DIGRAD

Phantom for
Digital Radiography
The DIGRAD phantom is intended for use in the
acceptance and constancy testing of digital radiographic
equipment.

jw May 2002

pehamed
PEHA med. Geräte GmbH
Mühlstr. 38
D - 65843 Sulzbach, Germany
Tel. +49 6196 500 40 30
Fax +49 6196 500 40 50
http://www.pehamed.com
e-mail: pehamed@t-online.de
 pehamed DIGRAD
Seite 3
Contents

Image Quality Assurance of Projection Radiography using Digital Image

Receptor Systems ..................................................................... 4
General Information .................................................................. 4
Test Procedure for Digital Image Receptor Equipment:Acceptance Testing
per DIN 6868/58 and Constancy Testing per DIN 6868 Part 13 ................. 5
Test Tools .............................................................................. 5
Test Preparation and Test Steps.................................................... 8
Phantom Positioning.................................................................. 8
Correct Phantom Positioning using the Light Field of the Light Sight ........ 9
Slide the Patient-Equivalent-Filter into the Light Sight....................... 10
Preparing the Dosimeter for the Measurement ................................. 11
Acceptance Test Form per DIN 6868 Part 58 Page 1 .......................... 12
Acceptance Test Form per DIN 6868 Part 58 Page 2 .......................... 13
Constancy Test Form per DIN 6868 Part 13 ..................................... 14
The DIGRAD Phantom and its Structural Elements .............................. 15
Test Film Analysis -Acceptance Test .............................................. 16
Sample Test Film..................................................................... 16
Analysis of Permissible Deviations from Tolerances - Acceptance Test ..... 17
Test Film Analysis - Constancy Test ............................................... 18
Sample Test Film..................................................................... 18
Analysis of Permissible Deviations from Tolerances - Constancy Test ....... 19
Measurement and Calculation of the Deviation between the Light Field and
the Effective Radiation Field....................................................... 20
 pehamed DIGRAD
Seite 4

Image Quality Assurance of Projection Radiography using

Digital Image Receptor Systems
General Information
During the acceptance testing of projection radiography equipment using a digital image
receptor system such as storage phosphor screens or a semi-conductor detector (DR
System), a number of key parameters must be determined, in addition to or deviating
from those key parameters /measurement values which are required for the acceptance
testing of conventional intensifying screen image receptor systems. The key parameters
in question are contrast, low contrast and homogeneity of the image receptor.

The constancy testing of digital equipment, with the newly conceived structural phantom and
the corresponding test procedure, replaces entirely the phantom and the measurements
which are mandated by DIN 6868 Part 3 for the constancy testing of conventional projection
radiography equipment.

The DIN 6868 Part 58 Norm (for the Acceptance Test) and Part 13 (for the Constancy Test),
which are currently being circulated as draft norms, describe how phantoms must be
configured and which key parameter measurements must be made.

The pehamed DIGRAD phantoms fully meet the requirements of both the DIN 6868 Part 58
and Part 13 Norms.

The following table gives the user an overview of the various types of phantoms which are
available from pehamed for the acceptance testing and constancy testing of digital and
conventional projection radiography equipment. It also shows which combinations with
existing phantoms are possible.

Phantom Acceptance Testing Constancy Testing

suited for

Conventional ALPHA ALPHA 1) ALPHA ALPHA

Projection per DIN 6868/ 3 per DIN 6868/ 3+4 per DIN 6868/3 per DIN 6868/ 3+4
Radiography (w/o lead bar (w/ lead bar pattern) (w/o lead bar (w/ lead bar pattern))
pattern) Test per Test per pattern) Test per
DIN 6868/50 DIN 6868/50 Test per DIN 6868/3 DIN 6868/3 and 4

Projection
Radiography DIGRAD / A 1) DIGRAD / A+K
using a Digital
Image (w/o lead bar pattern) (w/ lead bar pattern)
Receptor Test per DIN 6868/58 Test per DIN 6868/13
System
DIGRAD / A+K
per DIN 6868/13+58
(w/ lead bar pattern) Test per DIN
6868/58

