CRDR PRELIM REVIEWER Front side

 Is made of a low atomic number material (e.g.

CONVENTIONAL RADIOGRAPHY
plastic or carbon) to enable ease in passage of
RADIOGRAPHIC FILM x-rays.

Back side
 Is made of a high atomic number material (e.g.
lead) to reduce backscatter.
 has rubber or felt for adequate contact between
the screen film system or with the imaging
plate.

Two parts: the BASE and EMULSION
Emulsion
 In most x-ray films, the emulsion is coated on
both sides; therefore, it is called double
emulsion films.
 Is enclosed by a protective covering of gelatin
called the overcoat.
In Conventional Radiography….
 Two screens are mounted, one on each side of
the cassette, except in mammography, where a
single screen is mounted on the back side.
 These cassettes must be loaded with film in the
darkroom unlike the cassettes used in CR
which can be loaded with an imaging plate in
the light.
INTENSIFYING SCREEN

Overcoat
 It protects the emulsion from scratches,
pressure, and contamination during handling,
processing, and storage.

Adhesive Layer
 Ensures uniform adhesion of the emulsion to
the base.
 Allows the emulsion and the base to maintain
proper contact and integrity during use
and processing.

Thickness
 Approximately 150 to 300 µm
Formation of Radiographic Images:
RADIOGRAPHIC CASSETTE Conventional Radiography
 Are rigid holders used in conventional and
computed radiography (CR) for the screen film
system and imaging plate respectively.
X-ray from X-ray Tube
 X-rays are nearly uniformly distributed in space.

X-ray Interaction with Patient

 X-rays are not uniformly distributed in space
but vary in intensity according to the
characteristics of the tissue through which it has
passed.

Exit X-ray Beam/ Remnant X-rays CR PROCESS IN A NUTSHELL:

 Refers to the x-rays that remain as the useful
beam exits the patient.
 consists of x-rays scattered away from the
image receptor and image forming x-rays
(diagnostically useful information).
Image Receptor (IR)
 The medium that converts the x-ray beam into a
visible image.
INNOVATIONS IN RADIOGRAPHIC
TECHNIQUE
 Film-screen served as a good medium for
radiographic images for many decades. It has
many limitations that can be overcome with
digital imaging.
1. Image acquisition involves exposing the
patient with x-ray and recording the
transmitted x-ray with the PSP detector/
imaging plate.
2. The resultant latent image is extracted via
the CR reader device using laser
stimulation (RED LIGHT LASER) to
produce photostimulable luminescence
which will be collected and converted into
electric signal by the PMT.
3. These electrical signals will be again
converted into digital data with the use of
ADC to process the image for it to be
viewed in the display monitor.

Digital Imaging
 The latent image is stored as digital data must
be processed by the computer for viewing on a
display monitor that can be accomplished by
using a specialized image receptor that can
produce a computerized radiographic image.
Two types are in use today:
1. Computed Radiography (CR)
2. Direct digital radiography (DR)
DIGITAL RADIOGRAPHY (DR)
 It includes several imaging modalities
coupled to the PACS-RIS-HIS image and
information systems.
 The imaging modalities include computed
radiography (CR), flat-panel digital
radiography (FPDR), digital mammography
(DM), and digital fluoroscopy (DF).

COMPUTED RADIOGRAPHY (CR)

 It is a digital Radiographic imaging
modality.
 Digital detector is used to capture X-rays
transmitted through the patient.
 CR is an indirect capture digital imaging
technology, which means that plates are
used to capture the image before it is
transferred to a computer.
 HISTORICAL DEVELOPMENTS

1603
 Bolognese Stone 1982
(glowing stone)  Picture Archiving
discovered in Italy. and
 Is linked to Communications
Photostimulable System (PACS)
phosphor and the becomes
phenomenon of available.
Photostimulable
Luminescence

