Radiographic Technique

2
Ysmael O. Alip, RRT
 Image quality
• refers to the fidelity with which the anatomical
structures that is being
examined is rendered on the radiograph.
• A radiograph that faithfully reproducesstructure and
tissues is identified as a high-quality radiograph.
 Characteristics of image quality
• Contrast resolution
• Spatial resolution
• Noise
• artifacts
 Resolution is the ability to image two separate objects
and visually distinguish one from the other.

• (1) Spatial resolution – ability to image small objects that

have high subject contrast
• sharpness of image detail
• High subject contrast
• Eg. - Bone-soft tissue
- Breast microcalcification
- -calcified lung nodule
Note: Spatial resolution
improves as screen blur
decreases, motion blur
decreases, and geometric
blur decreases.
• (2) Contrast resolution – ability to distinguish anatomical
structures of similar subject contrast
• visibility of image detail Note: The actual size of objects that
• Low subject contrast can be imaged is always smaller under
• Eg. -Liver and spleen conditions of high subject contrast
than under conditions of low subject
-Gray and white matter contrast.
 Detail and Recorded Detail
the less precise terms that is sometimes used to refer as spatial resolution and
contrast resolution
Refer to the degree of sharpness of structural lines on a radiograph.
Visibility of detail – refers to the ability to visualize recorded detail when
image contrast and optical density are optimized
 Noise – random fluctuation in the OD of
the image

• 4 components of radiographic noise: Note: The use of high-mAs,

• (i) Film graininess – distribution in size and low-kVp and of slower image
space of the silver halide crystal
receptors reduces quantum
• (ii) Structure mottle – refers to phosphor of
the I.S. mottle.
Note: lower noise results
• (iii) Quantum mottle – principal contributor in a better radiographic
of image noise
image because it
• (iv) Scattered radiation – principal source
improves contrast
resolution
 Factors affecting image quality

• Film factors
• Geometric factors
• Subject factors
  Film factors

• Characteristic curve (H and D curve – Hurter and Driffield)

• Density
• Contrast
• Speed
• Latitude
 Characteristic curve Note: An increase in LRE of 0.3
results from doubling the
radiation exposure.

• Characteristic curve is the relationship between OD and

radiation exposure.
• The study of the relationship between the intensity of
film exposure and the blackness after processing is
called SENSITOMETRY.
• Straight-line portion (intermediate region) – is the region of
the characteristic curve in which the properly exposed
radiograph appears.
Density – logarithm of opacity/ degree of film
blackening( useful range of OD is 0.25 – 2.5)
• (i) 1. Unexposed films has an OD in range of 0.1 to 0.3 base plus fog
corresponding to 79% and 50% transmission.
• 2. The ODs of unexposed films are attributable to:
• (a) Base density – inherent in the film base (0.1)
• (b) Fog density – development of un-useful silver grains(should not exceed 0.1)
• i. Inadvertent exposure of the film
• ii. Chemical contamination Note: Radiographic film contains ODs
• iii. Improper processing that range from near 0 to 4.
• Example: a radiograph of the wrist
transmits 1 of 2000 light photons from
the incident light as detected by the
densitometer. What is the optical density
of the film?
Note: Unexposed radiographic
film allows no more than
approximately 80% of the
incident light photons to be
transmitted
 Reciprocity Law
• The reciprocity law states that the OD on a radiograph is proportional only
to the total energy imparted to the radiographic film and independent of the
time of exposure.
• Reciprocity law fails for screen-film exposures at exposure times less than
approximately 10 ms or longer than approximately 2 s.
 Factors affecting density
• Film speed • Use of contrast media • Filtration
• Screen speed • SID • Field size
• Grid ratio • mA • Collimation
• Processing time or • Time • Mass density
temperature • Voltage
• Patient thickness • Voltage ripple
Increased Optical Density is the result of:
Increasing: Decreasing
• Film speed • Grid ratio
• Screen speed • Patient thickness
• Processing time or temperature • Use of contrast media
• mA • SID
• Voltage ripple
• Time
• Filtration
• Voltage • Collimation
• Field size • Mass density
 Radiographic Contrast – difference in OD

