PRINCPLES OF IMAGING

James Lawrence Aduche, RRT, RSO

Review Lecturer
License No: 0023749
TOPIC OUTINE:
• Exposure Factors
‒ Kilovolt Peak
‒ Milliamperes
‒ Exposure Time
‒ Distance
• Imaging System Characteristics
‒ Focal-Spot Size
‒ Filtration
‒ High-Voltage Generation
TOPIC OUTINE:
• Patient Factors
‒ Thickness
‒ Composition
‒ Pathology
• Image Quality Factors
‒ Optical Density
‒ Image Contrast
‒ Image Detail
‒ Distortion
EXPOSURE FACTORS
 SCREEN-FILM RADIOGRAPHIC TECHNIQUE

• The combination of settings selected on the control panel.

• Purpose: to produce a high-quality image

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 EXPOSURE FACTORS

• Proper exposure of a patient to x-radiation is necessary to produce a

diagnostic radiograph.
• The factors that influence and determine the quantity and quality of x-
radiation to which the patient is exposed are called exposure factors.
– Radiation quantity refers to radiation intensity measured in mGya or
mGya/mAs (mR or mR/mAs)
– Radiation quality refers to x-ray beam penetrability, best measured by
the half-value layer (HVL) of the x-ray beam

7
 FACTORS THAT MAY INFLUENCE X-RAY QUANTITY AND
QUALITY

• Proper exposure of a patient to x-radiation is necessary to produce a

diagnostic radiograph.
• The factors that influence and determine the quantity and quality of x-
radiation to which the patient is exposed are called exposure factors.
– Radiation quantity refers to radiation intensity measured in mGya or
mGya/mAs (mR or mR/mAs)
– Radiation quality refers to x-ray beam penetrability, best measured by
the half-value layer (HVL) of the x-ray beam

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PRIMARY EXPOSURE FACTORS

EXPOSURE
FACTORS

kVp mA Time SID

9
SECONDARY FACTORS

SECONDARY
FACTORS

FOCAL DISTANCE FILTRATION

SPOT SIZE
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 EXPOSURE FACTORS

• Of these, the most important are kVp and mAs, the factors principally
responsible for x-ray quality and quantity.

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 kVp

• The primary control of x-ray beam quality (beam penetrability)

• Function:
– Controls radiographic contrast
– Influences beam quantity
– Determines the average OD

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 kVp

• Higher kVp:
– Higher beam quality
– Greater beam penetrability
– More scatter radiation
• Rationale: more Compton effect interaction
– Less differential absorption
– Result: reduced image contrast

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 kVp

• Higher kVp:
– Higher beam quality
– Greater beam penetrability
– More scatter radiation
• Rationale: more Compton effect interaction
– Less differential absorption
– Result: reduced image contrast

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 MILLIAMPERES

• It determines the number of x-rays produced

(radiation quantity)
• 1 A = 1 C/s = 6.3 x 1018 per second
• Higher mA:
– More electrons produced
– Higher x-ray quantity
– Higher patient dose
– No change in x-ray quality

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 MILLIAMPERES

• Question:
– What is the electron flow from cathode to anode when the 500-mA
station is selected?

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 TIME (s)

• Kept as short as possible (ALARA)

– Purpose: to minimize the motion blur due to patient motion
– Decreased Exposure Time: mA must be increase
– Rationale: To provide the required x- ray intensity

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• Question:
– A radiographic technique calls for 600 mA at 200 ms. What is the mAs
value?

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• Question:
– A radiograph of the abdomen requires 300 mA and 500 ms. The patient is unable
to breath-hold, which results in motion blur. Therefore, the exposure is made with
a time of 200 ms. Calculate the new mA that is required.

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 DISTANCE

• It determines the intensity of the x-ray beam at the image receptor.

• Distance affects exposure of the image receptor according to the
inverse square law
• Tabletop Radiography: 100 cm (40 in)
• Chest Radiography: 180 cm (72 in)

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• The following relationship, called the direct square law, is derived from
the inverse square law.
• It allows a radiologic technologist to calculate the required change in
mAs after a change in SID to maintain constant OD.

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 DISTANCE

• Question:
– An examination requires 100 mAs at 180 cm SID. If the distance is
changed to 90 cm SID, what should be the new mAs setting?

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IMAGING SYSTEM
CHARACTERISTICS
 FOCAL SPOT SIZE

• Most x-ray tubes are equipped with two focal-spot sizes.