1867
 Notion of de-excitation
described by Becquerel.
 Discovery of Radioactivity
1926
 Hirsch proposed a way to
retain fluorescent image
by using Storage
phosphor-heat to re-
stimulate and red light to
erase.
1975
 KODAK patented an
apparatus that used infrared-
stimulable phosphor to store
image.
1983
 FUJI’s first
commercialized
computed
radiography (FCR
101) followed by
the FCR 201 in
1985 and the FCR
7000 in 1989 (Commercialization of CR
imaging systems for use in diagnostic
radiology began, when Fujifilm (Tokyo,
Japan) introduced their FCR-101 unit).
1984
 Laser – stimulable phosphors for computed
radiography appear (FUJI)
1992
 KODAK’s first commercial
storage phosphor unit.

1980/1981
 FUJI patented a process 1994
in which photostimulable  Agfa-Gavaert
phosphor was used to introduces CR
record image by imaging technology.
absorbing radiation and
then releasing stored
imaged when stimulated
by helium-neon laser.
1996
 Digital radiography that uses thin – film
transistors (TFT’s) is developed.
Silicon substrate
 Contains the charge storage area.
1998
 Amorphous silicon – CsI image receptor is
demonstrated for digital radiography.
 Sample schematic of amorphous silicon
based flat panel detector:

1997
 Charge – coupled device (CCD) digital
radiography is introduced by Swissray
Amorphous selenium flat panel image 2001
receptor is demonstrated by Rowlands.  Other in CR research include general
electric healthcare, Philips healthcare;
Konica Minolta healthcare, and Canon, etc.

Present
 Fujifilm medical system; Carestream health;
and agfa healthcare are actively engaged in
research and development of state-of-the-
art CR systems.

 A photosensitive receptor and electronics

embedded into a substrate material in a
silicon chip make up a CCD.
 Incident light from a scintillator strikes the
detector and electron/hole pairs are
produced in the silicon. The number of
electron/hole pairs is related to the amount
of light that is absorbed. The electrons are STRUCTURE AND MECHANISM
held by electrostatic forces in the array until
the charge is read out to form the image. CR Imaging Plate
STRUCTURE:
Chip
 Is made up of a polysilicon layer, a silicon
dioxide layer, and a silicon substrate.

Polysilicon layer
 Is coated with a photosensitive material and
contains the electronic gates.
Silicon dioxide layer
 is an insulator.
1.) Protective layer
 Very thin, tough, clear plastic that protects
the phosphor layer.
 Provides durability.
 Must also allow light from the laser and the
stimulated light to pass through it.
2.) Phosphor/ Active Layer
 Layer that “traps” electrons during
exposure.
 Usually made of phosphors from the barium
fluorohalide family.
 The phosphor is mixed with an organic
binder (e.g., polymer, such as polyester)
and coated onto the support layer.
 May contain a DYE (absorbs the stimulating
light to prevent as much spread as
possible)
4.) Conductive Layer
 Absorbs and reduces static electricity that
may degrade image quality.
5.) Color Layer
 Newer plates may contain a color layer,
located between the active layer and the
support, that absorbs the stimulating light
but reflects emitted light.
6.) Support Layer
 A semirigid material that gives the imaging
sheet some strength.
7.) Backing Layer
 A soft polymer that protects the back of the
cassette.

Physical characteristics of phosphors used 8.) Barcode

in CR:  Allows the technologist to match the image
information with the patient-identifying
1) Phosphors should have good X-ray
absorption efficiency and must be capable barcode on the examination request.
of being stimulated by a helium-neon (He-
Ne) laser or red-light laser.
2) The luminescence light must be compatible
with the photomultiplier tube (PMT)
phosphor (for proper detection and
capture)
3) and the time for luminescence must be
shorter than 1 μs.
4) finally, these phosphors should be able to
store the latent image for a number of hours
without compromising the signal from the
IP.

