Principles of Projection

Radiography
 X-rays
• X-rays is electromagnetic radiation.

2
 Reducing patient dose is
important, but the image quality
also is essential.

Thus, optimize QC testing is

crucial to improve clinical image
quality and reduce patient
radiation exposure.

3
 Production of X-ray
• Involves the bombardment of a target with energetic electrons.
• Electrons undergo collisions and scattering processes during the
slowing down process which results in the production of
– Bremsstrahlung and
– Characteristic Radiation

4
 Production of X-ray
• Energetic electrons are mostly slowed down in matter
by:
▪ Collisions and
▪ Excitation interactions

5
 Production of X-ray
❑ The energy of the emitted photon is
subtracted from the kinetic energy of the
electron.
❑ Bremsstrahlung depend on
• Attractive Coulomb forces
• Distance of the electron from
the nucleus

6
 Production of X-ray
• Electron bombardment on target yields a constant energy fluence (Ψ)
from zero up to the initial electron kinetic energy (T).
• The superposition from rectangular distributions forms a triangular
energy fluence distribution for a thick target, known as Ideal Spectrum.

7
 Production of X-ray
According to this model
• An increase in electron energy increases the number
of thin layers each radiating X rays
• The triangular area grows proportional to the square
of the electron energy

Therefore, the Radiation Output of an XRT is

proportional to U2

8
 Production of X-ray
• Characteristic radiation
• Fast electron knock-out electron
(atomic shell)
• The KE > BE of atomic electron
• Vacancy shell filled out higher
energy state.
• During the transition, an X-ray
photon is emitted.
The binding energy is Highest in the most
inner K-shell and decreases for the outer
shells (L, M, ..)

9
 Production of X-ray
• For each element binding energies and the Monoenergetic radiation
resulting from such interactions, are unique and Characteristic for that
element

Instead of characteristic radiation the energy available could be

transferred to an electron which is ejected from the shell (Auger
Electron) - production probability decreases with Z

10
Production of X-ray
a) Ideal Bremsstrahlung
spectrum for a tungsten
anode
b) An actual spectrum at the
beam exit port with
characteristic X rays
(anode angle: 20°, inherent
filtration: 1 mm Be)
c) The spectrum filtered with
an equivalent of 2.5 mm Al

11
 Production of X-ray
❑ The Mass Stopping Power of electrons is proportional to
Z².
❑ Integration along the electron path gives the total X ray
energy fluence as
 I .Z .U 2

where I: electron current and U: tube voltage

❑ If a high Bremsstrahlung yield is required, metals with high
Z are preferable
**Tungsten (Z=74) is commonly chosen as it also withstands high
temperatures (2757°C at 1.3∙10-2 Pa vapour pressure)

12
 X-ray Tube

Principle components of an X ray tube are an

▪ Electron source from a heated tungsten filament
▪ Focusing cup serving as the tube Cathode
▪ an Anode or Target and
▪ a Tube Envelope to maintain an interior vacuum.

13
 X-ray Tube
❑ There are two main circuits operate within the XRT:
• Filament circuit
• Tube voltage circuit
❑ The Filament is heated by a current that controls the
thermionic emission of electrons (Tube or Anode
Current)
e.g. <10 mA in fluoroscopy and 100 to >1000 mA in single exposures

❑ The accelerating Potential Difference applied between

cathode and anode controls both X ray energy and yield
e.g. 40 to 150 kV for general diagnostic radiology and 25 to 40 kV in mammography

14
 X-ray Tube (Cathode)
• The arrangement of tube (filament, focusing cup, anode) generates an
electric field to accelerate the electron.
• Biasing and unbiased focusing cup leads to a compression of the
trajectories giving a smaller focus and broad focus.

15
 X-ray Tube (Cathode)
• The spiral-Wound filament is
typically made from tungsten wire
of 0.2 to 0.3 mm diameter and
operates at around 2700o K.
• Thermionic emission of electrons
increases with temperature
(Richardson’s law) and produces a
cloud of electrons (Space Charge)
enclosing the filament.