• On the operating console, these usually are identified as small and large
– 0.5 mm/1.0 mm
– 0.6 mm/ 1.2 mm
– 1.0 mm/2.0 mm

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 FOCAL SPOT SIZE

• X-ray tubes used in interventional radiology procedures or magnification

radiography may have 0.3 mm/1.0 mm focal spots.
• Mammography x-ray tubes have 0.1 mm/0.3 mm focal spots.
• These are called microfocus tubes and are designed specifically for
imaging very small microcalcifications at relatively short SIDs.

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 FOCAL SPOT SIZE

• Large focal spot

– For general imaging
– Ensures that sufficient mAs can be used to image thick or dense body parts.
– Provides for a shorter exposure time, which minimizes motion blur.
– Produce more x-rays compared with small focal spot

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 FOCAL SPOT SIZE

• Small focal spot

– For fine-detail radiography, in which the quantity of x-rays is relatively
low.
– Always used for magnification radiography
– These are normally used during extremity radiography and in
examination of other thin body parts in which higher x-ray quantity is
not necessary.

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 FILTRATION

INHERENT FILTRATION

FILTRATION ADDED FILTRATION

COMPENSATING FILTERS
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 FILTRATION

• Inherent filtration
– Glass or metal envelope
– For general-purpose tubes, the value of inherent filtration is
approximately 0.5 mm Al equivalent
• Light-localizing collimator
– Provides an additional 1.0 mm Al equivalent

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 FILTRATION

• Added filtration
– 1-mm Al filter is inserted between the x-ray
tube housing and the collimator

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 COMPENSATING FILTERS

• Are shapes of aluminum mounted onto a transparent panel that slides in

grooves beneath the collimator.
• These filters balance the intensity of the x-ray beam so as to deliver a
more uniform exposure to the image receptor.
• For example, they may be shaped like a wedge for examination of the
spine or like a trough for chest examination.

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 HIGH VOLTAGE GENERATION

• Three basic types of high-voltage generators are available:

1. Single phase
2. Three phase
3. High frequency
• The radiation quantity and quality produced in the x-ray tube are
influenced by the type of high-voltage generator that is used.

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 HIGH VOLTAGE GENERATION

• Half-wave rectification
– Results in the same radiation quality as is produced by full-wave
rectification, but the radiation quantity is halved.
– Used in mobile and dental x-ray imaging systems
• Full-wave rectification
– Same as half-wave rectification except there is no dead time.
– X-rays are emitted continually as pulses.
– The required exposure time for full-wave rectification is only half that
for half-wave rectification.
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 HIGH VOLTAGE GENERATION

• Three-phase power 6p/12p

– Results in higher x-ray quantity and quality.
– more efficient than singlephase power.
– More x-rays are produced for a given mAs setting
– The average energy of those x-rays is higher.
– The x-radiation emitted is nearly constant rather than pulsed.

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 HIGH VOLTAGE GENERATION

• High-frequency generators
– The voltage waveform is nearly constant, with less than 1% ripple.
– High-frequency generation results in even greater x-ray quantity and
quality.
– Used increasingly with dedicated mammography systems, computed
tomography (CT) systems, and mobile x-ray imaging systems.

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PATIENT FACTORS
PATIENT FACTORS

THICKNESS

PATIENT
FACTORS COMPOSITION

PATHOLOGY
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 HIGH VOLTAGE GENERATION

• The general size and shape of a patient is called body habitus;

• Sthenic
– Meaning “strong, active”—patients are average patients.

• Hyposthenic
– Thin but healthy appearing; these patients require less radiographic technique.

• Hypersthenic
– Big in frame and usually overweight.

• Asthenic
– Small, frail, sometimes emaciated, and often elderly

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HIGH VOLTAGE GENERATION

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 THICKNESS

• The thicker the patient, the more x-radiation is required to penetrate the
patient to expose the image receptor.
• For this reason, calipers are available to the radiologic technologist for use
to measure the thickness of the anatomy being imaged.

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 THICKNESS

• The thicker the patient, the more x-radiation is required to penetrate the
patient to expose the image receptor.
• For this reason, calipers are available to the radiologic technologist for use
to measure the thickness of the anatomy being imaged.