IMAGE FORMATION
 It is a Conventional Projection Radiography
in which the image is acquired in digital
format using the Imaging Plate rather than
3.) Reflective Layer film.
 Sends light in a forward direction when
released in the cassette reader.
 May be black to reduce the spread of
stimulating light and the escape of emitted
light.
 Some detail is lost in this process.
PSP Image acquisition and processing
steps:
1. Image acquisition involves exposing the
patient with a study specific x-ray
technique and recording the transmitted
x-ray flux with the PSP detector.
2. The resultant latent image is extracted
via the reader device using laser
stimulation and recording the PSL
intensity.
3. Image pre-processing involves
correcting systematic variations in the
extraction process and determining the
range of pertinent information with
subsequent adjustment of digital values
to a normalized output range.
4. Image post- processing translates the
digital values of the raw digital image to
render a grayscale and frequency
enhancement appropriate for anatomy
and study.
5. The output image is displayed on a
calibrated image monitor for
presentation.
CR CASSETTE
 Looks like a conventional Radiography
cassette.
 Made of durable lightweight plastic material
 Backed by thin sheet of Aluminum that
absorbs x ray.
 Instead of Intensifying Screen inside, there
is an antistatic material that protects against
static electricity build up, dust collection and
mechanical damage to plate.
IMAGING PLATE
 In CR, Image is captured in thin sheet of
plastic known as imaging Plate.
It has several layers:
 Protective layer
 Phosphor/ Active layer
 Reflective layer
 Electro Conductive layer
 Support layer
 Color layer
 Backing layer
Types of IPs:
 Standard Resolution IP
 High Resolution IP
Standard Resolution IP
 Have thick phosphor layers and absorbs
more radiation.
 Have faster radiographic speeds. Thick
phosphor IPs have fast speeds.
High Resolution IP
 Have thinner phosphor layers and provide
sharper images compared to thick
phosphors.
 The sharpness is because thinner
phosphors reduce the lateral spread of the
laser light.
 Have slower radiographic speeds. Thin
phosphor IPs have slow speeds.
 Will be used for extremity imaging and
other small parts where detail (sharpness)
is critical.
1. EXPOSE
 The first of a sequence of the events
that results in an x-ray-induced image
forming signal.
Acquiring and forming the latent image:
 The patient is x-rayed the same way as in
conventional radiography. The patient is
positioned using appropriate positioning
techniques, and the cassette is placed
either on the tabletop or within the table
Bucky.
 2. STIMULATE
 The patient is then exposed using the  Stimulation of the latent image results from
proper combination of kilovoltage peak the interaction of the infrared laser beam
(kVp), milliamperage seconds (mAs), and with the photostimulable phosphor (PSP).
distance.
Doping of PSP:
 The difference lies in how the exposure is
recorded.
 In CR, the remnant beam interacts with
electrons in the barium fluorohalide
crystals contained within the imaging
plate.
 This interaction stimulates, or gives Doping Barium Fluorohalide with
