KVP > Adding filtration (filters out low energy photons

as they cannot reach up until IR, just reduces the

> The primary controlling factor for radiographic
contrast.
> INCREASE IN KVP = INCREASES both quantity and
quality of X-Radiation
quality and only adds radiation dose to patients) to the
x-ray tube reduces x-ray beam intensity but enhances
quality.
> Change in SID, changes OD (Inverse Square Law)

Why? When there is an increase in kVp, there are also
greater number of x-rays that are transmitted through
the patient + Higher portion of the primary beam reacts
to the image receptor or reaches the image receptor
because of higher kVp thus increasing the quantity and
quality of x-radiation = It affects the OD.
> Increases Compton Effect – releases of scatter
radiation, decrease in differential absorption and
subject contrast. = increase in kVp
> Time of exposure should be as short as possible – to
avoid motion blur as well as reduce patient dose
(reduce exposure time)
The continuing trend in rad. technique is to use high kVp
with compensating reduction in mAs to produce a
radiograph of satisfactory quality while reducing the
patient dose and repeat examination due to technique
error = high kVp and low mAs

> Increased scatter radiation, increase noise thus there

will be loss of contrast

> Increased kVp reduces patient dose. In what way?

Because of high penetrating power – meaning less
adsorption of patient; wide latitude of exposures
allowed.

> Use grids to compensate for contrast – grids reduces

scatter radiation and improves contrast.

MAS (current, filament current)

> Primarily controls the Optical Density, Quantity of
Radiation, Beam Quantity, Number of X-Ray Photons.

> Radiation quantity, number of x-rays in image EXPOSURE TECHNIQUE CHART

receptor, and optical density is increased with lower
noise but increases patient radiation dose.

Increase in mAs = lower noise (quantum mottle) in the

radiograph. Drawback – increses patient dose.

Maximum contrast (determines the quality of the image)

is attained only when the film is exposed over a range
that results in optical density along the straight line
portion of the characteristic curve.

• Radiographic technique charts are tables that provide

a means for determining the specific technical factors to
be used in given radiographic examination.

• An RT must understand its purpose, how it is made,

and its uses.

> Too low mAs ⇢ low OD • If used properly, technique charts allows consistently
> Too high mAs ⇢ high OD good diagnostic images.
• The scale of contrast and the Optical Density are more If the generator is single phase or 3 phase, 30 or 25,
predictable. respectively is the additive factor.

• Radiographic technique charts can be prepared to

accommodate all types of facilities. 3. Using the product of the formula stated, determine
the optimal mAs
• The type of chart prepare usually depends on the
technical director of a radiological facility.

PURPOSE OF TECHNIQUE CHARTS

1. RADIATION PROTECTION

2. MINIMIZE WASTAGE

PRELIMINARY REQUIREMENTS

• X-ray equipment must be calibrated by a medical

physicist.

• Processing system must be evaluated.

• Total filtration should be determined, because a total

filtration of more than 3mm Al, can significantly alter the
contrast, and makes a considerable difference in any
technique chart.
To prepare a variable –kvp chart for other anatomical
• The type of grid used should be known and the parts, the same procedure is used.
collimator or beam restrictor checked for accurate light
field and x-ray beam coincidence.
2. FIXED KVP RADIOGRAPHIC TECHNIQUE CHART
• These things should be checked so that all variables
are reduced to a minimum. • This chart is often used and developed by Arthur
Fuchs.

1. VARIABLE KILOVOLTAGE TECHNIQUE CHART • It is a method of selecting exposures hat produce

• It uses a fixed mAs value and a kVp that varies
according to the thickness of the anatomical part.
• The basic characteristics of the Variable kVp
technique chart is an inherently short scale of contrast.
radiographs with a longer scale of contrast.
• The kVp is selected as the optimum required for
penetration of the anatomical part. This usually results
in somewhat higher kVp values for most examinations
than are produced by the variable-kVp chart.