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 COMPOSITION

• The thorax and the abdomen may have the same thickness, but the
radiographic technique used for each will be considerably different.
• The radiologic technologist must estimate the mass density of the
anatomical part and the range of mass densities involved.
• Soft tissue
– Low kVp and high mAs are used.
• Extremity,
– Consists of soft tissue and bone, low kVp is used because the body part is thin.

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 COMPOSITION

• Chest
– Takes advantage of the high subject contrast.
– Lung tissue has very low mass density, the bony structures
have high mass density, and the mediastinal structures have
intermediate mass density.
– high kVp and low mAs can be used to good advantage.
▸ This results in an image with satisfactory contrast and low
patient radiation dose.

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 PATHOLOGY

• The type of pathology, its size, and its composition influence radiographic
technique.
• In this case the patient examination request form and previous images may
be of some help.
• The radiologic technologist should not hesitate to seek more information
from the referring physician, the radiologist, or the patient regarding the
suspected pathology.

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 PATHOLOGY

• Destructive pathology
– Causing the tissue to be more
radiolucent.
• Constructive pathology
– Increasing mass density or composition,
causing the tissue to be more
radiopaque.

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IMAGE QUALITY FACTORS
 IMAGE QUALITY FACTORS

• These factors provide a means for the radiologic technologist to:

REVIEW

PRODUCE EVALUATE

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 IMAGE QUALITY FACTORS

• Image quality factors are considered the “language” of radiography;

often, it is difficult to separate one factor from another.
• It refers to the characteristics of the radiographic image
1. Optical Density
2. Contrast
3. Image detail
4. Distortion

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OPTICAL DENSITY/
IR EXPOSURE
OPTICAL DENSITY

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 OPTICAL DENSITY

• The degree of blackening in the radiograph

• It determines the amount of light transmitted
through a radiograph
• Black: 3 OD or greater
• Clear:<0.2
• Controlled by Two Major Factors: mAs (primary)
& SID

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 OPTICAL DENSITY

• Overexposure
– Radiograph: too dark or high OD
– Rationale: too much x-rays reaches the image receptor
– Can cause saturation artifact
• Underexposure
– Radiograph: too light or low OD
– Rationale: too little x-rays reaches the image receptor
– Can cause quantum mottle
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 OPTICAL DENSITY

A, Overexposed radiograph of the chest is too black to be diagnostic. B, Likewise, an underexposed chest
radiograph is unacceptable because no detail to the lung fields is apparent. (Courtesy Richard Bayless, University
of Montana.)
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 MILLIAMPERE-SECONDS (mAs)

• The relationship between mAs and IR exposure is a direct proportional

one.
• A change in mAs of approximately 30% is required to produce a visible
change in OD.
• As a general rule, when only the mAs is changed, it should be halved or
doubled.

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 MILLIAMPERE-SECONDS (mAs)

• As mAs increases, x-ray exposure increases proportionally and film

density also increases.

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 FIFTEEN PERENT kVp RULE

• Fifteen Percent Rule An increase in 15% is equivalent to doubling the

mAs
• Result: same OD

kVp BY 15% , mAs must be halved

kVp BY 15%, mAs must be doubled

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Normal chest radiograph taken at 100 cm source-to-image receptor distance (SID). B, If the
exposure technique factors are not changed, a similar radiograph at 90 cm SID (A) will be
overexposed, and at 180 cm SID (C) will be underexposed. (Courtesy Kurt Loveland, Southern
Illinois University.)

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 FIFTEEN PERENT kVp RULE

• Question:
– A Radiographer performed Chest PA examination on a 14 year old girl,
with the following factors, 82 kvp, 3 mAs, 72 inches SID. The
radiologist observed that the image is too dark and displays many
shades of colors, and requests to repeat the examination. What are
the new factors to be used by the RT?

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 KILOVOLTAGE

• kVp controls average energy of x-ray photons at

anode target
• Controls the strength of the electrons striking the
target of the x-ray tube for any given mAs.
• kVp affects production of scatter
• Change in kVp varies quantity and quality
– Therefore, has tremendous impact on
density/IR exposure

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 KILOVOLTAGE

• The 15 percent rule is used as a guide to maintain the same IR exposure

when kilovoltage changes, as follows:

15% kilovoltage = Doubling IR exposure

15% kilovoltage = Halving IR exposure

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 KILOVOLTAGE

• Question:
– A radiograph of the elbow is produced using 4 mAs at 60 kVp. What
kVp would be required to halve the exposure to the IR?
• Answer:
– 60 kVp (60 kVp X 15%)
– 60 kVp (60 kVp X 0.15)
– 60 kVp - (9 kVp) 51 kVp

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 FOCAL SPOT SIZE

• Will not affect density/IR exposure in properly calibrated equipment

• Blooming

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 ANODE HEEL EFFECT

• The anode heel effect alters the intensity

of radiation, and therefore the IR
exposure, between the anode and
cathode ends of the x-ray tube.
• Depending on the angle of the anode,
this effect can cause an IR exposure
variation of up to 45% between the
anode and cathode ends of the image.