energy to electrons in the crystals, Europium:
allowing them to enter the conductive
layer, where they are trapped in an  When Pure crystals of Barium fluorohalide
area of the crystal known as the color are doped with small amount of Europium,
or phosphor center. Crystals develop a tiny defect called
 This trapped signal will remain for hours, metastable sites of F center. (From German
even days, although deterioration begins Farbzentren or Color center).
almost immediately.  F centers act like electronic holes in the
 In fact, the trapped signal is never crystals that can trap electrons.
completely lost.
 That is, a certain amount of exposure
remains trapped so that the imaging
plate can never be completely erased.
 However, the residual trapped
electrons are so few in number that
they do not interfere with subsequent
exposures. 1. A portion of the electrons ejected during
 According to the American Association of x-ray exposure become trapped in F
Medical Physicist in Medicine, it will lose centers within the lattice of the
about 25% of the stored signal between 10 molecule.
min and 8 hrs after an exposure resulting in
the loss of the energy through spontaneous 2. Laser light from the CR reader adds
phosphorescence. energy to these trapped electrons, they
escape the F-centers and fall back into
Action of X-ray exposure: their normal atomic shells, emitting light
 When the X-ray is absorbed by the again in the process. This dimmer light
material, absorbed energy excites the is amplified by the CR reader to form the
europium atoms, causing ionization of Eu image.
+2
atom. Eu+3 +e−¿=Eu ¿ Latent Image Formation and PSL:
 The electrons are raised to a higher energy
 X-ray exposure of the PSPIP creates a
state in the conduction band. Once in the
latent image, and laser scanning of the
conduction band, electrons travel freely
exposed IP produces PSL. The information
until they are trapped in a so-called F-
captured from the PSL is used to create the
center in a metastable state with an energy
CR image.
level slightly below that of conduction band
but higher than that of the valence band.
 When X-rays fall upon the PSPIP, the The Reader
europium atoms are ionized by the
 No chemicals
radiation, and the electrons move from the
and dark room
valence band (ground state) to the
necessary.
conduction band (higher energy).
 Electrons in the conduction band are free to  Cassette is fed
travel to a so-called F-center. F comes from into the reader.
the German Farbe (farbzentren) meaning  Removes IP
color. and scans
 Doping of Europium creates defects in the plate with the
BaFBr/I crystals, that allows electrons to be laser to release
trapped more efficiently. the stored
 When Pure crystals of Barium flurohallide energy.
are doped with small amount of Europium,
Crystals develop a tiny defect called  With CR systems, no chemical processor or
metastable sites of F center. (From German darkroom is necessary. Instead, following
Farbzentren or Color center). F centres act exposure, the cassette is fed into a reader
like electronic holes in the crystals that can that removes the imaging plate and scans it
trap electrons. with a laser to release the stored electrons.