• (ii) 1. Image receptor contrast RADIOGRAPHIC CONTRST

– inherent in screen-film
combination and influenced by
film processing
• 2. Subject contrast – IMAGE SUBJECT
determined by size shape and RECEPTOR CONTRAST
mass density of the anatomy that CONTRAST
is being examined and the energy
of the x-ray beam.
 Image Receptor Contrast
• is related to the slope of the straight-line portion of the characteristic curve.
• Methods used for specifying image receptor contrast:
I. Average gradient – a slope of a straight-line drawn between two points on the
characteristic curve at ODs 0.25 and 2.0 above base and fog densities.
II. Gradient – is the slope of tangent at any point on the characteristic curve

Note: Toe gradient is Note: mid gradient or

more important than shoulder gradient is more
average gradient in important for
general radiography mammography
 Factors affecting contrast
• Grid ratio • Screen-film contact • Field size
• Processing time or • mA
temperature • Time
• Patient thickness • Voltage
• Use of contrast media • Voltage ripple
• OID • Filtration
 RADIOGRAPHIC CONTRAST
INCREASES BY:
DECREASING:
INCREASING OR
• Processing time or temperature DECREASING:
• Patient thickness INCREASING: mA and/or time
• Voltage • Use of contrast media
• Voltage ripple • OID
• Grid ratio
• Total filtration
• Field size
• Screen-film contact
Speed – respond of image receptor to a low x-
ray exposure

• 1. Par speed – 100

• 2. High – speed – higher than 100
• 3. Detail image receptors – less than 100
• (a) Fast – closer to y-axis of the characteristic curve
• (b) Slow – farther from the y axis
 Effects of imaging system speed with image
quality and noise
• High speed or fast image receptors have high quantum mottle producing
high image noise therefore reducing the image resolution.
• Imaging system speed also affects
• Patient dose
• Motion blur
• Optical density
 Latitude

• 1. range of exposures over which image receptor responds with ODs

• 2. Margin of error in technical factors
• 3. Latitude and contrast are inversely proportional
• 4. Wider latitude, mAs can vary more
• 5. Wide latitude, long gray-scale
• 6. High contrast IR has narrow latitudes
 Processing
• (i) Concentration of chemicals
• (ii) Degree of chemistry agitation during development
• (iii) Time
• 1. Increased time will decrease film contrast and increase fog
• (iv) Temperature
• 1. Increased dev. Temperature will increase fog and decrease contrast
  Geometric factor

• Magnification
• Distortion
• Focal-spot blur
 Magnification

• objects on the radiograph which appears larger than its

actual size
• 1. Increased SID will decrease magnification
• 2. Increased OID will increase magnification
• 3. thicker objects has higher magnification
 1.
Magnification is expressed by magnification
factor(MF)
 Magnification factors
• MF=Image size/Object size
• MF=source-to-image receptor distance SID/source-to-object (SOD)

• Object size =Image size(SOD/SID)

 Question:
• 1. A kidney measures 5 cm on the radiograph. The SID is 40 inches, and
SOD is estimated at 36 inches. What is the actual size of the kidney?
• 2. What is the magnification factor if an object measures 10 cm at its
maximum width and its image on the radiograph is 13.75 cm?
• The actual size of an object measures 20 cm, and its image on the radiograph
is measure at 22 cm at 100 cm SID. What is the SOD?
 Shape Distortion – unequal magnification of
different portions of the same object

• 1. Object thickness – thicker object has more distortion

• 2. Object position – if object and image plane is parallel, distortion
will not occur
• (a) Foreshortening – objects appears shorter ( positioning of patient)
• (b) Elongation – objects appears longer (tube angulation)
• 3. Object shape Note: Spatial distortion is the misinterpretation in the
image of the actual spatial relationships among objects
 Focal-spot Blur

• 1. Focal spot blur most important factor in determining spatial resolution(

greater in the cathode side)
• note: high-contrast objects that are smaller than the focal spot blur normally
cannot be imaged
• (a) Decreased OID will decrease focal spot blur
• (b) focal-spot blur is greater on the cathode side than on the anode side
 Factors that affects focal-spot blur
• Patient thickness • SOD/OID=Effective focal spot/
• Focal-spot size Focal spot blur
• SID
• OID • Focal spot blur=Effective focal
spot(OID/SID)
• Heel effect
 Question:
• An x-ray tube target with a 0.6-mm effective focal spot
is used to image a calcified nodule estimated to be 8 cm
from the anterior chest wall. If the radiograph is taken in a
PA projection at 180cm SID with a tabletop to image
receptor separation of 5 cm,what will be the sizeof the focal-spot
blur?
  Subject Factors

