Physics of Radiography

Part 2: image characteristics

Laura Ziegler, DVM

What makes a good radiograph?

Should be able to see everything you are
supposed to see given the study
Intent of the study may change what
constitutes a good radiograph
(e.g. a good cervical spinal radiograph is
generally poor for assessing the pharynx)

We will leave off talking about positioning,

centering, etc.

Excellent Reference
Radiograph Quality Evaluation for
Exposure VariablesA Review
Robert M. Kirberger, Vet Radiol Ultrasound
Vol 40, NO. 3, 1999, pp 220-226

What makes a good radiograph?

Appropriate density (referring to optical
density) of the ENTIRE film
High density film=relatively BLACK
Low density film=relatively WHITE

Density is related to the number of photons

interacting with the silver in the film

Film Density
Directly related to mAs
Directly, but not linearly, related to kVp
Affected by film/screen type (remember
characteristic curves?)
Also affected by processing
Affected by grid (if not compensated)
MUST have a good technique chart (see
lab!)

Film Densitytoo white

Periphery of film (where the patient isnt)
should be BLACK
Quick test-you should not be able to see a
finger through it

If not, either have:

Inadequate mAs
Inadequate developing

Film Densitytoo white

Film Densitytoo white

Inadequate mAs
If pure technique issue, either double mAs or
change to a more efficient (faster) film/screen
Make sure you have compensated for
Using a grid
Using a slower film/screen

Make sure no obstruction to beam path (two

films in cassette, paper in new cassette)

Film Densitytoo white

Inadequate mAs
Make sure the incoming voltage is constant
(can be a problem with portables)
May need to call someone to service the tube

Inadequate developing
Developer exhausted, diluted, incorrectly mixed
Developing time too short
Developer too cold

Film Densitytoo white

If the periphery is black, but the overall
density is too white, check gross image
detail
If you cant see anything, kVp is way too low,
and no amount of mAs will make up for it
If you can see gross detail, can increase kVp
*or* mAs

Film Densitytoo white

Corrected image

Film Densitytoo white

Roughly speaking, halving or doubling mAs
is equivalent to increasing or decreasing
kVp by 10-15%
Must change kVp by at least 5% to detect a
visible difference
kVp change of 15% will approximately
double the density of the film

Film Densitytoo black

Evaluate under a hot light for small, thin
bones
If they are visible, the kVp is ok
If they are not visible, the kVp is too high

Film Densitytoo black

Film Densitytoo black

Film Densitytoo black

If kVp is ok, there is either
Too many photons hitting the film
Over development in processing

Film Densitytoo black

Too many photons
mAs set too high
Make sure to compensate for grids (or absence of),
film/screen, SID etc.

Line surge
Double exposure
Fog (light leak, radiation scatter, etc.)

Film Densitytoo black

Over development
Developer incorrectly mixed
Developer time too long
Developer temperature too high

Film Densitytoo black

If kVp is too high (small detail not visible),
must decrease kVp
However, the factors mentioned above
(usually too high mAs) are also in play
If kVp is too high but mAs is fine, overall
film density is ok, but IMAGE CONTRAST
suffers

Film Densitycorrected image

Film Density
When in doubt, err (slightly) on the side of
OVEREXPOSURE (higher kVp or mAs),
as information can frequently be retrieved
with a hot light

Contrast
Contrast is defined as the the difference between
an object and surrounding background
Degree of contrast in an image depends on:
the composition of the object and background
(calcified nodule in lung vs. soft tissue nodule in fat)
Film characteristics
kVp

Contrast

Contrast
As kVp (remember p is for Peak) increases, a
few photons can squeak through the higher density
materials

Gas

Fat

Soft
tissue/
Fluid

High Z
mineral

Metal

Contrast
As kVp (remember p is for Peak) increases, a
few photons can squeak through the higher density
materials

Gas

Fat

Soft
tissue/
Fluid

High Z
mineral

Metal

Contrast

Contrast
When radiographing the thorax, we like a
long scale of contrast (many shades of gray)
The subject contrast is quite high (soft tissue vs.
air for the most part) so it doesnt need a lot of
help
Many of the things that we are looking for can
be quite subtle shadings of gray that may get
burned out with a high contrast technique

Contrast-thorax

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Contrast

Relatively HIGH kVp for thorax

radiographs

Contrast
When radiographing the abdomen, we like
higher contrast (shorter scale)
This is mostly because the subject contrast is
quite low (soft tissue vs. fat)
In order to tell the difference between the two,
we need to compensate with our technique

Contrast-abdomen

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Contrast

Relatively LOW kVp for abdomen

radiographs

Contrast
For orthopedic studies, we generally like
quite high contrast techniques (very short
scale)
Subject contrast often even lower than abdomen
(more dense bone vs. less dense bone)
Dont care too much about peripheral soft
tissues (although soft tissues should NOT be
ignored or burned out completely)

Contrastorthopedic

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Contrast

Relatively LOW kVp for orthopedic studies

Detail
Detail (resolution) is the ability to discern
two discrete objects as being separate from
one another
Objectively measured in line pairs per
millimeter
Higher lp/mm, better resolution

Detail
Remember, biggest influences on detail are the
film (big/little silver crystals, thick/thin emulsion,
double/single emulsion) and the screen (big/little
phosphor crystals, thick/thin phosphor layer)
Trade off for high detail is high technique
Generally, want to use the highest detail system
you can get away with (exposure time generally
the limiting factor)

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Detail
Remember that distance also degrades detail
(penumbra)
Scatter degrades detail and also decreases
contrast (grays the image out)

Artifacts
An artifact is where the image appears to represent
something that is not real or interferes with the
ability to see things that are real
Things can go wrong anywhere in the process,
from electrons boiling off to the final image being
produced and safely stored in a folder or electronic
file (and sometimes beyond)

Optical illusions and percepts

In addition to artifacts,
be aware of the
influence of your brain
Your brain is not
always as helpful as it
tries to be

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Effect of surrounding opacity on

perception

Mach lines (bands)

Occur at interfaces of
markedly different
opacity
Commonly mistaken
for fractures

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 If your brain knows

there is something
there, it will piece
together unrelated
contours to make it
happen.

Even if an object is
real, your brain may
misinterpret its
significance

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