TWO TYPES OF CR SYSTEM

1. Cassette-Based Systems
 These systems use individual IPs of
different sizes analogous to cassette-based
film-screen radiography.
 An exposed IP must be physically taken to
a CR reader unit for scanning to acquire an
image from the IP, followed by erasure of
the IP and subsequent transport of the IP in
A. Normal Atom
the unit itself for reuse.
 Electron energy levels consist of a filled
 This means that the IP is in contact with
band, valence band, and a conduction band
various transport mechanisms that may in
which lies outside the atom’s binding
time result in plate/ phosphor damage.
influence.
B. Atom in BaFH molecule
2. Cassette-less Systems
 When barium fluorohalide crystals are
 These systems evolved to overcome some
doped with europium, the molecular
of the problems with cassette-based
structure results in the creation of F
systems.
centers, which consist of an additional
 One such problem, for example, is related
energy band which is created between the
to the physical task of taking an exposed IP
valence and conduction bands. In the CR
to the CR reader for processing, as well as
reader, exposure to the laser beam causes
mechanical transport of the IP itself in the
electrons in this band to fall back into their
reader.
normal shells.
 It incorporates a fixed stationary single IP
that is encased in a special housing that
forms a part of the unit.
 There is also no contact with the IP in the
unit when it is read. The single fixed IP can
accommodate various exposure sizes
ranging from 17′′ × 17′′ and 14′′ × 14′′ to 10′′
× 12′′ and 8′′ × 10′′ or 10′′ × 8′′. These
varying sizes will have varying matrix sizes
as well. Once the fixed stationary IP is
exposed, the patent image is acquired
using a scanning technology appropriate to
the system.
CR READERS SCANNING
TECHNOLOGIES
 Acquiring the image from the exposed IP
can be accomplished by point-scan (P-S)
CR readers or by line-scan CR readers.
1. Firstly, the IP is removed from the cassette
and is placed on the transport mechanism
for scanning by a laser beam. While the
movement of the IP is referred to as the
“slow-scan” direction, the laser beam
movement across the IP is called the “fast-
scan” direction. The laser beam is used to
stimulate the trapped electrons (latent
image) in the exposed IP. In the past, gas
lasers such as a helium-neon (He-Ne)
laser were used; however, current CR
readers use solid-state laser diodes that
emit a red laser beam having wavelengths
of about 630 nm/ 670–690 nm. The laser
stimulation of the IP causes it to emit light
(by photostimulable luminescence (PSL)
that is of a much different wavelength than
the stimulating laser light.
2. Secondly, the emitted light from the IP is
optically filtered and collected by the light
channeling guide or light collection optics
as it is sometimes referred to as. This light
(PSL) is then sent to the photodetector (a
photomultiplier tube) or charge-coupled
device (CCD) which converts the PSL into
an electrical signal (analog signal) that is
first amplified and subsequently digitized
by the ADC.
3. Finally, the analog signal from the
photodetector is sent to the ADC for
digitization. Digitization involves both
sampling the analog signal and
quantization. Depending on the
amplification, the ADC will produce 8–16
bits of quantization per pixel, providing
discrete gray levels ranging from 28 to 216.
Dual-sided reading technology
 has become available in more recent CR
units.
 It is apparent that two sets of
photodetectors (dual light collection
system) are used to capture PSL from the
front and back side of the IP.
 In this way, more signal is obtained to
improve the signal-to-noise ratio and,
hence, improve image quality.
 Additionally, a thicker phosphor layer can
be used to increase the absorption of X-
rays, hence improving system efficiency.
PHENOMENON OF LASER LIGHT
 The cassette is placed in the reader where digital computer for processing and CR
the IP is extracted and faster- scanned with image creation.
a highly focused and intense laser light of
LASER IN IMAGING PLATE
low energy (~2 eV).
 To render the latent image visible, the
PSPIP is taken to the CR
reader/processor to be scanned by a
laser beam. This process is referred to
as photostimulated excitation.
 The laser light used must be capable of
being absorbed by the “F-centers.”
 This absorption causes the trapped
electrons to move up to the conduction
band, where they are free to return to
the valence band, thus causing the
Eu3+ to return to the Eu2+ state.
 Laser light is absorbed at the F-center
(Farbzentren center) and, thus, stimulates
the trapped electrons up to conduction
band where they are free to move to
Europium atom thereby leaving high energy
conduction band to lower energy valence
band.
 This transition of the electrons from a
higher energy state to a lower energy
state (ground state) result in an
emission of bluish purple light (~415 nm
wavelength).
 This is referred to as photostimulable
luminescence (PSL) in the PSPIP.
 When these electrons become reabsorbed  The extracted imaging plate is scanned with
by trivalent Europium, trivalent Europium is gas laser and gives energy to trapped
transferred back into divalent Europium electron and energizes them.
atom. This involves the liberation of high  Extra energy allows the trapped energy to
energy (~3 eV) and this is done by emission escape the active layer where they emit
of blue - purple light. blue light at energy of 3 eV.
 The lasers used today for PSL in CR  Photomultiplier tubes are only
units are semiconductor lasers that sensitive to blue light.
produce light with a 680 nm wavelength  Laser scans IP multiple times.
compared to He-Ne lasers that produce  Scanning produces lines of light intensity
light with a 633 nm wavelength used in information that are detected by
earlier CR units. photomultiplier tube that amplifies and
 The PSL from the IP is collected by a sends it to digitizer.
special light collection device and sent
to a photomultiplier tube that produces
an electrical signal. This signal is
subsequently digitized and sent to a IMAGING PLATE MOVEMENT