• Patient Thickness • Object shape

• Subject contrast • Motion
• Mass density • kVp
• Atomic number
 Patient Thickness

• a thick body section attenuates a greater

number of x-rays than does a thin body
section
 Patient thickness affects the following:
• Patient dose
• Magnification Note: The degree of subject contrast is
• Blurring directly proportional to the relative
number of x-rays leaving those
• Density sections of the body.
• contrast
 Tissue Mass Density
• Amount of a molecules per unit area

Tissue mass density affects:

• Patient dose
• Optical density
• contrast
 Effective atomic number

• In the diagnostic range of x-ray energies,the

photoelectric effect is of considerable importance;
therefore, subject contrast is influenced greatly by
the effective atomic number of the tissue that is
being radiographed.
 Object shape
• The shape of the anatomical structure under
investigation influences its radiographic
quality, not only through its geometry
but also through its contribution to
subject contrast.

Note: Absorption Blur is the

characteristic of the subject that
affects subject contrast.
 Kilovoltage peak
• The only factor that is under the control of the radiologic technologist.
• The most important influence on subject contrast
• Low kVp result in high-subject contrast or short gray scale contrast
• High kVp results in low-subject contrast of long gray scale contrast
 Motion blur
• Movement of the patient or
the x-ray tube during
exposure results in blurring
of the radiographic image.
• Patient motion is the usual
cause of motion blur
 Procedures for reducing motion blur
• Use the shortest possible exposure
time.
• Restrict patient motion by providing
instruction or using a restraining
device.
• Use a large source-to-image receptor
distance (SID). •
• Use a small object-to-image receptor
distance (OID).
 Tools for improving image quality
• Patient positioning
• Image receptor
• Selection of Technical factors
 Principles to be considered when planning a
particular examination:
• 1. Use of intensifying screens decreases patient dose by a factor of at least
20.
• 2. As the speed of the image receptor increases, radiographic noise
increases, and spatial resolution is reduced.
• 3. Low-contrast imaging procedures have wider latitude, or margin of error,
in producing an acceptable radiograph.
 Remember!
• The primary controlling factor of radiographic contrast in kVp, while mAs is for
optical density.
• kVp affects both radiographic contrast and optical density
• High kVp exposures results in lower differential absorption and reduced subject
contrast
• Higher kVp results in higher radiographic noise
• Higher contrast results produces wider latitude and increase margin of error.
• The principal advantage of high kVp techniques is the reduction of patient dose.
SCATTERED RADIATION
 SCATTERED RADIATION
Three factors contribute to
increased scatter radiation:
1. increased kVp,
2. Increased x-ray field size,
3. Increased patient thickness.
• Two principal tools for controlling
scattered radiation:
1. Beam-restricting device
2. Grids
Note:Even under the most favourable
conditions, most remnant x-rays are
scattered.
 kVp
• During high kVp techniques, • kVp is relative to x-ray energy
Compton interaction decreases but
photoelectric interactions decreases
more rapidly.
• Therefore, differential absorption
decreases and scattered radiation
from Compton interaction
predominates.
 Field Size
• Radiographic exposure factors
should be increased when using
smaller field sized compared to
larger ones to maintain the same
optical density.
• Reduced scatter radiation resultsin
lower radiographic OD, which must
be raised by increasing technique.
 Patient Thickness
• Imaging of the bony structures of
the extremities will appear sharper
compare with bony structures of
the chest even if the same factors
used are the same, this is due to a
decreased in the amount of
scattered radiation.
Note: Compression of anatomy improves
spatial resolution and contrast resolution and
lowers the patient radiation dose.
• The type of tissue also affects the
production of scattered rays
• Exposure of a 3-cm-thick extremity
at 70 kVp produces about 45%
scatter radiation
• 30-cm-thick abdomen causes
nearly 100% of the x-rays toexit the
patient as scattered x-rays.
 Tool for Controlling Scattered Radiation
BEAM RESTRICTORS GRIDS (types)
 Aperture Diaphragm  Parallel
 Cones and Cylinders  Crossed
 Variable Aperture Collimators  Focused
 Moving
 BEAM RESTRICTOR
• APERTURE DIAPHRAGM • An aperture diaphragm dedicated
• The simplest type of beam- for chest radiography s deisgned for
restricting device 35X43 cm (14X17 in) IR. Except
for a 1 cm border.
• A fixed lead opening designed for
image receptor size and constant
SID.
 BEAM RESTRICTOR
CONES AND CYLINDERS • An interference in the useful beam
• Considered as modification of by cone collimator is called CONE
aperture diaphragm. CUTTING.