• In general, exposures made with this method provide
radiographs of shorter contrast scale because of the
use of lower kVp.
• Exposure directed by the variable kVp chart usually
results in higher patient dose and less exposure
latitude.
• Once selected, the kVp is fixed at that level for each
type of examination and does not vary according to
different thickness of the anatomical part. The mAs
value, however, is changed according to the thickness
of the anatomical part, to provide proper optical density.
• Measurement of the part is not critical because part
size is grouped as small, medium and large.

STEPS IN PREPARING A VARIABLE KVP

TECHNIQUE CHART 3. HIGH –KVP TECHNIQUE CHART

1. Select a body part for examination. For example, if
the knee is chosen, use a knee phantom for test
exposures.
2. Measure the thickness of the knee phantom, using a
caliper. Multiply that thickness by 2, and add 23; this
indicates a kVp with which to begin if the high voltage
generator is of high frequency.
• The kVp selected for high-kVp technique charts is
usually greater than 100.
• High kVp techniques are ideal for barium procedures
to ensure adequate penetration of the barium sulfate.
• This type of exposure technique could also be used in
for routine chest radiography to attain improved
visualization of the various tissue mass densities
present in the lung fields and the mediastinum.
• The preparation of high kVp technique chart is similar
to preparing the variable kVp chart.
4. AUTOMATIC EXPOSURE TECHNIQUES
• Radiation exposure in most x-ray imaging system is
determined by an automatic exposure control (AEC).
• It incorporates a device that senses the amount of
radiation incident on the image receptor.
• Radiation exposure is terminated when a sufficient
number of x-rays has reached the image receptor to
produce an acceptable optical density.
• Changing the OD is termed as “TWEAKING”
• With AEC devices, usually two or more exposure
sensors are available.
• Regulations require that AECs have a 600-mAs safety
override.
• In addition to selecting exposure cells, the RT has a 3
– 7 position dial labeled “OD” with numeric steps for
tweaking.
• Microprocessors are being incorporated even more
frequently into operating consoles.
• This allows the operator to select digitally any kVp or
mAs setting, the microprocessor automatically activates
the appropriate mA station and exposure time.
• With falling load generators, the microprocessor
begins exposure at a maximum mA setting and then
causes the tube current to be reduced during exposure.
• The overall objective is to minimize exposure time to
reduce motion blur.
5. ANATOMICALLY PROGRAMMED RADIOGRAPHY
(APR)
• APR also uses a microprocessor technology. Rather
than have the RT select a desire kVp, and mAs,
graphics on the console guides the RT on what to
select.
• The Microprocessor selects the appropriate kVp, mA
and time setting.
• The whole process uses an AEC resulting in a near
flawless radiographs and fewer repeats.
• The principle of APR is similar to the of AEC , with the
technique chart stored in the microprocessor of the
control unit.
GEOMETRIC FACTORS
The geometric conditions also apply to the production
of high-quality radiographs.
3 Principal geometric factors affect radiographic quality:
1. Magnification
2. Distortion
3. Focal-spot Blur
MAGNIFICATION
• When image/object on the radiograph are larger than
the object they represent.
• For most medical images, the smallest magnification
possible should be maintained.
• Some examinations, however, magnification is
desirable and is carefully planned, known as
Magnification Radiography.
• Quantitatively, magnification is expressed by
Magnification Factor (MF)
MF= image size/object size = SID/OID
• 2 factors affect image magnification: SID and OID
• Minimize Magnification:
> Use Large SID
> Small OID, place the object as close to the image
receptor as possible.
DISTORTION
• Unequal magnification of different portion of the same
object, called shape distortion
• Distortion can interfere with diagnosis.
• 3 Conditions that contribute to image distortion:
> Object Thickness
Thick objects are more distorted than thin object.
> Object Position
❖ Foreshortened or elongated
❖ Spatial resolution – misrepresentation in the image
of the actual spatial relationships among objects. As
object position is shifted laterally from the central
ray, spatial resolution can become more significant.
> Object Shape
• A single image is not enough to define the three-
dimensional configuration of a complex object.
Therefore most, radiographic examinations are made
with two or more projections.
FOCAL SPOT BLUR
• Focal spot blur is caused by the effective size of the
focal spot, which is larger to the cathode side of the
image.
• The physical dimensions of the focal spot on the anode
target in standard radiographic applications are usually:
0.5 and 1.2mm
• Small focal spot sizes are usually 0.5 of 0.6 mm
• Large focal spot sizes are usually 1.0 mm or 1.2 mm
• Focal spot size is an important consideration for the
radiographer because the focal spot size only affects
recorded detail.
Important relationship
Motion unsharpness (due to motion)
• The factors affecting motion unsharpness are:
1. Motion of the tube
2. Part being examined (patient factor)
3. Image receptor.

