FUNDAMENTAL

PRINCIPLES OF
EXPOSURE
milliampere-second (mAs)

Digital IRs can detect a wide range of radiation intensities (wide dynamic range) exiting the
patient and are not as dependent on the mAs as film-screen IR’s.

Exposure errors can adversely affect the quality of the digital image .

Most manufacturers of digital IRs suggest a If the exposure indicator value falls outside of this range,
range for the exposure indicator based on the image quality or patient exposure or both could be
radiographic procedure. compromised.
 In digital imaging, the kVp affects the variation in
radiation intensities exiting the patient and image
contrast; however, image brightness and contrast
are primarily controlled during computer
processing.

Kilovoltage-p A kVp that is too high, increased scatter radiation

reaches the IR and may adversely affect image
eak quality.

kVp use for computed radiography should be lower

compared to F/S radiography.
Important Relationship
• Exposure Errors in Digital Imaging
• kVp and mAs exposure errors should be reflected in the exposure indicator
value; however, image brightness can be maintained during computer
processing
• Patient Protection – Excessive Radiation Exposure and Digital
Imaging
• Even if the computer can adjust image brightness for technique exposure
errors, using more radiation than required for the procedure unnecessarily
increases patient exposure. Even though the digital system can adjust for
overexposures, it is an unethical practice to overexpose a patient knowingly.
Collimation

• Changes in beam restriction alter the

amount of tissue irradiated and
therefore affect the amount of exposure
to the IR.
• The effect of collimation is greater
when imaging large anatomic areas,
performing examinations without a
grid, and using a high kVp.
Important Relationships

• Beam Restriction and Patient Dose

• As beam restriction or collimation increases, field size decreases, and
patient dose decreases. As beam restriction or collimation decreases,
field size increases, and patient dose increases.
• Collimation and Scatter Radiation
• As collimation increases, the field size decreases, and the quantity of
scatter radiation decreases; as collimation decreases, the field size
increases, and the quantity of scatter radiation increases.
Important Relationships

Collimation and Radiographic Collimation and Exposure to

Contrast the Image Receptor
As collimation increases, the quantity of As collimation increases, exposure to the IR
scatter radiation decreases, and radiographic decreases; as collimation decreases,
contrast increases; as collimation decreases, exposure to the IR increases.
the quantity of scatter radiation increases,
and radiographic contrast decreases.
 Electronic
Collimation

The image can be altered by

electronic collimation known as
masking or shuttering. Electronic Electronic collimation has no
collimation can remove regions effect on overall image quality or
within the radiation-exposed field patient exposure.
that provide no useful
information.
 Source-to-image receptor distance is the
distance between the source of the
radiation and affects the amount of
radiation reaching the patient

SID Divergence of the x-ray beam, the

intensity of the radiation varies at different
distances .

The relationship between distance and

x-ray beam intensity is best described by
the inverse square law.
 SID and X-ray Beam Intensity

• As SID increases, the x-ray beam

intensity is spread over a larger area.
This decreases the overall intensity of the
x-ray beam reaching the IR.
Important
Relationships SID and mAs

• Increasing the SID requires that the mAs

be increased to maintain exposure to the
IR, and decreasing the SID requires a
decrease in the mAs to maintain
exposure to the IR.
OID

Object-to-Image Receptor Distance

is the distance between the object The presence of OID may result to
and the object radiographed and the decreased beam intensity.
IR.

the OID also affects the amount of

If there is a sufficient distance image distortion and recorded detail
between the object and receptor. Air or spatial resolution. Optimal
gap is created. recorded detail or spatial resolution
is achieved when the OID is zero.
Important Relationship
• OID, Size Distortion, and Recorded
Detail or Spatial Resolution
• Increasing the OID increases
magnification and decreases the
recorded detail or spatial resolution,
whereas decreasing the OID
decreases magnification and
increases the recorded detail or
spatial resolution.
Grid
• It is a device that is placed between the
anatomic area of interest and the IR to
absorb scatter radiation exiting the
patient. Limiting the amount of scatter
radiation that reaches the IR improves
the quality of the image.
 Grids, Scatter, and Contrast

• Placing a grid between the anatomic area of

interest and the IR absorbs scatter radiation exiting
the patient and increases radiographic contrast.
Important
Relationship
Grids and Image Receptor Exposure

• When grids are used, the mAs must be adjusted to

maintain exposure to the IR. In addition, the more
efficient a grid is in absorbing scatter, the greater
is the increase in mAs.
 Speed class is preferred term

Speed class is set in a given department by consulting with

an interpreting radiologist.

