I.

TERMS
PRIMARY X-RAY
 The beam of photons before it interacts with the patients
REMNANT X-RAY
 A type of radiation that exits the anatomic part and exposes the intensifying screens
placed in the cassette.
OPTICAL DENSITY
 The degree of blackening in the finished radiograph
 The degree of overall blackening of the film

` CONTRAST

 The difference between adjacent densities

II. FILM CASSETTE

 Protective holder

CASSETTE FRONT
 Low atomic number
 No x-ray interaction (radiolucent)
 Composition: Bakelite/Carbon fiber

LEAD FOIL

 Absorbs backscatter radiation

CASSSETTE BACK

 Steal of light weight of metal

 Composition: Magnesium

III. INTENSIFYING SCREEN (IS)

 A device that converts the energy of the x-ray beam into visible light

FOUR PRINCIPAL LAYERS OF RADIOGRAPHIC INTENSIFYING SCREEN (IS)

 Protective coating
 Phosphor
 Reflective layer
 Base

A. PROTECTIVE LAYER
 The layer closest to the radiographic film
 Applied to the face of the screen
 Thickness:
o 10-20 um
 o 25 um
 Characteristic: transparent to light

B. PHOSPHOR
 The active layer of the screen
 Emits light during stimulation by x-rays
 Converts the x-ray beam into light
 Active substance:
o Calcium tungstate (Blue)
 For blue-sensitive film
o Rare earth elements (Blue and Green)
 for green and blue-sensitive film
 Gadolinium, Lanthanum and Yttrium
o Barium Platinocyanide
 A phosphor that was never successfully applied to diagnostic
radiology
 Layer thickness: 50-300 um

LUMINESCENCE

 The emission of visible light

 Phosphor:
o A luminescent material
o Emits light of a characteristic color
 Two Types:
o Fluorescence
o Phosphorescence
 Fluorescence
o Instantaneous emission
o Occurs when the phosphor emits visible light while or during stimulation
 Phosphorescence:
o Screen lag or afterglow
o Delayed phosphorescent emission
o Occurs when the phosphor continues to emit visible light after stimulation

C. REFLECTIVE LAYER
 The layer between the phosphor and the base
 Intercepts light headed in other directions and redirects it to the film
 Thickness: 25 um
 Composition:
o Magnesium oxide
o Titanium dioxide

D. BASE
 The layer of the screen farthest from the film
 Serves principally as mechanical support for the active phosphor layer
  Thickness: 1 mm
 Composition:
o Polyester
o Cardboard
o Metal

IV. RADIOGRAPHIC FILM

 X-ray film
 Manufacture in total darkness
 It has a spectral response
 Thickness:
o 150 – 300 um

FOUR PRINCIPAL LAYERS OF RADIOGRAPHIC FILM

 Supercoat/Overcoat/Protective layer
 Emulsion
 Adhesive Layer
 Base

A. SUPERCOAT/OVERCOAT/PROTECTIVE LAYER
 A protective covering of gelatin that enclosed the emulsion
 A layer of hard, protective gelatin
 Purposes:
o Protects the emulsion from scratches, pressure and contamination during
handling, processing and storage
 Thickness: 2-5 um

B. EMULSION
 The heart of the radiographic film
 The material with which x-rays or light photons from radiographic intensifying screen
interact
 Composition: Mixture of gelatin and silver halide crystals
 Thickness:
o 3-5 um
o 5-10 um

GELATIN

 A nonreactive medium though which chemicals can diffuse to each silver halides
 Functions:
o To provide mechanical support for silver halide crystals by holding them
uniformly dispersed in place
 Characteristics:
o Clear
o Sufficiently porous
o Flexible
 o Low atomic number (Z=7)