−W
J = AGT e 2 kT

16
 X-ray Tube
Space Charge shields the filament from the anode voltage.

Anode current IA vs.

filament current If for
various anode voltages UA
showing space-charge
limited anode currents for
the lower tube voltages.

17
 X-ray Tube

❑ Tube current IA vs. tube

voltage UA depending
on filament current If

Note: current saturation occurs for

the lower filament currents

18
 X-ray Tube (Anode)
• Stationary anodes
– Usually for low anode current or infrequent low power exposures (e.g
dental units, portable X-ray)
– Here small tungsten is brazed to copper block to dissipate the heat
efficiently
– The maximum loading for stationary focal spot is determined by anode
temperature and temp gradients.

19
 X-ray Tube
• The continuous bombardment to the anode will led to melting and
destruction of anode target (which reduce the fluence).
• Require dissipation of the energy into much larger volume.
• The rotating anode is introduces to increase the target area (the
circumference of focal tract)

• The anode disk is

• fixed to a Rotor
• asynchronous Induction
Motor
• Speed between (9000-
10000 rpm)

20
 X-ray Tube
❑ The Limiting Factor in the use of X ray tubes is given mainly by the
thermal loading capacity of the anode

Maximum Permissible
Tube Load vs. time for
a single exposure,
constant current.
(100 kV tube voltage
and a 50-kW tube)

Q = m  C p  T

21
 X-ray Tube (Housing)
❑ The XRT (often referred to as the Insert) is installed in a
Housing providing the structural support required
• Typical housing assembly for
a general purpose XRT.
• The housing also provides
i. Radiation Shielding -
prevent any radiation
except the primary
beam from leaving the
housing
ii. Lead Sheets - to
minimize leakage
radiation

22
 X-ray Tube (Filtration)
• Filtration, is the removal of x-rays as the beam passes
through a layer of material.
• Basically
– Inherent filtration (SiO2, Z=14 which attenuate 15 keV X-rays)
– Added filtration (Al, filtered the low-energy X-rays)
• At a given kVp, added filtration increases the HVL.

 
=  Wi ( )i
0.693 ⎯⎯ →
HVL = ⎯⎯
   

23
 X-ray (Generator)
Generally, the essential components are:
▪ a Filament Heating circuit to determine anode current
▪ a High Voltage supply
▪ a Motor Drive circuit for the stator windings required for a rotating
anode tube
▪ an Exposure Control providing the image receptor dose required
▪ an Operational Control

25
 X-ray (Generator)

Schematic diagram of a basic X ray system

26
X-ray (Generator)

27
 X-ray (Generator)
• The Operational Control is often accomplished by a
microprocessor system, but electromechanical devices
are still in use.
• Modern generators provide control of the Anode
Temperature by
▪ Monitoring the power applied to the tube and
▪ Calculating the cooling times required according to
the tube rating charts

28
 X-ray (generator)
❑ Irrespective of the waveform the tube voltage is defined
as the Peak Voltage, kVp, of the voltage train
– The Voltage Ripple, R, is given as the relative difference of the
minimum voltage, kVmin, from the peak voltage:

2Vac 2 kVp − kVpmin

Vripple − rms = −1 Vripple =
 8 kVp

• The tube voltage is supplied Symmetrically to the tube,

i.e. a net potential difference of 150 kV is achieved by
feeding -75 kV to the cathode and +75 kV to the anode

29
 Tube Voltage
• Single-phase generators
• Step-Up Transformer with a fixed
winding ratio.
• Half-Wave Rectification gives a 1-
Pulse waveform
• pulse is a half-wave per period of
frequency (50 or 60 Hz)
• Three phase
• mains supply three AC-voltages
each with a Phase-Shift
• Full-Wave Rectification
• 6 half-waves per period (6-Pulse
waveform) with a nominal ripple of
13.4%
 Tube Voltage
High-frequency generators, stabilized the power supply in the front end
of the device
i. rectified and filtered AC to produce a DC-supply voltage for Inverter
Circuit.
ii. Inverter transformed, rectified the pulse
iii. Capacitor collect the pulse to give higher voltage.
iv. Inverter Pulse Rate is used to control the tube voltage.