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 ANODE HEEL EFFECT

• More pronounced when:

1. Collimator is open wide
2. When using extremely small angle
anodes (12° or less)
3. Short SID’s

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 SOURCE TO IMAGE RECEPTOR DISTANCE (SID)

• SID alters the intensity of the beam reaching the IR, according to the
inverse square law.
• The inverse square law affects exposure in inverse proportion to the
square of the distance.
• In radiography the most common situation is a need to maintain an
acceptable IR exposure while changing the distance.
• To maintain IR exposure, mAs (or an influencer) must be changed to
compensate for the exposure change. The exposure maintenance
formula is used.

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 SOURCE TO IMAGE RECEPTOR DISTANCE (SID)

• This formula is based on the inverse square law but is reversed to a direct
square law because mAs must increase when distance increases, and vice
versa, in order to maintain IR exposure.

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 SOURCE TO IMAGE RECEPTOR DISTANCE (SID)

• Question:
– If a satisfactory exposure is obtained with 20 mAs at 72”, what mAs
will be required to maintain the same exposure at 40”?

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 SOURCE TO IMAGE RECEPTOR DISTANCE (SID)

• Question:
– If a satisfactory PA chest radiograph is made at 72” with 4 mAs, what
mAs will be required at 56”?

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 OBJECT TO IMAGE RECETOR DISTANCE (OID)

• The air-gap technique uses an increased OID to prevent scatter radiation

from reaching the IR.
• This scatter radiation would normally cause a visible increase in IR
exposure when radiographing large patients.

OID IR Exposure

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 FILTRATION (all types)

• Filtration and its ability to alter beam

intensity affect IR exposure.

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 BEAM RESTRICTION

• Restricting the beam, collimating, or reducing the primary beam field size
reduces the total number of photons available.
• This reduces the amount of scatter radiation and therefore reduces the
overall IR exposure.

Collimation IR Exposure

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 ANATOMICAL PART

• Because the patient is the prime attenuator of the beam, the anatomical
part being examined has a great deal of influence on IR exposure.
• Attenuation is dependent on the thickness and type of the tissue being
imaged.
• Tissue type
– Affected by the average atomic number and the density (quantity of matter per unit
volume) of the tissue.
– The use of contrast media will alter the average atomic number of the tissue and
can affect IR exposure.
– Pathology can alter tissue thickness and/or type.
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ANATOMICAL PART

Tissue Thickness
Average Atomic Number IR Exposure
Tissue density

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 ANATOMICAL PART

• Depending on the type of contrast media or the type of pathology, an

inverse or a direct relationship may exist.

Radiolucent CM (air) IR Exposure

Radiopaque CM (Ba,I) IR Exposure

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 ANATOMICAL PART

• Pathology can be either an additive or a destructive effect.

Destructive pathology IR Exposure

Additive pathology IR Exposure

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 ANATOMICAL PART

• Tube angles (more than 150) causes a

significant difference in tissue thickness
between the edges of the image.
• Measurement of body parts for angles
must occur at the central ray to average
these differences.
• Casts
– Treat as if thicker part

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 GRIDS

• Grids absorb scatter, which would otherwise add exposure to the IR and
density to the film.

Grid Ratio
Low frequency Grid IR Exposure
Dense interspace material
Moving Grids
Improperly used grids
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 GRIDS

• Compensation for varying grid ratios is generally accomplished by

increasing mAs.
• The amount of mAs required can be calculated using the grid conversion
factors.
• Changing between grids, which is the most common clinical problem, is
accomplished by using the following formula:

78
 IMAGE RECEPTOR

• Film screen and digital systems have impact on density/IR exposure

– Exposure index numbers useful parameter for digital systems
– Relative speed (RS) numbers
▸ Useful parameter for film screen combinations
• RS numbers have been developed by manufacturers to permit easy
adjustment of technical factors when changing film-screen
combinations.