SILVER HALIDE CRYSTAL

 The active ingredient of the radiographic emulsion

 Size: 1 um
 Composition:
o Modern silver halide
 Silver bromide
 95% - 98%
 Silver iodide
 2%-5%
 Shapes: Tabular, cubic, octahedral, polyhedral or irregular, flat and triangular
 Characteristic:
o Negatively charged surface
o Positively charged interiors
o High atomic number (Z)
 Zbr: 35
 Zag: 47
 Zi: 53
o Physical imperfection (Sensitivity center/Specks)
 Not perfect shape and lattice structure (imperfection)
 Results in the imaging properties of the crystals
 Caused by: gold-silver sulfide
 Gold-silver Sulfide
o An impurity added to the SHC
 Sensitivity Center/Specks
o Serves as an electrode during latent image formation
o Physical imperfection in the lattice of the emulsion layer

C. ADHESIVE LAYER
 Substratum coating
 A thin coating material
 Purpose:
o Allows emulsion and base to maintain proper contact and integrity
during use and processing
o To glue the emulsion to the base
 Location: between the emulsion and base

D. BASE
 The foundation of radiographic film
 Purpose:
o To provide a rigid structure onto which the emulsion can be coated
 Composition: polyester (Z=7)
 Characteristics:
o Flexible and fracture resistance
o Dimensional stability
o Uniform lucency and transparent to light
 o Tinted with blue dye
 Thickness: 150-300 um

V. LATENT IMAGE
 Invisible or potential image

GURNEY-MOTT THEORY
 The accepted, incomplete, explanation of latent image formation
 Proposed by Ronald Wilfred Gurney and Nevill Francis Mott in 1938

FORMATION OF THE LATENT IMAGE ACCORDING TO GURNEY-MOTT THEORY

1 Remnant x-rays exit the patient
2 Remnant x-rays interact with the radiographic intensifying screen
3 Visible light energy is emitted
4 The incident light photon is absorbed by a bromine or iodide ion and ejects an electron
(Compton or photoelectron)
Note:
 The ejected electron has sufficient energy to travel a large distance within the crystals
 The bromine and iodine atoms are neutralized and migrate out into the gelatin portion of
the emulsion (remove from the crystal)
5 The ejected electron is trapped at the sensitivity center (becomes negatively-charged)
6 The negatively-charged sensitivity center attracts a free positively-charged silver ion
7 The silver ion neutralizes at the sensitivity center forming metallic silver
8 Repetition of the process deposits several silver ions at the sensitivity center (silver atoms
buildup)
9 Invisible or latent image is produced
Note:
 Most developable silver halide crystals collected 4-10 silver atoms at the sensitivity
center
CONVERSION OF LATENT IMAGE TO MANIFEST IMAGE
10 The developer provides electrons to the sensitivity center (film processing)
11 The negatively-charged sensitivity center attracts the remaining free positively-charged
silver ion
12 The silver ions are changed to metallic silver
13 Crystal with silver deposited at the sensitivity center are developed to black grain
14 Visible or manifest image is produced

VI. DARKROOM
 It is the area wherein the exposed films are being developed.
 It is a room devoid of all white light in which the processing cycle of the exposed film
takes place
 Location: In proximity/near to exposure room
 Size: 15ft x 9.5ft or greater - 200 radiograph/day
 Note: Darkroom MUST have a Wet and Dry Sections
o 4ft away from each other, to prevent contamination of the dry section
 Protects against radiation
o Darkroom can be adjacent to exposure room only:
  HOLLOW BLOCKS: Filled with cement
 CONCRETE: greater than 6 inches
 WOOD: with 1.6 mm Pb

DARKROOM ENTRANCES

 Single door
 Light lock or double door
 Labyrinth or maze
 Revolving door

A. SINGLE DOOR
 It is appropriate for small x-ray section wherein few persons only use the room
 The door must have an inside lock to prevent any accidental opening while working
on the said film

B. LIGHT LOCK OR DOUBLE DOOR

 It consists of small hall with two doors, an entrance to the darkroom and the other
will be used for exit
 The door must have a mechanical interlock so that it cannot allow the two doors to
open at the same time

C. LABYRINTH OR MAZE
 It is a zigzag hall way and without source of light which end up to the processing
room.
 This type of entrance has no doors; it provides air circulation yet it prevents the
entrance of white light.
 The walls and ceilings are painted with non-reflected paint and it will be illuminated
with white light and safelight

