PRINCIPLES OF IMAGING LECTURE REVIEWER

X-ray Production
X-ray machine has three (3) major parts:
1. X-ray Tube
2. High voltage generator
3. Operating console
X-RAY TUBE
⊗ The most important part of the x-ray machine because the tube is where x-rays are produced.
⊗ Radiographers must understand how the x-ray tube is constructed and how to operate it.
⊗ The radiographer controls many of the actions that occur with within the tube.
⊗ Kilovoltage peak (kVp), milliamperage (mA), and exposure time are all factors that the radiographer selects on the control
panel to produce a quality image.
⊗ The radiographer also needs to be aware of the amount of heat that is produced during x-ray production because excessive
heat can damage the tube.

- The production of x-rays requires a rapidly moving stream of electrons that are suddenly decelerated or stopped.
- The source of electron is the cathode (negative electrode)
- Electron are stopped or decelerated by the anode (the positive electrode)
- Electrons move between the cathode and the anode because there us a difference in charge between the
electrodes.

PROCESS INVOLVED IN X-RAY PRODUCTION

♦ Production of electrons (therminionic emission)
♦ Formation of electrons as space charge
♦ Acceleration of electrons
♦ Deceleration of electrons\emission of electron as X-RAYS

Cathode

➢ Negatively charge electrode.

➢ Comprises of: Filament and focusing cup
! Filament
- Coiled tungsten wire that is the source of electrons during x-ray production.
- Cathode of an x-ray tube are referred to as dual focus tubes because they have two filaments:
° Large filament
° Small filament
- Only one filament is energized at any one-time during x-ray production.
- If the radiographer selects a large focal spot when setting the control panel, the large filament is energized. If a
small focal spot is chosen, the small filament is energized

! Focusing Cup
- Made of nickel and nearly surrounds the filament.
- It is open at one end to allow electrons to flow freely across the tube from cathode to anode.
- It has a negative charge, which keeps the cloud of electrons emitted from filament from spreading apart.
- Its purpose is to focus the stream of electron
Anode

➢ Positively charged electrode.

➢ It consists of: target, rotating anode tube, stator, and rotor. (Composed of)
- Molybdenum
- Copper
- Tungsten
 - Graphite
➢ These materials are used for their thermal and electrical conductive properties.
! Target
- Metal that abruptly decelerates and stops electrons in the tube current.
- Rotating anodes are manufactured to rotate at a set speed ranging from 3000 to 10000 revolution per minute.
- The part of the anode that is struck by the focused stream electrons coming from the cathode.
- The target stops the electrons and thus creates the opportunity for the production of x-rays.
- It is made of: tungsten and rhenium alloy.
- This layer, or track, is then embedded in a base of molybdenum and graphite.
- Tungsten generally makes up 90% of composition of the rotating target, with rhenium making up the other 10%
- Tungsten is used in both rotating and stationary targets because it has a high atomic number of 74 for efficient x-
ray production and a high melting point of 3370 deg cel.

- Because tungsten has a high atomic number (74) and a high melting point. It efficiently produces x-rays
! Stator
- Is an electric motors that turns the rotor at very high speed during x-ray production.
! Rotor
- Rigidly connected to the target through the anode stem.
! Dissipating Heat
- As heat is produced when the x-ray exposure is made, the rotating anode conducts the heat to insulating oil that
surrounds the x-ray tube.

! Rotating anode
- Rotating anodes can withstand higher heat loads than stationary anodes because the rotation cause a greater
physical area, or focal track, to be exposed to electrons.

- The ability to withstand high heat loads relates to the actual focal spot which is the physical area of the target that
is bombarded by electrons during x-ray production.

- With the stationary target the focal spot is fixed area on the surface of the target.
- With rotating targets, this area is represented by a focal track.
- The size of the focal spot is not altered with rotating anode, but the actual physical area of the target bombarded
by electrons is constantly changing, causing a greater area-a focal track-to be exposed to electrons. Because of
the larger area of the target being bombarded during an exposure, the rotating anode is able to withstand higher
heat loads produced by greater exposure factors.

- Rotating anode tubes are used in all applications in radiography, whereas stationary anode tubes are limited to
studies of small anatomic structures such as the teeth.
X-RAY TUBE HOUSING
• The component necessary for production housed in a glass or metal envelope.
• Metal envelopes are more commonly used because of their improved electrical properties.
• A disadvantage of a glass envelope x-ray tube is that tungsten evaporated from the filament during exposure can deposit on the
inside of the glass, especially in the middle portion of the envelope.
• This evaporation could affect the flow of electrons and can cause the tube to fail. Replacing all of this section of glass with
metal prevents these problems and extends the tube life.
• An additional advantage of a metal envelope is the reduction of off-focus radiation.
° Off-focus radiation – occurs when projectile electrons are reflected and x-rays are produced from outside the focal
spot. The meatal tube can collect these electrons and conduct them away from the anode. The envelope allows air to
be evacuated completely to anode. The envelope serves two important functions:

1. It provides some insulation and electric shock that may occur because the cathode and anode contain electrical
charges and

2. It dissipates heat in the tube by conducting it to insulating oil that surrounds the envelope
❖ The purpose of insulating oils is to provide more insulation from electric shock and to help
dissipates heat away from the tube. All of these components are surrounded by metal tuber housing
except for a port, or window, which allows the primary beam to exit the tube. It is the metal tube
housing that the radiographer sees and handles when moving the x-ray tube. The tube housing is lined
with lead to provide additional shielding from the leakage radiation
• Leakage radiation
° Refers to any x-rays, other than the primary beam, that escape the tube housing.
 ° The tube housing is required to allow no more than 100 m/R/hr of leakage radiation to escape when measured at 1m
from the source while the tube operates at maximum output.
° Electric current is supplied to the x-ray tube by means of two high voltage cables that enter the top of the tube
assembly

Preparing the X-RAY tube for exposure:

• When the rotor, or prep, button is pushed:
o On the cathode side of the x-ray tube:
a) Filament current heats up the filament
b) This boils electrons off the filament (thermionic emission)
c) These electrons gather in a cloud around the filament (space charge)
d) The negatively charged focusing cup keeps the electron cloud focused together.
e) The number of electrons in the space charged is limited (space charge effect)
o On the anode side of the x-ray tube:
a. The rotating target begins to turn rapidly, quickly reaching top speed.
Making an Exposure
• When the exposure, or x-ray, button is pushed:
o On the cathode side of the x-ray tube:
a. High negative charged strongly repels electrons
b. These electrons stream away from the cathode and toward the anode (tube current)
o On the anode side of the x-ray tube:
a. High positive charged strongly attracts electrons in the tube current.
b. These electrons strike the anode.
c. X-rays and heat are produced.

• Thermionic Emission
o When the tungsten filament gains enough heat (therm), the outer shell electrons (ions) of the filament atoms are
boiled off, or emitted, from the filament.
• Tube Current
o Electrons flow in only one direction in the x-ray tube from cathode to anode.
o This flow of electrons is called the tube current and is measure in milliamperes (mA)
• Energy Conversion in the X-ray
o As electrons strike the anode target, approximately 99% of their kinetic energy is converted to heat, whereas only
1% (approx..) of their energy is converted to x-rays

X-RAY Quantity and Quality

▪ The radiographer initiates and commands the production of x-rays, Manipulating the prime exposure factors on the control
panel (kVp, mA, and exposure time) allows both the quantity and quality of x-ray beam to be altered.

▪ The quantity of the x-ray beam indicates its penetrating power.

▪ Knowledge of the prime exposure factors and their effect on the production of x-ray assists the radiographer in producing
quality radiographs.

Kilovoltage

▪ Kilovoltage (kVp) that is set by the radiographer and applied across the x-ray tube at the time of exposure initiated determines
the speed at which the electrons in the tube current move.

Kilovoltage and the Speed of Electrons

▪ The speed of the electrons traveling from the cathode to the anode increases as the kilovoltage applied across the x-ray tube
increases.

The speed of Electrons and the Quality of the X-rays

▪ The speed of the electrons in the tube current determines the quality or energy of the x-ray produced.
▪ The quality or energy of the x-rays that are produced determines the penetrability of the primary team.
kVp and Beam Penetrability

▪ Higher kVp results in electrons that move faster in the tube current from cathode to anode
▪ The faster the electrons in the tube current move, the greater the quality of x-ray produced.
▪ The greater the quality of x-ray produced, the greater the penetrability of the primary beam.
o In order to provide sufficient potential difference (kVp) to allow x-ray production, a generator is required to convert
low voltage (volts) to high voltage (kilovolts). Three basic types of x-ray generators are available:

1. Single phase
2. Three phase
3. High frequency
Quality Control Check: Kilovoltage Accuracy:

➢ X-ray quality can be affected if the actual kilovoltage used is inaccurate.

➢ A digital kVp meter measures the actual kilovoltage and a Wisconsin Test cassette estimates the kilovoltage by measuring
the densities (blackness) produce on a film

➢ The maximum validity of the kilovoltage is +-5%

Milliamperage

➢ Milliamperage (mA) is the unit used to measure the tube current.

➢ The tube current is the number of electrons flowing per unit time between the cathode and anode.
➢ The milliamperage that is set by the radiographer determines the number of electrons flowing in the tube and the quantity of
electrons and quantity of x-rays increase proportionally.

➢ If the milliampere decreases, the quantity of electrons and the quantity of x-rays decrease by the same proportion.
Milliamperage does not affect the quality, or energy, of x-rays produced.

Milliamperage, Tube Current, and X-ray Quality

➢ Milliamperage (mA) is the unit used to measure the tube current.

➢ The tube current is the number of electrons flowing per unit time between the cathode and anode.
➢ The quantity of electrons in the tube current and quantity of x-rays produced are directly proportional to the milliamperage.
MA and X-ray Quantity:

➢ Higher mA results in more electrons that move in the current from cathode to anode.
➢ The more electrons in the tube current, the more x-rays that will be produced.
➢ The number of x-rays that are produced is directly proportional to the mA.
Exposure Time

▪ Exposure time determines the length of time that x-ray tube produces x-rays.
▪ The exposure time set by the radiographer can be expressed in seconds or milliseconds, ad either a fraction or a decimal
▪ This exposure time determines the length of the time that the tube current is allowed to flow from cathode to anode.
▪ The longer the exposure time, the greater the quantity of electrons that flow from the cathode to anode and the greater the
quantity of x-rays produced.

Exposure Time, Tube Current, and X-Ray Quantity

▪ The quantity of electrons that flows from the cathode to anode and the quantity of x-rays produced are directly proportional to
the exposure time.

Exposure Time and X-ray Quantity:

▪ Longer exposure time results in more electrons that move in the tube current from cathode to anode.
▪ The more electrons in the tube current, the more x-rays produced.
▪ The number of x-rays that are produced is directly proportional to the exposure time.
Milliamperage and Time
▪ When milliamperage is multiplied by exposure time, the result is known as mAs which the radiographer may be able to set at
the control panel.

▪ Mathematically mAs is simply expressed as follows: mA x s = mAs, where s= represents exposure time in fraction of a
second (as actual fractions or in decimal form) or in seconds.

mAs and X-Ray Quantity:

▪ Higher mAs results in more electrons tat move in the tube current from cathode to anode,
▪ The more electrons in the tube current, the more x-rays that will be produced.
▪ The number of x-rays that are produced is directly proportionate to the mAs.
The Quantity of Electrons, X-ray, and mAs

➢ The quantity of electrons flowing from the cathode to the anode and the quantity of x-rays produced are directly proportional
to mAs.

Quality Control Check: Radiation Output:

• Variations in the generator or x-ray tube performance may cause inconsistent exposures and affects x-ray quantity.
• Three quality control tests are typically performed with a dosimeter (a device that measure x-ray exposure) to evaluate
radiation output by measuring the radiation intensity reproducibility of exposure. mAs reciprocity, milliamperage, and
exposure time linearity.
o Reproducibility of exposure:

° Verifies the consistency of radiation output for a given set of exposure factors.
° The maximum variability of reproducibility of radiation exposure is ==+/-5%
o mAs reciprocity

° Verifies the consistency of radiation intensity for changes in mA and exposure time with constant mAs.
° The maximum variability of reciprocity is +/-10%
o Milliampere and exposure time linearity:

° Verifies that proportional changes in mA or exposure time both likewise change the radiation intensity.
° Doubling the mA or exposure time should double the radiation intensity.
° The maximum variability of linearity is +/-10%

Line focus Principle

• The line focus principles describe the relationship between the actual focal spot. where the electrons in the tube current
bombard the target, and the effective focal spot, that same area as seen from directly below the tube.
Actual Focal Spot Size
• Refers to size of the area on the anode target that is exposed to electrons from the tube current.
• It depends on the size of the filament producing the electron stream.
Effective Focal Spot Size
 • Refers to the focal as measured directly under the anode target.
° The tube’s focal spot is an important factor because a large focal spot can withstand the heat produced by large
exposures, whereas a small focal spot produces better image quality. The line focus principle demonstrates how, by
angling the face of the anode, the actual focal spot can remain relatively large, while the effective focal spot is
reduced in size. Greater heat capacity can be achieved while maintaining good image quality.
° When manufactured, every tube has a specific anode angle, typically ranging from 5 to 20 degrees. Based on the line
focus principle. The amount of anode angle determines the size of the effective focal spot
° A larger target angle produces a larger effective focal spot, and a smaller target angle produces a smaller effective
focal spot

Anode Angle Heel Effect

Based on the line focus principle, the smaller the anode angle, the smaller the effective focal spot size.

