Effects of kVp and mAs on image

spatial resolution, contrast, dose,

and noise
Vibha Chaswal, Ph.D.
Peak Voltage (KVp) of an X-ray
tube
• Highest X-ray energy
is determined by peak
voltage applied
across the x-ray tube.
• With filtration:
Eave = (1/2-1/3)Emax
• KVp and filtration =
Quality of the X-ray
beam

Ref: Bushberg
 Milli Ampere Second (mAs) tube
current
• Tube current is the rate of electron flow from
the cathode to anode, measured in
milliamperes (mA)
• 1 mA = 6.24 x 1015
• S = exposure time, duration of x-ray
production
• Indicates quantity: Number of photons is
proportional to mAs
 Rules of Thumb
• kVp and exposure:
• Exposure α (kVp)2
• For a fixed exposure technique:
• (kVp1/kVp2)5 = mAs2/mAs1
• kVp determines quantity, quality, and
transmission through the object whereas mAs
determines quantity
 Image Contrast
• Medical Imaging is the Process of
Converting Tissue Characteristics
into a Visual Image

• Contrast: Difference in the image

gray-scale between closely adjacent
regions on the image.
Contrast sensitivity: imaging
system's ability to translate
physical object contrast into image
contrast

Increasing Contrast Sensitivity

Increases Image Contrast and the
Visibility of Objects in the Body
 Different definitions of contrast
• Subject contrast: difference in some aspect of
the signal prior to its being recorded
(x-ray operators use different kVp and mAs to
control subject contrast)
• Displayed contrast: digital imaging
(CT (x-ray tomography) imaging uses mAs for
increasing contrast resolution (contrast to
noise ratio) kVp dependence:Once kVp is set,
out of sight out of mind
 Dose and contrast versus kVp

For screen film radiography

Ref: Bushberg
 Computed Tomography: 3 steps

Scan: produces image data

Reconstruction: produces digital image => a matrix of pixels with CT numbers
Digital to analog conversion: produces visible analog image represented by
different shades of gray
 Hounsfield Unit
X-ray attenuation depends on both the density and atomic number (Z)
of materials and the energy of the x-ray photons. For CT imaging a
high KV (like 120-140) and heavy beam filtration is used. This
minimizes the photoelectric interactions that are influenced by the Z of
a material. Therefore, CT numbers are determined by the density of the
tissues or materials.
 Displayed Contrast: CT
• Defined by difference in gray scale values of
closely lying adjacent structures
• Gray scale values assigned to pixels during DI
to analog conversion of DI
• Visible contrast can be controlled by window,
level and zoom or post-processing techniques
• CT imaging uses a high KV (like 120-140 kVp)
and heavy beam filtration => minimizes the
photoelectric interactions
Digital Radiography
• Enhance contrast
digitally using
Window and Level
and

Ref: Bushberg
Digital Radiography
• Post-
processing
using the
Edge
enhancement
filter

Ref: Bushberg
 Spatial Resolution
• Ability of an image system to distinctly depict
two objects as they become smaller and
closer together
• Directly related to mAs = quantity of photons
making the image
• kVp set for a technique
• LOTS of other factors that affect spatial
resolution
• Quantified using MTF (cycles/mm)
Spatial resolution of different
imaging systems - MTF

Ref: Bushberg
 Noise
• Local variations in contrast due to a background
texture called noise that does not represent the
attenuation in patient
• Random: e.g., caused by random variations in x-
ray photons interacting in the tissue
• Screen-film radiography: Visual perception of
noise is reduced when the detected x-ray
photons increase.
• Increasing mAs and kVp decrease noise as the #
of detected photons increase, so does patient
dose.
 Signal-to-Noise Ratio
• If N = photons/pixel then
• SNR = √N
• Noise and Dose:
• to increase the SNR by 2 the dose to the
patient (N) has to be increased by 4
Thank You!