Image Formation and Radiographic Quality
Image Formation and Radiographic Quality
Sujud Suboh
Medical imaging and biophysics Department
An-Najah National University
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Content Layout
• Image Formation
• Radiographic Quality
• Image characteristics
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Real images for stationary and rotating
anodes
Stationary anode Rotating anode
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Stages of Forming Radiographic
Image
4- Image Processing
1- X-Ray Beam Formation
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1- X-Ray Beam Formation
1. Filament current
2. Thermionic emission
3. Space charge
4. Anode Rotation
5. Supply KV to the tube
6. Flowing of electrons from the cathode to the
anode forming tube current.
7. Anode interactions KVP Beam Quality primarily
8. X-Ray beam formation with specific quality Beam Quantity secondarily
and quantity. MA Beam Quantity
Exposure time Beam Quantity
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IMAGE FORMATION
• To produce a radiographic image, x-ray photons must pass through tissue
and interact with an image receptor (IR) (a device that receives the
radiation leaving the patient)
• Both the quantity and the quality of the primary x-ray beam affect its
interaction within the various tissues that make up the anatomic part.
• In addition, the composition of the anatomic tissues affects the x-ray
beam interaction.
• The absorption characteristics of the anatomic part are determined by its
thickness, atomic number, and tissue density or compactness of the
cellular structures.
• Finally, the radiation that exits the patient is composed of varying
energies and interacts with the image receptor to form the latent or
invisible image and must be processed.
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Differential Absorption
• Differential absorption is a process whereby
some of the x-ray beam is absorbed in the tissue
and some passes through(transmits) the anatomic
part.
• The term differential is used because varying
anatomic parts do not absorb the primary beam
to the same degree.
• As the primary x-ray beam interacts with the
anatomic part, photons will be absorbed,
scattered, and transmitted.
• The differences in the absorption characteristics
of the anatomic part create an image that
structurally represents the anatomic part.
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Beam Attenuation
• As the primary X-ray beam passes through anatomic tissue,
it will lose some of its energy.
• Two distinct processes occur during beam attenuation:
1. absorption
2. Scattering = Attenuation
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Absorption
• As the energy of the primary x-ray beam is deposited within the
atoms composing the tissue, some x-ray photons will be
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 a photoelectron.
• The ability to remove (eject) electrons, known as ionization, is
one of the characteristics of x-rays.
• In the diagnostic range, this x-ray interaction with matter is
known as the photoelectric effect.
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• This secondary x-ray photon typically has very low energy
and is unlikely to exit the patient.
• The probability of total photon absorption during the
photoelectric effect is dependent on
• 1-Energy of the incoming x-ray photon
• 2-Atomic number of the anatomic tissue.
• The energy of the incoming x-ray photon must be at least
equal to the binding energy of the inner shell electron.
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Dr.Ali Abu Arra 13
Scattering
• Some incoming photons are not absorbed, but instead they
lose energy during interactions with the atoms comprising the
tissue.
• This process is called scattering and results from the
diagnostic x-ray interaction with matter, which is known as
the Compton effect.
• The loss of energy of the incoming photon occurs when it
ejects an outer-shell electron from the atom.
• The ejected electron is called a Compton electron or
secondary electron.
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• The probability of a Compton interaction occurring is dependent on
energy of the incoming photon.
• It is not dependent on the atomic number of the anatomic tissue
• The percentage of photoelectric interactions generally decreases at higher
kilovoltages within the diagnostic range,
• whereas the percentage of Compton interactions are likely to increase at
higher kilovoltages within the diagnostic range.
• If a scattered photon strikes the image receptor, it does not contribute any
useful information about the anatomic area of interest.
• If scattered photons are absorbed within the anatomic tissue, they contribute
to the radiation exposure to the patient.
• In addition, if the scattered photon leaves the patient and does not strike the
image receptor, it could contribute to the radiation exposure of anyone near
the patient.
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Is attenuation the same
as absorption?
NO!