The Voltage Ripple for

low-power applications
is typically ~13%,
dropping to ~4% at
higher currents.

31
Tube Voltage

32
 Exposure Timing (AEC)
• Most of the system employed digital timers
– High reproducibility
– Accuracy of microsecond
– The timer activates and terminates a switch
• The accuracy of X-ray exposure time depend on the
switches.
• The countdown timer is used to terminate exposure
when the exposure switch failure.

33
 Exposure Timing (AEC)
• Switches for three phase and constant potential
generators, known as triode, tetrode and pentode.
– To initiate and terminate the exposure
– Control by the electronic timer or photo timer
• Most of high-frequency generator utilize electronic
switching.
• Alternatively, a grid can be used to any generator to
switch the exposure.

34
 Exposure Timing (AEC)
• Phototimer
• Use to measure the actual amount of radiation incident on the
image receptor (e.g., screen-film detector)
• terminate x-ray production when the proper amount is obtained.
• Phototimer consist of
• Radiation detectors
• Amplifier
• Density selector
• Comparator circuit
• Termination switch
• Backup timer

35
Exposure Timing (AEC)

36
Exposure Timing (AEC)
• Falling load generator works
simultaneously with AEC
system.
• The falling-load allows
maximum possible mA for the
selected kVp, by considering
the heat load characteristics
of X-ray tube.
• 50 mAs of 80 kVp (400 mA
with 125 msec) ~initially 600
mA, with 50 mAs in 100
msec)

37
 Factors Affecting X-ray
• The output of X-ray is based on terms quality,
quantity and exposure.
– Quality describes the penetrability of an x-ray beam,
with higher energy x-ray photons having a larger HVL
and higher "quality.“
– Quantity refers to the number of photons comprising
the beam.
– Exposure, is nearly proportional to the energy fluence
of the x-ray beam and therefore has quality and
quantity associated characteristics.

38
 Factors Affecting X-ray
• The quality, quantity and exposure can be
determined by six major factors
i. Anode target “affects the quantity of
bremsstrahlung photons and the quality of the
characteristic radiation”.
ii. Tube voltage (kVp) “determines the quality of
spectrum, the efficiency and exposure of X-ray

Exposure  kVp 2

39
• The quality, quantity and exposure can be
determined by six major factors
iii. Tube current (mA) “the exposure and filtration is
proportional to the tube current”.
iv. Exposure time “duration of X-ray production and
proportional to the product of tube current and
exposure time (mAs)
v. Beam filtration “modifies the quantity and quality of
X-ray beam, by removing the low energy photons”
vi. Generator waveform “ a single phase has lower
potential difference compared to three phase or high
generator frequency. Both quality and quantity are
affected.

40
 Detector Image System
(Image Formation)
• X ray imaging is the collection of attenuation shadows that are
projected from an ideal X ray point source onto an image receptor
• This simple form is true for all X ray imaging modalities, including
complex ones that involve source and receptor movement such as
CT.
• This simplified view however is made vastly more complex by:
– the Non-Ideal point source
– the consequences of Projecting a 3D object onto a 2D detector
– the presence of Scattered Radiation, generated within the patient, which will
degrade any image that is captured

41
 Detector Image System
(Image Formation)
• The principal components of a system for X ray
projection radiography:

42
 Detector Image System
(Image Formation)
• The X ray intensity is related to thickness by the
attenuation law, therefore the Primary Contrast:

where:
xd: thickness of the detail
μd: linear attenuation coefficient of the
detail
μb: linear attenuation coefficient of the
background material

43
 Detector Image System
(Image Formation)
Energy absorbed in a small region of the image receptor:
Ep: energy absorbed due to primary rays
Es: energy absorbed due to secondary rays

• Scatter may be quantified by:

Scatter Fraction S = Es
E p + Es
f

Es
Scatter to Primary Ratio Sp =
Ep

“The relationship between the two is

S f = ( S p −1 + 1) −1

44
Components of an Imaging System
• In the presence of scattered radiation, the Primary
Contrast equation becomes

• The primary effect of projection radiography is to record

an image of a 3D object (the patient) in 2D, resulting in
superposition of the anatomy along each ray
• This leads to several effects that need to be considered
in:
• the Design of equipment
• the Production of the images and
• their Interpretation
45
 Effect of Tube Voltage on Contrast,
Noise & Dose
• With screen-film systems, technique selection is
relatively straightforward:
• The choice of kV setting is based largely on the required
contrast
• the mAs is chosen to produce a suitable optical density for
the region of clinical interest
• To determine whether a detail will be detectable in the image,
Noise must be considered.
• The primary source of noise is generally the random arrival of
photons at the image receptor, a Poisson process

46
 Effect of Tube Voltage on Contrast,
Noise & Dose
• In digital systems the choice of suitable kV and mAs
combinations requires that for each projection:
• the kV and mAs produce the correct value of the EI and that
• the maximum value of the kV is chosen that will allow
diagnostically acceptable CNR
• If a suitable phantom is radiographed at a low kV with
suitable mAs, and a range of further images is obtained
at increased kV settings at the same mAs, the images
will appear very similar.

47
 Scattering In Projection Radiography
• It is often stated that photon Scattering is of no benefit
for projection radiography, leading only to fogging of the
image.
• However, this is incorrect, as the appropriate contrast for
each projection is chosen by setting a suitable kV to
provide the Correct Proportion of photoelectric and
scatter interactions.
• At low kV settings the contrast is high, due to the
predominance of the Photoelectric Effect, while at high
kV it is low, due to the predominance of Scattering
interactions.

48
 Scattering In Projection Radiography
These effects are illustrated below - showing the
contribution of photoelectric and scattering interactions for
the primary contrast of a 1 mm sphere of calcium
embedded in water, calculated over a range of energies
from 20-100 keV

Calculated

49
 Origins of Scattered Radiation

• Both the Incoherent and Coherent interactions lead to

scattered radiation impinging on the image receptor
• The former is by far the more significant for example
– for a 10 cm patient thickness and a 20 x 20 cm2 X ray field only
19% of the scatter fraction is due to coherent scatter at 50 kV
and 9% at 120 kV.

50
 Magnitude of the scatter

• The magnitude of the scatter depends on many variables

• Radiographic procedure,
• X ray beam size,
• Patient thickness and
• Position in three-dimensions
• The magnitude is also widely claimed to depend on the
kV setting, but as shown here, this is the case only for
very inefficient image receptors

51
 Magnitude of the scatter
Dependence upon Radiographic Procedure
• The radiographic procedure itself has a strong influence
on the proportion of scatter, depending on whether the
subject is a region consisting largely of bone, or soft
tissue, or some intermediate combination.
• This is because the scatter interactions are predominant
for soft tissue, but the photoelectric interaction is
predominant for bone over much of the diagnostic
energy range (except mammography).

52
 Magnitude of the scatter
Dependence on Field Size
As the field size increases from a narrow beam with almost no
scatter to very large, the Scatter Fraction increases until a
saturation level is reached, beyond which little or no further
increase in scatter fraction occurs

Dependence of scatter
fraction on beam area for four
phantom thicknesses at 80 kV

53
 Magnitude of the scatter
Dependence on Thickness
The Scatter Fraction increases rapidly with patient
thickness, but tends to saturate for very large patients

Dependence of scatter
fraction on phantom thickness
for four X ray field sizes at 80
kV

54
 Magnitude of the scatter
Dependence on Position (in 3D)
• the Scatter Fraction (at the image receptor) has been
considered so far, it is also important to quantify the
scattered radiation in all directions from the patient, as
this affects the dose to Personnel
• Knowledge of scatter levels is required in order to
determine appropriate Radiation Shielding levels
• Scatter may be categorized as forward scatter and side
and back scatter

55
 Magnitude of the scatter
Dependence on Energy
• Conversely, the energy of the scattered photons
increases as the energy increases
• So that they are less likely to be attenuated in the body
and are more likely to escape
• The overall effect is that side-scatter, back-scatter and
forward- scatter all increase as energy is increased
• However, the primary beam attenuation also decreases
as energy is increased

