMINESCENT SCREENS advantage of gatotiniven ny lanthanum is added fe cath screens ynex Quanta V). at WM keV, ef “between 30 king the ws. This 8 W jogphor vf some t Pont ( sim, with its K ed Joses the window’ bev much tothe ph {ouch Lanthi fectively and 50 keV. In Figure sorption cut ‘9-8 the approximate x-ray ab es of LaOBr, € 10,5, al CANO, are compared. By combining the two rare earth phosphors, the rare earth crreen has a significant absorption advan- tage over CaWO, in the 39 to 70-keV range. Figure 9-9 shows the approximate sorption of yttrium oxysulfide (¥,0,8:1 is the phosphor in the GAF Rarex B Mid- speed screens) compared to that of CaWO,, Notice that CaWO, and Y,0,$ match from 17 to 70 keV. Although these two phos- phors absorb about the same x-ray energy, the Y,0,5 screen produces more light pho- tons because of its higher x ray to conversion efficiency (18 versus 5%). Let us summarize this section. The K edges of Ba, La, and Gd correspond closely to the maximum intensity of x rays in the primary beam, causing much of the energy in the primary beam to decrease in the re- edge Gadolinium ot 64,0,8 edge Tungston SCREEN PHOSPHOR ABSORPTION 5 XRAY ENERGY bev Figure 9-8 Comparison of the approximate xray abeorption carves of CaO, LaO%ir and 3,055 127 Woadge Wire Wedge Tongaten | RELATIVE SCREEN PHOSPHOR ABSORPTION 25 30 75 X-RAY ENERGY kev Figure 9-9 Comparison of the approximate x-ray absorption curves of CaWO, and Y,0,S gion of increased absorption for these phosphors. This is the principal reason that these phosphors have higher absorption of x rays used in diagnostic radiology as com- pared with CaWO,, even though the atomic number of tungsten (74) is higher than that of barium (56), lanthanum (57), or gadolinium (64). The absorption for yt- trium (39) is the same as that of tungsten from 17 to 70 keV, but yttrium is “faster” because of a higher conversion efficiency. Emission Spectrum This section will deal with the wave- length (color) of light emitted by the vari- ous phosphors, an important consideration because the light output of the screen and the maximum sensitivity of the film used must be matched. The spectrum of light emitted by some of the new screen phosphors is quite dif- ferent from that of CaWO,, which pro- duces a continuous spectrum of light in the blue region with a peak wavelength of about 4300 A (430 nm) shown in Figure 9-2. Some phosphors other than calcium tungstate also produce light in the blue- violet range. Table 9-4 lists some of these phosphors. Natural silver halide films areLUMINESCENT SCREENS Several Scroon Phosphors SPL CHA East0H ran aurea pone ETORaet es cronex family Tungsten 490 ‘bu Pont Cronex Barium lead suitate ta Kodak x-Omatic Fine Du Pont Hi Spoed ular Barium strontium sullate 360 Kodak x-Omatic Regt Yitrium tantalate:niobium Maximally sensitive to light of this wave- length. Figure 9-10 shows in graphic form the approximate spectral emission of the Screen phosphors listed in Table 9-5, com. Pared to the sensitivity of natural silver hal, ide film (such as Du Pont Gronex filine and Kodak X-Omatic films). Keep in mind 1 the speed of these screens covers a wide range, We must now consider the light emission of the rare earth phosphor Gd,0,$:Tb The spectral emission of this earth phos. Phor is produced by the terbium ion. ‘The terbium emission is not a continuous spec- trum (as is CaWO,) but is concentrated in harrow lines with a very strong peak at 544 nim, which is in the green light part of the spectrum. There are less intense emission SILVER HALIDE FILM \ - BARIUM LEAD,“ SULFATE / RELATIVE SCREEN EMISSION RELATIVE FILM SENSITIVITY VIOLET ‘> 300 350 400 aa ULTRA- BLUE Du Pont Quanta Fast Detail__ and peaks in the blue, blue-green, ieee gee redl areas. Because standard *-ray S10 halide film will not absorb (Le. is pot se sitive to) light in the green area, a SPC film must be used with these screens. Sach films are Kodak Ortho Gand Du Pont oe nex 8. (This subject will be explored a tore detail in Chapter 11.) Figure 91 is a graph of the spectral emission of the KO- dak Lanex regular screen (which cont Gd,0,5:Tb in its phosphor) and the a sitivity of Kodak Ortho G film. Because the sensitivity of natural silver halidefilm stops at about 500 nm, use of this film ae rth screens would result in loss of mnuch of the speed of these screens because the film would be insensitive to much of the light produced. 7 ~~ BARIUM STRONTIUM SULFATE WAVELENGTH in nm Figure 9-10 Approximate spectral emission of several different intensify screen phosphors compared to the natural sensitivity of silver halideLUMINESCENT SCRE NG Yotious tntensifying Scronn Table 9-8, Spon Loss oF srr ee ioe heen tase ne » Pont Crono Rar Speed Caw, Bw Cromox 4 Beton Gann HI Ph CaWo, Die Gronox 4 Gronox Quanta LnO0 tm Bio Crono 4 Gronox Quanta V Laon tin Bue Crono A nl 4,0,5.10 Groen Gronox 400 Quanta Detail YInO,Tm ——UllviolaCronox A100 luo Quanta Fast Dotall YTaO,Nb ——UltraviolnGronox 4400 luo Kodak X-Omatie Fine taPvSO,, Blue xnp a2 ypollow ayo X-Omatic Rogular DAS'SO,Eu, Bun xn 200 nnoutral dyo Lanox Fine Gd,0,5:1b, Groon Ortho G10 noutral dyo Lanex Medium Gd,0,S:Tb, Groon Ortho G 250 yollow dyo Lanox Regular Gd,0,S:Tb Groon_ Cio 400 Note: Dupont Cronex 4 is now largely replaced by Cronex 7 and Cronox 10, and