X-rays are more intense on the cathode side of the tube. The intensity of the x-rays decreases toward the anode side.
BEAM FILTRATION

The X-ray beam produced at the anode exits the tube housing to become the primary beam.

This is the x-ray beam that eventually records the body part into the image receptor.

The x-ray that exits the tube are polyenergetic. They consist of low-energy, medium-energy, and high energy photons.

The low-energy photons are unable to penetrate the anatomic part and do not contribute to image formation.

They contribute only to patient dose.

Added Filtration

Describes the filtration that is added to the port of the x-ray tube.

Aluminum is the material primarily used for this purpose to absorb the low energy photons while allowing the useful higher-
energy photons to exit.
Inherent Filtration

Refers to the filtration that is permanently in the path of the x-ray beam.

Three components contribute to inherent filtration:

1. the glass envelope of the tube,

2. the oil that surrounds the tube,
3. the mirror inside the collimator

↑
Total Filtration

• In the x-ray beam is the sum of the added filtration and the inherent filtration.
• For x-ray tubes operating above 70 kVp must have a minimum filtration of 2.5 mm of aluminum or its equivalent.
Special filters
Compensating Filters – are special filters to be added to the primary beam to alter its intensity. These types of filters are used to
image anatomic areas that non-uniform in make-up, and assist in creating a radiographic image with more uniform density.

1. Wedge Filters – most common type of compensating filters. The thicker part of the wedge filter is lined up with the thinner
portion of the anatomic part that is being image, allowing fewer x-ray photons to reach that end part. Most commonly used
in AP femur.

2. Trough Filters – performs a similar function to the wedge filter; however, it is designed differently. It has a double wedge.
Commonly used for AP thorax to compensate for the easily penetrated air-filled lungs.

HEAT UNITS

• During x-ray production, most of the kinetic energy of electrons is converted to heat.
• This heat can damage the x-ray tube and the anode target.
• The amount of heat produced from any given exposure is expressed by the heat units (HU).
• The number of Hus produced depends on the type of x-ray generator being used and the exposure factors selected for a
particular exposure and can be expressed mathematically as follows:
° HU = mA x time x kVp x generator factor
Generator factor:

• Generator type ​ ​ ​Factor

• Single phase ​ ​ ​1.00
 • Three phase ​ ​ ​1.35
• High frequency ​ ​ ​1.40
EXTENDING TUBE LIFE
♦ If applicable, warm up the tube according to the manufacturer’s specifications, especially if it has not been energized for 2
hours or more.
♦ Avoid excessive heat unit generation.
♦ Repeatedly using exposure techniques near an x-ray tube’s limit increases the total heat units.
♦ Do not hold down the rotor button without making an exposure. Holding down the rotor button unnecessarily causes
excessive wear on both the filament and the rotor.
♦ Use lower tube currents with longer exposure times when possible to minimize wear on the filament.
♦ Do not move the tube while it is energized. This movement can cause damage to the anode and anode stem as a result of
torque, the force that acts to produce rotation.
♦ If the rotor makes noticeable noise, stop using the tube until it has been inspected by a qualified service person. Noises can
be indicative of a potentially serious problem.
IMAGE FORMATION

• Differential Absorption
° The process of image formation is a result of differential absorption of the x-ray beam as it interacts with the
anatomic tissue.
° Differential absorption is a process whereby some of the x-ray beam is absorbed in the tissue and some passes
through (transmit) the anatomic part.
° The term differential is used because varying anatomic parts do not absorb the primary beam to the same degree.
Anatomic parts composed of bone absorb more x-ray photons that parts filled with air.
Differential Absorption and Image Formation
♦ A radiographjc image is created by passing x-ray beam through the patient and plate in computed radiography (CR).
interacting with an image receptor, such as an imaging The variations in absorption and transmission of the exiting x-ray
beam structurally represent the anatomic area of interest.
Processes Involved in Differential Absorption

➢ Beam Attenuation.
° As the primary x-ray beam passes through anatomic tissue, it lose some of its energy.
° Fewer x-ray photons remain in the beam after it interacts with anatomic tissue.
° This reduction of energy or number of photons in the primary x-ray beam is known as attenuation.
➢ Absorption.
° As the energy of the primary x-ray beam is deposited within the atoms comprising the tissue, some x-ray photons are
completely absorbed.
° Complete absorption of the incoming x-ray photon occurs when it has enough energy to remove (eject) an inner-shell
electron.
° The ejected electron is called photoelectron and quickly loses energy by interacting with nearby tissues.
➢ Scattering.
° Some incoming photons are not absorbed but instead lose energy during interactions with atoms comprising the
tissue.
° This process is called scattering. It results from the diagnostic x-ray interaction with matter known as the Compton
effect.

Factors Affecting Beam Attenuation:

• Tissue Thickness
° For a given anatomic tissue, increasing its thickness increases beam attenuation by either absorption or scattering.
° X-rays are attenuated exponentially and generally reduced by approximately 50% for each 4 to 5 cm (1.6 to 2 inches)
of tissue thickness.

• Type of Tissue.
° Tissue of a higher anatomic number, such as bone, attenuates the x-ray beam more that tissue composed of a lower
atomic number, such as fat.

• Tissue density
° (matter per unit volume), or the contractness of the anatomic particles comprising the anatomic part, also affect the
amount of beam attenuation.
 • X-ray Beam Quality
° The quality of the x-ray beam or its penetrating ability affects its interaction with anatomic tissue.
° Higher penetrating x-rays (shorter wavelength with higher frequency) are more likely to be transmitted through
anatomic tissue without with the tissues’ atomic structures.
° Lower penetrating x-rays (longer wavelength with lower frequency) are more likely to interact with the atomic
structures and be either absorbed or scattered.

• Transmission
° if the incoming x-ray photon passes through the anatomic part without any interaction with the atomic structures, it is
called transmission.

• Exit radiation.
° When the attenuated x-ray beams leaves the patient, the remaining x-ray beam, referred to as exit radiation or
remnant radiation, is composed of both transmitted and scattered radiation.
RADIOGRAPHIC QUALITY
A quality radiographic image accurately represents the anatomic area of interest, and information is well visualized for diagnosis. It is
important to identify the attributes of a quality radiographic image before comprehending all the factors that affects radiographic
quality

• The visibility of the anatomic structures and the accuracy of the structural lines recorded (sharpness) determine the overall
quality of the radiographic image.

• Visibility of the recorded detail refers to the brightness or density of the image; and the accuracy of the structural lines is
achieved by maximizing the amount of spatial resolution or recorded detail and maximizing the amount of spatial
resolution or recorded detail and minimizing the amount of distortion

• Visibility of the recorded detail is achieved by the proper balance of image brightness on density and contrast.
Image Brightness or Density
How the radiograph is displayed determines whether to evaluate the image in terms of brightness or density?

Brightness and density refer to the same image quality attribute but are defined differently.

• Brightness is the amount of luminance (light emission) of a display monitor.

• Density is the amount of overall blackness on the processed image
Image Contrast

• Radiographic contrast
° is the combined result of multiple factors associated with the anatomic structure, quality of the radiation, capabilities
of the image receptor, and, in digital imaging, computer processing and display.

• Subject Contrast
° refers to the absorption characteristics of the anatomic tissue radiographed and the quality of x-ray beam.
° Differences in tissue thickness, density, and effective atomic number contribute to subject contrast.

• Radiographic or image contrast

° is a term used in both digital and film screen imaging describe variation in brightness and density.
° Radiographic film images are typically described by their scale of contrast, or the range of densities visible.
° A film image with few densities but great differences among them is said to have high contrast; this is also described
as short-scale contrast.
° A radiograph with a large number of densities but few differences among them is said to have low contrast; this is
also described as long-scale contrast.

• The term contrast resolution

° is used to describe the ability of an imaging receptor to distinguish between objects having similar subject contrast.
° Digital image receptors have improved contrast resolution compared with film-screen image receptors.

• Spatial resolution
° refers to the smallest object that can be detected in an image and is the term typically used in digital imaging.
• Recorded detail
° refers to distinctness or sharpness of the structural lines that make up the recorded image and is the term used in film-
screen imaging.

• Distortion
° results from radiographic misrepresentation of either the size (magnification) or the shape of the anatomic part.
° When image is distorted, spatial resolution or recorded detail is also reduced.
• Size Distortion (Magnification)
° refers to an increase in the image size of an object comparted to its true, or actual size.
° Radiographic images of objects are always magnified in terms of the true object size.
° The source-to-image receptor distance (SID) and object-to-image receptor distance (OID) play an important role in
minimizing the amount of size distortion of the radiographic image.
° As SID increases, size distortion (magnification) decreases; as SID decreases, size distortion (magnification)
increases.

• Shape Distortion
° can appear in two different ways radiographically: elongation or foreshortening.
• Elongation
° refers to images of objects that appear longer than the true objects.
• Foreshortening
° refers to images that appear shorter than the true objects.
• Shape distortion
° can occur from inaccurate central ray (CR) alignment of the tube or part being radiographed, or the image receptor.
° Any misalignment of the CR among these three factors-tube, part, or image receptor-alters the shape of the part
recorded in the image.
Scatter Radiation

• Can add unwanted exposure to the radiographic image as a result of Compton interactions.
• Unwanted exposure or fog on the image does not provide information about the anatomic area of interest.
• Scatter degrades or decreases the visibility of the anatomic structures.
• The scatter or unwanted exposure recorded on the image has the effect of decreasing contrast by masking the desired
brightness or densities on the image and changing the degree of differences.

Quantum Noise

• Image noise contributes no useful diagnostic information and serves only to detract from the quality of the image.
• Quantum noise is a concern in digital and film-screen imaging and is photon dependent.
• Quantum noise is visible as brightness or density fluctuations on the image.
• Quantum mottle is the term typically used when referring to noise on a film image.
• The fewer the photons reaching the image receptor to form the image, the greater the quantum noise visible on the digital
image.

An artifact

• is any unwanted image on a radiograph.

• Artifacts are detrimental to radiographs because they can make visibility of anatomy, a pathologic condition, or patient
information difficult or impossible. They decrease the overall quality of the radiographic image.

• Various methods are used to classify artifacts.

Classification of Artifacts

• Plus density artifacts

° are greater in density than the area of the image immediately surrounding them.
• Minus density artifacts
° are less density than the area of the image immediately surrounding them.
PRIMARY FACTORS

• The primary exposure technique factors the radiographer selects on the control panel are:
milliamperage (mA),

time of exposure, and

 kilovoltage peak (kVp).

Milliamperage and Exposure Time

• The quantity of radiation reaching the patient affects the amount of remnant radiation reaching the IR.
• The product of milliamperage and exposure time has a direct proportional relationship with the quantity of x-ray produced.
• Once the anatomic part is adequately penetrated, as the quantity of x-rays is increased, the exposure to the IR proportionally
increases.

• Conversely, when the quantity of x-rays is decreased, the exposure to the IR decreases.
• Therefore, exposure to the IR can be increased or decreased by adjusting the amount of radiation (mAs).

Mathematical Application:

• mAs = mA x s
• Adjusting Milliamperage or Exposure Time
▪ 200 mA x 0.1s -= 20mAs
• To increase the mAs to 40, you could use:
▪ 400 mA x 0.1 s = 40 mAs
▪ 200 mA x 0.2 s = 40 mAs
• Adjusting Milliamperage and Exposure Time to Maintain mAs
200 mA x 100 ms (0.1s) = 20 mAs

• To maintain the mAs use:

↑
400 mA x 50 ms (0.05s) = 20 mAs

100 mA x 299 ms (0.2s) = 20 mAs

• ‘Milliamperage and exposure time have an inverse proportional relationship when maintaining the same mAs.
• *mAs and Film-Screen Density
• The amount of mAs has a direct effect on the amount of radiographic density produced when using a film-screen IR.
• The minimum change needed to correct for a density error is determined by multiplying or dividing the mAs by 2.

• To visualize the anatomic area of interest best, the mAs selected must produce a sufficient amount of radiation reaching the IR,
regardless of type.

• An excessive or insufficient amount of mAs adversely affects image quality and patient radiation exposure.

