COMPUTED

RADIOGRAPHY &
DIGITAL
RADIOGRAPHY

Dr Mohit Goel
JR II, 1/10/2013
 Digital X-ray Technology

There are two ways to obtain Digital X-rays:

• Computed Radiography

• Digital Radiography
 Computed Radiography (CR)

• A Digital way of doing general radiography

with Conventional X-ray machines
 What is CR?

• Computed Radiography (CR) is a process of

capturing radiographic data from a
conventional X-ray machine and processing
the data digitally to produce crisp and high
quality radiographic images
 What is CR?…

• For exposure, an Imaging Plate (IP) is placed in a

cassette instead of a piece of film. The IP captures
and "stores" the X-rays
• The image is "developed" in a CR reader instead
of a film processor. The CR reader extracts the
information stored in the plate and produces a
digital image
 What is CR?…

• Computed Radiography is a digital image

acquisition process that produces images that
have much better contrast than a
Conventional X-ray film-screen system
 Basic Modules of CR
ID Tablet Preview & ID Station
Cassette with
Imaging Plate

Digitizer Laser Camera

Processing Server

M ATR IXLR 3300

 Imaging Plate (IP)
• The Imaging Plate looks like the intensifying
screens found in Conventional film-screen
cassettes
• They are made of photostimulable phosphor
 Imaging Plate (IP)
• Instead of emitting light immediately when exposed
to X-rays, the photostimulable phosphor has the
special property of storing the X-ray energy in a
latent form and releasing the same when stimulated
by a laser energy in the CR Reader / Digitizer
 Imaging Plate (IP)…
• Storage phosphors are unique because they
respond to a very wide range of X-ray exposures
• This latitude gives the flexibility in selecting
X-ray technique and takes care of under or over
exposure
• Regardless of the exposure, the image can be
displayed correctly
• As a consequence, retakes due to inappropriate
exposures are drastically reduced
 Storage phosphor principle
Absorption Emission

laser stimulation

electron electron
trap trap

x-rays
 Storage phosphor principle…

• The imaging plate is coated with

photostimulable phosphor, also called storage
phosphor
• The phosphor material is generally a kind of
Bariumfluorohalide
• The Imaging Plate contains not only the
phosphor layer, but also a protective coat, a
conductive layer, support and laminate layers
 Storage phosphor principle…

• Incident X-rays excite electrons into a higher energy

level (electron traps)
• A latent image is created in the form of “stored energy”
• Stimulation with a scanning laser beam releases
electrons
• Typical wavelength of the stimulating laser is 633 nm
• Falling back, electrons emit luminescent light
• Typical wavelength of the emitted light is 390 nm
CR Readout
 Storage phosphor principle…

• The emitted light intensity is proportional to

the original incident X-ray intensity
• The emitted light is captured with an optical
array and a photomultiplier and is digitized
• The residual image is erased from the plate by
an intense light source, which returns all
electrons to their original state. This makes
the plate ready to be reused for new exposures
How is a Storage Phosphor plate
exposed?

• The storage phosphor plate fits inside a standard

size cassette and is exposed to X-rays exactly like
film
• The X-ray energy is stored on the plate in the form
of latent energy
 Patient ID Station
• Before exposing the cassette, the patient
demographic and exam data is stored on the
microchip attached on cassette
• This is done by inserting the cassette in a slot
of ID station and entering the data with the
help of keyboard
• When cassette is inserted in digitizer after
X-ray exposure, the digitizer reads both
patient data as well as X-ray exposure data
• The two data are combined to display images
along with patient data
 Digitizer

• The plate is inserted into the digitizer

where it is scanned with a high power laser
• The laser light causes the storage
phosphors to release the energy they have
captured in the form of blue light
• In the digitizer, this blue light energy is
converted to electrical signals which are
then digitized to produce digital images
 What happens to a Storage Phosphor
Plate after it is scanned?

• After exposure and scanning, the phosphor

plate is "erased" by exposing to a bright light
exposure within the digitizer
• The previous image stored in the phosphors is
removed and the plate is ready to be exposed
again
 Workstation

• The digitized image

data is processed on
a processing server
and is displayed on
its monitor
 How many times can we use a
Storage Phosphor Plate?

• The life of a phosphor plate depends on

how carefully it is handled. Physical
damage to the plate will limit its useful
life
• If properly cared for, a plate will produce
thousands of images
• Imaging Plates are known to last more
than 50000 Exposure Cycles
 Does CR require X-ray machine
replacement?

• No, CR uses the existing X-ray equipment

• One CR system can support multiple x-ray
rooms
 How is the workflow different with
CR ?

• Instead of taking the film cassette to a dark

room for processing, the technologist takes
the cassette with imaging plate to the CR
reader for digital processing of the image
• Instead of manually taking the films to the
reporting radiologists , the softcopy images
reach the workstation almost immediately
 How is the workflow different with
CR ?…

• The time required to acquire a Digital

image is much less compared to
conventional darkroom process
• The film is the first product in Conventional
where as the film is the last product in CR
 CR WORKFLOW
Cassette with Imaging Plate

MATR IXLR 3300

Rx Exposure
Printing
Network

Processing server
Identification Digitizer
The cassettes fit into X-ray table. After the exposure, the cassette is identified in the ID-station. Here patient
and exam related information is stored. Next the digitizer reads the identification data, handles the plates, reads
the image and sends out a raw dataset in DICOM-format. The automatic processing server processes the image
according to the type of exam. For each type of exam, an optimized image processing parameter set-up is used.
The processing server then pushes the processed image to the preview station for previewing. After approval
the image is routed to other destinations such as a printer, a review station and an archive server.