D. REVOLVING DOOR
 This is the best type of door which consists of master door and inside door
 The master door has two opening, one coming from the outside and other from the
inside of the darkroom. The inside door has only one opening

DARKROOM ILLUMINATION

 White light
 Safelight

A. WHITE LIGHT
 It is a form of fluorescent bulb or small bulb that gives enough light that we needed
to do such activities like cleaning the room, washing the tanks, mixing a solution,
placing film in the dryer and unloading films in the hanger
B. SAFELIGHT
 It is a lamp with color filters that provide sufficient illumination in the darkroom to
give enough visibility in the processing room for the handling and processing of x-ray
films
 The safelight must be mounted on the top of dry section. It should be no closer than
5 feet from the work surface.
 Consist of:
o Bulb (15-Watts)
o Filter

REQUIREMENT FOR SAFELIGHT FILTER

o Amber Filter (Kodak Wratten Series 6B Filter)

 Emits orange-brown light
 Use for blue sensitive film only
o Red Filter (Kodak GBX Filter)
 Emits dark-red light
 Suitable for both green and blue sensitive film

TYPES OF SAFELIGHTS

 Direct Type
o Is mounted on the dry side with the light emitted toward the area
 Indirect Type
o Directs the light towards the ceiling which reflects light back into the room

DARKROOM SECTION

 Dry Section
o Section wherein the first handling of films for loading and unloading of
cassette and film hanger which is being done
 Wet Section
o Section wherein the processing of exposed films is being done

COMPONENT OF DRY SECTION

 Loading bench
 Film bin
 Storage of hanger
 Storage compartment
 Cassette transfer cabinet or pass box
 Waste receptacle
 Storage cabinet

A. LOADING BENCH
 It is the primary component of the dry section
 This area is used for loading and unloading of film to the cassette and hangers
  Loading bench is a form of small table with a size of 28 inches long and 17 inches
width
 The height of the loading bench must be 3 feet

B. FILM BIN
 The film bin is located under the bench
 It is made up of metal with different divisions that coincide with the film size

C. STORAGE OF HANGER
 Film hanger storage should be placed above the loading bench so that it will be
easier to find if it will be used
 The hangers must be arranged into two parallel bars with the handle above
 Hanging bars should coincide to the different sizes of the films for convenient use

D. STORAGE COMPARTMENT
 A compartment mounted above the loading bench for the storage of unsealed boxes
of films
 It has also a side for the storage of cassette
 This storage compartment is an alternative storage if the film bin is not available

E. PASSBOX
 Also known as Cassette Transfer Cabinet
 A box which is divided into two, Exposed and Unexposed film
 A pass box is mounted through the wall between darkroom and exposure room

F. WASTE RECEPTACLE
 The waste receptacle must be placed close to the side of loading bench if you’re
using a film bin
 If not, it should be placed under the bench

G. STORAGE CABINET
 Storage cabinet must be placed on the side of the room, close to the loading bench
which is divided into two, the upper portion should contain of different film boxes
and the lower portion for storage of different solutions

COMPONENTS OF WET SECTION

 Automatic Processor
 Processing Tank
 Wash Tank
 Processing Hanger
 Interval Timer
 Thermometer
 Mixing Equipment
 Water Proof Apron
 Wet Film Brackets
  Film Dryer

A. AUTOMATIC PROCESSOR
 It is a machine which consists of different stages for processing and complete
procedure of the cycle

B. PROCESSING TANK
 A processing tank is used for manual processing and mounted on the opposite side
of loading bench to prevent any splash of solution on the loading area
 2 Parts of Processing Tank:
o Master Tank
 It serves as jacket to hold the inserted tanks and usually provides a
space between the inserted tanks for rinsing and washing films
o Insert Tank
 It is a removable container for individual solutions and is placed in a
jacket of the master tank. It is made up of stainless steel or hard
rubber plastic

C. WASH TANK
 It is a second type of tank with the same size as the processing tank
 Washing is separated in the master tank if the water between the developer and
fixer is use only for stop bath or rinsing
 2 Types of Wash Tank
o Single Compartment
 This type of wash tank permits rapid washing in which fresh water is
circulated across the film surfaces
o Cascade Wash Tank
 The size of the tank is also the same as the single compartment; the
difference is that it has two divisions: The first stage is for initial
washing and the second stage for final washing

