DETECTIVE QUANTUM EFFICIENCY

- Detective quantum efficiency (DQE) refers to a measurement of the efficiency of an image receptor
in converting the x-ray exposure it receives to a quality image
- If an image receptor is able to convert x-ray exposure into a image with 100% efficiency (meaning no
information loss), DQE would measure 100% or 1.0. However, no imaging system has 100%
conversion efficiency
- Detective quantum efficiency (DQE) value to capture the exit radiation and the energy of the x-ray
is determined by the thickness of the capture layer and its atomic composition
- Higher the detective quantum efficiency (DQE) of an imaging system, the lower the radiation exposure
required to produce a quality image, thereby decreasing patient exposure.
- ↑DQE, ↓ exposure required to produce an image, ↓ patient does

SIGNAL - TO - NOISE RATIO

- Signal-to-noise ratio (SNR) refers to a method of describing the strength of the radiation exposure
compared with the amount of noise apparent in a digital image
- SIGNAL refers to the x-ray that exits the patient and reaches the IR
- Signal refers to the number of x-ray photons that strike the receptor
- NOISE refers to the random disturbances that obscure or REDUCE clarity of the image
- Increasing the SNR means that the strength of the signal is high compared with the amount of noise.
Therefore, image quality is improved
- High SNR, ↑signal, ↓noise, ↑image quality
- Decreasing the SNR means that noise increased compared with the strength of the signal is low.
Therefore,image quality is degraded
- Low SNR, ↑noise, ↓signal, ↓image quality
- Increasing the SNR increases the visibility of anatomic details
- ↑SNR, ↑resolution
- Quantum noise results when too few x-ray photons captured by the IR to form a latent image
CONTRAST - TO - NOISE RATIO
- Contrast-to-noise ratio (CNR) refers to a method of describing the contrast resolution compared
with the amount of noise apparent in a digital image
- Similar to Signal-to-noise ratio (SNR), as increased noise, it affects visibility of the anatomic details and
contrast displayed within the digital image
- ↑noise, ↓signal, ↓contrast
- Brightness differences in the digital image are a result of varying exit-radiation intensities from
the attenuation of the x-ray beam in anatomic tissue
- A system with higher contrast resolution means that anatomic tissues that attenuate the x-ray beam
(low subject contrast) can be better visualized. Digital images with a HIGHER CNR will increase the
visibility of anatomic tissues
- ↑CNR, ↑resolution

RAW IMAGE DATA

- Raw image data refers to the unprocessed data from the image detector
- Raw image data are to be processed to be displayed

DIGITAL IMAGE PROCESSING

- Digital image processing refers to various computer manipulations applied to digital images for the
purpose of optimizing their appearance
- Digital image processing occurs after the raw image data is converted to digital data
 - Digital image processing has a principal advantage is the ability to manipulate the image before
display preprocessing and after display—post processing
- Digital image pre-image and post-image processing alter image appearance for the purpose of
improving image contrast before diagnostic interpretation

HISTOGRAM ANALYSIS
- Histogram analysis refers to the image-processing technique commonly used to identify the edges
of an image and assess the raw data prior to image display
- Histogram analysis refers to a computer process to analyzes histogram model using a processing
algorithms and compared with a pre-established histogram model specific to the anatomic part. Value
of interests (VOI) is identified, and the image is displayed
- In CR imaging, the entire imaging plate is scanned to extract the image from the PSP through a
process of histogram analysis the exposure field and the edges of the image are identified
- If at least three edges are not identified, all data, including raw exposure or scatter outside the field,
may be included in the histogram resulting in a histogram-analysis error
- Histogram analysis functions to maintain consistent image brightness through automatic
rescaling regardless of digital image receptor overexposure or underexposure
- Figure shows automatic rescaling during histogram analysis to maintain a consistent image brightness
despite overexposure or underexposure of the IR