Relative speed IR Exposure 79

 IMAGE RECEPTOR

• Compensations for changes in relative speed can be made by adjusting

mAs because exposure is directly proportional to mAs when using film.
• Density can be maintained by using the following formula:

80
 IMAGE RECEPTOR

• Question:
– What is the proper mAs for use with an 80-RS system when technical
factors of 55 kVp and 5 mAs produce an acceptable image with a 200-
RS system?

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CONTRAST
OPTICAL DENSITY

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 CONTRAST

• The difference in OD between adjacent anatomical structures

• The variation in OD in the radiograph
• The most important factors in radiographic quality
• Function: to make anatomy more visible
– High Contrast: black & white
– Low Contrast: many shades of gray

84
 CONTRAST

• Dynamic range describes the concept of contrast as it is displayed on a

monitor for digital images.
• It is the proper term for the range of brightness of the display monitor
light emission.
• For all radiographic images, the term dynamic range can be applied.
• Window width accurately describes the digital processing that produces
changes in the range of brightness, so it also is appropriate to use when
controlling image contrast of a digital image displayed on a monitor.

85
 CONTRAST

• Gray Scale of Contrast

– It refers to the range of ODs from whitest to the blackest part of the
radiograph

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87
 KILOVOLTAGE

• Kilovoltage peak (kVp) is the primary controller of subject contrast. As

kVp increases, a wider range of photon energies is produced.
• The wider the range of photon energies, the greater will be the ability of
the photons to penetrate the body tissues.
• kVp affects image contrast for two reasons:
1. Differential attenuation
2. Scatter radiation

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DIFFERENTIAL ATTENUATION

89
DIFFERENTIAL ABSORPTION

Differential
kVp Contrast
Attenuation
90
DIFFERENTIAL ABSORPTION

Differential
kVp Contrast
Attenuation
91
SCATTERED RADIATION

High Contrast Low Contrast 92

SCATTERED RADIATION

93
SCATTERED RADIATION

94
95
 FIVE PERCENT kVp RULE

• An increase in 5% in kVp may be accompanied by a 30% reduction in

mAs
• Results: same OD but slightly reduced contrast

kVp BY 5 %, DECREASE mAs BY 30 PERCENT

kVp BY 5 %, INCREASE mAs BY 30 PERCENT

96
 FIVE PERCENT kVp RULE

• Question:
– A modest reduction in image contrast is required for a knee exposed
at 62 kVp/ 12 mAs. What technique should be tried?

97
 FIVE PERCENT kVp RULE

• Question:
– The exposure factors of 300 mA, 0.07s, and 95 kVp were used to produce a
particular radiographic density and contrast. A similar radiograph can be
produced using 500 mA, 80kVp and ?
a. 0.01 s
b. 0.04 s
c. 0.08 s
d. 0.16 s

98
 FIVE PERCENT kVp RULE

• Question:
– The exposure factors of 300 mA, 0.07s, and 95 kVp were used to produce a
particular radiographic density and contrast. A similar radiograph can be
produced using 500 mA, 80kVp and ?
a. 0.01 s
b. 0.04 s
c. 0.08 s
d. 0.16 s

99
 MILLIAMPERE-SECONDS (mAs)

• Milliampere-seconds alter IR exposure of the

image and therefore affect contrast.
• When the change is sufficient to move IR
exposure differences out of the range of
human vision, either over- or underexposed,
the contrast is decreased.
• With film, under- or overexposure was clearly
evident in the resultant image.

100
 MILLIAMPERE-SECONDS (mAs)

• For digital systems, the exposure indicator should be in the acceptable

range to assure that the detector received the correct exposure.

101
 FOCAL SPOT SIZE

• The possibility of the focal spot size altering contrast enough to be visible
is extremely unlikely.
• Focal spot sizes have such a small effect on IR exposure that it is unlikely
that their effect on contrast could be detected.

102
 ANODE HEEL EFFECT

• The anode heel effect alters the intensity of radiation and therefore
affects IR exposure, which can affect contrast.
• The intensity of radiation is greater at the cathode end of the tube. This
difference would become visible only with open collimation and a small
anode target angle (less than 12°).
• The anode heel has very little effect on contrast.

103
 SOURCE TO IMAGE RECEPTOR DISTANCE

• Alters image receptor exposure according to inverse square law.