Fast Scan Direction  The direction as a
PSP plate moves through the CR reader
(processor) is the crosswise laser beam scan
direction.
Slow Scan/ Sub-scan Direction  Direction
of the plate movement.
3. READ
 The light signal emitted after stimulation
is detected and measured.
Photomultiplier Tube
 A device sensitive to electromagnetic
radiation, consisting of a photocathode,
from which electrons are released by
incident photons, and an electron
multiplier, which amplifies and produces
a detectable pulse of current.
 When the laser beam in the CR reader
stimulates the PSP plate, the visible light
emitted from it is directed through a light-
channeling guide onto a photocathode layer
on the input side of a PM tube.
 Electrons are emitted from the
photocathode.
Photocathode
 A cathode that emits electrons when
exposed to radiant energy and
especially light.
 The photocathode converts the light
photons emitted by the entrance
phosphor to photoelectrons via the PE
effect: electrons are produced in direct
proportion to the brightness of the input
screen.
 It employs a photocathode plate which
emits electrons (by ionization) when
struck by light.
 The electron stream by a series dynode
which sequentially boosts the signal.
 A photomultiplier tube, useful for light
detection of very weak signals, is a
photoemissive device in which the
absorption of a photon results in the
emission of an electron.
 These detectors work by amplifying the
electrons generated by a
photocathode exposed to a photon
flux.
Photomultiplier Tube (continued)
 But this electronic signal is too small to
be detected by most other types of
electronic devices, so it needs to be
amplified.
 This is accomplished through a series of
dynode plates.
Dynode plates
 An electrode in an electron tube that
functions to produce secondary
emission of electrons.
 The dynode is made of a metal plate
containing a substance on the surface
such as a bialkali compound, which emits
secondary electrons upon impact with
accelerated electrons. The acceleration of
the photoelectrons and the impact of these
on the dynode produce multiple secondary
electrons.
 Dynodes are electrodes which can be
switched back and forth between positive
and negative charges.
 With each strike, the dynode plate switches
from positive to negative, repelling the
 stream of electrons toward the next plate,
but with increasing effect such that the
number of electrons in the stream is
multiplied.
 Each collision of an incident electron with a
dynode plate releases about 5 electrons
from the plate.
 By having the electron beam pass through
10–12 of these dynodes in succession, the
electronic signal can be amplified by more
than a million times.
Electrode
 is an electrical conductor used to make
contact with a nonmetallic part of a
circuit (e.g. a semiconductor, an
electrolyte, a vacuum or air). Electrodes are
essential parts of batteries that can consist
of a variety of materials depending on the
type of battery.
 An electric conductor, usually metal,
used as either of the two terminals of an
electrically conducting medium; it
conducts current into and out of the
medium, which may be an electrolytic
solution as in a storage battery, or a solid,
gas, or vacuum.
DIGITALIZING THE SIGNAL
 It is the assigning of numerical value to
each light photon.
 In the process of digitizing the light
signal, each phosphor storage center is
scanned, and the released electrons
enter a digitizer that divides the analog
image into squares (matrix) and assigns
each square in the matrix a number
based on the brightness of the square.
 Each square is called a pixel or picture
element.
 Each phosphor storage is scanned and the
electrons enters the digitizer where the
analog image is converted into square
matrix and assigns each matrix a number
based on the amount of signal .
 Analog refers to a device or system that
represents changing values as
continuously variable physical
quantities.
 The typical number of pixels in a matrix
range from about 512 × 512 to 1024 ×
1024 for CT but can be as large as 2500
× 2500 for radiography.
 The more pixels there are, the greater
the image resolution.
 More Pixel = greater resolution.
 The number of Photons detected
determines the Grey level.
 Grey level will determine the Quality of
Image.
 Pixel (Picture Element) - a minute area
of illumination on a display screen, one
of many from which an image is
composed.
 The image is digitized both by position
(spatial location) and by intensity (gray
level). Each pixel contains bits of
information, and the number of bits per
pixel that define the shade of each pixel
is known as bit depth.
DIGITAL IMAGES
 In digital radiography, a digital image is a
numerical representation of the patient, for
