01/04/2021

Fundamental Principles of
Exposure and Image
Evaluation

Ms. Danica P. Pardalis, R.R.T.

Lecturer, B.S. Radiologic Technology Program
La Consolacion University Philippines

COURSE OUTLINE:
V. Fundamental Principles of Exposure

1. Optimal receptor exposure

1.1. Milliampere-seconds (mAs)
1.2. kVp
1.3. Collimation
1.4. Grid
1.5. Source-to-image distance (SID)
1.6. Speed class
1.7. Fog
2. Exposure myths and misconceptions associated with
digital systems

COURSE OUTLINE:
V. Fundamental Principles of Exposure

3. Control patient exposure

3.1. Higher kVp levels
3.2. Additional filtration
3.3. Interfacing with automatic exposure control (AEC)
systems
3.4. As low as reasonably achievable (ALARA) principles
4. Monitor patient exposure
4.1. Part of quality assurance (QA) program
4.2. Vendor-supplied software

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COURSE OUTLINE:
VI. Image Evaluation
1. Evidence of appropriate exposure level (exposure indicator range)
1.1. Exposure indicator range
1.2. Noise
1.2.1. Computer noise
1.2.2. Electronic noise
1.2.3. Material mottle
1.2.4. Quantum mottle
2. Contrast
3. Recorded detail
4. Artifacts
4.1. Patient
4.2. Equipment
4.3. Exposure
4.4. Processing
4.5. Moiré effect 4

LEARNING OBJECTIVES:

a. Apply the fundamental principles to digital detectors

b. Determine potential impact of digital radiographic
systems on patient exposure and the application of the
ALARA concept in a digital system
c. Associate impact of image processing parameters to the
image appearance
d. Evaluate the effect of a given exposure change on
histogram shape, data width and image appearance and
describe the conditions that cause quantum mottle in a
digital image;

OPTIMAL RECEPTOR EXPOSURE

◼ Milliampere-seconds (mAs)
❑ Controls the radiographic density
❑ Controls the quantity of x-rays produced
❑ Controls the duration of exposure
❑ Quantity of exposure is directly proportional to exposure time

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OPTIMAL RECEPTOR EXPOSURE

OPTIMAL RECEPTOR EXPOSURE

◼ Kilovoltage peak (kVp)

❑ Controls the radiographic contrast
❑ Controls the quantity and quality of x-rays beam

OPTIMAL RECEPTOR EXPOSURE

◼ Collimation
❑ Affects the radiographic contrast
❑ Restricts the field of view
❑ Reduced the patient dose

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OPTIMAL RECEPTOR EXPOSURE

◼ Grid
❑ Affects the radiographic contrast
❑ Reduced the scattered radiation
❑ Increases the patient dose

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OPTIMAL RECEPTOR EXPOSURE

◼ Source to image receptor distance (SID)

❑ Affects the density and intensity of the x-ray beam
❑ Quantity of exposure is inversely proportional to the square of
the distance

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OPTIMAL RECEPTOR EXPOSURE

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OPTIMAL RECEPTOR EXPOSURE

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OPTIMAL RECEPTOR EXPOSURE

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EXPOSURE MYTHS AND

MISCONCEPTION

◼ Must be highly maintained

◼ Increase patient exposure
◼ Increase radiation dose
◼ Increase scatter radiation

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CONTROL PATIENT EXPOSURE

◼ Higher kVp levels

◼ Additional filtration
◼ AEC Systems
◼ ALARA Principle

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Appropriateness of Exposure level

◼ Technique charts are based on the “average

patient”

◼ The thicker the part the more x-radiation is

required to penetrate. Calipers should be used

◼ Keep in mind not only the measurement but the

type of tissue you need to penetrate (fat vs
muscle)

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Technique

◼ In general, Soft tissue = low kVp and high

mAs

◼ Extremity (soft tissue & bone) = low kVp

◼ Chest (high subject contrast) = high kVp

◼ Abdomen (low subject contrast) = middle kVp

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Pathology

◼ Can appear with increased radiolucency or

radiopacity

◼ Some pathology is destructive causing tissue

to be radiolucent

◼ Others can be additive causing tissue to be

radiopaque

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Image Quality
• Is the exactness of the representation of
the patient’s anatomy

• 3 major factors affecting image quality that

is under the control of the technologist:
Image Receptor selection/use, Geometric
factors & Subject factors.

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Judging Image Quality

• The most important characteristic of
radiographic quality are: Spatial
Resolution, Contrast Resolution, Noise &
Artifacts

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Main Factors Affecting

Recorded Detail
• kVp & mAs • Material
• Motion Unsharpness/ Film
• Object Screen Combo
Unsharpness • Focal Spot Size
• SID (Source to • MTF (modulation
Image Distance) transfer function)
• OID (Object to
Image Distance)

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Recorded Detail
• Other names:
- detail
-sharpness of detail
-definition
-resolution
-degree of noise
- visibility of detail

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Modulation Transfer Function

• The ability of a system to record available
spatial frequencies.
• The sum of the components in a recording
system cannot be greater than the system
as a whole.
• When any component’s function is
compromised because of some type of
interference, the overall quality of the
system is affected.

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Contrast Resolution
• Is the ability to distinguish anatomic
structures of similar subject contrast. Ex:
liver-spleen, gray matter-white matter

• Magnetic Resonance Imaging has the

highest contrast resolution
• Computed Tomography is excellent as
well

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The contrast of an object is expressed relative to

its surrounding background.
That is what determines its visibility.

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“Noise”
• Borrowed from electrical engineering
• Audio noise = hum or flutter heard from a
stereo
• Video noise = “snow” on a TV

• Radiographic noise = random fluctuation

on the OD of the image

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QUANTUM MOTTLE
Not enough PHOTONS – can create a mottled or grainy
image - MORE COMMON IN CR SYSTEMS

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Radiographic noise

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Quantum mottle

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F/S vs Digital
Dynamic Range

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Image quality control:

Matrix size is determined by . . .

• Receptor size (Field of View: FOV)
• Pixel size
• CR - Sampling frequency
• DR - DEL size

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Sampling Frequency

• The sampling frequency is the rate at

which the laser extracts the image data
from the plate.

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Signal Sampling Frequency

Good sampling under sampling

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Nyquist Frequency

• The Nyquist Frequency will be ½ of the sampling

frequency.
• A plate that is scanned using a sampling
frequency of 10 pixels per millimeter would not
be able to demonstrate more than 5 line pairs
per millimeter based upon the Nyquist
Frequency.
• The Nyquist Frequency allows the determination
of the spatial resolution for a given sampling
frequency.

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Questions?

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REFERENCES:

1. Bushberg, J., Seibert, J.A., Leidholdt, Jr., E.,

Boone, J. (2012). The Essential Physics of Medical
Imaging. 2nd Edition. Philadelphia Lippincott
Williams & Wilkins.
2. Bushong, Stewart C. (2013). Radiologic Science
for Technologist: Physics, Biology, and Protection.
10th Edition. Mosby.

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