• Can change contrast as if change in mAs

104
 OBJECT-TO-IMAGE-RECEPTOR DISTANCE

• OID also has an effect on IR exposure and

contrast.
• An air-gap technique increases OID, and this
permits scatter radiation to avoid the image
receptor.
• This scatter radiation would normally
contribute radiation fog to the IR exposure.
• Removing scatter from the image will
increase contrast when film-screen systems
are used.
105
 FILTRATION (all types)

• Filtration increases the effect of kVp by

changing the average photon energy of the
beam.
• Filtration affects contrast by changing the
average photon energy and decreasing beam
intensity.
• The increase in the average photon energy
causes more Compton scatter production,
and this decreases contrast.

106
 BEAM RESTRICTION

• Restricting the beam, collimating, or reducing the primary beam field

size reduces the total number of photons available.
• This reduces the amount of scatter radiation and therefore increases
contrast.

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BEAM RESTRICTION

108
BEAM RESTRICTION

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 ANATOMICAL PART

• Dependent on tissue type, thickness, pathology, etc.

Anatomical part size Scattered

Contrast
Tissue density Radiation

Average atomic Photoelectric Contrast

number (contrast absorption
media) 110
 GRID

• The primary function of a grid is contrast improvement.

• Grids improve contrast by removing scatter before it reaches the image
receptor.
• The contrast improvement factor (K) is the best measure of how well a
grid accomplishes this function.
• As the amount of scatter radiation that reaches the image receptor
increases, the lower the contrast and the lower the contrast
improvement factor.

111
 GRID

• The contrast improvement factor K is measured by using the average IR

exposure.
• The contrast improvement factor K is measured by using the average IR
exposure.
• 1 = no improvement in contrast
• 1.5 and 3.5 = contrast improvement of most grids

112
 IMAGE RECEPTOR

• Film/screen
– Determined by D log E curve
– Steeper the slope, greater the contrast
• Digital systems
– Determined by histogram and LUT
– Displayed as various bit depth values

113
RECORDED DETAIL/ SPATIAL
RESOLUTION
115
 RECORDED DETAIL

• The sharpness of appearance of small structures on the radiograph

• Two Means of Evaluation:
– Sharpness of image detail
– Visibility of image detail

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 SHARPNESS OF IMAGE DETAIL

• It refers to the structural lines or borders of tissues in the image & the
amount of blur of the image
• Controlling Factors:
– Geometric factors
– Focal spot size (primary)
– SID
– OID

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 SHARPNESS OF IMAGE DETAIL

• Influencing Factors:
– Type of intensifying screen used
– The presence of motion
• Sharpest Image Detail:
– Small focal spot size
– Longest SID
– Minimize OID

118
 RECORDED DETAIL

• Influencing Factors:
– Type of intensifying screen used
– The presence of motion
• Sharpest Image Detail:
– Small focal spot size
– Longest SID
– Minimize OID

119
 VISIBILITY OF IMAGE DETAIL

• The ability to see the detail on a radiograph

• Best Visibility of Image Detail:
– Collimation
– Use of grids
– Other methods that prevent scatter radiation from reaching the
image receptor

120
 VISIBILITY OF IMAGE DETAIL

• Loss of visibility refers to any factor that causes deterioration or

obscuring of image detail.
• Factors that provide the best visibility of image detail:
1. Collimation
2. Use of grids
3. Other methods that prevent scatter radiation from reaching the
image receptor

121
 FOCAL SPOT SIZE

• Focal spot size is controlled by the line focus

principle.
• The focal spot size is a major controller of
spatial resolution because it controls
penumbra.
• The fact that the source of the x-ray
photons is not a point source, although it is
sometimes convenient to think of it as such,
is what causes penumbra.

122
 FOCAL SPOT SIZE

• Focal spot size is controlled by the line focus

principle.
• The focal spot size is a major controller of
spatial resolution because it controls
penumbra.
• The fact that the source of the x-ray
photons is not a point source, although it is
sometimes convenient to think of it as such,
is what causes penumbra.

123
 FOCAL SPOT SIZE

• Focal spots are usually not capable of imaging structures smaller than
the focal spots themselves.
• The width of the penumbra (unsharpness) can be mathematically
calculated using the following formula:

124
 FOCAL SPOT SIZE

• Question:
– Calculate the penumbra for an image taken with a 1.0-mm focal spot,
at a 400 distance and an OID of 30.