EXPOSURE INDICATOR
- Exposure indicator refers to a numeric value that is representative of the exposure the image
receptor has received
- Exposure indicator displayed for each exposure indicates over exposure or underexposure
- The value came from the effect of mAs and kVp and is determined by logarithmic calculations
- Optimal ranges of the exposure indicator values are vendor specific and vary among the types of
procedures. DR imaging systems also display an exposure indicator that varies according to the
manufacturer’s specifications
- Deviation index displays a value ranging from +3 to 3 representing exposure levels 0 indicates that
the level of exposure was appropriate
- + Deviation Index value indicates overexposure
- Deviation Index value indicates underexposure
- +1 indicates a 26% overexposure and 1 indicates a 20% underexposure.
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LOOKUP TABLE
- Lookup table refers to a method of altering the image to change the digital image display
- Lookup tables refer to the image-processing technique to alter brightness and grayscale of the
image using computer algorithms to reverse or invert image grayscale
- Digital receptors have linear exposure response and wide dynamic range, raw data images exhibit low
contrast and require alteration to improve the visibility of anatomic structures
- Each pixel value could be altered to display the digital image with a change in contrast. New pixel
values would be calculated that result in the image being displayed with higher contrast altering from
low-contrast to high contrast
- Lookup table determines the numbers assigned to the input pixel values that change them into
output pixel values that result in a change in contrast and brightness of the image
- Lookup tables provide a method of processing digital images in order to change the displayed
brightness and contrast required for each anatomic area
- Lookup tables provide the means to alter original pixel values to improve brightness and contrast
of the image
IMAGE COMPUTING
- Image computing refers to computational and mathematical methods to reconstruct image data to
extract clinically relevant information
1. Image enhancement
- Image enhancement refers to a process to refine a transform representation of an image to
improve interpretability of the contained information
- Image enhancement is subdivided into spatial and frequency domain techniques
a. SPATIAL DOMAIN operates directly on image pixels, useful for contrast optimization
b. FREQUENCY DOMAIN use frequency transformation, useful for smoothening and
sharpening digital images
- Utilization of all these techniques allows for noise and inhomogeneity reduction, contrast
optimization, enhancement of edges, elimination of artifacts, and improvement for the
subsequent image analysis and accurate interpretation
2. Image Analysis
- Image analysis refers to the central process in image computing
- Image analysis is grouped into three main categories
a. SEGMENTATION process partitions into meaningful contours of anatomical
structures
b. REGISTRATION ensures correct alignment of multiple images
c. QUANTIFICATION determines properties of the identified structures characteristics
3. Image Visualization
- Visualization refers to a process of rendering the volume image data to visually represent
anatomical and physiological imaging information in a specific form over defined dimensions
- Visualization can be performed at the initial and intermediate phases of imaging analysis
and at the final phases to refine image display results
Visualization described into three forms
1. Projection rendering
- the Projection rendering refers to the simplest and fastest volume rendering method
- Multi-planar Reconstruction (MPR) refers to the reconstruction of images in
arbitrary orientations such as orthogonal, oblique, or even curved plane
- Maximum Intensity Projection (MIP) refers to the reconstruction projection of
voxels with highest intensity onto an arbitrarily oriented plane to visualize vessels
- Minimum Intensity Projection (MinIP) refers to the reconstruction of voxels with
lowest intensity onto an arbitrary plane to visualize air-filled structures.

2. Direct volume rendering

- Direct volume rendering refers to the image rendering in 3D volume data sets without
extracting any geometrical information
- Image-order techniques refer to the reconstruction that uses rays casting from a
point through each pixel in the result image to the 3D volume data
- Object-order techniques refer to the reconstruction that compute the projection
and contribution of each voxel in 3D volume data set to the pixels in the image plane

3. Surface rendering
- Surface rendering refers to image rendering that utilizes shading models to render
the surface inside a volume having a uniform value
 - Shaded surface display refers to a classic techniques using a threshold of pixel
intensity values, everything below the threshold is removed and everything above is
assigned a color and is shown as a three-dimensional object

PREPROCESSING
- Preprocessing refers to a computer process designed to produce artifact-free digital images
- Preprocessing provides electronic calibration to reduce pixel-to-pixel, row-to-row, and
column-to-column
- response differences
- Preprocessing actions are automatically applied with most systems.

A. Signal interpolation
- Signal interpolation refers to a preprocessing actions to correct defective pixel by
averaging the pixel surrounding response value to be assigned to the defective pixel
B. Offset/gain images
- Offset/gain images refer to an automatic calibration images designed to make the
response of the image receptor uniform
- Offset images are obtained by averaging images obtained with no x-ray input to the
detector Gain images are obtained by averaging images obtained with a uniform x-ray
fluence
- Image lag refers to the remains generated latent image (may not be made visible)
- Offset correction or offset voltage is used to reduce image lag.
- Offset correction is used to maintain sensing error below specified tolerance level
C. Line noise
- Line noise refers to the voltage variations along each buses that drive each pixel
- Voltage correction is used to reduce line noise by correction from a row or a column of pixels
in a dark, unirradiated area of the image receptor