Kodak Ortho G film vy the purpose of this table. The spectral emission of yttrium oxy: sulfide screens is similar to that of the rare carth screens in that it shows line emission, but a large fraction of the emission from a Y,0;8:Tb screen falls within the sen range of natural silver halide films. ‘The principal emission of the terbium at 544 op8K ORTHO-G FL cs ee LL 300 400 500, 600, vita aut chen vELow waver WAVELENGTH an nm Figure 9-11 Approximate spectral of the Kodak Lanex Regular screen (rare ¢: compared to the sensitivity of Kodak Ortho G film. (This is similar to charts supplied through the courtesy of the Eastman Kodak Company) fat G. The older fils stil accurately roflect rolativo intonsitying scroon spoads which is im, though, is still present. Yuriam oxy- sulfide screens may be used with natural rer halide films, but will exhibit even more speed when used with green-sensitive films. “The Du Pont Gronex Quanta V, con two phosphors, terbium-activated gadolin- ium oxysulfiae (Gd,0,5:1b) and thulium- activated — lanthanun — oxybromide (LaO Br: Tm), It is interesting to note that the color of light emitted by a rare earth phosphor depends on the activator used; terbium (Tb) produces green light and thu- lium (Tm) blue, For example, Gd,0,8:Tb is a green-emitting intensifying screen phosphor, and LaOBr:Tm is a blue-emit- ting intensifying screen phosphor. The spectral emission of LaQBr:T'm is illus- trated in Figure 9-12. The Du Pont Quanta V intensifying screen is in that it contains both a blue (La) and a green (Gd,0,5:Tb) emitting phos- phor. This “double” spectral emission al- lows a wider choice of suitable films, be- cause both blue- and green-sensitive films130 are matched te the spe screens, An example ot stave eth sereen with Ui bkeemiting phosption s the Du Pont Tey uaMe HHL which has bacttect q wants Phosphor (see Fig. 9-12), Re cnt ad- Sances in separating rare ea suitably pure supplies of la able for use in intensit ing screens, he yttrium tantalate sereene cri light in the ultraviolet and blue wavele ths. Yee rium tantalate (TAO) hy broadband emission with | p fm. Activation with thulium (Y adds Tm) nother peak at 463 nm. Activation ium (YTaO:Nb) produces broadband emission with ite peak at 410 ie tee’ mission spectrum of VTaO,.NL is illustrated in Figure 9-10, Table 9-5 is an attempt to compare Teughly the relative speed (speed clas) of the newer screens we have bk adiscuussry (The term “speed class” will be discuss in more detailin Chapter 11.) ltiscomman (© express the speed of an intensifying Screen relative to that of a par speed cal cium tungstate screen (specifically, the Du Pont Cronex. P ir red sercen). In our speed class scheme the speed of the pi Speed CaWO, screen is assigned a valu 3 0m a 3 y nd —__ ne 300, 300 600 uctna: Bue omen YEctow woe HAVELENGIH fom) Figure 9-12 Approximate spectral em sion of LAB: (b. a courtesy of E.I. du Pont de Nemours & Comp ches y than reer mist be nd per thar a fal tral enuisaion of the scree ne Fable 45 Du Pont Cron Bgl Kuniak Sith ate his sensitive ieee Green-light-sensitive films are io G odak On by Du Pont Cromex # and Kerlak O Seed films. When co ng the F fhe sms of ying sercens, the ns that were used must be specified. (In Crap se films will ter 11 the characteristics of th be presented in more deta ter 14 we will examine potent associated with very fast screens.) Response to Kilovoltage In the past we compared the speeds 2 other screens to that of CaWO, as ifthe CaWO, screen had a constant responst to Kilovoltage. The response of cuore kVp is not flat, but drops down at low P This is illustrated in Figure 9-13, which shows the kVp response of CaWO,, LaOBr.'m, and a combined Gd,0.S:0b and LaOBr:Tm phosphor. Figure 9-13 shows that the speed of the rare eaith screens varies much more with kVp than 8 Ge Lo0Br: Tm /Cronex 7 ge (Quanto HI) BE wh A oe Fag S280 foreman as pis (2004: tm/ 3 nia) BB 12 (@vontay, . a3 ss § t 35 CoWO4/Cronex 4 (Hi Ptes} 6 8 100 120 140 kvp 9-13 Response to kVp of a Du Pont CVO, (it Pan LaObesten (Quanta 11D), and dual phosphor Gd,0,5:Tb plus LaQBr:I'm (Quanta V) screen, (Data courtesy of EL. da Pont de Nemours & Company, Inc.)LUMINES OT SC does the CaWO, screen, Note that the atte earth screns show maximum speed at vivout 80 kVp. with Fess spect at ott Loe nd high kilovoltages. The need for ex chnique axfjustment because ol screen speed variation with kVp isnot great, and is usually of litle importance unless kilovoltage lower than 70 kVp is used. It is generally advisable to establish constant kVp (with variable mAs) expose technique charts when using noncalcinm tungstate screens. Figure 9-13 introduces two areas we will not explain until Chapter 11. Film-screen speed is often expressed as the reciprocal of the exposure in milliroentgens required to produce a net film density of 1.0. ‘This explains the numbers used to express film- screen speed. The speed of a film-screen system depends on the speed of the screen and on the speed of the film. The films used to determine the curves in Figure 9-13 werea medium-speed and half-speed blue-sensitive fll (Csunes 4 and Cr 7) and a medium-speed green-sensitive film (Cronex 8). We will repeat Figure 9-13 in Chapter 11; don’t worry if these areas are not entirely clear now. posure te¢ Phototimers Some phototimers being used today will work well with rare earth screens. Many of these phototimers have a response time of about 30 milliseconds (i.e. it takes 30 milliseconds for the phototimer to measure the radiation and terminate the exposure) With fast screens a response time of 3 mi liseconds is recommended.’ In addition, the phototimer must be able to recognize differences in screen speed caused by var- tion in kVp. If a photomultiplier-type phototimer is used, the phosphor in the fluorescent screen used to convert x rays to light should be matched to the phosphor in the intensifying screen. The photomul- tiplier tube selected should be sensitive to the light output of the phosphor. loniza- tion chamber-type phototimers can be made to work satisfa-*orily, Use of photo- ne ENS vequite special cansidl ould plan for appropuate thanye Quantum Motte Quantum motte, commonly called ¢." results from statistical fuctua- tion in the number of x-ray photons ab- sorbed by the intensifying screens to form the light image recorded on film, With the fast screens and films now available, itis possible to use a film-sereen system so fast (ie, the screen does not have to absorb any x rays) that noise makes the resulting tory. (This subject will be reviewed in painful detail in Chapter 14), Atthis time, we only wish woemphasize that any discussion of ast screens demands careful evaluation of system noise, One paysa price for speed. PHOTOSTIMULABLE PHOSPHOR centional radiography uses an x intensifying screen, x-ray film, or both as the image receptor. The exposed film is then developed and viewed. Now, a process sometimes called computed radiography (CR) uses a photostimulable phosphor as the image receptor. A phosphor that is cur- rently used is composed of europium tivated barium fluorohalide. The phosphor crystals are coated on a screen that looks like an intensifying screen. The phosphor coated screen is contained in a cassette sim- ilar to standard film-screen cassettes. A ra- diographic exposure is made using con: ventional x-ray equipment, but here the similarity to conventional radiography ends. The photostimulable phosphor ab- sorbs some of the energy in the x-ray beam and stores a portion of this energy as va- lence electrons stored in high energy traps to create a latent image. When this latent image is scanned by a laser beam, the trapped electrons return to the valence band with the emission of light. This light is viewed by a photomultiplier tube, and the output of the photomultiplier tube con- ay432 The si processed and coved, sutnites the signal nal is fed ta where anit may be displayed in This filmless,” or formats. mology 1s somet called puted” radiography Luminescence Luminescence describes the process of emission of light (optical radiation) trom a material caused by some process other than, heating to incandescence, Luminescent materials can absorb energy, store a frace tion of it, and convert the energy into light, which is emitied. There are two forms of luminescence that are determined by the time it takes for light to be emitted after an exciting event takes place. In fluorescence, light is emitted within 10+ sec of the stimulation, ‘This or- curs when an electron is excited from one ergy Teves, and then returns to that en- ergy level without anything additional hap pening to i Phosphorescence is the emission of light that is delayed beyond 10+ sec. This delay requires some additional interaction of the electron: normally this is described as a trapping of the electron in some localized energy state, Intensifying screens are made from fluorescent: material that emits its light immediately after stimulation. This is just fine, because film is there to capture the light. However, if we would like the screen to retain the x-ray image, we would use a phosphorescent material, In radio ogy, there are two such applications, One is thermoluminescent dosimetry (TLV), 1 which the phosphor is encouraged to emit its light by heating. A thermoluscent do- simeter is a small chip of activated lithium fluoride that is exposed to radiation. The chip is then heated, and emits light in pro: portion to the amount of radiation it re- ceived (the term “thermoluminescence’ dicates heating to liberate luminescence). The second application of phosphores- cence is our current topic of photostimu- lable phosphors as used in computed ra- LUMMESer sy ScRE PN! ats the sie suggests choyraphy (photes! as ye ng Be eee of ight phe ny soup Hive matensal ailable photo activated com nosphor is idle bromide n activalor teed one anulable pl jum fuori (uF lie-Fu). Europiain uilded to Bak De, (In the diset conductors, added mater “impurity atoms," but they P same function as activators.) The reason for using an activa i ° make traps at the activator site in WE 0) talline structure, Other types are Procure ‘1 atoms are missing from their nor ‘e structure. These traps activator lly exist ssion of sent lied position in the la ane localized energy levels at aes or vacancy site that do not nor inthe cryataline structure. If by chance an electron is captured in the trap, it behaves very much like an electron trapped (bound) in an atom, We remember that (0 remove an electron bound to an atom, We must supply it with the ionization energy of that