COMPUTED AND DIGITAL RADIOGRAPHY

SEMI-FINALS: SECOND SEMESTER REVIEWER

RESCALING ▪ When the CR reader reads the IP, it scans all

of the sensitive parts but only the area
ANATOMIC MENU SELECTION exposed to x-rays will have the data
necessary for image viewing.
▪ Since computers are integrated into data
▪ In CR / DR imaging systems, the
processing, the computer algorithm
preprocessing of the patient’s data and
automatically detects the part of the IP that
postprocessing of images are under the
has been exposed and recognizes it as a
control of the RT with the use of a
useful data and displays the data as a visible
computer that has integrated program for
image on the monitor (image below, right) for
patient data and image processing and
the RT to conduct postpocessing steps when
storage.
necessary.
o When a patient is to be examined, in
▪ Same thing happens except the IP is replaced
the computer, the RT selects the
with direct/indirect digital receptors
anatomy to be examined and selects
integrated into the chest or table assembly.
various projections related to the x-
ray examination.
o This prompts the CR system to
select a dedicated histogram
analysis of the examination,
basically, the computer
automatically adjusts the gray scale
of the visible image on the monitor
based on the manufacturer’s pre-set
scale of contrast for each
examination.
o Histograms are different for
anatomic sites, this is because
exposure factors are different for IMAGE HISTOGRAM
each exam and the contrast and
density are different. ▪ All digital radiographic imaging systems have
the ability to evaluate the original image data
through histogram analysis.
▪ A histogram is a plot of the frequency of
appearance of a given object characteristic.
▪ A histogram is a discrete plot of values rather
than a continuous plot.
▪ The histogram in Figure 21-10 is a plot of the
number of penguins (frequency) that have a
given height as a function of that height
(value interval). Because there are two
penguin populations, two peaks are evident
on this histogram.
EXPOSURE FIELD RECOGNITION

▪ In CR, imaging of the imaging plate (IP) is the

same with screen-film imaging, a 14x17”
cassette may be used for an examination and
only a portion of the cassette is exposed
(collimated exposure), thereby creating a
visible image with collimated borders.
▪ With the use of IP in CR imaging, the same
thing can happen, a 14x17” IP can be used but
only a portion of the IP is exposed (image
below, left).
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▪ Most digital radiographic imaging systems ▪ If the x-ray exposure field is not properly
have the ability to store and analyze collimated, sized, and positioned, exposure
characteristic image histograms for each field recognition errors may occur.
radiographic projection PA chest image o These can lead to histogram
histograms and averaging the value of each analysis errors because signal
frequency interval, a representative outside the exposure field is
histogram is produced for each image included in the histogram.
receptor. o The result is very dark or very light
▪ The histogram can be regularly updated from or very noisy images
newer images.
AUTOMATIC EXPOSURE CONTROL (AEC)

▪ The AEC is a device that measures the

quantity of radiation that reaches the image
receptor.
▪ It automatically terminates the exposure
when the image receptor has received the
required radiation intensity.
▪ The type of AEC used by most manufacturers
incorporates a flat, parallel plate ionization
chamber positioned between the patient and
the image receptor.
o This chamber is made radiolucent
so that it will not interfere with the
radiographic image.
o Ionization within the chamber
creates a charge.
o When the appropriate charge has
been reached, the exposure is
terminated.
o After the AEC is in clinical operation,
the radiologic technologist selects
the type of examination, which
then sets the appropriate mA and
kVp.
o At the same time, the exposure
COLLIMATION AND PARTITION timer is set to the backup time.
o When the electric charge from the
ionization chamber reaches a preset
level, a signal is returned to the
operating console, where the
exposure is terminated.
o When radiographs are taken in the
AEC mode, the electronic timer
should be set to 1.5 times the
expected exposure time as a
backup timer in case the AEC fails to
terminate.
▪ This precaution should be
followed for the protection of
the patient and the x-ray
tube.
▪ Many units automatically set
this precaution.
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SEMI-FINALS: SECOND SEMESTER REVIEWER

in its contrast / density based on the

histogram of your selected exam on the
computer.
▪ For example, you selected Chest x-ray on
the computer but you exposed the
Abdomen of the patient, after processing
(CR) or when the image will be displayed
on the monitor (DR), the contrast and
density of the abdomen that you will see on
the monitor is based on the histogram of
the your selected exam, which is Chest.
▪ This slight differences in histogram and
display on the monitor can be easily
corrected by the RT through window and
level adjustment.