1) Combination possible No combination possible

 pehamed DIGRAD
Seite 5

Test Procedure for Digital Image Receptor

Equipment:Acceptance Testing per DIN 6868/58 and
Constancy Testing per DIN 6868 Part 13
Test Tools
For Acceptance Testing: DIGRAD / AK Test phantom with lead
Structural Phantom per bar pattern or DIGRAD / A w/o lead bar
DIN 6868 / 58 pattern, if a lead bar pattern is already
available.
Dosimeter
Homogeneous absorption filter Patient-equivalent-filter = 25 mm
Aluminum, near focal spot
or
For Constancy Testing: DIGRAD / AK Test Phantom with lead
Structural Phantom per bar pattern
DIN 6868 / 13
Reference Dosimeter alpha Dosimeter
Homogeneous absorption filter Patient-equivalent-filter = 25 mm
Aluminum, near focal spot

In addition:

Phantom holder for Bucky Wall Accessory for the DIGRAD System
Stand
Additional Copper plate for Copper plate 100 kV
measurements at 100 kV Near focal spot, for screw mounting on
the patient-equivalent-filter
Densitometer for measurement of Densonorm
the optical density of the test film
Light Intensity Measuring Device CANDELAMON
for the image display (monitor)
For storage phosphor equipment User-supplied
Cassette with the storage
phosphor screen, min. size 26x26
cm to ensure that the radiation
field fully covers the test
phantom.

Also needed for testing:

Test documentation Data Forms DIN 6868/58 or 6868/13
Accessory for DIGRAD

Important Note for Constancy Testing: Always use the same test tools/configuration
for each test so that by comparing with current target values, a valid assessment of
the constancy of the X-Ray system can be made!
 pehamed DIGRAD
Seite 6

Phantom DIGRAD A+K for the

Acceptance Test per DIN 6868/58
and for the Constancy Test per DIN
6868/13

Left: Dosimeter Measurement Device, Right: Patient-Equivalent-Filter

Upper: Detector with cable, for insertion into the patient-equiva-lent
filter directly under the cover plate.
 pehamed DIGRAD
Seite 7

Phantom and holder for Bucky wall stand

(The arrows point to the drill holes in
the phantom, into which the pins of the
holder are inserted.)

Spacer Plate Copper Plate for 100 kV exposures

In position for Mounting of the copper plate on the
radiation from above underside of the patient-equivalent-filter
 pehamed DIGRAD
Seite 8

Test Preparation and Test Steps

Phantom Positioning

Note for correct phantom

positioning: The step-wedge for the
dynamic range on the phantom and
the longitudinal axis of the X-Ray
tube should be perpendicular to one
another. Exception: When inserted
into the light sight of Philips X-Ray
tubes.

Longitudinal axis of X-Ray

For exposures on the Bucky table:

on the table above the cassette tray

Phantom
orientation

1. For exposures on the Bucky wall stand: The phantom is mounted on the holder
by inserting the pins on the holder into the drill holes of the phantom and then
suspending the holder/ phantom on the wall stand.
 pehamed DIGRAD
Seite 9

Correct Phantom Positioning using the Light Field of the Light Sight

The radiation field should normally be

so adjusted that so that the phantom is
completely covered by the light field.

If the Acceptance Test is performed

using a small size, then the light sight
should be aligned to the 18x24 cm
markings.

During the Constancy Test, the light

field is aligned to the markings of the
most frequently used format.

For mobile X-ray exposure units: The

phantom is placed on the test cassette,
the light sight is correctly aligned, and
then the spacer plate (w/ legs downward)
is positioned over the phantom.
 pehamed DIGRAD
Seite 10

Slide the Patient-Equivalent-Filter into the Light Sight

The insertion width of the light sight

varies depending upon the X-Ray
equipment manufacturer. The
rectangular plastic plate with the
patient-equivalent filter can either be
inserted lengthwise or widthwise into
the tracks of the light sight. (See the
markings: “For Siemens light sight”,
“For Philips light sight” on the
plate).Depending upon the type of
light sight used, the detector must be
inserted into the corresponding
opening of the patient-equivalent
filter and positioned according to the
exposure distance (1.2 or 2 m). The
patient-equivalent filter and the
phantom must be so aligned with each
other, so that the detector insertion
with the detector in the patient-
equivalent filter and the position for
the dose measurement on the
phantom are exactly aligned.