• As focal spot increases, unsharpness increases and

recorded detail decreases. FILTRATION
• As focal spot decreases, unsharpness decreases and
recorded detail increases.

Object – to – image receptor distance (OID)

• Increasing the OID increases the amount of
unsharpness and decreases the recorded detail,
whereas decreasing the amount of OID decreases the
amount of unsharpness and increases the recorded
detail.
• The radiographer should select the smallest focal spot
when maximal recorded detail is important; one should
also consider the amount of heat load within the x-ray
tube. In addition, the radiographer should select the
standard SID when OID is minimal.
• When increased OID is unavoidable, SID should be
increased slightly to compensate.

Image receptor unsharpness (of the IR)

• The type of device used to record the image also
affects the amount of unsharpness recorded in the
image.
• Variations in the construction and composition of the
intensifying screen combined with different types of
radiographic film affect not only the photographic
properties of the image but also its geometric
properties.
• Filtration is the process of eliminating undesirable low-
energy x-ray photons by the insertion of absorbing
materials into the primary beam.

• It allows the radiographer to shape the photon

emission spectrum into a more useful beam.

• It is referred to HARDENING THE BEAM, sometimes.

• The primary reason for filtration is the elimination of

photons that would cause increased radiation dose to
the patient but would not enhance the radiographic
RESOLUTION image.
• It is defined as the ability of the imaging system to
resolve or distinguish between two adjacent structures.
• Expressed in the unit of line pairs per millimeter
(Lp/mm).
• Can be tested by a device used to record and measure
line pairs.
• The greater the line pairs per millimeter resolved, the
greater the resolution and recorded detail.
• Resolution can be considered a combined result of
both spatial and contrast resolution.
• At 20 KeV, 45% of the incident photon will penetrate 1
cm of soft tissue.
• At 50 KeV 3.5% of the incident photon will penetrate
15 cm of soft tissue
• Significant soft-tissue penetration occurs between 30
and 40 KeV.
MEASUREMENT
• Any material designed to selectively absorb photons
from the x-ray beam is called a FILTER.
• Aluminum is the most common filter material used,
although other materials such as:
a. Glass
b. Oil
c. Copper
d. Tin
• Aluminum is considered the standard filtering material
and all filtration can be expressed in terms of the
thickness of aluminum equivalency (Al/eq).
• Half-Value Layer (HVL) is the amount of absorbing
material that will reduce the intensity of the primary
beam to one-half its original value.
• It is the indirect measure of the total filtration in the
path of the x-ray beam.
• HVL’s are usually expressed in terms of aluminum
filtration equivalency.
• If the HVL is at the appropriate level, the total filtration
in the x-ray tube is adequate to protect the patient from
unnecessary radiation.
TYPES OF FILTRATION
Filtration occurs at various points between the x-ray
tube and image receptor. It is either inherent in the
design of the tube or added between the tube and the
image receptor.
1. INHERENT FILTRATION
• Filtration that is the result of the composition of the
tube and housing is often
called inherent filtration because it is a part of these
structures:
> The thickness of the glass envelope
> The dielectric oil that surrounds the tube
> Glass window of the housing
• A typical x-ray tube might have a total inherent filtration
of 0.5 – 1.00 mm Al/eq.
Most of the inherent filtration comes from the window of
the glass envelope.
• Mammographic tubes designed to produce lower
energy photons utilizes BERYLLIUM windows in the
glass envelope to eliminate the majority of the inherent
filtration. Which can reduce the inherent filtration to 0.1
mm al/eq
• As tubes become gassy, the anode begins to pit and
the glass envelope may gain a mild coating of vaporized
material.
• All these factors will cause an increase in the inherent
filtration, thus reducing the tube efficiency.
2. ADDED FILTRATION
• Any filtration that occurs outside the tube and housing
and before the image receptor is considered added
filtration.
• Filtration materials are selected to absorb as many
low-energy photons as possible while transmitting a
maximum number of high-energy photons.
• Aluminum, with an atomic# of 13, functions very well
as a low-energy absorber.
• The collimator device also adds filtration to the beam
and is considered to be added filtration.
• Collimators average 1.0 mm Al/eq. most of which
comes from the silver mirror situated in the beam.
• The mirror is designed to reflect the collimator light to
simulate the primary beam field size for positioning
purposes.
• This addition to the inherent filtration is why
mammographic units often do not use collimators.
 3. COMPOUND FILTRATION • The wedge filter can be useful for procedures on the
thoracic spine, the feet and the lower extremities,
• A compound filter uses two or more materials that particularly during venography and femoral
complement one another in their absorbing abilities. angiography.
• Most compound filters are constructed so that each • A trough filter is useful to even the density differences
layer absorbs the characteristics photons created by the between the mediastinum and the lungs on a chest
previous layer. radiograph.
• Compound filters are also referred to as K-EDGE TOTAL FILTRATION
FILTERS.
• Total filtration is equal to the sum of inherent and
• Compound filters place the highest atomic number added filtration. Mathematically expressed as:
material closes to the tube and the lowest atomic
number material closest to the patient.