125
 FOCAL SPOT SIZE

• Penumbra is increased by another phenomenon known as attenuation

or absorption unsharpness.
• Because of the divergence of the incident x-ray beam, only an object
that is trapezoidal would have a perfectly sharp edge

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127
 DISTANCE

• The distances between the source or focal spot (S), object or part (O),
and image receptor (I) are critical in establishing sufficient spatial
resolution.

SPATIAL
SID PENUMBRA RESOLUTION

SPATIAL
OID PENUMBRA RESOLUTION
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129
130
 IMAGE RECEPTOR

• Digital Systems
• The primary factors affecting the spatial resolution of digital imaging
systems are the detector geometric properties and the image processing
system.
• Factors affecting spatial resolution for Computed Radiography:
1. Phosphor size,
2. Layer thickness
3. Concentration
4. Scanning of the phosphor screen and during the processing phase

131
 IMAGE RECEPTOR

• Factors affecting spatial resolution for Digital Radiography:

1. Size of the detector element
2. Matrix size
3. Pixel size
4. Grayscale bit depth

132
 IMAGE RECEPTOR

• Film Screen
– The resolving power of an intensifying screen depends on three
factors:
1. Phosphor size
2. Phosphor layer thickness
3. Phosphor concentration

133
EFFECTS OF INTENSIFYING-SCREEN FACTORS ON RESOLUTION

134
 MOTION

• Motion affects spatial resolution because it fails to permit enough time

for a well-defined image to form.
• Instead, the image is spread over a linear distance and appears as a
blurred series of IR exposures. As a result no fine detail can be perceived

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 VOLUNTARY MOTION

• Voluntary motion is that which is under the direct control of the patient.
• For the most part, this comprises the voluntary nervous system in
cognizant adults (children and incognizant adults may be excepted in
some cases).
• Communication, especially in a manner that establishes a professional
and competent atmosphere, is the best method of controlling voluntary
motion.

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 INVOLUNTARY MOTION

• Involuntary motion is not under the conscious control of the patient.

• For the most part, involuntary motion is controlled by the autonomic
nervous system and is physiological in nature.
• Heartbeat and peristalsis are the most common examples.
• Involuntary motion can be best reduced by decreasing exposure time or
with an increase in kVp combined with compensating mAs decrease
(i.e., 15 percent rule).

137
 EQUIPMENT MOTION

• If the movement of the reciprocating grid mechanism is not dampened,

it can cause vibration of the image receptor in the Bucky tray, when one
is used.
• If the x-ray tube suspension system is not balanced and isolated from
other moving devices, especially overhead suspended units, it can
vibrate or drift.
• This type of motion is extremely difficult to detect.
• It is usually suspected only when various patients examined with the
same x-ray unit appear to have motion problems.

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 COMMUNICATION

• The best method of reducing motion is patient

communication.
• It is assumed that appropriate aids to positioning,
such as foam pads, angle sponges, and sandbags,
are already in use. The radiographer should
consider the instructions that are given to be sure
that they are clear, concise, and understandable.

139
 EXPOSURE TIME REDUCTION

• When the patient is unable to cooperate, the best method is a reduction

in exposure time with a corresponding increase in mA to maintain
sufficient mAs and IR exposure.
• Involuntary motion can be best reduced by a reduction in exposure time.
• Other methods of decreasing exposure time while maintaining exposure
include decreasing SID, increasing kVp, and using higher-speed film and
screens with film-screen systems

140
 IMMOBILIZATION

• When communication and exposure time reduction are not sufficient to

reduce motion, partial immobilization must be considered.
• Immobilization devices, such as foam pads, angle sponges, and sandbags,
should be considered routine positioning aids.

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DISTORTION
 IMMOBILIZATION

• When communication and exposure time reduction are not sufficient to

reduce motion, partial immobilization must be aids.

143
 DISTORTION

• Distortion is a misrepresentation of the size or shape of the structures

being examined.
• It creates a misrepresentation of the size and/or shape of the anatomical
part being imaged.
• This misrepresentation can be classified as either size or shape distortion.
• Size distortion is controlled by the radiographic distances, source-to-
image-receptor distance (SID) and object-to-image-receptor distance
(OID).

144
 DISTORTION

• In digital image receptor systems post-processing can resize the image.

• In all instances, reduced magnification size distortion increases the spatial
resolution.