particular atom. In doing so, we produce a positive ion (which is the atom without an electron) and an electron that is free to move away from the atom. The same is true for an electron that is trapped sn activator or vacancy site. If we want to free the electron from the trap, we must supply it with sufficient energy to free itself from the uapping mechanism. If we sup- ply the energy, the electron is free to move through the crystalline structure, and it Jeaves behind an empty trap (that looks like a positive ion) ready to capture another electron. A photostimulable phosphor is a material that has: activator and vacancy taps from which electrons may be re- moved by absorbing energy from light photons. Without looking further into the physics of trapping mechanisms, we will describe how a photostimulable phosphor plate is used in clinical radiography, Let usacknowledge that we have not pre- sented a complete and totally accurate pic. ture of the physics of BaFBr:Eu. We would like to quote Hartwig Blume from the Phil-LUMINESCENT Ape PUR Testntaal Rese, tose Noo p Soto give we anore accuntate pictte of the trapping of elev tions and holes in the phe otra eno de tostmuable mage plates, We sire to get nto the physics of sth things as hole taps and vacancy taps Let me fist describe a bit of the physi the stinmulable phosphor stay detector The majority of vray photons which interact with: the phosphor material mteract via the pho. toctevttic eltext and create a high-energetic photoctection, The photoelectron in turn, through a cascade process, generates a lange per of low energetic holes (A bole isa missing elec he crystalline structure of the phosphor) In an ordinary mensifving screen, the electrons and holes recombine with eaci other and create “spon: tancous” huminescence which exposes the x- ray film, In our stinmulable phosphor, about half of the electron-hole-pairs recombine at euro- pium centers during the x-ray exposure and. Create spontaneous, purple oF m ‘let huminescence characteristic for euro: m in BaFRr. The spontancous lumine uk. 1 1 half of the electrons and holes are trapped separately, holes at divalent electrons at halogen vacancie ine lattice of the phosphor. The local concentration of trapped holes and electrons is proportion: to the local wray exposure and represents the latent image of the x-rayed abject By stimulation with red light, electrons ean, be liberated may migrate to with them to opium cence, To enhance the efficiency of the ht, the phosphor ser prepared with a very high, uniform and st Ue concentration of tapped electrons at hile ogen vac Obviously, b with (red) light, che latent image is destroyed. Photostimulable Phosphor Imaging Let us now look at the process of pho- tostimulable phosphor (or computed ra- diographic) imaging by steps as follows: The phosphor prior to exposure Formation of the latent image Detecting the image To prepare a BaFBr:Eu plate for imag- ing the plate is loosed with light from CALENS, Iagh mtensity sodas disc This erases pny expose The plate is now exposed ter standard radiographic equipme the ge Lamps, ining fre ys. tsi During posure, electrons in the phosphor awe excited inte a higher energy. state About half of these electrons return to the hormal energy state instantly and are no longer available for image formation. The test of the excited electrons are trapped and form the latent image. 1 seems self evident that the number of trapped elec- trons per increment of area is directly pro- portional to the amount of x rays absorbed (otherwise, this would not be an imaging method). ‘The trapped electrons may be thermally removed from the trap on a sta- tistical basis, ‘The thermal agitation of elec- trons out of the traps will degrade the la- tent image. In BaF Br:Eu, the image will be readable for up to about 8 hours at room temperature. We should note that the image should be retrieved as san as sible to prevent degradation duc to thermal agitation, The image is retrieved by putting the imaging plate in a reader. The reader ‘made so that the plate is scanned by a small dot (about 100 microns) of light from a helium-neon taser: (633-mm wavelength). The trapped electrons exposed to thi small dot of laser light will absorb the laser light energy. This addition of energy free the electrons from their traps, and they will become free to return to the lower energy state associated! with the crystalline structure. Note that the crystalline state of the lattice structure has lower energy level than the electron trap. When the electrons return to this lower energy level they will emit a light photon. Since the energy level of the normal crystalline structure is lower than the activator energy level, the light photon emitted on return to the lower en- ergy level will have more energy (shorter wavelength) than the energy of the laser light used to excite them out of their traps. That is to say, the stimulated emission hashaa Hunan lengih that is shorter than the es cating laser beam, In BaFBa:ban, this wave Fongth isa narrow band an the $00 nny fal Farstolet) to 500 ua (greenish) range That the avo fights (the laser and simulated emission) have different wave Tengths is critical for image retrieval, Alter all, we have an intense red laser light andl shat feeble greenish light