Kilovoltage Peak

• The kVp affects the exposure to the IR because it alters the amount and penetrating ability of the x-ray beam.
• When adequate penetration is achieved, increasing the kVp further results in more radiation reaching the IR.
• In addition to affecting the amount of radiation exposure to the IR, the kVp also affects image contrast.
• * kVp and the Radiographic Image
▪ Increasing or decreasing the kVp changes the amount of radiation exposure to the IR and the contrast produced within
the image.

Kilovoltage Peak and Exposure to the Image Receptor

• Maintaining or adjusting exposure to the IR can be accomplished with kVp by using the 15% rule. The 15% rule states that
changing the kVp by 15% has the same effect as doubling the mAs or reducing the mAs by 50%.
 Mathematical Application:

• Using the 15% Rule:

° To increase exposure to the IR, multiply the kVp by 1.15 (original kVp +15%):
• 75 kVp x 1.13 = 86 kVp
° To decrease exposure to the IR, multiply the kVp by 0.85 (original kVp -15%)
• 75 kVp x 0.85 = 64 kVp
° To maintain exposure to the IR, when increasing the kVp by 15% (kVp x 1.15), divide the original mAs by 2:
• 75 kVp x 1.15 = 86 kVp and mAs / 2
° When decreasing the kVp by 15% (kVp x 0.85), multiply the mAs by 2:
• 75 kVp x 0.85 = 64 and mAs x 2

Kilovoltage Peak and Radiographic Contrast

• A high kVp results in less absorption and more transmission in the anatomic tissues, which results in less variation in the x-ray
intensities exiting the patient (lower subject contrast), producing a low-contrast image.

• A low kVp results is more absorption and less x-ray transmission but with more variation in the x-ray intensities exiting the
patient (higher subject contrast), resulting in a high-contrast image.

Kilovolatage and Digital Image Quality

• Assuming that the anatomic part is adequately penetrated, changing the kVp affects the radiation exposure to the digital IR
similarly to changing the mAs, but dissimilar to mAs, kVp also affects image contrast.

• However, image brightness and contrast are primarily controlled during computer processing.

Kilovoltage, Scatter Radiation, and Radiographic Contrast

• At higher kVp, a greater proportion of Compton scattering occurs compared with x-ray absorption (photoelectric effect), which
decreases radiographic contrast.

• Decreasing the kVp decreases the proportion of Compton scattering and increases radiographic contrast
SECONDARY FACTORS

• Focal Spot Size

! Focal spot size is determined by the filament size.
! When the radiographer selects a particular focal spot size, he or she is actually selecting a filament size that is energized
during x-ray production.

! Focal spot size is an important consideration for the radiographer because focal spot size affects recorded detail.

Focal Spot Size and Recorded Detail

• As focal spot size increases, unsharpness increases, and recorded detail decreases;
• as focal spot size decreases, unsharpness decreases, and recorded detail increases.
• Generally, the smallest the focal spot size available should be used for every exposure. However, exposure is limited with a
small focal spot size.

• When a small focal spot is used, the heat created during exposure is concentrated in a smaller area and could cause tube
damage.

Source-to-Image Receptor Distance (SID)

• The distance between the source of the radiation and the IR, source-to-image receptor distance (SID), affects the amount of
radiation reaching the patient. Because of the divergence of the x-ray beam, the intensity of the radiation varies at different
distances.

• This relationship between distance and the x-ray beam intensity is best described by the inverse square law.
• The inverse square law states that the intensity of the x-ray beam is inversely proportional to the square of distance from the
source.
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.
 • Mathematical Application:
• I (D )
1 = 2
2

___________

• I = (D )
2 1
2

• The intensity of radiation at an SID of 40 inches is equal to 400 mR. What is the intensity of radiation when the distance is
increased to 72 inches?
2
400 mR = (72)
______________ 400 mR x 1600 = 640,00 = x; 123.5 mR
2
X = (40) 5184

SID and mAs

• Increasing the SID requires that the mSa be increased to maintain exposure to the IR, and
• decreasing the SID requires a decrease in mAs to maintain exposure to IR.
• Maintaining consistent radiation exposure to the IR, when SID is altered requires that the mAs be adjusted to compensate.
• The mAs/distance compensation formula provides a mathematical calculation for adjusting the mAs when changing the SID.
Mathematical Application:

• mAs/Distance Compensation Formula

2
mAs1 = (SID1)
____________________

2
mAs 2 = (SID2)

• Optimal exposure to the IRF is achieved at an SID of 40 inches using 25 mAs. The SID must be increased to 72 inches. What
adjustment in mAs is needed to maintain exposure to the IR?

​25 (40) 2

​ = ____ ; 1600 x = 129,600; 129,600 ; x = 81 mAs2

​X (72)
2
1600

SID, Size Distortion, and Recorded Detail

• As SID increases, size distortion (magnification) decreases, and recorded detail or spatial resolution decreases.
Object-to-Inage Receptor Distance (OID)

• When distance is created between the object radiographed and the IR, known as object-to-in-image receptor distance (OID),
decreased beam intensity may result.

• As the exit radiation continues to diverge, less overall intensity of the x-ray beam reaches the IR.
• Decreasing the exposure to the IR may require an increase in the mAs to compensate.
OID, Size Distortion, and Recorded Detail or Spatial Resolution

• Increasing the OID increases magnification and decreases recorded detail or spatial resolution, whereas decreasing the OID
decreases magnification and increases the recorded detail or spatial resolution.
Calculating Magnification
90
Mathematical Application:

• An anteroposterior projection (AP) of the knee is produced with an SID of 40 inches and an OID of 3 inches (SOD is equal to
37 inches). What is the MF?

​SOD = SID – OID ​ ​MF = 40 ; MF= 1.081

​37 = 40-3 37 ​
• It may be helpful to know the measurement of the true object size in comparison with its size on a radiographic image. Once
the MF is known, the object size can be determined. This requires the use of another formula:

​ ​Object size = Image size

​ ​ ​ ​ MF

•Mathematical Application:
Determining Object Size

• On an AP of knee taken with an SID of 40 inches and an OID of 3-inches (SOD = 3 inches), the size of a lesion measures 0.5
inch in diameter on the radiograph. The MF has been determined to be 1.081. What is the object size of this lesion?
 ​40 = 1.081 MF ​ ​ Object size = 0.5 inch
37 1.081

• The object size is 0.463 inch

Central Ray Alignment

• Shape distortion of the anatomic area of interest can occur from inaccurate central ray (CR) alignment of the tube, the part
being radiographed, or the IR.

• Any misalignment of the CR among three factors alters the shape of the part recorded on the image.
Grids

• A radiographic grid 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 reaches the IR improves the quality of image.
• Much of the scatter radiation exiting the patient does not reach the IR when absorbed by a grid.
• The effect of less scatter, or unwanted exposure, on the image is to increase the radiographic contrast.
GRID CONVERSION CHART
GRID RATIOS GRID CONVERSION
FACTOR
No grid -
1 NO 1

5:1 2
I
6:1 3 26
5.11
3
:p
8:1 -
4 8 ! I 4
12:1 -
5 12 :L 3
16:1 -
6
ly :L a

Grids, Scatter, and Contrast

♦ Placing a grid between anatomic area of interest and the IR absorbs scatter radiation exiting the patient and increases
radiographic contrast.
♦ The more efficient a grid is in absorbing scatter, the greater is its effect on radiographic contrast.
♦ Grids also absorb some of the transmitted radiation exiting the patient and therefore reduce the amount of radiation reaching
the IR.

Grid and Image Receptor Exposure

♦ Adding, removing, or changing a grid requires an adjustment in mAs to maintain radiation exposure to the IR.
♦ 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.
♦ The grid conversion formula is a mathematical formula for adjusting the mAs for changes in the type of grid.

mAs1 = Grid conversion factor 1

mAs2 Grid conversion factor 2

Mathematical Application:
Adjusting mAs for Changes in Grid

• A quality radiograph is obtained using 5 mAs at 70 kVp without using a grid. What new mAs is needed when adding a 12:1
grid to maintain the same exposure to the IR?

​ ​5 mAs ​ 1 ; 1 x =25; x= 25 mAs

​ ​ X = 5

• The new mAs produces an exposure comparable with the IR

Grid Selection

➢ Decisions regarding the use of a grid and grid ratio should be made by balancing image quality and patient protection.
➢ To keep patient exposure as low as possible, grids should be used only when appropriate, and the grid ratio should be the
lowest that would provide sufficient contrast improvement.
Beam Restriction
♦ Any change in size of the x-ray field alters the amount of tissue irradiated.
♦ A larger field size (decreasing collimation) increases the amount of tissue irradiated, causing more scatter radiation to be
produced, and increases the amount of radiation reaching the IR.
♦ The increased amount of scatter reaching the IR results in less radiographic contrast.
Beam Restriction and Image Receptor Exposure
 • 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.
Generator Output

! Exposure techniques and the amount of radiation output depend on the type of generator used.
! Generators with more efficient output, such as three-phase or high frequency units, require lower exposure technique settings to
produce an image comparable with single-phase units.
Tube Filtration
o Small variations in the amount of tube filtration should not have any effect on radiographic quality.

o Variability of the x-ray tube filtration should be checked as a part of routine quality control checks on the radiographic
equipment.
o X-ray tubes that have excessive or insufficient filtration may begin to affect image quality.

oIncreasing the amount of tube filtration increases the percentage of higher-penetrating x-rays to lower-penetrating x-rays.
Compensating Filters

• When imaging an anatomic area that varies greatly in tissue thickness, a compensating filter can be placed in the primary beam
to produce a more uniform exposure to the IR.

• The use of compensating filters requires in the increase in the mAs to maintain the overall exposure to the IR.
PATIENT FACTORS
♦ Body Habitus
° Body habitus refers to the general form or build of the body, including size.
° It is important for radiographer to consider body habitus when establishing exposure techniques.
° There are four types of body habitus:
1. sthenic,
2. hyposthenic,
3. hypersthenic, and
4. asthenic.
1. Sthenic
° accounts for approximately 50% of the adult population and is commonly called as normal or average build.
2. Hyposthenic
° accounts for approximately 35% of adults and refers to a similar type of body habitus as sthenic, but with a tendency
toward a more slender and taller build.

3. Hypersthenic
° large, stocky build, accounts for only 5% of adult. These individuals have thicker part sizes compared with sthenic
and hyposthenic individuals, so exposure factors for their radiographic examination is higher.

4. Asthenic
° refers to very slender body habitus and accounts for only 10% of adults. Exposure factors for asthenic individuals are
at low end of technique chrats because their respective part sizes are
Pediatric patients

• Are a technical challenge for radiographers for a number of reasons.

• Pediatric patients, because of their smaller size, require lower values of kVp and mAs when compared with adults
Chronological Maturity Minimum kVp to penetrate
Premature 50
Infant 55
Child 60
Adapting Exposure Factors For Children Based On Exposure Factors For Adults, Excluding Chest And Skull Examinations

Age (in years) Exposure Factor Adaptation

0-5 25% of mAs indicated for

adults
6-112 50% of mAs indicated for
adult
 Casts and Splints

• Cast and Splints can be produced with materials that attenuate x-rays differently.
• Selecting appropriate exposure factors can be challenging because of the wide variation of materials used for these devices.
Cast

Cast produced in fiberglass generally requires no change in exposure factors from the values used for the same anatomical
parts without cast.

Cast produced in plaster present a problem in terms of exposure factors.

Plaster cast require an increase in exposure factors compared with that needed to radiograph the same part without a cast.
However, the method and amount of increase in exposure has not been standardized.

One of method of approaching the exposure factor conversion is to consider whether the cast is still wet from the application
or whether it is dry. This approach states that increase of 2 times the mAs is needed for dry plaster casts and an increase of 3
times the mAs is needed for wet plaster casts.
Splints

• Splint present less of a problem in determining appropriate exposure factor than casts.
• Inflatable (air) and fiberglass splints do not require any increase in exposure. Wood, aluminum, and solid plastic splints may
require that exposure factors be increased, but only if they are in path of the primary beam.

Pathology
Pathologic condition that can alter the absorption characteristics of the anatomic part being examined are divided into two categories:

1. Additive diseases
° are diseases or conditions that increase the absorption characteristics of the part, making the part more difficult to
penetrate.

2. Destructive diseases
° are those diseases or conditions that decrease the absorption characteristics of the part, making the part less difficult to
penetrate.

It is necessary to increase kVp when radiographing parts that have been affected by additive disease and to

decrease kVp when radiographing parts that are affected by destructive diseases.