145
146
 FACTORS AFFECTING SIZE DISTORTION

• Magnification size distortion is controlled by positioning the body part

and tube to maximize SID while minimizing OID.
• This can be accomplished by various procedures and by positioning.
• For example, an upright oblique cervical vertebra projection can be
performed at 720 (180 cm), whereas a supine projection is performed at
400 (100 cm). An AP chest may place the heart 60 (15 cm) from the
image receptor, whereas a PA projection would place it 20 (5 cm) away.

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 SOURCE-TO-IMAGE-RECEPTOR DISTANCE

• The SID has a major effect on magnification.

• The greater the SID, the smaller the
magnification, because as SID increases, the
percentage of the total distance that makes
up OID decreases.
• The OID is the critical distance for
magnification and resolution.

148
149
 OBJECT-TO-IMAGE-RECEPTOR DISTANCE

• The OID is also a critical distance in both

magnification and resolution.

150
151
152
 CALCULATING SIZE DISTORTION

• Size distortion is present in any radiographic image and can be measured

very accurately by using simple geometry.
• Magnification, or size distortion, can be assessed by calculation of the
magnification factor.
• The magnification factor is the degree of magnification and is calculated
by

153
 CALCULATING SIZE DISTORTION

• Question:
– If the SID is 40” (100 cm) and the SOD is 30“
(75 cm), what is the magnification factor? SID

M SOD

154
 CALCULATING SIZE DISTORTION

• Question:
– If the SID is 40” and the OID is 2“, what is the
magnification factor? SID

M SOD

155
 CALCULATING SIZE DISTORTION

• The magnification factor permits calculation of the actual size of an

object that is projected as an image by using the formula

O M

156
 CALCULATING OBJECT SIZE

• Question:
– If a projected image measures 5” and the
magnification factor is 1.02, what is the size
of the actual object? I

O M

157
 CALCULATING SIZE DISTORTION

• If the image size and the object size are known, the percent of
magnification can be determined using the following formula:

158
 CALCULATING SIZE DISTORTION

• Question:
– If an object measures 5 cm and the image measures 6 cm, what
would be the percent of magnification of the object?

159
 FACTORS AFFECTING SHAPE DISTORTION

• Magnification size distortion is controlled by positioning the body part

and tube to maximize SID while minimizing OID.
• This can be accomplished by various procedures and by positioning.
• For example, an upright oblique cervical vertebra projection can be
performed at 720 (180 cm), whereas a supine projection is performed at
400 (100 cm). An AP chest may place the heart 60 (15 cm) from the
image receptor, whereas a PA projection would place it 20 (5 cm) away.

160
 SHAPE DISTORTION

• Shape distortion is the misrepresentation by unequal magnification of

the actual shape of the structure being examined.
• Shape distortion displaces the projected image of an object from its
actual position and can be described as either elongation or
foreshortening.
• Elongation projects the object so it appears to be longer than it really is,
whereas foreshortening projects it so it appears shorter than it really is.

161
 SHAPE DISTORTION

• Elongation occurs when the tube or the image receptor is improperly

aligned.
• Foreshortening occurs only when the part is improperly aligned.
Changes in the tube angle cause elongation, never foreshortening.

162
163
164
 ALIGNMENT

• Shape distortion can be caused or avoided by careful alignment of the

central ray with the anatomical part and the image receptor.
• Proper positioning is achieved when the central ray is at right angles to
the anatomical part and to the image receptor. This means the part and
the image receptor must be parallel.

165
 CENTRAL RAY

• Centering away from the specified central ray

entrance point is equivalent to angling the
tube away from perpendicular because the
entire perspective of the anatomical part is
distorted.
• Some projections take advantage of this type
of distortion. For example, a PA lumbar
projection uses the divergence of the beam to
open the lordotically curved intervertebral
joints

166
 ANATOMICAL PART

• The long axis of the anatomical part, or object, is intended to be

positioned perpendicular to the central ray and parallel to the image
receptor.
• When these positions are incorrect, distortion may occur.
• Foreshortening occurs only when there is poor alignment of the part

167
 ANATOMICAL PART

• The long axis of the anatomical part, or object, is intended to be

positioned perpendicular to the central ray and parallel to the image
receptor.
• When these positions are incorrect, distortion may occur.
• Foreshortening occurs only when there is poor alignment of the part

168
Thank You!
James Lawrence Aduche, RRT, RSO
Faculty, Southwestern University - PHINMA
Jbaduche.swu@phinamaed.com