3. (CR system only) Exposes the cassette

twice? (different areas of the IP, i.e. 2 in 1
exposure)
▪ It is common in film-screen imaging to
perform two exposures in a single cassette,
In CR or DR imaging, what would happen if the
in CR imaging, it can also be performed.
RT:
▪ When you are to consider exposing an IP
twice (image below, automatic processing),
1. overexposes the patient? (using high KV
it is recommended that you apply four-
and High mAs values)
sided collimation and use lead blockers
▪ The main advantages of CR and DR
in order to protect the unexposed area and
imaging over film-screen imaging is its
the exposed area when exposing the other
reduction of repeat examination, it has
side, this is due to the fact that IPs are very
almost a 0% repeat chance because of the
sensitive to radiation.
postprocessing capabilities of the computer
▪ With automatic processing of the
application dedicated to radiographic
computer system, it may display the image
imaging.
as too dark, this image can be rescaled after
▪ Gone are the days when the RT has to
manual postprocessing of window and
repeat examination because of
level.
overexposure, underexposure,
underprocessed, overprocessed, or
repeating exam simply because the
radiograph is too dirty (too many
scratcher).
▪ With CR/DR imaging, even when the RT
overexposes the patient (uses too much
kVp or mAs), the computer will still
display the image as an acceptable image
based on the histrogram stored in the
memory for each examination type.
▪ This slight increase in use of factors to
reduce repeat exams has been an issue in
radiography since it also increases the
dose of the patient.
4. (Using AEC) fails to remove metallic objects
2. selects incorrect anatomic menu selection from the patient?
▪ In anatomic menu selection, when the pre- ▪ As review, AEC is a device that measure the
set examination is not the same with the amount of radiation that reaches the image
actual x-ray exposure, the display image receptor, it automatically terminates the
on the monitor may have a slight change
 COMPUTED AND DIGITAL RADIOGRAPHY
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exposure when the required radiation

intensity has been received.
▪ If metal objects will be present in the
patient’s body, it will absorb a lot of x-rays
and will affect the intensity of radiation that
reaches the image receptor, therefore, x-rays
will continually be produced until enough
radiation is received.
▪ If this would happen, the patient will be
overexposed or the dose to the patient will
increase.
o To prevent this from happening, a
back-up mAs or timer is set to
limit the time or intensity of
exposure to avoid overexposing the
patient.

PEAK

IMAGING PLATE SCATTER RADIATION

▪ The PSP screen is housed in a rugged cassette ▪ The imaging plate is highly sensitive to
that appears similar to a screen-film cassette. scattered radiation.
▪ In this form as an image receptor, the PSP ▪ Therefore, cassettes should be kept away from
screen-film cassette is called an imaging plate radiation fields, because radiation leads to a
(IP). deterioration of image quality.
▪ The latent image can remain "stored" in the ▪ No object should be kept on a cassette when it
photostimulable phosphor (PSP) plate for 8 is in a radiation field, because the object will be
hours before information is lost. imprinted on the image, leading to
▪ Imaging plates should be used soon after the unwarranted repeating of the radiograph.
erase cycle has been completed o Hence, the cassette must be protected
▪ The PSP is sufficiently sensitive that it can from all sources of ionizing radiation,
become fogged by background radiation. including scatter radiation, as well as
▪ Background radiation is approximately 40 heat and humidity.
microRoentgens- 80 microRoentgens per ▪ A cassette seen to be lying unidentified in the
day. radiography room should be erased before use.
▪ Cassette-based imaging plates are sensitive ▪ If the cassette was previously exposed or kept
to levels of radiation as low as 60 in a field of radiation, it has to be put through
microRoentgens. the process of erasure before reuse because it
▪ Make sure to erase the image plate if it has will hamper the quality of the image and cause
been unused for more than 48 hours. erroneous artifacts.
▪ Computed radiography cassettes are highly
sensitive to background radiation and scatter.
If a CR cassette has not been used for several
days, it should be inserted into the reader for
re-erasure
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▪ Kilovoltage, which is one of the factors that

affect the level of scatter radiation, can be
controlled by the radiologic technologist.
o Unfortunately, when kVp is increased,
the level of scatter radiation also
increases, leading to reduced image
contrast.