Additive Conditions
Abdomen

Aortic aneurysm

Ascites

Cirrhosis

Hypertrophy of some organs

(e.g., splenomegaly

Skeleton

Hydrocephalus

Metastases (osteoblastic)

Osteochondroma (exostoses)

Paget’s disease (late stage)

Chest

Atelectasis

Congestive heart failure

Malignancy

Pleural effusion

Pneumonia

Destructive Conditions
 Bowel obstruction

Free air

Emphysema

Pneumothorax
Gout

Matastases (osteolytic)

Multiple myeloma

Paget’s disease (early stage)

Osteoporosis I

Atrophy

Emaciation

Malnutrition

CONTROL OF SCATTERED RADIATION

SCATTER CONTROL

• Controlling the amount of scatter radiation that reaches the image receptor is essential in creating an optimal quality image.
• Scatter Radiation is detrimental to radiographic quality because it adds unwanted density to the image without adding any
patient information.
kVp and Scatter

• The amount of scatter produced within the patient depends, in part, on the kVp selected.
• Exams using higher kVp’s produce a greater proportion of scattered x-rays as compared to low kVp exams.
X-ray Beam Field Size, Thickness of the Part, and Scatter

The amount of scatter produced within the patient depends, in part, on the kVp selected.

The thicker the part being imaged, the greater the amount of scatter radiation produced.
Volume of Tissue Irradiated and Scatter

The volume of tissue irradiated is affected by both the part thickness and the x-ray beam field size.

Therefore the greater the volume of tissue irradiated, because of either or both factors, the greater the amount of scatter
radiation produced.
Beam Restriction
⊗ Beam Restriction serves two purposes:
▪ limiting patient exposure and
▪ reducing the amount of scatter radiation produced within the patient.

Beam Restrictors:

1. Aperture diaphragm
! the simplest type of beam restricting device. It is a flat piece of lead that has a hole in it.
2. Cone/cylinder
! is essentially an aperture diaphragm that has an extended flange attached to it.
! The flange can vary in length and can be shaped as either a cone or cylinder.
3. Collimator
! useful, and accepted type of beam-restricting device. Considered to be the best type available for radiography.
4. Automatic collimator
! also called positive beam limiting devices (PBL).
! Automatically limits the size and shape of the primary beam to the size and shape of the image receptor.
 Beam Restriction and Patient Dose

I
▪ 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 increase, 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.
Collimation and Radiographic Contrast

As collimation increases, the quantity of scatter

radiation decreases, and radiographic contrast
increases;

as collimation decreases, the quantity of scatter

radiation increases, and radiographic contrast
increases.
Collimation and Radiographic Density

As collimation increase, radiographic density decreases;

as collimation decreases, radiographic density decreases.

​It has been recommended that significant collimation requires an increase in as much as 30% to 50% of the mAs to compensate for
the loss density that occurs because of collimation.

Restricting The Primary Beam

INCREASED FACTOR RESULT
COLLIMATION ⊗ Patient dose decreases
⊗ Scatter radiation
decreases
⊗ Radiographic contrast
increases
⊗ Radiographic density
decreases

Field size ⊗ Patient dose increases

⊗ Scatter radiation
increases
⊗ Radiographic contrast
decreases
⊗ Radiographic density
increases

Radiographic Grids

• Was invented in 1913 by Guatave Bucky.

• Is a device that has a very thin interspaced lead strips intended to absorb scatter radiation emitted from the patient before it
strikes the image receptor.

• Grid should be used when the anatomic part being imaged is 10cm or more and more than 60 kVp is appropriate for the exam.
Grid Construction

• Grid contain thin lead strips or lines that have a precise height, thickness, and space between them.
• Radiolucent interspace material separates the lead lines. Interspace material typically is made of aluminum.
• The lead lines and interspace material of the grid is covered by an aluminum front and back panel.
Grid construction can be described by:

1. Grid Frequency – expresses the number of lead lines per unit length, in inches, centimeters or both. It can range in value
from 25 to 45 lines/cm (60 to 110 lines/inch).

2. Grid Ratio – is defined as the ratio of the height of the lead strips to the distance between them. Grid ratio can also
expressed mathematically as follows:
⊗ Grid ratio = h/D
 ! Where: h is the height of the lead strips
! D is the distance between them
As grid ratio increases, scatter cleanup improves and radiographic contrast increases;

as grid ratio decreases, scatter cleanup is less effective and radiographic contrast decreases

GRID FREQUENCY
⊗ The number of grid lines per inch or centimeter.
⊗ Gird frequency ranges from
o 60 to 196 lines/inch (25-78 lines/cm)
⊗ Most commonly used grids have a frequency of
o 85-103 lines/inch (33-41 lines/cm)
⊗ In general, as the lead content increases, the ability of the grip to
remove scatter and improve contrast increases.

Grid Pattern

• Refers to the linear pattern of the lead lines of a grid.

• Two types of grid pattern exist:
1. Linear Grid
o has lead lines that run into one direction. It is most popular in terms of grid pattern because they allow angulation
of the x-ray tube along the length of the lead lines.

2. Crossed or cross-hatched Grid

o has lead lines that run at a right angle to one another.
o It removes more scatter photons than linear grids
because they contain more lead strips, oriented in
two directions.

Grid Focus

Refers to the orientation of the lead lines to one

another. Two types of grid focus exist:

1. Parallel or Non-Focused Grid

o has lead lines that run parallel to one another. Used
primarily in fluoroscopy and mobile imaging.

2. Focused Grid
o has lead lines that are angled to approximately
match the angle of divergence of the primary beam.
 Types of Grids

1. Wafer Grid
o matches the size of cassette and is use by placing it on top of the image receptor.
2. Grid Cassette
o is an image receptor hat has a grid permanently mounted to its front surface.
3. Grid Cap
o contains a permanently mounted grid and allows the image receptor to slide behind it.
STATIONARY GRIDS
⊗ AKA “Water” Grids or leisholm grids
⊗ Produce x-rays that have very fine white lines on them.
⊗ These are the area of the film that are blocked from receiving and x-ray by the lead strips
⊗ To eliminate these “grids lines” the moving or Potter-Bucky diaphragm was developed by Potter in 1913
Moving Grids
• Motion starts with second trigger
• Grids move 1-3 inches
o Must fast enough not to see grid lines for short exposure
• Motion blurs out lead strip shadows

Reciprocating Grid
o A reciprocating grid is a moving grid that is motor-driven back and forth several times during x-ray exposure.

o The total distance of drive is approximately 2cm.

Oscillating Grid
o An oscillating Grid is positioned within a frame with a 2-3cm tolerance on all sides between the frame and the grid.

o Delicate, springlike devices located in the four corners hold the grid centered within the frame.

o A powerful electromagnet pulls the grid to one side and releases it at the beginning of the exposure.

o Thereafter, the grid oscillates in a circular fashion around the grid frame, coming to rest after 20 to 30 seconds.

Grid Performance

• The best measure of how well a grid performs is the contrast improvement factor. It is expressed mathematically as follows:
K= Radiographic contrst with a grid

Radiographic contrast without a grid

Where: K = signifies the contrast improvement factor

The Grid conversion factor (GCF), or Bucky factor, can be used to determine the adjustment in mAs needed when
changing from using a grid to non-grid (or vice versa) or for changing to grids with different grid ratios.

The GCF can be expressed mathematically as:

mAs with the grid

GCF =
mAs without the grid
Grid Cutoff

Is defined as a decrease in the number of transmitted photons that reach the image receptor because of some misalignment of
the grid.

The primary radiographic effect of grid cutoff is a further reduction in the number of photons reaching the IR, and a decrease
in radiographic density.
Types of Grid Cutoff Errors:

1. Upside Down Focused

o occurs when a focused grid is place upside down on the image receptor, resulting in grid lines going opposite the
angle of divergence of the x-ray beam.

2. Off-Level
o results when the x-ray beam is angled across the lead strips. It is the most common type of cutoff and can occur
from either the tube or grid being angled.

3. Off-Center
o also called lateral decentering, occurs when the central ray of the x-ray beam is not aligned from side to side with
the center of a focused grid.

4. Off-Focus
o occur when using an SID outside of the recommended focal range.
o It occurs when the SID is less than or greater than the focal range.
UPSIDE- DOWN FOCUSED
♦ Up-down focused grip cutoff occurs when a focused grid is placed upside-down on the image receptor, resulting in the grid
lines going opposite the angle of divergence of the x-ray beam
♦ This appears radiographically as significant loss of density along the edges of the image photons easily pass through the
center of the grid because the lead lines are perpendicular to the image receptor surface.
♦ Lead lines that are more peripheral to the center are angled more and thus absorb the transmitted photons.

OFF-LEVEL
• Off-level grid results when the x-ray beam is angled across the lead strips.
• It is the most common type of cutoff and can occur from either the tube or grid being angled.
• Off-level grid cutoff can often be seen with mobile radiographic studies or horizontal beam exams and appears as a loss of
density across the entire image.
• This type of grid cutoff is the only type that occurs with both focused and parallel grids

OFF-FOCUS
• Off-focus grid cutoff occurs when using an SID outside of the recommended focal range.
• Grid cut off occurs if the SID is less than or greater than the focal range.
• Both appear the same radiographically as a loss of density
at the periphery of the film.

OFF-CENTER
♦ Also called lateral decentering, off-center grid cutoff
when the central ray of the x-ray beam is not aligned from
side to side with center of a focused grid. Because of the arrangement of the lead lines of the focused grid, the divergence of
the primary beam does not match the angle of these lead strips when not centered.
♦ Off-center grid cutoff appears radiographically as an overall loss of density.
Air Gap Technique

Is an alternative to using a grid to control scatter reaching the image receptor.

By moving the image receptor away from the patient, more of the scatter radiation will miss the IR. The greater the gap, the
less scatter reaches the IR.

When the air-gap technique is used, the image receptor is positioned to 10-
15cm from the patient. A large fraction of scattered x-rays does not interact
with the image receptor.
Alternatives to grid use
• Air-gap technique
• OID is increased
• Equal is to approximately 8:1grid
• Increases magnification
• Distance must be increased to overcome magnification
• Not effective w high kVp

IMAGE RECEPTORS AND IMAGE ACQUISION

Film-Screen System

• Radiographic Film- (image receptor) - the medium that converts x-ray beam into a visible image.
Film Construction
Double Emulsion Film

Parts of a Radiographic Film

Base
• the foundation for radiographic film; supports the emulsion
♦ Properties
a. transparent and clear
b. flexible and sturdy
c. slight blue tint
d. polyester (flexible and transparent) ​ ​
• Purpose of Film Base
• Provide rigid structure onto which the emulsion can be coated
 • Should be flexible but unbreakable to allow easy handling
• Should be sturdy/ strong to maintain size and shape during use and processing (Dimensional Stability)
• Should be nearly transparent to light so there will be no unwanted pattern or shading on the film caused by the base
(Uniform Lucency)
Types of Film Base

! Glass Plate l
! Cellulose Nitrate
! Cellulose Triacetate
! Polyester (1960)
! Advantages of Polyester
• More resistant to warping with age and stronger than cellulose triacetate, permitting easier transport through
processor

• Thinner compared to all other bases (175 µm) compared to cellulose triacetate (200µm) but just as strong
Emulsion

• Emulsion- the heart of x-ray film.

• It is the material in which x-rays or light photons from the screen interact and transfer information.
• The emulsion consists of homogenous mixture of:
! gelatin and
! silver halide crystals.
o Gelatin- mixture where the silver halide crystals are suspended.
o The main function of the gelatin is to provide mechanical support for the silver halide crystals by holding
them uniformly dispersed in place.

• Properties:
• Clear, so that it transmits light
• Porous- to penetrate the silver halide crystals during processing
! Silver Halide Crystals
o the active ingredient of the radiographic emulsion.
o These are flat triangular and approximately 1µm on a side.
o The arrangements of atoms are in cubes.
o The shape and lattice structure of the silver halide crystals are not perfect, and the imperfections result in
the imaging property of the crystals.
o The type of imperfection thought to be responsible is a chemical contaminant, usually Silver Sulfide, and
this contaminant is named sensitivity specks.
o The crystals are made by:

dissolving the metallic silver (Ag) in nitric acid (HNO3) to form Silver Nitrate (AgNO3).

o The light-sensitive Silver Bromide (AgBr) crystals are formed by:

mixing silver nitrate with Potassium Bromide (KBr).

• Silver Bromide- 95%

• Silver Iodide- 5 %

• AgNO 3
+ KBr → AgBr ↓ + KNO3

Film Grain
• clumping of the silver halide crystals. In actuality, these silver halide crystal during manufacturing are dispersed through-out
the gelatin.
• During manufacture, film speed is determined and controlled by adding the right amount of dyes to the film emulsion.
 Cubic Arrangement of Atoms in the Crystal

Supercoat

durable protective layer that is intended to prevent damage to the sensitive emulsion layer underneath it
Adhesive Layer

binds the emulsion to the base of the film

Antihalation layer

colored backing on single-emulsion film that prevents film from curling and prevents halation (refers to an image being
recorded on the film by reflected light that exposes the emulsion a second time.

This is unwanted light could come from intensifying screen used in mammography; from the light source used in multiformat
camera.