POST PROCESSING
- Postprocessing functions refer to computer software operations available that allow manual
manipulation of the displayed image
- Postprocessing functions require intervention by the end-user to manually adjust many presentation
features of the image to enhance the diagnostic value
- Postprocessing functions are as follows

A. MASKING
- Electronic masking refers to the electronic collimation or cropping of the digital image that
occurs during post- processing of the acquired image and does not alter the size of the
irradiated field
- Electronic masking is also referred to as shuttering, a post processing technique that may be
used to eliminate ambient light around an image for the purpose of improving the quality of the
displayed image “Electronic masking should not be used as a substitute for insufficient
collimation
B. ANNOTATION
- Annotation refers to the postprocessing feature of adding text to an image Figure shows
annotation on a digital image

C. WINDOW LEVEL Brightness

- Window level refers to the postprocessing feature to adjust the brightness display
 - Windowing functions to amplify brightness level to visualize the range of recorded details
- Changing the window level on the display monitor allows the image brightness to be increased
or decreased throughout the entire range
- Pixel values from 0 to 2048 are used to represent the full range of image brightness levels
- High pixel value represents a volume of tissue that attenuates fewer x-ray photons and is
displayed as a decreased brightness level
- ↑ pixel, ↑brightness level
- Low pixel value represents a volume of tissue that attenuates more x-ray photons and is
displayed as increased brightness
- ↓ pixel, ↓brightness level
- Increasing the window level increases the image brightness
- ↑ WL ,↑brightness (vice-versa)

D. CONTRAST
- Contrast refers to the number of different shades of gray that can be stored and displayed
by a computer system
- Contrast resolution is used to describe the ability of an imaging system to distinguish
between objects that exhibit similar densities
- Contrast resolution of a pixel is determined by the bit depth or number of bits, which affects
the number of shades of gray available for image display
- Increasing the number of shades of gray increases the contrast resolution within the image
- ↑grayscale ,↑contrast resolution
- Increased contrast resolution increases the visibility of very subtle anatomic features
- ↑contrast resolution ,↑visibility of recorded detail
- Window width refers to the postprocessing feature to adjust the contrast display
- Windowing functions to amplify contrast level to visualize the range of recorded details
- Adjusting the range of visible shades of gray varies the image contrast
- Wide window width represents the entire number of shades of gray are displayed results in
lower contrast
- Wide WW, ↓contrast
- Narrow window width represents a smaller number of shades of gray are displayed results in
higher contrast
- Narrow WW, ↑contrast

E. WINDOWING
- Windowing functions to adjust image contrast and brightness on the MONITOR Windowing
determines the brightness and contrast of the displayed image Figure shows annotation on a
digital image
F. MAGNIFICATION
- Magnification refers to postprocessing feature to render the smallest detail visible
- Magnification in digital imaging is similar to using a magnifying glass with a film image Figure
shows magnification on a digital image

G. REORIENTATION
- Reorientation refers to postprocessing feature flip image horizontal or vertical
- Image flip purpose is to place image into a standard viewing order

H. MEASUREMENTS
- Measurements refers to the distance and angle measurements function
I. INVERSION
- Inversion refers to postprocessing feature to reverses the grayscale from the original
radiograph
- Inversion results in black appearance of bone and a white appearance of soft tissue

J. SUBTRACTION
- Subtraction refers to the postprocessing feature that can remove superimposed structures so
that the anatomic area of interest becomes more visible

K. Region of Interest ROI

- Region of interest (ROI) refers to the range designation used when image processing is
applied to a specific area
- Region of interest (ROI) the postprocessing feature is particularly useful for bone mineral
assay, calcified lung nodule detection, and renal stone identification

L. Contrast enhancement
- Contrast enhancement refers to the postprocessing feature that alters the pixel values to
increase image contrast
- Contrast enhancement also KNOWN as grayscale mapping or gray scale processing

M. Edge enhancement
- Edge enhancement refers to the postprocessing feature that improves the visibility of small,
high-contrast structures. However, CONTRIBUTES to image noise
- Edge enhancement also KNOWN as high-pass filtering

N. Smoothing
- Smoothing refers to the postprocessing feature that suppresses image noise. However,
DEGRADES spatial resolution
- Smoothing also KNOWN as low-pass filtering

O. Equalization
- Equalization refers to postprocessing feature whereby underexposed areas are made darker
and overexposed areas are made lighter