Cassette with Imaging Plate

MATR IXLR 3300

Rx Exposure
Printing
Network

Processing server
Identification Digitizer
 Digital Radiography

This technique is performed by digital X-ray

machines with flat panel detectors
 Digital Radiography

Digital Radiography uses two types of

detectors:
• Direct
• Indirect
 TFT = THIN-FILM TRANSISTOR ARRAY
 Indirect detectors

Uses a two step

process that first
converts X-rays
into light, then
converts that
light energy into
electronic signals
 Direct detectors

• Direct detectors
automatically convert X-
rays into electronic signals.

 X-rays interact with

semiconductor material
 Amorphous selenium

 X-rays converted directly

into electrical charge
 No intermediate steps
 Direct detectors
• The flat panel detector consists of an amorphous
selenium semiconductor X-ray absorber coating over
a thin-film transistor array of amorphous silicon
• In this system,X-ray photons are immediately
converted into electronic signal
• This immediate conversion eliminates the need for
additional steps to capture and convert incident X-ray
energy
• Corrective image processing which can result in
increased image noise is reduced with the highly
efficient X-ray energy conversion of direct DR
Limitations of Conventional X-ray process

(X-ray film / Screen/Darkroom)

• Film has a limited exposure latitude i.e less

detail contrast
• Time consuming & cumbersome
• Intolerant to exposure errors
• Repeat X-rays ( More radiation exposure )
• Film wastage
 Limitations of Conventional X-ray process
(X-ray film / Screen/Darkroom)…

• Cannot be duplicated without loss of quality

• Film storage is a problem
• Scatter radiation reduces contrast and increases
patient dose
• Quality control is an issue
 What are the advantages of
Digital X-rays?

• Post processing (soft tissue and bony details can

be viewed at same time )
• Reduction in hazardous X-ray dose to patients
• More info on one image
• Constant image quality
• Possibility of viewing X-ray images wherever
needed
 What are the advantages of
Digital X-rays?…

• Digital images are of extremely high

quality
• Digital images have a future scope of
better image management
• Facility of giving multiple images of
investigative studies on a single high
definition laser film
 How is Digital X-ray similar to Conventional
basic radiography process ?…

• Radiography consists of following

functions:
-Image data acquisition
-Image processing
-Reproduction of image
-Storage
 How is Digital X-ray similar to Conventional
basic radiography process ?…

• In Screen film system, all the processes are

done on the X-ray film itself which is used
for:
-Image data acquisition
-Image reproduction
-Storage
 How is Digital X-ray similar to Conventional
basic radiography process ?…

On the other hand, Digital X-ray distributes all the

processes into different stages:
• Imaging plate and digitizer are used for
image data acquisition in CR and Amorphous
Selenium detector array in DR
• Processing server is used for image processing and
storage
• Workstation monitor is used for image reproduction
 What is the role of Digital X-ray
in PACS Environment?

• Digital X-ray is the only film less way to

link the existing general radiography set up
into the digital environment of PACS
 Features of Digital X-ray
• Image enhancement
• Printing
• Annotation
• Black border
• Panoramic dental package
• Full leg / Full Spine
Under/over exposure
Soft tissue and bone windows
Digital image manipulation

• Image pre-processing
• Scale the data to appropriate range
• Contrast enhancement – Anatomy specific
grayscale manipulation
• Spatial frequency enhancement
Soft tissue and bone windows
Zoom
Collimation
 Collimation

MISS.PADMINI 20YRS,F 14/08/2004 20:15:01 MISS.PADMINI 20YRS,F 14/08/2004 20:17:01

SKULL, MASTIODS 23 SKULL, MASTIODS 23

MISS.PADMINI 20YRS,F 14/08/2004 20:15:01 MISS.PADMINI 20YRS,F 14/08/2004 20:17:01

SKULL, MASTIODS 23 SKULL, MASTIODS 23
Magnifying glass
Invert image
 Invert image

DIGITIZER, EMERGENCY 1O/07/2004 22:3O:28 DIGITIZER, EMERGENCY 1O/07/2004 22:3O:28

Annotation
 Vertical flip

MR.RAVINDER 33YRS, M 19/08/2004 14:20:08

MR.RAVINDER 33YRS, M 19/08/2004 14:20:08
RIGHT LEG, AP&LAT 268
RIGHT LEG, AP&LAT 268
Multiple images on single film

MRS.SWAPNA 30YRS, F 29/06/2004 09:15:32

Multiple images on single film

MRS.FARIDA 30YRS ,F 12/8/2004

09:15:23
CR vs DR
CR DR
 imaging plate  transistor receiver
(like bucky)

 Processing is done  directly into digital

in a Digital Reader signal

 Signal sent to
computer
 seen immediately
 Viewed on a monitor on monitor –
Thank
you