This colored backing is removed during processing

LATENT IMAGE FORMATION

Latent Image

Refers to the image that exists on film after that film has been exposed but before it has been processed.
Manifest Image

Refers to the image that exist on film after exposure and processing.

The manifest image typically is called radiographic image.

Gurney-Mott Theory of Latent Image Formation:

• Before exposure, silver halide (AgBr and AgI) is suspended in gelatin in the emulsion layer.
 • Sensitivity specks exist as physical imperfections in film lattice.
• Exposure to x-rays and light ionizes the silver halide.
• Negatively charged electrons and positively charged silver ions float freely in the emulsion gelatin.
• Sensitivity specks trap electrons
• Each trapped electrons attracts a silver ion
• Silver clumps around the sensitivity specks
• Sensitivity specks serves as the focal point for the development of latent image centers.
• After exposure, these specks trap the free electrons and then attract and neutralize the positive silver ions.
• After enough silver is neutralized, the specks become a latent image center and are converted to black metallic silver after
chemical processing.

Types of Film:
Screen Film
• photographic film used in conjunction with intensifying screen.
• This is also known as indirect exposure film.
• This type of film reacts to light.
• The use of a screen film together with intensifying screen greatly reduces patient dose up to 95%.
• Blue Sensitive
• Green Sensitive
Non-Screen Film
• film used without intensifying screen.
• This is also known as direct exposure film.
• This type of film reacts to x-rays.
• This film provides better sharpness of the image but with higher patient dose compared to screen film.
• It is most applicable for the imaging of thin body parts such as the hands and feet that have high subject contrast.
• The emulsion is thicker and contains higher concentration of silver halide crystals to enhance direct x-ray interaction.
• The direct exposure film is usually used together with a cardboard film holder, although some are available in individually
packaged paper wrappings.
Specialty Film:

• Duplicating film- used for duplicating existing radiograph

• Subtraction film
• Cine films
• Roll films
• Therapy localization film
• Personnel monitoring film or dosimeter films
• Industrial film
• Automatic serial changer film
• Spot film
• Dental films
• Intraoral (1 ¼ in X 1 5/8 in)
• Panoramic films ( 5in X 12in)
Factors Affecting Film Sensitivity:

• Number of silver halide crystals

• The size of silver halide crystals
Film Characteristics:
Film Speed
♦ the degree to which the emulsion is sensitive to x-rays or light
♦ The greater the film speed of a film the more sensitive it is.
♦ This increase in sensitivity results in less exposure necessary to produce a specific density.
 ♦ Screen film is also available in film speed.
♦ In general, the thicker the emulsion, the more sensitive is the film and therefore, higher the speed
♦ Most extremity examination now employ fine-grain, high detail screens and single-emulsion film as image receptor.
♦ In general, large-grain emulsions are more sensitive than small-grain emulsions.
♦ Current emulsions contain less silver yet produce the same optical density per unit exposure.
♦ This more efficient use of silver is termed as the covering power of the emulsion.
♦ Films are commonly double emulsion to maximize speed, which provides twice speed than of a single-coated film.
Light Sensitivity/ Spectral Response
⊗ use green sensitive film with a green emitter intensifying screen and
⊗ Blue sensitive film with a blue emitter intensifying screen
• Orthochromatic (Green Sensitive)
• Panchromatic (Blue Sensitive) ​ ​ ​ ​
Crossover
♦ a problem that is unique to double-emulsion film used with intensifying screens.
♦ Crossover refers to light that has been produced by an intensifying screen that exposes one emulsion and then crosses over
the base layer of the film to expose the other emulsion. (decreases recorded detail on the radiograph)
Spectral Matching

• Refers to the color of light to which particular film is most sensitive.

• In radiography, there are generally two categories of spectral sensitivity films:
1. blue sensitive
2. green sensitive (orthochromatic)
• When radiographic film is used with intensifying screens, it is important to match the spectral sensitivity of the film with
spectral emission of the screens.
Spectral emission
• refers to the color of light produced by a particular intensifying screen.
Spectral matching
• refers to correctly matching the color sensitivity of the film to the color emission of the intensifying screen.
Handling and Storage

• Radiographic film is pressure sensitive, so rough handling or the imprint of any sharp object will produce an artifacts.
• Creasing the film before processing will produce line-like or fingernail-appearing artifact
• Dirt on hands or intensifying screens will result in a specular-type of artifacts
In dry environment, static electricity can cause characteristics artifacts like tree-like branching, smudge and crown.

Heat and Humidity

• Temperature should not exceed 20⁰C (68⁰F). 10⁰C (50⁰F) of temperature can make storage time longer to about 1 year.
• Relative Humidity should be maintained at 40%.
Light

• Any photographic film should not be exposed to any form of light.

• All films should be handled in the darkroom.
Radiation

• Films should be stored away from the source of radiation.

Shelf Life

• Take note of the expiration date.

FIFO
• Stocks that came first should be used first. (First In, First Out)
• Films should be stacked in vertical rather than horizontal to avoid any pressure marks.
• Forty-five days is a reasonable maximum storage time for radiographic film.
Handling

• Hands should be clean and dry

• Do not use lotion and hand creams
• Do not lay in cabinets
• Do not slid across surfaces
• Open only in darkroom
Storage:
• Keep in cool and dry place ( 50 F and 5% humidity)
o

• Keep away from radiation sources

• Note expiration date
• Stack upright
Possible Consequences of Storing Unexposed Film in Environment with Improper Temperature and Relative Humidity:
Storage Environment Problem Possible Consequences
Temperature too high Increased for levels
Temperature too Low Increase static discharges
Humidity too High Increased fog levels
Humidity too Low Increased Static Charges

Intensifying screens

• Is a device found in radiographic cassettes that contains phosphors that convert x-ray energy to light, which then exposes the
radiographic film.

• Intensify or amplify the energy to which they are exposes.

• With screens, the total amount of energy to which the film is exposed is divided between x-rays and light. Approximately 90%
to 99% of the total energy to which the film is exposed is light. X-rays account for the remaining 1% to 10% of the energy.

Luminescence
♦ is the emission of light from the screen when stimulated by radiation.
♦ IS operates in this process.
Fluorescence
♦ refers to the ability of phosphors to emit visible light only while exposed to x-rays.
Phosphorescence
♦ occurs when screen phosphors continue to emit light after the x-ray exposure has stopped. It is also called screen lag or
afterglow.
3 Layers of Intensifying Screen:

1. Protective Layer
⊗ the outermost layer, found closest to the film. It is made of plastic and protects the fragile phosphor material
beneath it.

2. Phosphor Layer
⊗ or active layer, is the most important screen component because it contains the phosphor material that absorbs the
transmitted ex-rays and converts them to visible light.

3. Reflecting Layer
⊗ to reflect light toward the film.
⊗ It is made up of either:
o magnesium oxide or
o titanium dioxide.
4. Base
⊗ the bottom layer, found farthest from the film. Made of polyester or cardboard.
⊗ It must be flexible and chemically stable.
⊗ It provides support and stability for the phosphor layer.
 Intensifying Screen Phosphor Materials and Their Spectral Emissions
Phosphor Spectral Emission
Calcium Tungstate (CaWo4) Blue
Rare Earth Elements Blue
Lanthanum oxybromide Ultraviolet/blue
(LaOBr)
Yttrium Tantalate (YtaO4) Green
Gadolinium oxysulfate Green
(Gd2O2S)
Others Blue
Barium lead sulfate Blue
(BaPbSO4)
Barium strontium sulfate Blue
(BaSrSO4)

Characteristics of a good phosphor material

1. Quantum Detection Efficiency

o States that phosphors should have a high atomic number, so that x-ray interaction is also high.
2. Conversion Efficiency
o States that there should be a large amount of light per x-ray interaction.
3. Spectral Matching
o The image receptor’s sensitivity matches the spectral emission of the phosphor.
4. Phosphor afterglow should be minimum
Screen Speed
• the capability of a screen to produce visible light.
Screen Speed and Light Emission

The faster an intensifying screen, the more light emitted for the same intensity of x-ray exposure.
Intensification Factor

The intensifying action of the screen.

This factor accurately represents the degree to which exposure factors (and patient dose) are reduced when intensifying
screens are used.

The intensification factor (IF) can be sated as follows:

Exposure required without screens

IF =
Exposure required with screens

Screen Speed and Patient Dose

• As screen speed increases, less radiation is necessary and radiation dose to the patient decreases;
• as screen speed decreases, more radiation dose to the patient increases.
Relative speed
• the ability of the screen to produce light, and therefore density.

Screen Speed and Density

For the same exposure, as screen speed increases, density increases;

as screen speed decreases, density decreases.

Screen speed density are directly proportional.

The mAs conversion formula for screens

o is a formula for the radiographer to use in determining how to compensate or adjust mAs when changing
intensifying screen system speeds.
o This formula is stated as follows:
 ​ ​mAs 1=
Relative screen speed 2

​ ​mAs 2
Relative screen speed 1

Older names for screen speeds

Name of the Screen Relative Speed Value

Ultra high or hi-plus 300

High or fast 200
Medium, par, or standard 100
Detail, slow, or high resolution 50
Ultra-detail 25

Factors Affecting Screen Speed:

Cannot be controlled by the Technologist/ Radiographer:

• Phosphor Composition
o well phosphor efficiently converts x-rays into usable light.
• Phosphor Thickness-
o the thicker the phosphor layer, the higher is the relative number of x-rays converted into light
• Reflective layer
o the presence of a reflective layer increases screen speed but reduces resolution
• Dye- light
o absorbing dyes are added to some phosphors to control the spread of light.
o These dyes increases resolution but reduce speed
• Crystal Size
o the larger the individual phosphor crystals, the higher the light emission per x-ray interaction.
o The phosphor crystals of fine-detail screens are approximately half that size.
o The crystals of par-speed screen are of immediate size ​ ​
• Concentration of phosphor crystals
o the higher the crystal concentration, the higher the screen speed.
Can be controlled by the Technologist/ Radiographer:

• Radiation Quality
o When there is an increase in x-ray energy, the x-ray absorption decreases.
• Temperature
o intensifying screens emit more light per interaction in low temperature
• Film Development
o excessive developing can decrease intensification factor because the emulsion nearest to the base that contains no
image is also reduced.

Phosphor Thickness, Crystal Size, and Screen Speed

As thickness of the phosphor layer increases, the speed of the intensifying screen increases;

as the size of the phosphor crystals increases, the speed of the screen.

Summary of Effect of Screen factors on Screen Factors on Screen Speed, Recorded Detail, and Patient Dose

Screen Factor Screen Speed Recorded Detail

Thicker Phosphor Increase Decrease
Layer
Larger Phosphor Increase Decrease
crystal size
Reflective Layer Increase Decrease
Absorbing Layer Decrease Increase
Dye in Phosphor Decrease Increase
Layer
Screen Speed and Recorded Detail
• With any given phosphor type, as screen speed increases, recorded detail decreases, and
• as screen speed decreases, recorded detail increases.
Quantum Mottle

Commonly called image noise,

can be defined as the statistical fluctuation in the quantity of x-ray photons that contribute to image formation per square
millimeter.

When a very low number of photons are needed by the intensifying screens to produce appropriate image density, the image
appears mottled or splotchy.

This appearance can be described as a “salt and pepper” look.

It decreases recorded detail, which results in a radiographic image that is grainy, or noisy, in appearance.

Screen Maintenance

The maintenance of intensifying screens is significant because radiographic quality depends I large part on how well the
screens are continuously maintained.

Two important maintenance procedures should be performed on intensifying screens:

1. regular cleaning
2. check cassette for film screen contact
Cassettes

• designed for screen film.

• Thin and light tight container slightly larger than the film, it is intended to hold the film.
• It should be light-proof and provides uniform contact between the film and the screen over the entire area of the film.
• Usually made of aluminum as some other equally radioluscent substance supported within a strong metal framework.
Cross Sectional View of Cassette:

Parts of a Cassette:
o Aluminum / Tube Front

! made up of a material with low atomic number like plastic or cardboard (Bakelite).
! It should be thin as possible but sturdy. Attenuation (reduction in energy) of the x-ray beam by the front of the cassette
is undesirable.
o Metal Back

! usually made up heavy metal to minimize back scatter.

! Can be with an Aluminum or Magnesium.
o Hinge

! ensures that the tube front and metal back will always be in placed
o Metal Locks

! to ensures that metal back and tube front is closed and the film is not exposed and ensures film-screen contact.
o Felt Padding/ rubber pad

! ensures flat contact of the screen and film

o Metal Frame

o Metal Ring

o Thin Lead foil

! contained at the back to prevent backscatter.

o Intensifying Scree

!
converts x-ray beam to visible light
Digital Imaging
 • Digital imaging, specifically digital radiography, involves identical x-ray production, differential absorption, and scatter control
when compared with film-screen imaging.