When testing a mobile X-ray

exposure unit, the patient-equivalent
filter is inserted into the cut-out of
the spacer plate.
Please be careful that neither the
spacer nor the phantom are misaligned
while doing so!
 pehamed DIGRAD
Seite 11

Preparing the Dosimeter for the Measurement

For the Acceptance Test, prepare the

Dosimeter for the measurement of the
image receptor dose.

For the Constancy Test, switch-on the

alpha Reference Dosimeter:
Press the On/Zero button.
Then wait until the Dosimeter has cali-
brated itself and 0000 appears on the
display.

For Storage Phosphor Screen Units: Insert the cassette with storage phosphor screen
into the cassette tray or wall stand.

Set the tube voltage and exposure values of the X-ray unit.

Acceptance test exposures are usually made with 70 kV.

If a different kV range is always used for patient exposures, then the acceptance
testing is conducted using this kV range.
If the image receptor system is used on different X-Ray units, then the test is
conducted with the most frequently used unit.

Make the X-Ray exposure

Read and note the Image Receptor Dose or the Reference Dose Value on the Dosimeter
Display

Use the following forms to document the device specific information and all test
data:
for the Acceptance Test, use the Form per DIN 6868 / 58 (Sample s. p.13 / 14)
For the Constancy Test, use the Form per DIN 6868 / 13 (Sample s. S. 15).
 pehamed DIGRAD
Seite 12

Acceptance Test Form per DIN 6868 Part 58 Page 1

Acceptance Test Report per X-Ray Decree (RöV) Digital Imaging Receptor System
DIN V 6868-58
Customer Customer.
No.
Street System No.
City Room No.
Exposure System A.T. on C.T. o.k.?
Generator: Mfg., Type Serial No.
Exposure Unit: Mfg., Type Serial No. Location
Image Receptor
System
Selection Unit: Mfg., Type Serial No. Location
Processor Unit: Mfg., Type Serial No. Location
Image A.T. on C.T. o.k.?
Documentation.
System
Unit Mfg., Type Serial No. Location
Film Mfg., Type
Image Display System A.T. on C.T. o.k.?
Unit Mfg., Type Serial No. Location
Exposure Parameters for additional information, please refer to the Acceptance Test Report
Film-Detetor Distance Focal Spot
Film-Phantom Distance
Processing
Parameters
Testing Tools Dosimeter, Type, No.
Phantom, Manufacturer Luminance measurement
device, Type, No.
Cassette I.D. No.

Test Positions: Positions 2. – 6.: large image receptor Requir met?

format -ment
1. Visual Inspection o.k.?
2. Image receptor dosage Measure- Factor m:
ment location
only 25 mm Al within the radiation beam Exp. 1 Exp. 2 Exp. 3
Expose Voltage [kV]
Selected Dosage Step (*)
Measured Value Dose [µGy] Exp 1: Exp 1:
Exp 2 Exp 3
Dose KB[µGy]
(*) Program, exposure step with automatic exposure control, mAs value with manual exposure adjustment
(e.g. enter. "10 mAs“)
2. Signal Standardization, Exp 1: Exp 1: Exposures
Dosage Indication Exp 2 Exp 3
Dosage Indication
Optical Density/Luminance/
Pixel Value
Deviation
 pehamed DIGRAD
Seite 13