D. PROCESSING HANGER
 It is a stainless metal with clips used to hang-up films when it’s subject for processing
E. Interval Timer
 Is used to regulate the period of development of the exposed film
 It controls the degree of imaged produced.
F. Thermometer
 It is a device used to regulate the temperature of the solution to acquire the
accurate functions of the chemical components
G. Mixing Equipment
 In mixing solutions, we need two sets, one for developer and the other for fixer
solution. A plastic funnel is used to allow a solution easily poured and stainless steel
or paddle for stirring the solution thoroughly
H. Water Proof Apron
 It is made up of plastic gown or cloth that should be worn while processing to
prevent a solution stain in uniform if accidentally splash will happen
 I. Wet Film Brackets
 A receptable with a drainage hole used for hanging wet films to drain the excess
water on the film surface before placing on the dryer
J. Film Dryer
 Consists of heating element and blower to blow the air towards the film surface.

VII. FILM PROCESSING

 The term applied to the chemical reactions that transform the latent image into a
visible/manifest image.
 Convert remaining silver ions in the exposed silver halide crystal into microscopic
black grains of silver.

PROCESSING SEQUENCE

PROCESSING SEQUENCE
WETTING 15 s
DEVELOPING 5 min
STOP BATH/RINSING 30 s
MANUAL FIXING 15 min
WASHING 20 min
DRYING 30 min
DRY-TO-DROP TIME 1 hr 10 min 45 s
DEVELOPING 22 s
FIXING 22 s
AUTOMATIC WASHING 20 s
DRYING 26 s
DRY-TO-DROP TIME 90 s

A. WETTING

 The first step in the processing sequence.

 Used to swell the emulsion
 Manual: 15 seconds
 Automatic: incorporated in the developing

B. DEVELOPING

 The stage of processing during which the latent image is converted to a visible image
 Produces a visible image from the latent image
 Manual: 5 minutes
 Automatic: 22 seconds
 Note: only crystals that contain a latent image are reduced to metallic silver by the
addition of developing agents.

C. STOP BATH/RENSING

 Designed to stop or terminate developing process

  Removes excess chemical from the emulsion
 Manual: 30 seconds
 Automatic: incorporated in the fixing

D. FIXING

 Removes the remaining or unexposed silver halide from the emulsion

 Hardens gelatin portion of the emulsion
 The process of clearing the unexposed silver halide from the emulsion
 Manual: 15 minutes
 Automatic: 22 seconds

E. WASHING

 Removes any remaining or excess chemicals from the previous processing steps
 Manual: 20 minutes
 Automatic: 20 seconds

F. DRYING

 Removes water used to wash it

 Prepares the radiograph for viewing
 Makes the film acceptable for handling and viewing
 Manual: 30 minutes
 Automatic: 26 seconds

PROCESSING CHEMISTRY

COMPONENTS OF THE DEVELOPER

 Developing agent
 Activator
 Restrainer
 Preservative
 Hardener
 Sequestering agent
 Solvent

A. DEVELOPING AGENT (Reducing Agent)

 FUNCTION:
o The chemical responsible to reduce the silver ion to metallic silver
 CHEMICAL:
o Hydroquinone
o Phenidone
o Metol
o Elon
B. ACTIVATOR (Buffering Agent)
 FUNCTION:
o Maintain Alkalinity (enhance the action of the reducing agent)
o Helps swell gelatin (to assists the reducing agents)
 CHEMICAL:
o Sodium carbonate
o Potassium carbonate
o Sodium hydroxide (Lye)
o Potassium hydroxide

C. RESTRAINER (Antifogging Agent)

 FUNCTION:
o Decreases activity of developing agent
o Restrict the action of the developing agent to only exposed silver halide
crystals
o Protects unexposed crystals from chemical attack
 CHEMICAL:
o Potassium bromide
o Potassium iodide