• An extended metal structure that • Cones improves image contrast

restricts the useful beam to the
required size
• The CYLINDER is the commonly
use type.
 BEAM RESTRICTOR
VARIABLE APERTURE
COLLIMATOR
 Most commonly used beam-restricting
device in radiography.
 To control off-focus radiation, a first
stage entrance shuttering device that
has multiple collimator blades
protrudes from the top of collimator
into the x-ray tube housing.
• Collimation reduces the patient
radiation dose and improves contrast
resolution.
• The leaves of the Second stage
collimator shutter are usually made of
3mm thick lead.
• Allows rectangular and square fileds
• Misalignment of light beam and x-ray
beam results in collimator cut-off
 continuation
 Positive beam-limiting device – a
device that is used to automatically align
the size of the x-ray beam with the image
receptor size.
 The size of the x-ray beam should not
exceed the size of the image receptor.
 Some collimator housings are designed to
allow easy changing of the added
filtration.
 RADIOGRAPIC GRID
• RADIOGRAPHIC GRIDS – device used for
• Parts of grids are:
reducing scatter radiation that reaches the image
receptor. • Grip strip – carefully fabricated section of
radiopaque materials
• Principal function of grid is to improve image • Interspace material – radiolucent material placed
contrast between each strips.
• typical grid strips may have grid strips 50 µm
• Positioned between patient and image receptor wide that are separated by interspace material 350
µm wide.
• Demonstrated by Gustave Bucky (1913)
• Scattered x-rays incident on the interspace
• Designed to transmit x-rays whose direction is on a material may or may not be absorbed
straight line from the x-ray tube target to the image depending on angle of incidence and physical
receptor characteristics of grid.

• High-ratio grids have less positioning latitude

 Grid surface absorption:
% of absorption = ((width of grid strip/ (width of grid strip + width of interspace)) X 100

• A grid is constructed with 50-µm • When viewed from the top, a

strips and a 350-µm interspace.
What percentage of x-rays incident
on the grid will be absorbed by its
entrance surface?
particular grid shows a series of
lead strips 40 µm wide separated by
interspaces 300 µm wide. How
much of the radiation incident on
this grid should be absorbed?
 Grid Ratio
Grid ratio is the height of the grid • grid ratios are as • 8:1
divided by the interspace width. follow: • 10:1
High ratio grids increase patient • 5:1 • 12:1
dose • 6:1 • 16:1
3 dimensions of grid Note:
1. Thickness of the grid strip (T) • 4:1 or 5:1 grid is used for mammography
• 8:1 and 10:1 grid is frequently used with
2. Width of interspace material (D)
general purpose imaging system.
3. Height of grid (h) • 5:1 grid reduces 85% of scatter radiation
• 16:1 grid reduces 97% of scatter radiation
 Question:
• A grid is made up of a 50 um lead • The grid used for a particular
strips sandwiched between examination has a ratio of 12:1. the
interspace material that is 500 um grid strips are sandwiched between
thick.. The height of the grid is a 200 um thick interspace material.
0.25 cm. What is the grid ratio? What is the height of the grid?
 Grid Frequency
• Grid frequency – is the number of grid
strips per centimetre.
• High-frequency grid shows less distinct
gridlines on the radiographic image.
• At constant grid strip width;
• Frequency and interspace are inversely
proportional
• Frequency and ratio are directly
proportional
• The increase in patient dose due the use of
high grid ratio can be compensated by
reducing the width of the grid strips.
• Most grids have frequency range of 25-45
lines per cm
• Grid frequency is computed by dividing the
thickness of one line pair expressed in um,
into cm.
• A line pair is thickness of
• strip plus interspace in um.
 10,000 𝑢𝑚/𝑐𝑚
Grid Frequency =
(𝑇+𝐷)/𝑙𝑖𝑛𝑒𝑝𝑎𝑖𝑟
• What is the frequency of a grid that • What is the width of the line pair in
has a grid strip width of 50 um and a grid that has a frequency of 40
an interspace width of 250 um? lines/cm?
• That is the width of the grid strip
in a grid with a frequency of 30.3
lines/cm and an interspace width
of 330 um?
 Interspace material
The purpose of interspace material is to maintain a precise
separation between the delicate lead strips of the grid