digital radiography, the following points are
noteworthy:
1. The digital radiography detector outputs an
analog signal (electrical signal).
2. This signal is sent to an analog-to-digital
converter (ADC).
3. The ADC changes the continuous analog
signal into discrete digital data. This is an
important step in generating a digital image,
simply because a digital computer requires
discrete data (0s and 1s) for operation.
4. The result of computer processing is a
digital image.
5. Since radiologists and technologists do not
view numerical representations (digital
images), these must be converted into a
form suitable for human viewing. Hence,
the digital image is converted into a visible
physical image, an analog image.
4. ERASE
 Before reuse, any residual metastable
electrons are moved to the ground state by
intense light.
 One of the advantages of CR is that the
IP can be used repeatedly for several
hundreds of exposures.
 IP is erased using a high intensity light to
remove any residual energy after the IP
has been scanned by the laser beam.
 The erased IP is now ready to be used
again.
 Not all electrons have came back to the
initial phase after reading.
 The process of reading the image
returns most but not all of the electrons
to a lower energy state, effectively
removing the image from the plate.
However, imaging plates are extremely
sensitive to scatter radiation and should
be erased to prevent a buildup of
background signal.
 The plates should be run at least once a
week under an erase cycle to remove
background radiation and scatter.
 The system automatically erase the plate
by flooding it with light to remove any
electron still trapped after initial plate
reading.
 CR readers have an erasure mode that
allows the surface of the imaging plate
to be scanned without recoding the
generated signal. Systems automatically
erase the plate by flooding it with light to
remove any electrons still trapped after
the initial plate reading.
 Cassettes should be erased before
using if the last time of erasure is
unknown.
IMAGE QUALITY IN CR
 Comparison of the radiographic film, H&D
response curve to linear plate response
Dynamic Range
 Excellent linear response to the intensity of
X-ray.
 DYNAMIC RANGE is the range of tonal
difference between the lightest light
and darkest dark of an image.
 The higher the dynamic range, the more
potential shades can be represented,
although the dynamic range does not
automatically correlate to the number of
tones reproduced.
 Information’s available in high and low
exposure regions too.
 Wider dynamic range
Wider Dynamic Range
A. Film-screen AP projection of the Knee
Radiograph
B. CR AP Projection of the knee image
 The difference in the amount of soft tissue
shown in detail with CR image.
Spatial Resolution
 is a measure of the smallest object that can
be resolved by the sensor, or the ground area
imaged for the instantaneous field of view
(IFOV) of the sensor, or the linear dimension
on the ground represented by each pixel.
 Amount of detail present in any image is
known as spatial resolution.
 Determined by Phosphor layer
thickness and Pixel size.
 Film Screen Radiography: 10 lp/mm
 CR: 2.5-5 lp/mm
Speed
 CR system “speeds” reflects the amount of
photostimulable luminescence (PSL)
given off by the imaging plate while being
scanned by the laser.
 For example, Fuji Medical Systems reports
that a 1-mR exposure at 80 kVp and a
source-to-image distance of 72 inches will
result in a luminescence value of 200,
hence the “speed” number.
 In CR, most cassettes have the same
“speed”; however, there are special
extremity or chest cassettes that produce
greater resolution. These are typically 100
relative “speed.”
 Great care must be taken when converting
to a CR system from a film/screen system
to adjust technical factors to reflect the new
“speed.”
ADVANTAGES AND DISADVANTAGES OF
CR
Advantages:
 Improved and expanded diagnostic scope.
 X ray dosage reduction.
 Repeat rate reduction.
 Teleradiographic transmission
 Picture Archival and Communication
System possible.
 Faster image receptor, so lower patient
dose is possible.
 Post-processing, manipulation & storage of
images.
 Repeat examinations are reduced due to
wide exposure latitude.
 IP is reusable, no need to reload the
cassette.
 Elimination of repeat exposures.
 Ability to produce consistent high-quality
images.
 Ability to deliver images quickly to those
who need to make critical decisions.
 Low cost of storage, retrieval and  Many newer CR readers now use solid-
expansion. state semiconductor laser diodes rather
 The ability to interface with the Radiology than helium-neon gas lasers. These emit
Information System. a slightly different wavelength of light but