in the same vicinity, and we would like to detect the greenish light as the image signal, One way to do this is to use a filter that will absorb the red light but be transparent to the greenish light. Uf, after the filter, we use an optical fiber, we can conduct the signal light to a photomultiplier tube at a remote position so that the photomultiplier tube and the laser light do not interact. In reality, we would expect to have a long fil ter and a fiber bundle so that we would scan the laser across the image plate to pro- duce a scan line. ‘The entire plate can be read, a scan at a time, by moving the image plate perpendicular to the scan line of the laser beam. In the output of the photomultiplier tube, we have a continuous point-by-point sean of the image. ‘The output is tical analog signal corresponding to ab- sorbed x rays in the nnage plate, This signal must be amplified, converted t a digital signal, and stored in a computer, Fron here on, the imaging is just like any other imaging method whose information 1s sored in a computer before being read by a radiologist a son Dynamic Range of Ph-*ostirs:!zble Phosphors When we study x-ray film in C! we will find that high-contrast x can record exposure differences of about 10021 (08:1). ‘That is, the exposure that causes the tilm to be developed as very black is about 100 times greater than the exposure that cazases such a faint gray that it can barely be detected by the eye, It has been found that the exposure range that a photostimulable phosphor can record is apter II, ray flim CE ENS, stort 10,000:1 F061), Phstostinnalable phosphors are said to have very dition, the dynanie range 1s | : means that the amount of photostimulable luminescence created by an exposure in ses, or decreases, in direct proportion 10 the amount of x-ray exposure the phos- ph ives. The actual exposure range over which this finear response is seen cO¥- ery it range of about § microroentgens (5 % 10 mR) to about 50 milliroentgens (5 % 10" ink), yielding an exposure range of about 101, Figure 9-14 is a rough graphic representation of this concept. No- tice that as the exposure increases from 5 x 10" mR to 50 mR (horizontal axis of Fig. 9-14), thetintensity of the resulting photostimulable luminescence increases in ‘linear fashion from a relative value of 1 toa value of 10. Atthis time you may want to take a glance ahead to Figure (1-5 and notice that film has a more narrow dynamic range, and-a-non-linear response to €x- posture at both the low and high ends of the exposure range. This concept of dy- namic range (we will often call this “ex- posure latitude") will be re-examined in swuch more detail in Chapter 1 What is the advantage of a system with » large, linear dynamic range? The most practical advantage deals with the technol- ITY OF PROTOSTIMULABLE LUMINESCENCE Ss 6 3S 0? 107 102 10°? 109 49! 492 EXPOSURE IN MR Figure 9-14. ‘The dynamic range of a photo- stimulable phosphor imaging plateFunan cr egis’s phic ex (Vy and Ned for The witer tine range ef expostre wall accept, the of AV pand mAs Ube imaging, syst Iatinide there isin chor Armajor problem in radiology departments reaults from the need for repeat exami nations because of incorrect exposures. A wide latitude system will decrease the need for repeat exposures. Because of this wide dynam necessary to process photostimulable phos. phor images in two steps. First, the imaging plate is scanned by a weak laser beam about 1.8 mm wide in an operation called "pre- reading.” Only a small portion of the image stored in the plate is read out at this time. The data in this pre-reading image is an- alyzed to compute the exposure level and ‘exposure range of the stored image. In this way, suck things as th~ sensitivity of the photomultiplier tube can be adjusted to the exposure level and exposure range for any individual examination. This pre-reading thus allows examinations made with a wide range of mAs settings to be converted into diagnostically useful images. As a result, underexposed and overexposed as well as correctly exposed examinations will be processed as satislactory images. Digital ir ¢ images can produce a variety of other image changes which we will consider in another chapter. range, itis essing of th SUMMARY Intensilying screens are used in diag- nostic radiology because they reduce x-ray dose to the patient. Also, the lower expo- sures required (less mAs) allow the shorter exposure times needed to reduce motion unsharpaess. Until about 1971, calcium tungstate ws the phosphor used in most screens New technology has resulted in very fast + and other phosphors. ‘There are three ways in which screens can be made “faster 1. thicker phosphor layer ev 135 my ethicency phas phor CaWO screen speed rs determined largely by the thickness of the phosphor layer. The newer fast phosphors exhibit a higher con version efficiency. Higher absorption of x rays in the diagnostic range i 4 function of the matching of the K-absorption edge of the screen phosphor to the energy spec trum in the x-ray beam, The spectral emis sion of some phosphors requires that an appropriately sensitized film be used, or much of the light will be wasted. Intensi fying screens are usually used in pairs, with a double-einulsion x-ray film sandwiched between the two