 ALUMINUM  PLASTIC FIBER

 Higher atomic number  Absorbs moisture and becomes warped.
 Provides selective filtration of scattered  Less absorption of primary rays
rays
 Less radiographic technique is required
 Produce less visible grid lines
 Less patient dose
 Increase absorption of primary rays in the
interspace especially at low kVp
 It is non-hygroscopic
 easy to manufacture
 Grid Strip

• grid strips should be infinitely thin
and should have high absorption
property.
• Lead is the most widely used
material for grid strip
• Reasons why lead is good for strips:
1. Inexpensive
2. High atomic number
3. High mass density
 Contrast Improvement Factor
• Specifies the property of grid to improve
contrast.
• Most grids have improvement factors
between 1.5 and 2.5.
• CIF of 1 indicates no improvement in
contrast.
• Image contrast approximately doubles
with the use of grids.
• CIF is usually measured at 100 kVp
𝑖𝑚𝑎𝑔𝑒 𝑐𝑜𝑛𝑡𝑟𝑎𝑠𝑡 𝑤𝑖𝑡ℎ 𝑔𝑟𝑖𝑑
• k=
𝑖𝑚𝑎𝑔𝑒 𝑐𝑜𝑛𝑡𝑟𝑎𝑠𝑡 𝑤𝑖𝑡ℎ𝑜𝑢𝑡 𝑔𝑟𝑖𝑑
• Question:
A pelvic examination was made without the
use of radiographic grid, it exhibits an
average gradient of 1.2. with the use of
10:1 grid, the image exhibits an average
gradient of 2.9. what is the Contrast
improvement factor of this grid?
 Bucky Factor
𝑖𝑛𝑐𝑖𝑑𝑒𝑛𝑡 𝑟𝑒𝑚𝑛𝑎𝑛𝑡 𝑟𝑎𝑦𝑠
• B = 𝑡𝑟𝑎𝑛𝑠𝑚𝑖𝑡𝑡𝑒𝑑 𝑖𝑚𝑎𝑔𝑒−𝑓𝑜𝑟𝑚𝑖𝑛𝑔 𝑥−𝑟𝑎𝑦𝑠 • Specifies the amount of increased in
the radiographic technique to produce
• Or the same amount of IR signals when
𝑝𝑎𝑡𝑖𝑒𝑛𝑡 𝑑𝑜𝑠𝑒 𝑤𝑖𝑡ℎ 𝑔𝑟𝑖𝑑
using radiographic grids.
• B= 𝑝𝑎𝑡𝑖𝑒𝑛𝑡 𝑑𝑜𝑠𝑒 𝑤𝑖𝑡ℎ𝑜𝑢𝑡 𝑔𝑟𝑖𝑑 • Measures the penetration of primary
The higher the grid ratio, the higher is the and scatter radiation through the grid.
Bucky factor.
The Bucky factor increases with increasing
kVp.
 • If the 2 mAs was used during a
• Bucky factor for each grid particular non-grid exposure.
ration: the necessary change in mAs to
• Without grid 1 produce the same amount of IR
exposure when using grid should be
• 5:1 2 as follows :
• 6:1 3  4 mAs for 5:1 grid
• 8:1 4  6 mAs for 6:1 grid

• 10:1 5  8 mAs for 8:2 grid

 10 mAs for 10:1 and 12:1 grid
• 12:1 5
 12 mAs for 16:1 grid
• 16:1 6
GRID TYPES
PARALLEL GRID
FOCUSED GRID
CROSSED GRID
MOVING GRID
 PARALLEL GRIDS
• Simplest type of grid
• All lead strips are parallel • Grid cut of is the undesirable
• Easiest to manufacture absorption of the primary rays by
• Cleans up scatter radiation in only one direction the grid