 Decreased time to acquire images thereby are more reliable and consistent in the long
increasing patient throughput. run.
 Increased Radiologist reading capacity and  Solid state: produces longer wavelength of
the ability to have instant comparison light.
images along with previous reports.
 Ability to have wide are distribution to
EFFICIENCY OF CR PHOSPHORS
doctors’ offices.
 Ability to print on paper or make CD media Absorption Efficiency
instead of film, saving thousands of dollars.
 is the ratio of x-ray photons absorbed by the
Disadvantages: phosphor crystals to the x-ray photons incident
upon the phosphor layer.
 Dose-creep: since exposure latitude is
wide, high exposure technique is used  Elements with high atomic numbers, thicker
which increases the patient dose which is phosphor layer are good in Absorption.
called dose-creep.  The more x-rays are absorbed by the
 This can be reduced by exposure indicator phosphor layer, the more light is emitted
or exposure index which gives the user when the plate is stimulated by a laser
feedback about the actual dose. beam in the digital reader (processor).
 Exposure latitude  is the extent to
which a light-sensitive material can Conversion Efficiency
be overexposed or underexposed  Is the percentage of energy from absorbed
and still achieve an acceptable result. x-ray photons that is converted into light rather
This measure is used for digital and than into infrared or heat energy.
analogue processes, e.g. optical
microlithography or photography. Emission Efficiency
 Is the ability of the light produced by the
phosphor crystals to escape the phosphor
RECENT DEVELOPMENT IN CR layer and reach the light guides in the CR
 Dual Sided reading: there are two sets of reader that direct it to the light detector, a
detectors in the reader that capture light photomultiplier tube.
from both sides of the plate upon
stimulation by the laser beam. Combined
with a thicker phosphor layer on the plates,
the signal to-noise ratio is improved in
these systems.
 New Line scan Reader: have increased
the speed of processing. They use a laser
line source and a shaping lens to refine the
beam into a fine line rather than a point.
Stimulated light is then emitted from the
phosphor line-by-line, captured by a lens
array and fed to a CCD photo detector
array.
BACKGROUND AND SCATTER RADIATION
 Approximately 10 times more sensitive than
the older film/screen.
Demonstration of the extreme sensitivity of CR
plates to both background and scatter
radiation.
 Image A- processed from a CR plate that
was erased and then stored behind the
control booth during an abdomen exposure.
 By comparison, for density from natural
background radiation can be made our on-
image B from a CR plate which had not
been erased after two days of protected
storage.
 Image C is from a plate set 2 meters away
from an abdomen phantom that was
exposed to 80 kVp and 30 mAs. Scatter
radiation is readily apparent.
SUMMARY:
The basic CR imaging cycle has three steps:
1. Expose
2. Readout
3. Erase
 When the PSP is exposed to the X-ray the
energy of the incident radiation is absorbed
and excites electrons to high-energy levels.
 These excited electrons remain trapped at
unstable energy levels of the atom.
 This trapped energy can be released if
stimulated by additional light energy of the
proper wavelength by the process of
photostimulated luminescence (PSL).
 The PSP is scanned in a separate CR
reader device.
 A GAS laser beam scans the
photostimulable screen stimulating the
emission of the blue light photons.
 Stored energy is set free with the emission
of blue light equivalent to the absorbed
remnant beam.
 Blue light is captured by photodiode and
converted to electric charge.
 Analog to digital converter converts it into a
corresponding digital image.
 Residual latent image electron is flushed
with high intensity white light.
 and erased without reintroducing electrons
from the ground energy level.
References:
 Carter C, Veale B, Cassette-Based
Equipment: The Computed radiography
Cassette, Imaging Plate and Reader,
Digital Radiography and PACS, Texas,
2011 ,63-76.
 Ballinger P, Frank E, Computed
radiography, Merill’s Radiographic
Positioning and Radiologic procedure,
Ohio, 2007 Vol: 3, 360-371
 Lanca L, Silva A, Digital Radiography
Detectors: A technical overview, Digital
Imaging Systems for plain Radiography,
Portugal, 2013, 12-3
 Carrol Q, Creating the Digital Image:
Radiography in Digital Age, Illinois, 2011,
369
 STEWART BUSHONG, Radiologic
Sciences for Technologist, 10th edition,
Elsevier Texas, 2013: MOSBY
 RICHARD R. CARLTON, Principles of
Radiographic Imaging: an art and a
science, 3rd edition, Delmar: 2001
 EUCLID SEERAM, Digital Radiography:
An Introduction, Delmar: 2011