screens in alight-tight cas- sette. System noise becomes important when the fastest film-screen systems are used, Computed radiography uses a photo- stimulable phosphor as the image receptor. The phosphor is composed of europium activated barium fluorohalide, which is coated on an imaging plate. ‘The phosphor temporarily stores a latent image on the naging plate. The lat i verted to a light image using faser stimu- fated Iu ence. A photomultiplier tube converts the light image intoan analog clecitical signal, This analog signal is am- plified, converted to a digital signal, and stored in a computer REFERENCES, in, RA. Propenies of nalying screens Presented at Mami, December, 1972, ‘and Laughlin, JS A photographic tneihod for the evalsation of the conversion el- jency of fluoroscopic sexeens. Radiology, 6145, 196. Wate Me: Proper fraoraphic ln and fe the efficacy Image Receptor Conference: FilnvScreen Com- Vi ber 13-15, 1975. Washington, DC, US. Government Print ing Office, HEW Publ. No. (FDA) 77-8003, 1975, p. 123, 4. Buchanan, R.A., Finkelstein, $.L,, and Wicker- sheim, Kas XIESCENI ScnEENS a4 4 wavelength ps n ngth % A tavioley 1 That % stimuls & % % % lengu’, 2% all, 2% %* othe : adliologic ly 10. “k. Frank, Ps Devel Tatiographicimage pros: E Vol, 347: Application o ‘Op- in Mestcne X, 1982, p18. samrence, DJ: Kodak X-Omati and Loner screens and Keak fms for medical adiograpiy Rochester, N. Radiography Marks Diiton, suman Kodak Compny File No. 8.03, June tas any ile No. 5.03, J Ludwig, GW, and Frener, JS: Evaluation of G4,0,8:Tb asa phosphor forthe input sreen of xray image intensier IEEE Trans, Biomed Eng. 19°3. 1972 Meredith, W.J, and Massey, J.8.: Fundamental Physics of Radiology. Baltimore, Willams & =" kins, 1958 Merit, C: Computed radiography: a new ap- proach to plain film imaging. Diagnostic Imaging, January, 1985, p, 58. Morgan, R.H.: Characteristics of x-ray films and. screens. Radiology, 49-90, 1947 Patterson, C.VS.: Roenigenography: Fluoro 19, 20. 22, 23, mn Medical YS tnt rnys a Chics a vensif ying sere Rote Neal Mo. Glasser C aero Manual for Do scope and i ies. Vol 2 Hawk Medical Ps Pattern, ONS. srapic al intensifying ies Vol, 3. Ealited Fiver tical Phys yo. Year Took Medical Pu fn Pauerson X-Ray Screens: Sales Man ing. Pom Patterson X-Ray Sereen Dealers WoT i jcpov E Company ine 1052. deterie oe \s, Radiology. Senate lumigencence. RaolOny- Needs for Reduction of Patient Dosage from Di- 7 Edited by M.L. lanower. warles C Thomas, 1963. ‘Thompson, T.T., Radford, F.L..and Kirby, CC. Alook at rare-earth and high-speed intensifying screens. Appl. Radiol., 6:71, 1977. 148:833. agnostic Radioloy Springfield, IL,he a CHAPTER | () Physical Characteristics of X-Ray F tlm and Film Processing When an x-ray beam reaches the patient, it contains no useful medical information. After the beam passes through and inter- facts with the tissues in the parlexamined, it contains all the information that can be led by that particular radiographic examination, This is represented by vari- ation in the number of x-12; photons different areas of the emergent be are unable to make direct of the infor- mation in this form, however, and must transfer it to a medium suitable for vit by the eye. The method of transfer involve a magnetic tape or dise, a fluoro: scopic screen, or xerography. The most im portant material used to “decode” the in: formation carried by the attenuated x-ray beam is photographic film. The film may be exposed by the direct action of x rays. More commonly, the energy of the x-ray beam is converted into light by intensifying screens, and this light is used to expose the filn Icis unfortunate that the transfer of in- formation from the x-ray beam to the screen-film combination always results ina Joss of information, In reviewing. x: film, we must examine both the film those factors that influence the amow information lost in the transfer process. FILM X-ray film is photographic film consist- ing of a photographically active, or radia- tion-sensitive, emulsion that is usually coated on both sides of a transparent sheet of plastic, called the base. Firm attachment between the emulsion layer and the film base is achieved by use of a thin layer of adhesive. ‘The delicate emulsion is pro- tected from mechanical damage by layers known as the supercoating (Fig. 10-1). Film Base The only function of the film base is to provide a support for the fragile photo- graphic emulsion. Three characteristics of the base must be considered. First, it must not produce a visible pattern or absorb too much light when the radiograph is viewed. Second, the flexibility, thickness, and strength of the base must allow for ease of processing (developing) and produce a ra- diograph that “feels right" when handled {a film too “floppy” to “snap” under the hangers of a viewbox gets a cool reception). Third, the base must have dimensional sta- ‘SUPERCORT 0005 in tS a ADHESIVE Y 97 in. pase —=: ial EMU. Sion —- & = sol = a 2 @ 60 = 2 < w 30) 2 5 \ a eo vee e ee So 20°60 100 140 180 200 kVp radi- Figure 10-6 Film sensitivity varies ation quality AocessiNG y be veloped fii of how inudi eray agers) He expr fin be snany elie En ‘of tive fil Because the sensitivity neue greatly with the energy (kVp) of the " ‘eof tlm does however, hlackening of piece of