ATTENUATION = SCATTER AND ABSORPTION
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Factors Affecting Beam Attenuation
1. 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 tissue
thickness of 4 to 5 cm (1.6 to 2 inches).
• More X-rays are needed to produce a radiographic
image for a thicker anatomic part.
• Fewer X-rays are needed to produce a
radiographic image for a thinner anatomic part.
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2. Type of Tissue.
• Tissue composed of a higher atomic number, such as bone,
attenuates the X-ray beam more than tissue composed of
a lower atomic number, such as fat.
• The higher atomic number indicates more atomic particles
to absorb or scatter the X-ray photon.
• X-ray absorption is more likely to occur in tissues with a
higher atomic number than tissues with a lower atomic
number.
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3. Tissue density
• The matter per unit volume, or the compactness of the atomic
particles comprising the anatomic part, also affects the
amount of beam attenuation.
• For example, muscle and fat tissue are similar in atomic
number; however, their atomic particles differ in compactness,
and tissue density varies.
• Muscle tissue has atomic particles that are more dense or
compact and, therefore, attenuate the X-ray beam more than
fat cells.
• Bone is composed of tissue with a higher atomic number, and
the atomic particles are more compacted or dense.
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• Anatomic tissues are typically ranked based on their
attenuation properties.
• Four substances account for most of the beam attenuation
in the human body: bone, muscle, fat, and air.
• Bone attenuates the X-ray beam more than muscle,
muscle attenuates the X-ray beam more than fat, and fat
attenuates the X-ray beam more than air.
• The atomic number of the anatomic part and its tissue
density affect x-ray beam attenuation.
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4. 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 interacting 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 absorbed or scattered.
• The kilovoltage selected during X-ray production determines the X-
ray photon's energy or penetrability, affecting its attenuation in
anatomic tissue.
• Beam attenuation is decreased with a higher-energy x-ray beam
and increased with a lower-energy x-ray beam
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Transmission
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Image Brightness or Density
• Digital images are typically displayed on a computer monitor,
whereas film-screen images are displayed on film.
• 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.
• A radiographic image must have sufficient brightness or density to
visualize the anatomic structures of interest.
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Radiograph with insufficient Radiograph with diagnostic density Radiograph with excessive density
density or excessive brightness. (brightness). or insufficient brightness.
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• The primary factor that affects the amount of brightness
or density produced in an image is the amount or quantity
of radiation reaching the image receptor.
• However, the quantity of radiation reaching the image
receptor has less of an effect on the brightness of a digital
image because of computer processing.
• The quantity of radiation reaching a film-screen image
receptor has a direct effect on the amount of density
produced in a film image.
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Image Contrast
• the radiograph must exhibit
differences in the brightness levels
or densities (image contrast) in
order to differentiate among the
anatomic tissues.
• 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.
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Subject contrast
• Subject contrast refers to the absorption characteristics of
the anatomic tissue radiographed and the quality of the x-
ray beam.
• Differences in tissue thickness, density, and effective atomic
number contribute to subject contrast
• the quality of the x-ray beam also affects its attenuation in
tissues, which alters subject contrast.
• Increasing the penetrating power of the x-ray beam
decreases attenuation, reduces absorption, and increases
x-ray transmission—resulting in fewer differences in
brightness or densities recorded in the radiographic image.
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The thorax is an anatomic area of high subject contrast
because there is great variation in tissue composition. The
tissues attenuate the x-ray beam very differently The abdomen is an anatomic area of low subject
contrast because it is composed of similar tissue
types.
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Gray scale/Contrast scale
• Radiographic or image contrast is a term used in both digital and film-
screen imaging to describe variations in brightness and density.
• In digital imaging, the number of different shades of gray that can be
stored and displayed by a computer system is termed grayscale.
• Because the digital image is processed and reconstructed in the
computer as digital data, its grayscale or contrast can be altered.
• 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.
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CONTRAST RESOLUTION
• 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.