• When the exit radiation leaves the patient, it interacts with a different image receptors for latent image formation.
• The latent image is converted to digital information, which can then be manipulated by the computer
Two Primary Methods in Performing Digital Radiography

• Computed Radiography (CR)

• using a cassette loaded with an imaging plate containing a photostimulable phosphor (PSP)
• Digital Radiography (DR)
• primarily uses a flat panel of detectors to absorb the exit radiation
Computed Radiography Image Receptor

• Form the outside, the image receptor (IR) used in CR looks very similar to the IR for conventional film-screen radiography.
• Both include a cassette, which comes in a variety of sizes.
• The CR image receptor can be used the same way as film screen cassettes-in the Bucky, on the tabletop, on mobile exams.
• When compared with a film-screen, IR that contains intensifying screens and film, an open CR cassettes contains only imaging
plate (IP), which looks quite similar to an intensifying screen.

• There is no film
• When the exit radiation interacts with the Ips phosphor layer, some energy is released as visible light (as with an IS as in
conventional radiography).

• The rest of the x-ray energy and electrons (produces via

photoelectric interaction) are trapped in the phosphor
layer, this constitute the latent image.

CR

Imaging
Plate

Direct

Readout Digital Radiography (DR)

❖ The DR flat panel direct capture consists of large array combination of detectors and thin film transistors (TFTs).
❖ The exit radiation interacts with the detector and an electrical charge is created.
❖ This charge is stored temporarily in the transistor until readout.
❖ There two types of detectors manufactured differ in how they convert x-rays to electrical charge.
Indirect Conversion

• The indirect conversion system has the x-ray absorbed by the cesium iodide, a scintillation phosphor, which then produces a
flash of light. This light interacts with a layer of amorphous silicon to create the electrical charge
Direct Conversion

• The direct conversion direct readout system has the x-ray interact directly with a layer of amorphous selenium, which then
produces the electric charge.

Direct Readout Digital Radiography (DR)

Latent Image Formation and Image Receptors

• Latent image formation differs significantly among

the three types of image receptors.

Film’s latent image is the result of deposits of

silver ions at the sensitivity specks in the emulsion.

CRs latent image is formed by electrons trapped in the barium fluorohalide crystals (in the phosphor layer).

The latent image from direct readout image receptors is the electric charge stored in the transistor
Quizlet Scattered Radiation

❖ the projected shape of the unrestricted primary beam is: circular

❖ a purpose of beam-restricting devices is to ________ by changing the size and shape of the primary beam: decrease scatter
radiation produced

❖ the most effective type of beam-restricting device is the ________ collimator

❖ of the beam-restricting devices listed in question 3, which two are most similar to one another? A and C
❖ the purpose automatic collimation is to ensure that: the field size does not exceed the image receptor size
❖ when making a significant increase in collimation: mAs should be increased
❖ which one of the following increases as collimation increases? Contrast
❖ which of the following statements is true of positive beam-limiting devices: they were once required on new radiographic
installations

❖ the purpose of a grid on radiography is to: increase image contrast

❖ grid ratio is defined as the ratio of the: height of the lead strips to the distance between them
❖ compared with parallel grids, focused grids: allow more transmitted photons to reach the image receptor
❖ with which one of the following grids would a convergent line be formed if imaginary lines from its grid lines were drawn in
space above it? linear focused

❖ if 15 mAs is used to produce a particular level of exposure to the image receptor without a grid, what mAs would be needed
to produce that same level of exposure using a 16:1 : 90

❖ grid cutoff, regardless of the cause, is most recognizable on a film radiograph as reduced ______ density
❖ off focus grid cutoff occurs by using an SID that is not: within the focal range of the grid
❖ the type of motion most used for moving grids today is reciprocating
❖ a grid should be used whenever the anatomic part size exceeds: 10 cm
❖ the air gap technique uses an increased ______ instead of a grid. OID
❖ the projected shape of the unrestricted primary beam is: Circular
❖ the purpose of radiography is to increase image contrast
Digital Image Processing

• After the raw image data are extracted from the digital receptor and converted to digital data, the image must be computer
processed before its display and diagnostic interpretation.

• The term digital image processing

refers to various computer manipulations applied to digital images for the purpose of optimizing their appearance.

Histogram Analysis

Is an image processing technique commonly used to identify the edges of the image and assess the raw data prior to image
display.

In this method, the computer creates a histogram of the image.

Histogram is a graphic representation of a data set.

A data set includes all the pixel values that represent the image before edge detection and rescaling.

The computer analyzes the histogram using processing algorithm and compares it with the preestablished histogram specific
to the anatomic part being imaged,

This process is called histogram analysis.

The computer software has stored histogram models, each having a shape characteristic of the selected anatomic region and
projection.

These stored histogram models have values of interest (VOI), which determine the range of the histogram data set that
should be included in the displayed image.

In CR imaging, the entire imaging plate is scanned to extract the image from the photostimulable phosphor.

The computer identifies the exposure field and the edges of the image, and all exposure data outside this field and the edges
of the image, and all exposure data outside this field are excluded from the histogram.
Histogram Analysis

❖ is also employed to maintain consistent image brightness despite overexposure or underexposure of the IR.
❖ This procedure is known as automatic rescaling.
❖ The computer rescale the images the image based on the comparison of the histograms, which is actually a process of
 mapping the grayscale to the VOI to present a specific display of brightness.

❖ Although automatic rescaling is a convenient feature, radiographers should be aware that rescaling errors occur for a variety
of reasons and can result in poor-quality digital images.

Exposure Indicator

▪ An important feature of digital image processing is it’s ability to create an image with appropriate amount of brightness
regardless of the exposure to the IR.

▪ The exposure indicator provides a numeric value indicating the level of radiation exposure to the digital IR.
▪ Currently, exposure indicators are not standardized among various digital imaging equipment in use today, however, the
industry is working toward standardization of the exposure indicator.
Important Relationship

• Exposure Indicators
• Radiographer should strive to select techniques that result in exposure indicator values within the indicated optimum
range for that digital imaging system.

• However, the radiographer also needs to recognize the limitations of exposure indicators in providing accurate
information.

Lookup Tables
⊗ Provide a method of altering the image to change the display of the digital image in various ways.
⊗ Because digital IRs have a linear exposure response and a very large dynamic range, raw data images exhibit low contrast
and must be altered to improve visibility of anatomic structures.
⊗ Lookup tables provide the means to alter the brightness and grayscale of the digital image using computer algorithms.
⊗ They are also sometimes used to reverse or invert image grayscale.
⊗ Lookup Tables
⊗ Lookup tables provide the means to alter the original pixel values to improve the brightness and contrast of the image.

Image Display

• Following computer processing, the digital image is ready to be displayed for viewing.
• Soft copy viewing
▪ refers to the display of the digital image at a computer work-station, as opposed to viewing images on film or another
physical medium (hard copy).

• The quality of the digital image is also affected by important features of the display monitor, such as:
▪ its luminance,
▪ resolution, and
▪ viewing condition such as:
- ambient lighting and
- monitor placement.
• Specialized postprocessing software is used at the display workstation to aid radiologist in image interpretation.
Display Monitors

• Monitors used by radiologists for diagnostic interpretation, referred to as primary, must be of higher quality than the monitor
used only for routine image review.

• Display monitors used for diagnostic interpretation are typically monochrome high-resolution monitors and can be formatted
as portrait or landscape and configured with one, two, or four monitors.

• A display monitor having diagonal dimensions of 54 cm (21 inches) is adequate to view images sized 35x43 cm (14 x 17
inches).

Types of Monitors
 • CRT monitor
! creates an image by accelerating and focusing electrons to strike the faceplate composed of fluorescent screen.
• LCD monitor
! passes light through liquid crystals to display the image on the glass faceplate.
Viewing Conditions

• Placement of the display monitors and the level of light in the room, referred to as ambient lighting, can affect soft copy
viewing of digital images,

• Positioning the monitor away from any direct light sources reduces the amount of reflection on the faceplate of the monitor.
• Display monitors that have a thicker faceplate such as CRT have a tendency to reflect more of the ambient lighting than
monitors with thinner faceplates such as an LCD.

Performance Criteria
♦ Several important features of a display monitor affect their performance.
♦ Digital images are captured and processed to display a specific matrix size.
♦ An image created with a large matrix having many smaller-sized pixels improves the spatial resolution of the digital image
(pixel image).
♦ Because the anatomic tissue is visualized as brightness levels, the amount of light emitted from the monitor (luminance)
affects the quality of the displayed image.
♦ Luminance
! is a measurement of the light intensity emitted from the surface of the monitor and is expressed in units of candela per
square meter .

Postprocessing

Postprocessing functions are computer software operations available to the radiographer and radiologist that allow the
operator to adjust manually many presentation features of the image to enhance the diagnostic value.

Electronic collimation
• Collimating or restricting the radiation field size to the area of interest is an important tool used to reduce patient exposure and
improve the quality of radiographic image.
• In order to process and display the image correctly, it is important that the only area of interest be included within the radiation
exposure area.
• Once the image is processed, regions viewed on the image can be altered further by electronic collimation, also known as
masking or shuttering.

Brightness

• Because the image is composed of numeric data, the brightness level displayed on the computer monitor can be easily altered
to visualize the range of anatomic structures recorded.

• This adjustment is accomplished using the windowing function.

• The window level (or center)
♦ sets the midpoint of the range of brightness visible in the image.
• Changing the window level on the display monitor allows the image brightness to be increased or decreased throughout the
entire range.

• When the range of brightness displayed is less than the maximum,

♦ the processed image presents only a subset of the total information contained within the computer.
• Window Level and Image Brightness
♦ A direct relationship exist between window level and image brightness on the display monitor.
♦ Increasing the window level increases the image brightness;
♦ decreasing the window level decreases the image brightness.

Contrast

• The number of different shades of gray that can be stored and displayed by a computer system is termed grayscale.
• Contrast resolution
• is another term associated with digital imaging and is used to describe the ability of the imaging system to distinguish
between objects that exhibit similar densities because they attenuate the x-ray beam similarly.
 • An important distinguishing characteristic of a digital image is its improved contrast resolution compared with the film screen
image.

• Window Width and Image Contrast

• A narrow (decreased) window width displays higher radiographic contrast, whereas a wider (increased) window
width displays lower radiographic contrast.

5 Most Common Postprocessing Techniques

1. Subtraction
⊗ is a technique that can remove superimposed structures so that anatomic area of interest is more visible.
⊗ Because the image is in digital format, the computer can subtract selected brightness values to create an image
without superimposed structures.

2. Contrast enhancement
⊗ is a postprocessing technique that alters the pixel values to icrease image contrast
3. Edge enhancement
⊗ is a postprocessing technique that improves the visibility od small, high-contrast structures.
⊗ Image noise may be slightly increased, however.
4. Black/white reversal
⊗ is a postprocessing technique that reverses the grayscale from the original radiograph.
5. Smoothing
⊗ is a postprocessing technique that suppresses image noise (quantum noise). Spatial resolution is degraded, however.

Laser Printers

Although not commonly needed for interpretation, hard copy records of digital images may still occasionally be desired.

Digital images can be windowed while being viewed on a display monitor and then printed onto film by a laser camera.

Multiple images can be printed on a single sheet, and multiple copies of images can be printed that were processed
differently.

Laser printers are available that use either wet or dry printing methods.

Digital Communication Networks

• Picture Archival Communication System (PACS)

! is a computer system designed for digital imaging that can receive, store, distribute, and display digital images.
• Radiology Information System (RIS) and Hospital Information System (HIS)
! are computer systems that provide medical information
• Digital Imaging and Communications in Medicine (DICOM)
! is a communication standard for information sharing between PACS and imaging modalities.
• Health Level Seven standard (HL7)
! is a communication standard for medical information.
! Connectivity and communication among these systems are necessary for radiology to realize the full potential of digital
communication.

! A well integrated system would improve patient care through cost-effective, reliable, secure, and timely delivery of
diagnostic information.

Radiographic Film Processing

Automatic Processing

Automatic processor

- is a device that encompasses chemical tanks, a roller transport system, and a dryer system for processing of radiographic film.
Processing cycle

- refers to the amount of time it takes to process a single piece of film.

- This amount of time varies between 45 seconds and 3.5 minutes, depending on the processor that is used.
Processor capacity
 - refers to the number of films that can be processed per hour.
The processing of radiograph occurs in four stages:

1. Developing
▪ converts the latent image into a manifest or visible image.
▪ There are also two secondary purposes of developing:
a. To amplify the amount of metallic silver on the film by increasing the number of silver atoms in each latent
image center.

b. To reduce the exposed silver halide crystals into metallic silver.