• Has high probability of grid cut-off • Grid cut-off can be partial or

complete
• Grid cut off is greater along the edge of the image
receptor
• When using parallel grid, shorter SID will result in an • Distance to cut-off =
𝑆𝐼𝐷
increased cut-off along the edge. 𝐺𝑟𝑖𝑑 𝑟𝑎𝑡𝑖𝑜
 CROSSED GRID
• Have lead grid strips that run
parallel to the long and short axes
of the grid
• Two parallel grid sandwiched
perpendicular to one another
• Crossed grid is twice as efficient as
parallel grid
• High probability of grid cut off
• Major disadvantages
1. Positioning the grid is critical
2. Tilt-table techniques are possible
only if the x-ray tube and the
table are properly aligned
3. Higher exposure technique is
required
 FOCUSED GRID
• Designed to minimize grid cut-off
• Lead strips of focused coincides with the
divergence of the x-ray beam.
• Difficult to manufacture
• Exhibits no grid cut-off
• Has geometric limitations
• The center of a focused grid must
coincide with the focal spot
• Marked by intended focal distance
 MOVING GRID
• Obvious short comings of the
previous types of grid is the grid line.
• Grid lines are produced when primary
radiation are absorbed within the grid
strips
• High frequency grids present less
obvious grid lines
• Moving grid is also called a Potter-
Bucky diaphragm. (Bucky)
• Moving grids are focused grids that are
moving before, during, and after
exposure
• Most used grid in diagnostic imaging
• Two types of moving grids are:
1. Reciprocating grid
2. Moving grid
 Types of moving grids
Reciprocating Grid
• Motor driven
• Moves back and forth
• Total drive distance is 2cm
Oscillating grid
• Oscillates in a circular fashion around
a grid frame
• Positioned withw-3 cm tolerance frame
• Has a spring-like device located in the
four corners
• Has an electromagnet that pulls the
grid on one side
• Resting time is 20 to 30 seconds
 Disadvantage of moving Grids
• Requires a bulky mechanism that is
subjected to failure
• OID is increased
• Can introduce motion into the
cassette-holding device
 Grid Problems
Type of misalignment Result
Off -level Grid cut off across image; light image;
underexposed

Off-center Grid cut off across image; light image;

underexposed

Off-focus Grid cut-off towards the edge of image

Upside down Severe grid cut-off toward edge of image

Off-center, Off-focus Grid cut-off on one side of the image

 Off-Level Grid
• Results from an improperly
positioned x-ray tube and
improperly positioned grid
• Occurs when grid tilts during
exposure
• Or when IR sinks into patient’s bed
 Off-center Grid
• The center of the grid and the central
ray is of the x-ray beam are misaligned
• More of an x-ray tube positioning
error
• The CR does not pass through the
centremost inter space of the grid
• Results from a lateral shift called
lateral decentering
 Off-focused Grid
• Results from improper used of SID
• The farther the grid from the
specified distance, the more severe
will be the cut-off.
• More severe at edges
• More critical for high-ratio grids
 Upside-Down Grid
• The grid is positioned upside-down
• Severe cut-off on either side of the
central ray
 Off center; off-focus grid
• Most common improper grid position
• Mostly occurs during mobile
radiography
• Results in an uneven exposure
• Resultant radiograph appears darker
on
• one side and lighter on the other.
 In air gap technique, a 10% When air gap technique is used,
increased in the mAs is
necessary for every cm of air Notes the IR is moved 10 to 15 m from
the patient.
gap
• When focused grid are used the • In selecting proper grid ratio, the following
following must be adjusted properly:
must be considered:
• SID
• STD • kVp
• COLLIMATOR • Degree of scatter radiation reduction
In general, grid ratios up to 8 : 1 are • Patient radiation dose
satisfactory at tube potentials below 90 kVp. • Size and shape of the anatomy of interest
Grid ratios above 8 : 1 are used when kVp
exceeds 90 kVp. High kVp exposures require the
use of higher-ratio grids
Learning is a process,
success is a choice,
success comes from learning
so choose wisely and continue processing.

THANK YOU VERY MUCH!