Speed
as speed class increases, so does the amount of image
noise.

In computed radiography, thicker phosphors has faster

speed and absorbs more radiation and thinner phosphors,
slower speed absorbs less radiation sharper image quality.
 It can be vendor specific.

Speed
The exposure index is
For carestream indirectly proportional
to the speed class of
operation.

The S-number can be

thought of as being
For Fuji equivalent to the speed
of the IP. If the
exposure is low, the
speed is increased
 Scatter radiation can add unwanted
exposure to the radiographic image
Fog as a result of Compton interactions.

Unwanted exposure or fog on the

image does not provide information
about the anatomic area of interest.

Fog produced as a result of scatter

reaching the image receptor can be
visualized on both a digital and a
film image.
Part thickness:

• A thick part absorbs more radiation, whereas a thin part

transmits more radiation.
• Maintaining the exposure to the IR when imaging a thicker part
requires the mAs to be increased accordingly.
• As the thickness of a given type of anatomic tissue increases,
the amount of scatter radiation also increases, and radiographic
contrast decreases.
Filtration

• The removal of these low energy x-rays from the beam

spectrum which would otherwise not contribute to image quality
but would add to patient dose and scatter.
• The x-ray beam has increased energy and can increase the
amount of scatter radiation reaching the IR.
Focal Spot Size:

ON THE CONTROL PANEL, THE GENERALLY, THE SMALLEST FOCAL THE HEAT CREATED DURING THE X-RAY
RADIOGRAPHER CAN SELECT WHETHER SPOT SIZE AVAILABLE SHOULD BE USED EXPOSURE IS CONCENTRATED IN A
TO USE A SMALL OR LARGE FOCAL SPOT FOR EVERY EXPOSURE. HOWEVER, SMALLER AREA AND COULD CAUSE
SIZE. EXPOSURE IS LIMITED WITH A SMALL TUBE DAMAGE.
FOCAL SPOT SIZE.
Interfacing with the
AEC
• AEC
• It is a tool available on most modern
radiographic units to assist the
radiographers in determining the
amount of radiation exposure to
produce a quality image.
• It is used to control the amount of
radiation reaching the receptors by
terminating the length of exposure.
Important Relationship
• Digital Image Receptors and AEC
• Because visual cues of increased or
decreased radiographic density
when using film-screen IR’s are
lacking in digital imaging, the
radiographer must be very
conscientious about excessive
radiation exposure to the patient.
ALARA Principle

• The principle of Optimization is intended to protect the patient

from unnecessary radiation by using a dose that is as low as
reasonably achievable.
• Optimization also must address image quality. Specifically, dose
optimization strategies must not compromise the image quality
required by physicians to diagnose diseases and conditions.
Factors that affect dose in Digital
Radiography
1. Increasing mAs and kV increases patient dose proportionally.
2. Collimation is intended to protect the patient from
unnecessary radiation by limiting the beam field size to the
anatomy of interest, thus reducing the volume of tissue
irradiated.
3. A short SID increases the photon concentration per unit area
thus increasing the surface exposure to the patient.
Factors that affect dose in Digital
Radiography
4. Alignment of the radiation field and the light field of the
collimator should be considered.
5. For scattered radiation grids, as the grid ratio and grid
frequency increase, the dose increases.
6. Detector sensitivity refers to the relative speed of the detector.
As detector sensitivity increases, the dose to the patient
decreases.
7. Gonad shielding is intended to protect the gonads from primary
radiation
Optimizing Exposure Indicators

• The EI has been identified as a dose control mechanism.

• The EI can be used as a “surrogate for dose management.”
• The use of the EI has been viewed as an opportunity for dose
optimization.