Developer Solution Agents, Chemicals, and Their Functions
Agent Chemical Function
Developing or Phenidone Fast-reducing,
reducing agents produces gray
densities

Slow-reducing,
Hydroquinone produces black
densities
Accelerator or Sodium Carbonate Elevates and maintains
activator solution pH
Restrainer Potassium bromide Decreases reduction of
unexposed silver
halide
Preservative Sodium Sulfate Decreases oxidation of
solution
Hardener Gluteraldedyde Hardens the emulsion
Solvent Water Dilutes the chemical

2. Fixing
! to remove unexposed silver halide from the film and to make the remaining image permanent.
! There are also two secondary functions of fixing:
a. To stop the development process.
b. To further harden the emulsion
Agent Chemical Function
Fixing agent Ammonium Clears away
Thiosulfate unexpected silver
halide crystals
Acidifier Acetic Acid Prevents mixing of
fixing agent and
acidifier
Hardener Chrome aluminum Hardens Emulsion
Potassium Aluminum
Sulfate
Aluminum Chloride
Solvent Water Dilutes the Chemical

3. Washing
▪ to remove fixing solution from the surface of the film.
▪ This is a step in making further step in making the manifest image permanent.
▪ If not properly washed, the resulting radiograph will show a brown staining of the image, resulting in image loss and
a decrease in its diagnostic value.

Archival Quality of Radiographs

• Maintaining the archival (long-term) quality of radiographs requires the most of the fixing agent be removed (washed) from the
film.

• Staining or fading of the permanent image results when too much thiosulfate remains on the film.
4. Drying
▪ the final processes.
▪ It removes 85% to90% of the moisture from the film so that it can be handled easily and stored while maintaining the
quality of the diagnostic image.
Archival Quality of Radiographs

• Permanent radiographs must retain moisture of 10% to 15% to maintain archival quality. Excessive drying can cause the
emulsion(s) to crack.

Automatic Processing System

• Tanks
o Developer tank

o Fixer tank

o Water tank

Principal Components of Automatic Processor

• Vertical Transport System

o Motor Drive System
• Recirculation
• Time-Temperature
• Replenishment System
• Drying System
• Electrical
Vertical Transport System

• Automatic processors use a vertical transport system of rollers that advance the film through the various stages of film
processing.

• All rollers in a processor move at the same speed.

• A film is introduced into the processor on the feed tray.
• Feed tray
o is a flat metal surface with an edge on either side that permits the film to enter the processor easily and correctly
aligned.

• The entrance roller assembly

o consist of rollers that are covered with corrugated rubber, that straightens the path of the film so that it moves
through the processor efficiently.

• The next type of roller that the film encounters is a transport rollers
o that moves the film through the chemical tanks and dryer assembly.
• A turnaround roller
o at the bottom of the roller assembly turns the film from moving down the transport assembly to moving up the
assembly.

• The final type of roller used in the vertical transport system is the crossover roller
o that moves the film one tank to another and into dryer assembly.
• Guide plates
o are slightly curved metal plates that properly guide the leading edge of the moving film through the roller assembly.
Motor Drive
• An electric motor provides power for the roller assemblies to transport the film through the processor.
• The on/off switch provides electrical power to the processor activates this motor.
• The standby control
♦ is an electric circuit that shuts off power to the roller assemblies when the processor is not being used.

• Drive Subsystem
• responsible for the movement of the transport assembly.
• A chain, pulley or gear assembly transfers power to the transport rack and drives the rollers.
• The tolerance on this mechanical assemble is rigid.
 • Film transport time should not vary by more than +/- 2% of the time specified by the manufacturer.
• Belts and Pulley
• Chains and Sprocket
• Gears

• Motor Drive Assembly

⊗ provides power for the roller assemblies to transport the film through the processor.
• ON/OFF Switch
⊗ provides electrical power to the processor activates this motor
• Standby Control
⊗ an electric circuit that shuts off power to the roller assemblies when the processor is not being used.
⊗ Some wash water system is also connected to the standby control.
⊗ Timer on the standby control system activates the standby circuit several minutes after the last film has been
processed to stop the rollers and the circulating wash water.
⊗ The purpose of this is to improve cost-efficiency, stopping all rollers when processing is not occurring reduces wear
and tear on these assemblies. ​ ​ ​ ​ ​ ​ ​
Replenishment System

• Refers to the replacement of fresh chemicals after the loss of chemicals during processing, specifically developer solution and
fixer solution.

• Provides fresh chemicals to the developing and fixing solutions to maintain their chemical activity and volume when they
become depleted during processing.
Aerial oxidation

refers to a reduction in chemical strength as a result of exposure to air.

Use oxidation

refers to a reduction in chemical strength as a result of exposure to increased temperature over an extended period.

Two types of Replenishment System:

• Amount of solution to be replenished on the size of the film to be processed.

• This replenishment system uses micro-switches that are connected to the entrance roller assembly.
• These micro-switches are wired to two pumps, developer and fixer.
• Over replenishment of developer causes increase in radiographic density and a decrease in radiographic contrast
• Over replenishment of fixer solution has no effect on radiographic quality but unnecessarily wastes solution
• Under replenishment of both may cause the film to jam in the roller transport system because of inadequate hardening of the
film emulsion. Under replenishment of can cause decreased density, whereas under replenishment of fixer could result in
poor archival quality of finish.

• Flood Replenishment
refers to the replenishment of solutions that occur at timed interval, independent of the size or number of films
processed.

This is useful in processors that process a low to medium volume of film, especially single-emulsion films because
of the stability of developer solution and radiographic density is difficult to maintain.

Recirculation System

! Acts to circulate the solutions in each of these tanks by pumping solution out of one portion of the tank and returning it to a
different location with the same tank from which it was removed.

! It keeps the chemicals mixed, which helps maintain solution activity and provides agitation of the chemicals about the film to
facilitate fast processing.

! Helps maintain the proper temperature of the developer solution.

! The developer recirculation system includes an in-line filter that removes impurities as the developer solution is being
recirculated.

Temperature Control
 ° Temperature control of the developer solution is important because the activity of this solution depends directly on its
temperature .
° An increase or decrease in developer temperature can adversely affect the quality of the radiographic image.
° In most 90-second automatic processors, developer temperature must be maintained at 93º to 95ºF (33.8º to 35ºC).
Drying System

• The dryer assembly controls the amount of moisture removal to maintain the archival quality of radiographic film
Indicators of Inadequate Processing
Radiographic Appearance Processing Problems
Decrease in Density Developer exhausted
Developer under replenished
Processor running too fast
Low developer temperature
Developer improperly mixed
Increased in density Developer over replenishment
High developer temperature
Light leaks in the processor
Developer improperly mixed
Pinkish Stain (Dichroic fog) Contamination of developer by fixer
Developer of fixer under replenishment

Brown Stain (thiosulfate Inadequate washing

stain)
Emulsion removed by Insufficient in developer
developer
Milky Appearance Fixer is exhausted
Inadequate washing
Streaks Dirty processor rollers
Inadequate washing
Inadequate drying
Water Spot Inadequate drying
Minus-plus density Scratches from guide plates caused by roller or plate
misalignment

Darkroom and processor Quality Control:

Quality Control Schedule Standards
Test
Dark Room Daily Maintained clean, well
Environment ventilated, organized
and safe.
Safelight Test Semiannually Less than =0.05 optical
density added as fog
Automatic Weekly Should not vary more
Processor Temp. than +/- 5% for
replenishment type
Developer Solution Quarterly Maintained between
Ph 10-11.5
Fixer Solution pH Quarterly Maintained between 4-
4.5
Developer Specific Quarterly Should not vary by
Gravity more than

Processor Control Daily Speed and contrast

Chart Monitoring indicators should vary
more than +/-0.15
optical density from
baseline measurement.

Exposure Technique Selection

Learning Objectives:

1. State the purpose of automatic exposure control (AEC) in radiography.

2. Differentiate among the types of radiation detectors used in AEC systems.
3. Recognize how detector size and configuration affect the response of the AEC device.
4. Explain how alignment and positioning affect the response of the AEC device.
5. Discuss patient exposure technique factors and their effect on the response of the AEC device.
 6. Analyze unacceptable images produced using AEC, and identify possible causes.
7. Recognize the effect of the type of image receptor on AEC calibration, its use, and image quality.
8. Describe patient protection issues associated with AEC.
9. Sate the importance of calibration of the AEC system to the type of image receptor used.
10. Define anatomically programmed radiography (APR).
11. Differentiate between the types of exposure technique charts.
Automatic Exposure Control
° Is a tool available on most modern radiographic units to assist the radiographer in determining the amount of radiation
exposure to produce a quality image.
° Is a system used to control consistently the amount of radiation reaching the IR by terminating the length of exposure.
° AEC systems also are called automatic exposure devices, and sometimes they are erroneously referred to as phototiming.
° When using the AEC systems, the radiographer must still use individual discretion to select an appropriate kVp, mA, IR, and
grid.

Important Relationship:

Principle of Automatic Exposure Control Operation

Once a predetermined amount of radiation is transmitted through a patient, the x-ray exposure is terminated.

This determines the exposure time and therefore the total amount of radiation exposure to the IR.
Radiation Detectors

Phototimers
♦ Are fluorescent (light-producing) screen and a device that converts the light into electricity.
♦ A photomultiplier tube is an electronic device that converts visible light energy into electrical energy.
♦ A photodiode is a solid-state device that performs the same function.
♦ Phototimer AEC devices are considered exit-type devices because the detectors are positioned behind the IR so that radiation
must exit the IR before it is measured by the detectors.
♦ Light paddles, coated with a fluorescent material, serve as the detectors, and the radiation interacts with the paddles,
producing visible light.
♦ The light is transmitted to remote photomultiplier tubes or photodiodes that convert this light into electricity.
♦ The timer is tripped, and the radiographic exposure is terminated when a sufficiently large charge has been received.
♦ This electrical charge is in proportion to the radiation to which the light paddles have been exposed.
♦ Phototimers have largely been replaced with ionization chamber systems.
Ionization Chamber Systems
° or ion chamber is a hollow cell that contains air and is connected to the timer circuit via an electrical wire.
° Ionization Chamber AEC devices are considered entrance-type devices because the detectors are positioned in front of IR so
that radiation interacts with the detectors just before interacting with the IR.
° When the ionization chamber becomes ionized, creating an electrical charge.
° When the ionization chamber is exposed to radiation from a radiographic exposure, the air inside the chamber becomes
ionized, creating an electrical charge.
° This charge travels along the wire to the timer circuit.
° The timer is tripped, and the radiographic exposure is terminated when a sufficiently large charge has been received.
° This electrical charge is in proportion to the radiation to which the ionization chamber has been exposed.
° Compared with phototimers, ion chambers are less sophisticated and less accurate, but they are less prone to failure.
° Most AEC system today use ionization chambers.
Important Relationship:
• Function of Ionization Chamber
• The ionization chamber interacts with exit radiation before it reaches the IR. Air in the chamber is ionized, and an electrical
charge that is proportional to the amount of radiation is created.

mAs Readout
 When a radiographic study is performed using an AEC device, the total amount of radiation (mAs) required to produce the
appropriate density is determined by the system.

Many radiographic units include a mAs readout display, where the actual amount of mAs used for that image is displayed
immediately after the exposure, sometimes for only a few seconds.

Knowledge of the mAs readout had numerous advantages:

o Allows radiographer to become familiar with manual exposure technique factors.

o If the image is suboptimal, knowing the mAs readout provides a basis from which the radiographer can make
exposure adjustments by switching to manual technique.
Important Relationship:
o Automatic Exposure Control and mAs Readout

o If the radiographic unit has a mAs readout display, the radiographer should take note of the reading after the exposure is
made. This information can be invaluable.
kVp and mA Selections
⊗ Because AEC controls only radiographic density and has no effect on radiographic contrast, the kVp for a particular
examination should be selected as it would be for that examination, regardless of whether an AEC device is used.
⊗ The radiographer must select the kVp level that provides an appropriate level of contrast and is at least minimum kVp to
penetrate the part.
⊗ Although the digital imaging contrast can be computer manipulated, the kVp should still be selected to visualized best the
area of interest.
⊗ The higher the kVp value used, the shorter the exposure time needed by the AEC device.
Important Relationship:
• Kilovoltage Selection
• Using higher kVp with AEC decreases the exposure time and the overall mAs needed to produce a diagnostic image,
significantly reducing the patient’s exposure.
• The kVp selected for an examination should produce the desired image contrast for the part examined and be as high as
possible to minimize the patient’s radiation exposure.

• When the radiographer uses a control panel that allows mA and time to be set independently, he or she should select the mA
value as it would be for that particular examination, regardless of whether an AEC device is used.
• The mA value selected will affect the exposure time needed by the AEC device.
• Therefore, if the radiographer wants to decrease exposure time for a particular examination, he or she may easily do so by
increasing the mA value.
Important Relationship:

! mA Level and Automatic Exposure Control Response

! If the radiographer can set the mA level when using AEC, it will affect the time of exposure for a given procedure. Increasing
the mA decreases the exposure time to reach the predetermined amount of exposure. Decreasing the mA increases the
exposure time to reach the predetermined amount of exposure.