D. PRESERVATIVE (Buffer Agent)

 FUNCTION:
o Controls aerial oxidation
 CHEMICAL:
o Sodium sulfite

E. HARDENER (Tanning Agent)

 FUNCTION:
o Controls swelling and softening of the emulsion
o Maintains uniform film thickness
 CHEMICAL:
o Glutaraldehyde

F. SEQUESTERING AGENTS
 FUNCTION: Removes metallic impurities
 CHEMICAL:
o Chelates

G. SOLVENT
 FUNCTION: Dissolves chemicals for use
 CHEMICAL:
o Water

COMPONENTS OF THE FIXER

  Activator
 Fixing agent
 Hardener
 Preservative
 Buffer
 Sequestering agent
 Solvent

A. ACTIVATOR
 FUNCTION:
o Provides an acid medium (acidic pH) and neutralized the developer
(Alkalinity) carried over on the film
 CHEMICAL:
o Acetic acid

B. FIXING AGENT
 FUNCTION:
o Removes unexposed and undeveloped silver halide crystals from the
emulsion
 CHEMICAL:
o Ammonium thiosulfate
o Sodium thiosulfate (Hypo)

C. HARDENER
 FUNCTION:
o Stiffens and shrinks the emulsion
 CHEMICAL:
o Potassium alum
o Aluminum alum
o Chromium alum
o Aluminum chloride

D. PRESERVATIVE
 FUNCTION:
o Needed to maintain the chemical balance
 CHEMICAL:
o Sodium sulfite

E. BUFFER
 FUNCTION:
o Maintain proper pH
 CHEMICAL:
o Acetate

F. SEQUESTERING AGENT
 FUNCTION:
o Removes aluminum ions
  CHEMICAL:
o Boric acid
o Salts

G. SOLVENT
 FUNCTION:
o Dissolves other components
 CHEMICAL:
o Water

VIII. ARTIFACTS
 Film artifacts are a mark which is foreign to the radiographic image and not
necessarily imposed by the action of x-rays
 Undesirable optical densities or blemishes on a radiograph or any other medical
image
 Disadvantage:
o Interfere with the visualization of anatomical structures
o Can lead to misdiagnoses
 Occurs in three areas:
o During radiographic exposure
o During processing of the film
o During handling and storage of film

EXPOSURE ARTIFACTS

 Associated with the manner in which the radiographer conducts the examination

COMMON EXPOSURE ARTIFACTS

Appearance on the Radiograph Cause
Unexpected foreign object Improper patient preparation
Double exposure Reuse of cassettes that already exposed
Blur Improper patient movement
Grid cutoff Improper patient positioning
Obscured detail Poor screen-film contact

PROCESSING ARTIFACTS

 Any artifacts produced during processing

COMMON PROCESSING ARTIFACTS

Appearance on the Radiograph
Guide shoe marks
Pi lines
Sharp increase or decrease in OD
Uniform dull, gray fog
Dichroic stain or “Curtain effect”
Cause
Improper position or springing of guide shoes in
turnaround assembly
Dirt or chemical stains on rollers
Dirty or warped rollers, which can leave sludge
deposits on film
Improper or inadequate processing chemistry
Improper squeezing of processing chemicals

Small circular patterns of increased in OD
Yellow-brown drops on film
Milky appearance
Greasy appearance
Brittle appearance
from film
Pressure caused by irregular or dirty rollers
Oxidized developer
Under replenished fixer
Inadequate washing
Improper dryer temperature or hardener in the
fixer

HANDLING AND STORAGE ARTIFACTS

 An artifact caused by improper handling and storage of film

COMMON HANDLING AND STORAGE ARTIFACTS

Appearance on the Radiograph Cause
Image fog Temperature or humidity is too high (>60%)
Film bin is not shielded adequately from
radiation
Pressure marks Film is stacked too high
Light or Radiation fog White-light leaks in the darkroom
White-light leaks within the cassette
Improper safelight filter
Improper safelight distance (4 feet)
Improper safelight wattage (15-watts)
Scratches or Kink marks Improper or rough handling before processing
Static Buildup of electron in the emulsion
Temperature or humidity is too low (<40%)
Three distinct patterns:
Crown
Tree
Smudge
Hypo Retention Inadequate washing