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Spatial Resolution and Recorded Detail
• The quality of a radiographic image depends on both the visibility and the
accuracy of the anatomic structural lines recorded (sharpness).
• Adequate visualization of the anatomic area of interest (brightness/ density
and contrast) is just one component of radiographic quality.
• To produce a quality radiograph, the anatomic details must be recorded
accurately and with the greatest amount of sharpness.
• Spatial resolution and recorded detail are terms used to evaluate accuracy
of the anatomic structural lines recorded.
• 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 the distinctness or sharpness of the structural lines
that make up the recorded image and is the term used in film-screen
imaging.
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• Factors such as patient motion
increase the amount of unsharpness
recorded in the image.
• It is the radiographer’s responsibility
to minimize the amount of
information lost by manipulating the
factors that affect the sharpness of
the recorded image.
• Diagnostic quality is achieved by
maximizing the amount of spatial
resolution or recorded detail and
minimizing the amount of image
distortion.
Image showing motion unsharpness.
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Distortion
• Distortion results from the radiographic misrepresentation
of either the size (magnification) or the shape of the
anatomic part.
• When the image is distorted, spatial resolution or recorded
detail is also reduced.
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Size Distortion (Magnification)
• The term size distortion (or magnification) refers to an
increase in the image size of an object compared with 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.
• Because radiographers produce radiographs of three-
dimensional objects, some size distortion always occurs as a
result of OID.
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• The parts of the object that are farther away from
the image receptor are represented radiographically
with more size distortion than parts of the object
that are closer to the image receptor.
• SID also influences the total amount of magnification
on the image.
• As SID increases, size distortion (magnification)
decreases; as SID decreases, size distortion
(magnification) increases.
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Shape Distortion
• Objects that are being imaged can be
misrepresented radiographically by
distortion of their shape.
• 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.
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• Shape distortion can occur from inaccurate central ray (CR)
alignment of the tube, the 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.
• Sometimes shape distortion is used to advantage in particular
projections or positions.
• For example, CR angulation is sometimes required to elongate a
part so that a particular anatomic structure can be visualized
better.
• Also, rotating the part (and therefore creating shape distortion)
is sometimes required to eliminate superimposition of objects
that normally obstruct visualization of the area of interest.
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Scatter
• 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 decreases the contrast by masking the desired
brightness or densities on the image and changing the
degree of differences
• Fog produced as a result of scatter reaching the image
receptor can be visualized on both a digital and a film image.
• Because digital image receptors can detect low levels of
radiation intensity, they are more sensitive to scatter
radiation than film.
Scatter and fog
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Quantum Noise
• 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.
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Image shows increased quantum noise as a result of
Image created using an appropriate x-ray
insufficient x-ray exposure to the image receptor.
exposure technique.
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• Although quantum noise can be a problem for both digital
and film-screen imaging, it is more likely to occur in digital
imaging.
• When the x-ray exposure to the image receptor is too low
(decreased number of photons), computer processing
alters the appearance of the digital image to make the
brightness acceptable, but the image displays increased
quantum noise
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ALARA Principle
• the radiographer is responsible for selecting exposure
techniques that produce acceptable image quality, while
simultaneously maintaining patient exposure as low as
reasonably achievable (ALARA).
• In particular, exposures that are too low adversely affect the
quantum noise of the image even though the computer can
adjust the brightness.
• Exposures that are too high result in excessive radiation
exposure to the patient.
• It is recommended that radiographers continue to select
exposure techniques that produce diagnostic-quality
radiographic images, regardless of whether the imaging system
is digital or film-screen.
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Image Artifacts
• 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
identification information difficult or impossible. They decrease
the overall quality of the radiographic image.
• Various methods are used to classify artifacts. Generally,
artifacts can be classified as plus-density and minus-density.
• Plus-density artifacts are greater in density than the area of the
image immediately surrounding them.
• Minus-density artifacts are of less density than the area of the
image immediately surrounding them.
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• Errors such as double exposing an image receptor or the improper use of
equipment can result in image artifacts and must be avoided.