• The final layer is usually aluminum.

• Although aluminum is the most common filtering
material, COPPER, with an atomic number of 29,
functions well for slightly higher energy.
• When copper filter is used, it must be backed by an
aluminum filter to
• The thickness of the added filtration varies depending
on the anticipated uses of the equipment.
• The percentage of photons attenuated decreases as
photon energy increases, even when filtration is
increased.

absorb the 8KeV K-shell characteristic radiation

produced by the copper.

• Copper filters should be at least 0.25 mm thick and

backed with a minimum

of 1mm aluminum.

• A good example of a compound filter is the THOREUS

FILTER used in radiation therapy. This filter combines
tin, copper, and aluminum in that order.

• Tin has the highest atomic number (50) and is placed

first in the beam. Next, a copper filter is added to absorb
the 29.3 KeV characteristic photon created by the tin.
Finally, aluminum is added to the copper to absorb
copper’s characteristic photons, which would only
contribute to increasing patient dose.

• The 1.5 KeV K-shell characteristic radiation produced

by the aluminum filter is absorbed in the air between the
filter and the patient.

COMPENSATION FILTER

• A compensating filter is usually designed to solve a

problem involving unequal subject densities or
thickness. The goal is to add an absorber to
compensate for unequal absorption within the subject,
thus making the overall absorption of the primary beam
more equal.

• Compensating filters can be made of aluminum,

leaded plastic trademarked under the name ClearPb™
or plastic. Even a simple saline solution bag can be
used as a filter.

• The 2 most popular compensating filters are:

WEDGE FILTER and TROUGH FILTER

• The thicker portions of the filter are matched to the less

dense patient body parts.
• The national Council on Radiation Protection and
Measurements (NCRP) recommends minimum total
filtration levels for diagnostic radiography shown above.

EFFECT ON OUTPUT

• Not only does filtration reduce the patient exposure

dose by eliminating low-energy photons from the
primary x-ray beam, it also removes a portion of the
useful beam. This has a visible effect on radiographic
film density.

• To compensate for the loss of exposure when filtration

is increased, technical factors must be increased to
maintain same image receptor exposure.

• Beyond 3.0 mm/Al filtration a point of diminishing

return is reached. The reduction in ESE does not
warrant the tube loading increase.