56
 Effect of Scatter
The Effect of Scatter: Noise
• The Quantum Noise in the image arises from both
primary and scattered photons
• Both of these image contributions therefore affect the
SNR
• Digital chest imaging with a grid shows that SP varies
between
• ~2 in the region of the mediastinum to ~0.6 in the lung fields
• leading to a value of SNR per pixel behind the mediastinum
of ~20, and in the lung fields ~60

57
 Methods for Scatter Reduction
Anti Scatter Grids
• The scatter component of the image may be considered
to consist of the primary image convolved with a Scatter
Spread Function which gives a highly blurred version of
the image
• The resulting image may be considered to be the Sum of
these two images
• Efforts are being made to employ this idea for
Computerized Scatter Removal, rather than using grids
or other methods

58
 Methods for Scatter Reduction
Grid Construction

Apart from the Special cellular grids used in some

mammography systems, a grid generally consists of an
array of Thin Lead Strips aligned to allow:
• Passage of the primary beam, but
• Interception of most of the scattered photons

The lead strips are separated by an Interspace Material

and have protective covers on the top and bottom

59
 Methods for Scatter Reduction
Grid Construction

Construction and
principle of operation
of a focused anti-
scatter grid (not to
scale)

60
 WHY QUALITY CONTROL (QC)?

01 Because quality is a required necessity

of medical care.

02 Because the actual clinical performance

of an imaging system can never be fully
assured with a priori knowledge and
actions.
What is "Advanced" Quality Control?

Providing the needed

information for the
01 clinical task at the
QC informed by the highest possible safety
purpose of the
radiography
examination
Improving the
02 precision
(consistency) in
radiographic delivery
RADIOGRAPHY TEST
RADIOGRAPHY TEST
WHAT IS ADVANCED IN QUALITY CONTROL?
WHAT IS ADVANCED IN QUALITY CONTROL?
 Precision by inference
Technology assesment

Precision by prescription Precision by outcome

Prospective use definition Retrospective qulity audit
 Clinical Physic Support in Radiography

PROSPECTIVE SYSTEM SELECTION AND ASSURANCE

• Intrinsic performance and specification evaluation

• operational performance evaluation

TASK-BASED SYSTEM CHARACTERIZATION AND

OPTIMIZATION
• Prospective use optimization
 Clinical Physic Support in Radiography

ASSURANCE OF SYSTEM QUALITY IN PRACTICE

• System performance monitoring

• Patient-based performance monitoring
Operational Performance Evaluation:

• Proper testing condition

Characterizing a system in settings
in which is going to be used
 MOST COMMON CLINICAL TECHNIQUES
SETTINGS

Survey of Multimodal Indicates how Used to

246, 259 DX distributions tubes (AEC) improve
exams are most often clinical
used relevance of
physics tests
Operational Performance Evaluation:

2. System-level
assessment
Including components of the system
that affect the eventual quality:

• Grid
• AEC
• Post-processing
 ANTI-SCATTER GRID

01 Acceptance testing
• Grid ratio verification
• Grid focus verification
• Primary and scatter transmission verification

02 Grid uniformity analysis

03 Grid damage assesment

04 Informing technique charts

 System as opposed to detector alone

• Testing a detector is half of the story

• Our testing strategy needs to extend beyond the detector to

system including:
• Scatter
• Anti-scatter grid
• Focal spot blur
• Out of focus radiation
 Summary
• X-rays are the basic radiologic tool for a majority
of medical diagnostic imaging procedures.
• Knowledge of x-ray production, x-ray
generators, and x-ray beam control is important
for further understanding of the image formation
process and the need to obtain the highest
image quality at the lowest possible radiation
exposure.