• Although the causes of some artifacts are the same regardless of the type
of imaging system, others are specific to digital or film imaging.
• Artifacts from patient clothing and items imaged that are not a part of
the area of interest are the same for both film and digital systems.
• Scatter radiation or fog and image noise have also been classified as
radiographic artifacts because they add unwanted information on the
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 image receptor, inadequate CR imaging, plate
erasure, or performance of the electronic detectors.
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Image artifacts
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IMAGE CHARACTERISTICS
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Digital Imaging
• In digital imaging, the latent image is stored as digital data and
must be processed by the computer for viewing on a display
monitor.
• Digital imaging can be accomplished by using a specialized
image receptor that can produce a computerized radiographic
image.
• Two types of digital radiographic systems are in use today:
computed radiography (CR) and direct digital radiography (DR).
• Regardless of whether the imaging system is CR or DR, the
computer can manipulate the radiographic image in various
ways after the image has been created digitally.
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• A unique characteristic of digital image receptors is their wide dynamic
range.
• Dynamic range refers to the range of exposure intensities an image receptor
can accurately detect; this means that moderately underexposed or
overexposed images may still be of acceptable diagnostic quality.
• Digital image receptors can accurately detect a wide range of exit radiation
intensities (wide dynamic range), and therefore anatomic tissues can be
better visualized.
• Digital images are composed of numeric data that can be easily manipulated
by a computer.
• When displayed on a computer monitor, there is tremendous flexibility in
terms of altering the brightness (density) and contrast of a digital image.
• The practical advantage of such capability is that, regardless of the original
exposure technique factors (within reason), any anatomic structure can be
independently and well visualized.
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pixels
• A digital image is recorded as a
matrix or combination of rows
and columns (array) of small,
usually square, “picture
elements” called pixels.
• The size of the pixel is
measured in microns (0.001
mm). Each pixel is recorded as a
single numeric value, which is
represented as a single
matrix
brightness level on a display
monitor.
• The location of the pixel within
the image matrix corresponds
to an area within the patient or
volume of tissue.
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• For a given anatomic area, or field of view (FOV), a matrix size of 1024 × 1024 has 1,048,576
individual pixels; a matrix size of 2048 × 2048 has 4,194,304 pixels.
• Digital image quality is improved with a larger matrix size that includes a greater number of
smaller pixels.
• A greater number of smaller pixels improves digital spatial resolution.
• Although image quality is improved for a larger matrix size and smaller pixels, computer
processing time, network transmission time, and digital storage space increase as the matrix
size increases.
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• the greater the number of pixels in an image
matrix, the smaller their size.
• An image consisting of a greater number of
pixels per unit area, or pixel density, provides.
improved spatial resolution
• In addition to its size, the pixel spacing or
distance measured from the center of a pixel to
an adjacent pixel determines the pixel pitch
• The major determinant of spatial resolution of
digital images is the pixel size and its spacing.
• The device used for digital image display also
affects the ability to view anatomic details.
• High-resolution monitors are required to
maximize the amount of spatial resolution
viewed in the digital image.
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Film-Screen Imaging
• A major difference between digital and film-
screen imaging is that film is used as the
medium for acquiring, processing, and
displaying the radiographic image.
• In order to create and display the radiographic
image, an active layer or emulsion is adhered
to a sheet of polyester plastic.
• The emulsion contains crystals suspended in
gelatin that serve as the latent imaging centers.
• To reduce patient exposure, radiographic film is
placed between two intensifying screens. The
intensifying screens convert the exit radiation
intensities into visible light, and the light
exposes the crystals in the emulsion.
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• The film must be processed chemically in an automatic processor before it
can be visualized.
• Once it is chemically processed, the film image displays densities ranging
from dark to light that correspond to the variations in the intensities of
radiation exiting the anatomic tissues.
• The dark densities are created when the exposed crystals are converted to
black metallic silver.
• The light or clear areas on the film result from removal of the unexposed
crystals during chemical processing.