EFFECT OF SCATTER RADIATION ON

IMAGE CONTRAST

REDIRECTION ▪ Even under the most favorable conditions, most

remnant x-rays are scattered. Figure 11-9
PRODUCTION OF SCATTER RADIATION illustrates that scattered x-rays are emitted in
all directions from the patient.
▪ As x-ray energy is increased, the absolute
number of Compton interactions decreases, but
the number of photoelectric interactions
decreases much more rapidly.
▪ Therefore, the relative number of x-rays that
undergo Compton scattering increases.
▪ Table 11-1 shows the percentage of x-rays
incident on a 10-cm thickness of soft tissue that
will undergo photoelectric absorption and
Compton scattering at selected kVp levels.

▪ If you could image a long bone in cross section

using only transmitted, unscattered x-rays, the
image would be very sharp (Figure 11-10, A).
o The change in OD from dark to light,
corresponding to the bone–soft tissue
interface, would be very abrupt;
therefore, image contrast would be high.
▪ On the other hand, if the radiograph were taken
with only scatter radiation and no transmitted
 COMPUTED AND DIGITAL RADIOGRAPHY
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x- rays reached the image receptor, the image

would be dull gray (Figure 11-10, B).
o The radiographic contrast would be very
low. In the normal situation, however,
image-forming x-rays consist of both
transmitted and scattered x-rays.
▪ If the radiograph were properly exposed, the
image in cross-sectional view would appear as
in Figure 11-10, C. This image would have
moderate contrast.
o The loss of contrast results from the
presence of scattered x-rays.

1. Aperture Diaphragm
▪ An aperture is the simplest of all beam-
restricting devices.
▪ It is basically a lead or leadlined metal
diaphragm that is attached to the x-ray tube
head.
▪ The opening in the diaphragm usually is
designed to cover just less than the size of
the image receptor used.

2. Cones and Cylinders

▪ Radiographic extension cones and
cylinders are considered modifications of
the aperture diaphragm.
▪ Figure 11-14 presents a diagram of a
typical extension cone and cylinder.
▪ In both, an extended metal structure
restricts the useful beam to the required
size. The position and size of the distal end
act as an aperture and determine field size.

▪ Two types of devices reduce the amount

of scatter radiation that reaches the image
receptor
1. Beam restrictors
2. Grids

BEAM RESTRICTORS

▪ Basically, three types of beam-restricting

devices are used: the aperture diaphragm,
cones or cylinders, and the variable-
aperture collimator (Figure 11-11).
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3. Variable-aperture collimator GRIDS

▪ Box-shaped device that contains a
radiographic beam–defining system. ▪ Scattered x-rays that reach the image receptor
▪ It is the device that is most often used to are part of the image-forming process; indeed,
reduce the size and shape of a radiographic the x-rays that are scattered forward do
beam contribute to the image.
▪ The light-localizing variable-aperture ▪ An extremely effective device for reducing the
collimator is the most commonly used level of scatter radiation that reaches the
beam-restricting device in radiography. image receptor is the radiographic grid, a
▪ The photograph in Figure 11-16 shows an carefully fabricated section of radiopaque
example of a modern automatic variable- material (grid strip) alternating with
aperture collimator. Figure 11-17 radiolucent material (interspace material).
identifies the principal parts of such a ▪ The grid is positioned between the patient and
collimator. the image receptor.
▪ The grid is designed to transmit only x-rays
whose direction is on a straight line from
the x-ray tube target to the image receptor.
▪ Scatter radiation is absorbed in the grid
material.
▪ Figure 11-18 is a schematic representation of
how a grid “cleans up” scatter radiation.