76
 Methods for Scatter Reduction
Grid Construction
• Scattered photons whose angle of incidence is less than
tan-1 r will hit a lead strip, so that scatter rejection will
increase with increasing grid ratio

• On the other Hand, the transmission of primary photons

through the grid will decrease because of the increased
thickness of the interspace

• If the Lead Strips are too thin, they can be penetrated by

the scattered X-ray photons and if they are too thick,
they will stop too many primary photons
77
 Methods for Scatter Reduction
Grid Construction
The design of the grid is a Compromise between the
requirements of:
• Good Scatter Rejection
• High Primary photon Transmission

Usually the lead strips are Tilted to match the Divergence

of the primary beam, at a chosen distance from the focus
called the Focal Length of the grid. The grid is then referred
to as a Focused Grid. Such grids must be used at the
correct focal distance within a permissible tolerance

78
 Methods for Scatter Reduction
Grid Construction
TYPICAL CONSTRUCTION DATA FOR THREE ANTI-SCATTER GRIDS

79
 Methods for Scatter Reduction
Measures of Grid Performance

Grid Performance is specified in terms of parameters which

relate to:
• the associated Dose Increase which is necessary
• the Improvement in Contrast which is achieved

A Good grid will:

• Eliminate 80-90% of the scatter
• Transmitting at least 75% of the useful beam

80
 Methods for Scatter Reduction
Measures of Grid Performance

The Grid Factor or Bucky Factor (BF) is the dose increase

factor associated with the use of the grid:

The Selectivity is a measure of the effectiveness of the grid,

given by:

81
 Methods for Scatter Reduction
Measures of Grid Performance
The Contrast Improvement Factor is given by:

It should be noted that as well as removing scatter, the grid

will Harden the X ray beam and calculations of the CIF,
should in principle allow for this effect - usually no more
than a few per cent - and to a good approximation, the CIF
can be calculated as: where, SFg and SFng are the
scatter fractions with and
without the grid
82
 Methods for Scatter Reduction
Grid Selection
• Each radiographic projection there is an optimum grid
ratio that will provide adequate scatter projection, with
acceptable increase in dose to the patient

• Practically however, the grid is permanently fitted to the

cassette holding device in radiographic tables and wall
mounted devices,

83
 Methods for Scatter Reduction
Grid Artefacts & Alignment
• There are several possible Misalignments that will lead
to Artefacts in projection images
• Additionally, a Damaged grid will generate artefacts and
must be replaced

84
 Methods for Scatter Reduction
Grid Artefacts & Alignment
Possible misalignments of
the grid:

In practice it is possible for

a number of these to be
present at once

Note that the moving grid is

laterally De-Centred during
operation, although the
degree of offset is small on
average

85
Other Methods for Scatter Reduction

While the use of a grid is effective at reducing scattered

radiation, image quality may be further improved by:
• Careful Collimation and
• Patient Compression

Alternatives to anti-scatter grids include the use of

• Air Gaps
• Slit Scanning Systems

86
Other Methods for Scatter Reduction
Collimation
Since smaller Field Sizes reduce the scatter fraction, it is
good practice to collimate the X-Ray Beam to as Small an
Area as Possible for Each Projection. It also helps to:
• improving image quality
• reducing patient dose

This process requires:

• Good Knowledge of anatomy
• Good Judgment of the wide variety of patients by
Radiographers

87
Other Methods for Scatter Reduction
Compression
• Scatter Fraction increases with Patient Thickness
• Therefore, if the patient thickness can be Reduced
during exposure by applying a Compression Band for
example, then the amount of scatter will be reduced
• This has further benefits, because a Shorter exposure
time can be used, reducing movement blur and patient
dose
• Alternatively, the kV setting may be reduced, improving
the contrast, or SNR in the image

88
Other Methods for Scatter Reduction
Air Gap

The use of an increased OID, or Air Gap, results in:

• Magnification and a
• Reduction in scatter fraction

This is because the Divergent scattered rays:

• Will be increasingly less likely to strike the image receptor as
the OID is increased and are therefore
• Much less likely to strike the image receptor than the primary
rays

89
Other Methods for Scatter Reduction
Air Gap

Xp is the source to patient exit

distance PMMA phantom of 20
cm thickness, X ray field size of
20 x 20 cm2, 90 kV

Effect of the Air Gap on Scatter Fraction:

90
Other Methods for Scatter Reduction
Scanning Slit
Scatter Fraction depends on the X ray Field Size

Slot Scanning systems take advantage of this to minimize

the scatter fraction by using a very small area x-ray field
with a slit aperture, which must be scanned across the
patient to produce the image

Such systems generally feature a

• Pre-Patient Collimator to define the fan-shaped beam
• Post-Patient Collimator to intercept any scattered radiation
produced
91
Other Methods for Scatter Reduction
Scanning Slit
These systems are capable of
good scatter rejection without
the necessity for a grid, but
require Smooth and precise
movement of the collimator
systems and Stable X ray
generator performance

There is increased probability of artefacts compared to conventional

methods, and the longer exposure time required increases the risk of
movement blur in the images and will reduce the life of the XRT

92
 Image Quality Assurance
• The preemptive measures taken to improve the quality of
treatment and services while being cost-effective are
characterized as quality assurance or quality
improvement.

• Radiographic image quality includes factors such

as contrast, dynamic range, spatial resolution, noise, and
artefacts.

93
 Image Quality Assurance
Contrast:
• A radiographic contrast is a subtle difference in signal strength or
brightness between an object of interest and its environment.

Dynamic range:
• The range of different X-ray intensities that the detector can capture
is known as the dynamic range.

Spatial resolution
• The scanning system's spatial resolution is its capacity to tell apart
similar structures from one another.

94
 Image Quality Assurance
Noise
• The variations in an image that are random or structured that do not
resemble the variations in an object's X-ray attenuation are known
as radiographic noise.

Signal to noise ratio (SNR)

• A significant statistic that incorporates the impacts of contrast,
resolution, and noise is the signal to noise ratio.

Artifacts:
• Poor image quality is a result of artifacts as well as low resolution,
noise, and SNR.

95
 Image Quality Assurance
Noise
• The variations in an image that are random or structured that do not
resemble the variations in an object's X-ray attenuation are known
as radiographic noise.

Signal to noise ratio (SNR)

• A significant statistic that incorporates the impacts of contrast,
resolution, and noise is the signal to noise ratio.

Artifacts:
• Poor image quality is a result of artifacts as well as low resolution,
noise, and SNR.

96
 Image Quality Assurance
Factors affecting image quality

• Beam energy and kVp-The energy spectrum of an X-ray

beam is used to form the images.
• Tube current - the total number of photons impinging on
the patient in the image formation
• Image acquisition geometric factors affecting image
quality include a source to image receptor distance,
orientation, the amount of magnification, and size of the
focal spot.

97
 Image Quality Assurance
Factors affecting image quality

• Magnification rises with a decrease in scatter radiation

due to an increase in the air gap or patient to image
receptor distance, improving picture contrast and noise.
• The focal spot size-The relationship between the spatial
resolution and the size of the X-ray tube focal spot is
inverse.
• The detector performance influenced by the detector's
resolution, element size, and SNR characteristics.

98
 Image Quality Assurance
Factors affecting image quality

• Collimation is the process of limiting the spatial extent of

an X-ray beam as it impacts the in between
the patient and detector's region of interest.
• The anti-scatter grid reduces dispersed radiation,
enhancing image quality.
• Image processing - After digital picture acquisition, post-
processing techniques can be used to artificially modify
the contrast to increase visual perception.

99
 Image Quality Assurance
Clinical Significance
• The radiation dose required to produce high-quality
digital radiographs can be reduced by changing kVp,
mAs, and focal spot size. Even though a larger radiation
dose results in less noise and improved image quality,
the patient should still be exposed to minimal radiation.

• To achieve consistently great image quality at the lowest

feasible radiation dose, the best imaging methods should
be created and established with the assistance of a
medical physicist.

100
 Image Quality Assurance
Clinical Significance

• For continually maintaining high-quality performance, a

thorough quality assurance procedure is necessary.
• Under the supervision of the medical physicist, monthly
checkups and maintenance assessments, as well as
comprehensive annual inspections, should be performed
to monitor the image quality.

101
TERIMA KASIH / THANK YOU
www.upm.edu.my