• The resulting image represents a range of densities created as a result of the
x-ray attenuation characteristics of the anatomic structures.
• Anatomic tissues that transmitted radiation are visualized as dark densities
and anatomic tissues that absorbed radiation are visualized as light or clear
areas on the film.
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Optical density
• Density on the radiographic film image can be
quantified and is therefore an objective measure that
can be used for comparison.
• A densitometer is a device used to numerically
determine the amount of blackness on the radiograph
(i.e., it measures radiographic density).
• This device is constructed to emit a constant intensity
of light (incident) onto an area of the film and then
measure the amount of light transmitted.
• The densitometer determines the amount of light
transmitted and calculates a measurement known as
optical density (OD).
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• Optical density is a numeric calculation that compares the
intensity of light transmitted through an area on the film (It) to
the amount of light originally striking (incident) the area (I0).
The ratio of these intensities is called transmittance.
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• As shown in Box 3-5, optical density is defined as the
logarithm (Log10) of the inverse of transmittance.
• For example, an area of the image that allows 10% of the
original incident light to be transmitted has a transmittance
of 1/10 or 0.1.
• The inverse of transmittance is therefore 10, and the
logarithm of 10 (the optical density) is 1.
• Similarly, an area that allows only 1% of the original incident
light through has an optical density of 2.0.
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• When 100% of the light is transmitted, the optical density
equals 0.0. When 50% of the light is transmitted, the optical
density is equal to 0.3, and when 25% of the light is
transmitted, the optical density equals 0.6.
• When a logarithmic scale base 10 is used, every 0.3 change
in optical density corresponds to a change in the percentage
of light transmitted by a factor of 2 (log10 of 2 = 0.3).
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Diagnostic Range
• Optical densities can range from 0.0 to 4.0 OD. However, the diagnostic
range of optical densities for general radiography usually falls between
0.50 and 2.0 OD.
• This desired range of optical densities is found between the extreme
low and high densities produced on the radiograph.
• The radiation exposure to the image receptor primarily determines the
amount of optical density created on the film after processing.
• The intensity of radiation exposure or exposure intensity is a
measurement of the amount and energy of the x-rays reaching an area
of the film. When all other factors remain the same, increasing the
exposure intensity will increase the optical density.
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Limitation of Film Screen
• Although film-screen served as a good medium for
radiographic images for many decades, it has many
limitations that can be overcome with digital imaging.
• One major deficiency is the limited dynamic range (the
range of exposure intensities an image receptor can
accurately detect) of film-screen.
• This limitation renders a film-screen radiograph very
sensitive to underexposure or overexposure, which may
necessitate image retakes.
• A limited dynamic range also restricts visibility of structures
that differ greatly in x-ray attenuation. 76
• Other drawbacks of film-screen imaging involve the cost of film itself,
the necessity of developing the latent image into a manifest image via
chemical processing, and potential artifacts related to film handling
and chemical processing.
• The time required to process the film before viewing the radiograph can
delay the progress of an examination or the diagnosis.
• Automatic film processors incur considerable equipment and
maintenance costs and demand frequent quality control procedures.
• Another restriction associated with a film image is that once the film
has been processed, the image is permanent, and further adjustments
cannot be made. There is no option to alter the density or contrast of
the manifest image.
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• In addition, film images cannot be electronically stored or duplicated,
displayed on computer monitors, or transmitted over computer
networks.
• Traditional film archives consume significant space and are frequently
prone to loss of films.
• In addition, personnel costs associated with maintaining the archive
and the expense of storing radiographs and then retrieving them when
needed for comparison is prohibitive.
• Digital imaging overcomes many of the limitations of conventional film
radiography.
• Digital radiographic images can be acquired and displayed quickly and
can be efficiently transmitted, processed, interpreted on a display
monitor, stored, and retrieved via electronic means.
• Digital image receptors eliminate the need for film and film processing
hardware and generally exhibit greater dynamic range and contrast
resolution than film-screen image receptors.
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