A been sub- film subjected (0 an at an xray energy of 1, exhibit a snple, exposure of 50 mR jected. Fore 50 kVp will, after developmen! * tnuch higher density (amount of bla re ing) than an identical film subjected 16 1 exposure of 50 mR by 200-kVp x ray’ ae problem of variation of film sensitivity oO radiation energy is partially solved by pli: ing various metal filters in front of the fi ; in an attempt to control the energy (VP) of the x rays that reach different areas 0! the film. The accuracy of film badge mon- itoring of x-rav exposure is about * 20%: Film badge inonitoring of personne! ex- posure offers several advantages ot methods, such as ionization chai bers. The film badge provides a permanent record, and is small in size and weight, rug- ged, and inexpensive. Supercoating Covering the emulsion is at thin layer, commonly gelatin, that serves to protect the emulsion from mechanical damage. In special types of film this superceat, or anti abrasive coatit contain substances: that make the film surface sinooth sand slick. This is a desirable quality in filay th must be transported through a cut film rapid film changer. FILM PROCESSING Development is a chemical process that lifies the latent image hy a factor of tnillions (about 100,000,000) to form a vis- ible silver pattern. The basic + duction (addition of an electron) of the sil- ver ion, which changes it into black metallic silver: ‘Ag? + electron -+ AgPrVAIOAL CHARA TERISIIOS OF The developer tothe restucing, agent De velopment as generally an ath or wane phe conve enn, Bee anise ay CEE yghlin iv ale ‘elipestcreatuced once the process begins Vie process is usually aniiateyt atthe ste ‘of a tatent amage speck (Commonly on the auntace ob the grain). I is believed that the jetion of the silver atoms a the Latent image iv to aecelerate (catalyse) the reduc tion of the silver dons in the ain by the developing cemieals The silver ina grain hat oes Hor contaitt a latent image can be tedtuced! by the developer, but at se mmelh slower rate, Thus, time iy a fundamental factor in the developing process, Devel opment should be discontinued whew the Hlerential between exposed developed grainy and unexposed nndeveloped grainy sate mayium, Modern developing solutions contain ovo developing .gents, hydroquinone plus phenidone or metol, Hydroquinone was discovered 10 be a developing agent in 1880, Hydroquinone requites a strong al ali to activate it, Developers mae of hy droquinone are characterized by high cons trast, Metol developers became available in 1891, and ave characterized by high speed, low contrast, and fine gratin, Phenidone was discovered in 1940, and is similar to metol Both metol and phenidone are used mainly combination with hydroquinone, Thi nit is usually expressed the othe way around by stating that hydroquinone is used mainly in combination with metal or phenidone, ‘Two agents are used bes cause of the phenomenon of synergism, or peradditivity. The mixture results in a development rate greater than the sum of the developing rate of each developing agent. ‘The reasons for development syn- ergism are complex and not fully under stood, so we will not explore the details. The ch mistry of developing is not our ‘hie! interest, but the formulas for the basie reactions help in_ gaining a good under- standing of the process. As shown in Figure 10-7, the developing agent reduces silver ions to metallic silver, causing oxidation HAN HEAL AHI FAL BOGE Shinn a awit inactivation ab the developing, agent ANE the Wheaton at hyd beagen ies Now ANAC the fearon nit pe ale sotition Whew hysthogiinone ise lived tw quinone, two electiany ate hber atedt Uy combine with the two silver ions to Fon metallic silver (Hig 12) The ve ation of phemidtone iy simar (Fy 10-71) The silver thus formed is deposited at the Latent image site, gradually enlarging this initially microscopic Black spot antes a single visible blick speck of silver in the emulsion Unadlition to developing agents, the des veloping solution contains (1) an alkali to auljust the pl, (2) a preservative (sodium sulfite), and (4) resteainers, or antifog- ants, ‘The alkall adjusts the hydrogen ion concentration (pl), whieh greatly atfects the developing power of the developing agents, especially hydroquinone, In adel tion, the alkali serves as a butler to ce the hydrogen ions Hil opment reaction, Most radi velopers fanetion at a plL range of 10 to 11.5. ‘Typical alkalies include sodium by- droxide, sodium carbonate, and borates (sodium metaborate and sodium tetrabor- ate). Sodium sulfite is addled for wo reason: The oxidation products.of the developing agents decompose in alkaline solution and form colored materials that can stain the emulsion, These products react rapidly with sodium sulfite o form colorless solu ble sulfonates. In addition, sodium sulfite acts as a preservative, In alkaline solution the developing agent will react with oxygen from the ait. The sulfite acts as a preser- vative by decreasing the rate of oxidation, especially that of hydroquinone. Sulfite the moves oxygen from the air dissolved i solution, or at the surface of the soluti before it has time to oxidize the developi agent. Fog is the development of unexposed silver halide grains that lo not contain a latent image. In a complex manner, dilute