Minimum Response Time

! Refers to the shortest exposure time that the system can produce.
!
Minimum response time usually is longer with AEC systems than with other types of radiographic timers.
Backup Time

! Refers to the minimum length of time the x-ray exposure will continue when using AEC system.
! The backup time may be set by the radiographer or controlled automatically by the radiographic unit.
! Backup time, the maximum exposure time allowed during an AEC examination, serves as a safety mechanism when the AEC is
not used or is not functioning.

! Backup time should be set 150% to 200% of the expected exposure time.
! This allows the properly used AEC system to appropriately terminate the exposure but protects the patient and tube from
excessive exposure if a problem occurs.
Patient Protection Alert

! Monitoring Backup Time

To minimize patient exposure, the backup time should be neither too long nor too short.

Backup time that is too short results in the exposure being stopped prematurely, and the image may need to be
repeated because of poor image quality.

Backup time that is too long results in the patient receiving unnecessary radiation if a problem occurs and the
exposure does not end until the backup time is reached. In addition, the image may have to be repeated because of
poor image quality.
Density Adjustment
 ° AEC devices are equipped with density that is produced by the unit.
° These generally are in the form of buttons on the control panel that are numbered -2, -1, +1 and +2.
° A common increment is 25%, meaning that the predetermined exposure level needed to terminate the timer can be either
increases or decreased from normal in one increment (+25% or -25%) or two increments (=50% or -50%).

Alignment and Positioning Considerations

Detector Selection
• Selection of the detector(s) to be used for a particular examination is critical when using an AEC system.
• The selected detectors actively measure radiation during exposure.
• The AEC systems with multiple detectors typically allow the radiographer to select any combination of one, two, or all three
detectors.
• The selected detectors actively measure radiation during exposure, and the electrical signals are averaged.
• Typically, the detector that receives the greatest amount of exposure has a greater impact on the total exposure.
Important Relationship:

❖ Detector Selection
❖ The combination of detectors affects the amount of exposure reaching the IR.
❖ If the area of radiographic interest is not directly over the selected detectors, that area likely will be overexposed or
underexposed. When performing any radiographic study where the IR is located outside of the Bucky, the AEC system
should be deactivated, and manual technique should be used.
Patient Centering
• Proper centering of the part being examined is crucial when using AEC system.
• The anatomic area of interest must be centered properly over the detectors that the radiographers has selected.
• Improper centering of the part selected detector(s) produces radiograph that is either underexposed or overexposed.
Important Relationship:
Patient Centering

❖ Accurate centering or the area of interest over the detectors is critical to ensure proper exposure to the IR. If the area of
interest is not properly centered to the detectors, overexposure or underexposure may occur.
Detector Size
• The size of the detectors manufactured within an AEC system is fix and cannot be adjusted.
• Therefore, it is important for the radiographer to determine whether AEC should be used during radiographic procedure.
• The radiographer must first determine whether the patient’s anatomic area of interest can adequately cover the detector
combination.

Compensating Issues

❖ Patient Considerations
❖ Some patients require greater technical consideration when AEC is used for their radiographic procedures.
❖ The size, shape and location of anatomic part of interest also affect the use of AEC system.
Patient Protection Alert
Patient Variability
⊗ Factors related to the patient affect the time of exposure reaching the IR and ultimately image quality. Increases or decreases
in patient thickness result in changes in the time of exposure if the AEC system is functioning properly. Pathology, contrast
media, foreign object, and pockets of gas are patient variables that may affect the proper exposure of the IR and ultimately
image quality.
Compensating Issues
Collimation

- Is a factor when AEC systems are used because the additional scatter radiation produced by failure to accurately restrict the
beam may cause the detector to terminate the exposure prematurely.

- The detector is unable to distinguish transmitted radiation from scatter radiation and, as always, ends the exposure when a
preset amount of exposure has been reached.
Important Relationship:
⊗ Collimation and Automatic Exposure Control Response
⊗ Excessive or insufficient collimation may affect the amount of exposure reaching the IR. Insufficient collimation may result
in excessive scatter reaching the detectors, resulting in the exposure time terminating too quickly. Excessive collimation may
result in too long of an exposure time.

Image Receptor Variations

! Different film screen system cannot be interchanged easily once an AEC device is calibrated to produce specific densities.
! When calibration is performed, it is done for a particular type of IR, including digital.
 ! The AEC device cannot sense when the radiographer uses
a different type or speed class of IR and instead
produces an exposure based on the system for which it
was calibrated, resulting in either too much or too little
exposure for that IR.
Important Relationship:

❖ Type of Image Receptor and Automatic Exposure

Control Response

❖ The AEC system is calibrated to the type and speed class of the IR used. If an IR of a different type or speed is used, the
detectors will not sense the difference, and the exposure time will terminate at the present value, which may jeopardize image
quality.
Automatically Programmed Radiography (APR)

Refers to a radiographic system that allows the radiographer to select a particular button on the control panel that represents
an anatomic area; a preprogrammed set of exposure factor is displayed and selected for use.

APR is controlled by an integrated circuit

or computer chip that has been
programmed with exposure factors for
different projections and positions of different anatomic parts.
Exposure Technique Charts

Are preestablished guidelines used by the radiographer to select standardized manual or AEC exposure factors for each type
of radiographic examination.

Technique charts standardized the selection of exposure factors for the typical patient so that the quality of radiographic
images is consistent.
Exposure Technique Charts and Radiographic Quality
A properly designed and used technique chart standardizes the selection of exposure factors to help the radiographer produce
consistent quality radiographs while minimizing patient exposure.
Conditions
Technique Chart Limitations
° Exposure technique charts are designed for the typical or average patient. Patient variability in terms of body build or physical
condition, or the presence of a pathologic condition, requires the radiographer to problem solve when selecting exposure
factors.
Equipment Performance
° Radiographic equipment must be operating within normal limits for technique charts to be effective
Measurement of Part Thickness
° Accurate measurement of part thickness is critical to the effective use of exposure technique charts.
Contents Standardize in a Technique Chart
° Anatomic part
° Automatic exposure control detector selections, if applicable
° Central ray location
° Type of image receptor
° Focal spot size
° Grid ratio
° Kilovoltage peak
° Milliamperage
° Part thickness and measuring point
° Position or projection
° Source-to-image receptor distance
Exposure technique Chart
Types of Technique Charts:

1. Variable kVp/Fixed mAs technique Chart

• is based on the concept that kVp can be increased as the anatomic part size increases.
• Specifically, the baseline kVp is increased by 2 for every 1 cm increase in part thickness, whereas the mAs is
maintained.
• The variable kVp charts adjusts the kVp for changes in part thickness while maintaining a fixed mAs.
Variable kVp Fixed mAs Technique Chart
• Variable kVp technique charts may be more effective when small extremities are being imaged.
2. Fixed kVp/Variable mAs Technique Chart
° uses the concept of selecting an optimal kVp value that is required for the radiographic examination and adjusting the
mAs for variations in part thickness.
 • Optimal kVp
° can be described as the kVp value that is high enough to ensure preparation of the part but not too high to diminish
radiographic contrast.
• Fixed kVp/variable mAs technique charts identify optimal kVp values and alter the mAs variations in part thickness.
Fixed kVp/ Variable mAs Technique Chart
• Accuracy of measurement is less critical with
fixed kVp/variable mAs technique charts than
that with variable kVp/fixed mAs technique charts.
• The fixed kvP/variable mAs technique chart has the advantages of easier use, more consistency in the production of quality
radiographs, greater assurance of adequate penetration of all anatomic parts, standardization of radiographic contrast, and
increased accuracy with extreme variation in size of the anatomic part.
Exposure Technique Chart Development

1. Select a kVp value appropriate to the anatomic area to be radiographed. Determine the mAs value that produces the desired
radiographic density.

2. Using a patient-equivalent phantom, produce several radiographs, varying the kVp and mAs values. Use the general rules
for exposure technique adjustment (i.e., the 15% rule). Radiographic densities should be similar.

3. Evaluate the quality of the radiographs, and eliminate those deemed unacceptable.

4. Of the remaining acceptable radiographs, select those having the kVp value appropriate for the technique chart desired and
according to departmental standards.

5. Extrapolate the exposure techniques (variable kVp or variable mAs) for changes in part thickness.
6. Use the concept of comparative anatomy to develop technique charts for similar anatomic areas.
7. Test the technique chart for accuracy, and revise if needed.
Example of How to Develop a Fixed kVp/Variable mAs Exposure Technique Chart
Step 1.
• Pelvis phantom is positioned on the radiographic table for an anteroposterior (AP) projection of the right hip. The central ray
(CR) is at the midpoint of the hip, the source-to-image receptor distance (SID) is 40 inches, and collimation is to film size.
The part was measured (2^ cm) at the CR entrance point. Select initial exposure technique factors based on departmental
standards.
Step 2. Using the kVp/mAs 15% rule, the following five radiographs are produced:

1. 51 kVp at 200 mAs

2. 60 kVp at 100 mAs
3. 70 kVp at 50 mAs
4. 81 kVp at 25 mAs
5. 93 kVp at 12.5 mAs
Step 3. Radiographs 1 and 5 are deemed unacceptable.
Step 4. Radiograph 3 is selected as
optimum based on departmental standards.

IMAGE EVALUATION
Criteria for Image Evaluation

• A quality radiographic image

° accurately represents the anatomic area of interest, and its information is well visualized for diagnosis.
• The visibility
° of the anatomic structures and the accuracy of their structural lines recorded (sharpness) determine the overall quality
of the radiographic image.

• Visibility of the recorded detail

° refers to the brightness or density of the image along with image contrast; the accuracy of the structural lines is
achieved by maximizing the amount of spatial resolution or recorded detail and minimizing the amount of
distortion. Image noise contribute

Brightness or Density

• Brightness and density

° refer to the same image quality attribute but are defined differently.
• Brightness
° is defined as the amount of luminance (light emission) of a display monitor.
• Density
° is defined as the amount of overall blackness on the processed image.
 ° An area of increased brightness, if viewed on the computer monitor, shows decreased density on a film image.
° An area of decreased brightness visualized on a computer monitor has increased density on film image.

​Contrast
• In addition to sufficient brightness or density, radiograph must exhibit differences in the adjacent brightness levels or density in
order to differentiate among the anatomic tissues.

• The level of radiograph is contrast desired in an image is determined by the composition of the anatomic tissue to be
radiographed and the amount of information needed to visualized the tissue for an accurate diagnosis.

• Radiographic contrast or image contrast

° is a term used in both digital and film-screen imaging to describe the variations in brightness and density.
• A film image with few densities but great differences among them is said to have high contrast or short-scale contrast.
• A radiograph with large number of densities but with few differences among them is said to have low contrast or long-scale
contrast.

Spatial Resolution or Recorded Detail

• The quality of radiographic image depends on both the visibility and the accuracy of the anatomic structural lines recorded
(sharpness).

• To produce a quality radiograph, the anatomic details must be recorded accurately and with the greatest amount of sharpness.
• The ability of a radiographic image to demonstrate sharp lines determines the quality of the spatial resolution or recorded
detail.

• A radiographic image that has a greater amount of spatial resolution or recorded detail minimizes the amount of unsharpness of
the anatomic structural lines.
Distortion

• Distortion results from the radiographic misrepresentation of either size (magnification) or the shape of the anatomic part.
• When the part is distorted, spatial resolution or recorded detail is also reduced.
• Radiographic images of objects are always magnified in relation to true object size.
• The SID and OID play an important role in minimizing the amount of size distortion of the radiographic image.
• Shape distortion can occur from inaccurate central ray alignment of the tube, the part being radiographed, or the image
receptor.
Quantum Noise
° s no useful diagnostic information and serves only to detract from the quality of the image.
Quantum noise
° is a concern in digital and film-screen imaging (quantum mottle) and is photon-dependent.
Quantum noise
° is visible as brightness or density fluctuations on the image. The fewer the
photons reaching the image receptor to form the image, the greater the quantum noise visible on the digital image.
° Most likely to occur in digital imaging.
Exposure Indicator

• An important feature of digital image procesreceptor. sing is its ability to create an image with the appropriate amount of
brightness regardless of the exposure to the image receptor.

• As a result of the histogram analysis, valuable information is provided to the radiographer regarding the exposure to the digital
image receptor.

• The exposure indicator provides numeric value indicating the level of radiation exposure to the digital image
Image-Artifacts
Artifacts
• is any unwanted image on a radiograph.
Artifacts
• are detrimental to radiograph because they can make visibility of anatomy, a pathologic condition, or patient identification
information difficult or impossible.
• They decrease the overall quality of the radiographic image.
• Artifacts specific to film-screen imaging are typically a result of film storage, handling, and chemical processing.
• Digital image artifacts can be a result of errors during extraction of the latent image from the IR or performance of the
electronic detectors.
Film-Screen Image Receptors