Acceptance Test Form per DIN 6868 Part 58 Page 2

Test Positions Positions 2. – 6.: large image receptor format Require- met?
ment
4. Contrast Resolution Image processing: Exposures
Dynamic step wedge clearly visible? Yes
Number of visible low contrast objects min. 3
5. Homogeneity M1 E1 E2 E3 E4 Exposures
Optical Density/Luminance/
Pixel Value
Deviation vs. "M1"
6. Imaging Geometry, Scale Exposures
Image completely visible? Yes
Double, Pseudo contours? No
Imaging errors, Distortion? No
in case of visible distortion Measured Deviation of W or H Deviation of W or H Exposures
value (in cm) (in %)
Image width "B"
max.
Horizontal Lines Image width "O"
3%
max.
Image width "U"
3%
Image height "H"
max.
Vertical Lines Image height "L"
3%
max.
Image height "R"
3%
Length at the Image Receptor
Entrance
Measured length in the exposure
Imaging Scale
7. Spatial Resolution Image processing: Exposures
Image Receptor: Type, Mode
Tested Format
Dosage step selected (*)
Dosage KB (s. above) [µGy]
Minimum value for Rgr [Lp/mm]
Current Value for Rist [Lp/mm]
8. Artifacts visual homogeneous unexposed Detectorunbelichteter Exposures
inspection Exposure Detektor
Scratches, Distracting areas? No
Phantom Images, (Storage Effects)? No
Misaligned Lines? No

Comments: Results

Responsible for Date:

the test
 pehamed DIGRAD
Seite 14

Constancy Test Form per DIN 6868 Part 13

Digital System Exp. Unit: No: Location:
Exposure: manual exposure adjustment ________ kV; Automatic exposure control ________ kV
Target values were determined during Justificat. for Part. Accept. Test:
Acceptance test on
Partial Acceptance test on Date, Signature:

Key Parameters Target Values Test Results

min. max.
Manual Dose [ Gy]
exposure Dose Indicator
adjustment Optical Density
MEA Luminance [cd/m2]
Automatic Dose [ Gy]
exposure Dose Indicator
control Opt. Dichte
AEC Luminance [cd/m2]
Spatial Res. [mm-1]
MEA or AEC Contrast Resolution

Artifacts
Deviation
Light Field |a|+|b|
Radiation Field |c|+|d|
Accept. result
Date
Test person
 pehamed DIGRAD
Seite 15

The DIGRAD Phantom and its Structural Elements

2.b
2.a

10.
5

3
4

1 1

2
9 7 2
1. X-Ray tube axis
2. Field markings for the (a) 18 x 24 cm format (X-ray opaque) and for the
(b) 26 x 26 cm format (X-ray transparent)
3. Step-wedge for the dynamic range (7 steps)
4. 6 low contrast objects
5. Marking (X-ray transparent): free space for signal adjustment
6. Cross-hair marking (X-ray transparent): centering marking
7. Lead bar pattern position
8. Homogeneity measurement area: 30 mm space to borders
9. Position of additional alignment markings (X-ray opaque) for analysis (on all 4
sides)
10. This area corresponds to the position of the detector in the patient-equivalent
filter.
 pehamed DIGRAD
Seite 16

Test Film Analysis -Acceptance Test

Sample Test Film

1 1

3 4

5
2

1. 4 field markings for imaging geometry

2. Lead bar pattern for spatial resolution
3. Dynamic step-wedge (7 steps) for contrast resolution
4. 6 elements for low contrast resolution
5. Field for signal adjustment
 pehamed DIGRAD
Seite 17
Analysis of Permissible Deviations from Tolerances -
Acceptance Test
Key Parameters Measurement / Analysis
Image receptor dose Measurement with dose measurement
KB device
Spatial resolution Visual inspection of the lead bar
pattern
Signal Adjustment For test film analysis:
Measurement of optical density in a
defined area (preferably in the
center of the film or on a middle
step in the dynamic step wedge)
w/ the Densonorm Densitometer
For analysis using a diagnostic
monitor:
Measurement of light intensity in a
defined area (preferably in the
center of the monitor ) w/ the
CANDELAMON measurement device
Dose Indicator Manufacturer’s specification under
defined conditions with correlated
image receptor dose
- Determine the dose indications
using 2 exposures w/ widely
differing dose settings (factor 4)
- Calculation of relationship
between lower to higher dose
Contrast Visual inspection of the 7 steps of
Contrast Resolution the dynamic step-wedge
Visual inspection of the low contrast
elements
Homogeneity Analysis of the border areas of the
phantom:
between the field markings
ca 30 mm away from the
phantom edge
using a densitometer w/ test film or
a light intensity measurement device
w/ monitor
Image Geometry and Measurement of the distances
Scale between the 4 field markings
Tolerances / Permissible deviations from
Target Value
The min. tolerance values are listed in the
Directive for Testing by Qualified Experts,
Attach. 1, Compendium of Regulations 13.
Per the Directive (Compendium of
Regulations 13) the following values apply:
for Image receptor Resolution tolerance
dose KB in µGy Line pairs / mm
≤ 10 2,8
≤5 2,4
The optical density should be in
range
1.0 < D opt < 1.5
Difference in measurement values
∆D opt < 0.20
The relative deviation of the light intensity
from the target value (as given by the
manufacturer) must not exceed
∆L< 58 % of the defined light
intensity
Deviation of the calculated relationship of
the doses from the manufacturer-specified
relationship
< 25 %
All 7 steps must be separately visualized
At least 3 low contrast elements must be
visible.
Deviations (excluding the influence of X-Ray
beam quality-related factors):
for test film measurements
0.20 D opt
for measurement using a monitor
relative deviation
< 58 % Light Intensity
The relationship of the measured distances
in the image must always be 0.97 - 1.03.
 pehamed DIGRAD
Seite 18