conce: ‘rations of soluble bromide (potas- 5144 PHYSICAL CHARACTE A TICS OF van enna PROCESSING Alkaline page2tt . Solution Y on ° Developer Oxidized Silver , Hydrogen (Hydroquinore) tons Developer Atoms fons (Guinene) A lo 5 +2 Aq —Sikaline } +209 +24 \ 8 8 i Ope ° Developer | Silver _ (Phenidone) * tons or phenidos © (B) n be used as the developer sium bromide) decrease the rate of fog for- mation. Toa lesser degree the bromide alee decreases the rate of development of the latent image. Soluble bromide produced as a byproduct of the development process also affects the artivity of the developer ‘The development reaction in a W-see x-ray Processor must be completed in about 20 sec. This rapid rate of development re quires that the temperature of the devel. ping solution be quite high, usually be- tween 90 and 95°F, This rapid, high. temperature rate of developing requires that modern x-ray developers comtain ad, ditional antifoggants to permit rapid de. velopment of exposed grains but minimize fox development. The most significant df. ___, Onaized | Siver igure 10-7 Basic chemical reactions involved in th on Hydrogen Developer * Atoms * ‘tons Ne development process. Hydlroquinone (4) ference in commercial x- tutions is in the antifogg: Developer to ay developin S present las also contait so- other ingredients designed to influence swelling of the x-ray sit, so. topment rate, and physical properties. All devel. faces in antifoggants and other ingrediems are often proprietary, so we carver Rive specific examples, ' The bromide ions released by the r duction of silver ions to si imo the developing soluti Ver atoms pass 'Uis mainly this increase in bromide concentration that Timits the life of developing solutionsPHYSICAL CHARACTERISTICS OF XRAY FILM AND FILM PROCESSING Replenishment We have seen that, during, use, devel veloping oping solutions consume ¢ agents andl preservatives, bit acquire hy: atrgen ions and bromide, Rack time a film is processed int an automatic processor a sinall portion (about GO ml ina 10-1 tank) ‘of the developing solution is removed and replaced with a replenishment solution, The purpose of this replenishment is maintain developing agent concentration, preservative concentration, bromide con- centration, and pHL at a constant level for the lifetime of the developer solution. Al- most all radiographs are now processed i automatic film processors with automatic developer replenishment. Traditional re- plenishment was developed for high vol- ‘ume operations where many films are proc- essed cach lay. However, many automatic processors operate in sinall installations where few films are developed each day. Under these circumstances, oxidation “of developer is more importa: sequences of the development process. We will discuss replenishment requirements for both high volume (developing reac- in dependent) and low volume (oxida- tion reaction dependent) sit ‘The development reaction m: ten: y be writ- 2AgBr + 1,0 + Na,SO, (silver bromide + hydroquinone + sodium sult) | Development 1 2 Ag + HBr + HOSO.Na + NaBr (Siver + hydrobromic acid + hhydroquinonemonosuifonate + sodium bromide) Notice that cach time a film is processed, bromide and acid are formed and some developer is consumed. Replenishment of developer must compensate for these changes by being free of bromide, by con- ning alkaline agents and buffers and, to a lesser extent, restoring depleted preser- vative and developing agents. With normal use in a busy department, the lifetime of a tank of developer in an automatic film pro- 145; cessor is about 2.10 4 months. A typical teplenishiment rate is to replace 60 inl of developer with replenisher for each Me Hein fin processed Now, let us consider a tank of developer that sits for long periods of time with few films being processed. In this situation, ox- ication of the developer becomes more im- portant than the development reaction ‘The oxidation reaction may be written: HO + Na,SO, + 0, (hydroquinone + sodium sulita + oxygen) | Oxidation i 4 HOSO,Na + NaOH + Na,SO, (hydroquinoremonosulfonate + sodium hydroxide + sodium sulfate) Notice that the oxidation reaction raises the pH of the developer by forming so- dium hydroxide. This is just the opposite of the development reaction in which the acid formed lowers developer pH. Also, the oxidation reaction produces no bro- mide. Since few films are processed, re- plenishment is infrequent. Also, since standard replenisher has a higher pH than developer and no bromide, routine replen- ishment will maintain the high pH and di- lute bromide, Bromide concentration drops sapidly, and this has an adverse ef- fect on film sensitometry. Developer and replenisher formulas are modified for low volume applications. De- velopers have a lower pH and concentration to retard oxidation, and a high buffering capacity to minimize the pH effects of oxidation. Replenishers compen- sate mostly for oxidation rather than de- velopment. The replenisher has a lower pH than developer and contains bromide. Replenishment rate is usually higher (about 90 ml per Mt x 17-in, film) to in- crease developer turnover rate The main consequence of an abnormal composition of developer ingredients is to produce films with a sharp decrease in toe gradient (we will discuss the terms “toe”