Test Film Analysis - Constancy Test

Sample Test Film

1
1

6
4

1. Field markings in all 4 corners (18 x 24 cm size)

2. Free space for signal adjustment
3. Lead bar pattern for spatial resolution
4. 7 step step-wedge for the dynamic range
5. Low contrast elements (6 objects)
6. Alignment marks for analysis of deviation of light field vs. effective radiation field
(scaled in 0.5 cm increments )

X-ray tube axis

 pehamed DIGRAD
Seite 19
Analysis of Permissible Deviations from Tolerances -
Constancy Test
Key Parameters Measurement /Analysis
Dose Measurement w/ Reference-
Dosimeter together w/
patient-equivalent filter
Dose Indicator
Optical Density Measurement of optical
density w/ a densitometer
in a defined area of the test
film on the middle step in
the dynamic step wedge
Light Intensity Measurement of light
intensity w/ a light intensity
measure-ment device in a
defined area of the test
image on the monitor
(This measurement is not needed
if the optical density of the test
film is measured.)
Spatial Resolution Visual inspection of the lead
bar pattern
Contrast Visual inspection of the 7
Contrast Resolution step, dynamic step-wedge
Visual inspection of the low
contrast elements
Deviations between Analysis using the field
the light field and markings and the alignment
the effective markings
radiation field (For more details, see sketch on
p.19)
Tolerance Values / Permissible
Deviations from Target Value
w/ automatic exposure control
±25% w/ 70 kV
± 20 % w/100 kV
(w/ additional, 1mm thick copper
plate)
w/ manual exposure
adjustment:
± 30 % w/ 70 kV and 100 kV
Deviations of the dose indicator from
the target value (per manufacturer
specification) may not exceed changes
corresponding to ± 50 % of the image
receptor dose.
Target Value : in range of 1.0 to 1.5
Permitted Deviation from target value
∆ Dopt ± 0.30
Measurement value L must be in the
range:
> 50 % of target value
< 200 % of target value
The target values in the Acceptance
Test Protocol are minimum values to
be reached.
All 7 fields must be visible.
Number of visible objects:
Not fewer than during the
Acceptance Test
Deviations between the light field and
the effective radiation field must not
exceed 2% of the focal spot-image
receptor distance.
 pehamed DIGRAD
Seite 20

Measurement and Calculation of the Deviation between the Light

Field and the Effective Radiation Field

1
Zero
marking

Zero
marking
a b

Photo: Deviation between light field and effective radiation field

Legend: 1 Effective radiation field (shaded area)
2 Light field (area within dotted lines)

Calculation of the deviation:

| a | + | b | < 0.02 x r x V In the photo: a = - (5x0.5) cm = | 2.5| cm
b = + (0x0.5) cm = | 0.0| cm
| c | + | d | < 0.02 x r x V c = + (5x0.5) cm = | 2.5| cm
d = - (8x0.5) cm = | 4.0| cm
a, b, c, d linear deviations
r Focal spot-image receptor distance
V Imaging scale as determined per Acceptance Test 6868-58 (see A.T.
Protocol)