Computed radiography

CR is a digital radiographic imaging modality, whereby a digital detector is used

to capture X-rays transmitted through the patient. CR is based on the phenomenon
of photostimulable luminescence which is exhibited by photostimulable
phosphors. The CR digital detector is made of a photostimulable phosphor which,
when struck by X-rays, creates a latent image. The latent image is rendered
visible when the detector is scanned by a laser beam to produce light
(photostimulable luminescence) that is subsequently converted into electrical
signals. These signals are digitized and processed by a digital computer that
produces the CR image, using special digital image processing algorithms
 INTRODUCTION
Computed radiography also commonly known as
(CR), phosphor (PSP) Photostimulable
imaging.
It employs reusable imaging plates and associated hardware and software to
acquire and to display digital projection radiographs.
It is cassette based system like analog film and is more commonly considered to
be a bridge between classical radiography and digital radiography
CR is used almost exactly like conventional Imaging plate in a cassette which
must be processed in CR reader after X-ray exposure for conversion to digital
images.
The imaging plate (IP) is a new and flexible X-ray sensor for the CR system which
uses the conventional medical X-ray imaging system and can be employ~d as a
substitute for the screen/film system. The IP IS made by densely applying
particles of inorganic crystals called photostimulable phosphor onto a polyester
film. The phosphor layer has the function of recording an X-ray image. The
photostImulable phosphor is a special luminescent mater~al which stores X-ray
energy and emits light proportional to the stored X-ray energy when stimulation
energy such as visible light is irradiated to it. The X-ray image is stored to be read
out at a later time.
CR system consists of following components
X ray or gamma ray sourcce

 Image plate (photostimulable phosphor) PSP

 Image reader/digitizer/scanner
 Photomultiplier tube (PMT), ADC (analoge to digital converter)
 Computer console or workstation, software, monitors, and a printer.
Image reader can be
 Single-plate readers (each cassette is loaded manually and read separately)
Multiple-plate readers (multipleplates—up to 10—can
be stacked and loaded automatically)
 HISTORY
Cassette-based computed radiography (CR) systems have continued to
evolve in parallel with integrated, instant readout digital radiography
(DR) systems.
The fundamental innovations in the development of CR was by Kodak
(luckey in 1975) who conceived the storage of an X ray image in a
phosphor screen.
It required significant technical steps and conceptualization of the
application by Fuji (kotera et al 1980) to produce the first medical X
ray images Fuji, the main developer of CR in the eighties, used
BaFlBR:𝐸𝑈2+ phosphor and a cassette-based approach.
PRINCIPLE OF OPERATION
In computed radiography, the imaging plates are inserted in a
radiographic table’s cassette holder and are exposed to X-rays or gamma
rays.
The energy of the incoming radiation is stored in a special phosphor layer,
electrons in the phosphor plate are excited into a higher energy state,
forming a latent image.
Then a specialized machine known as a scanner is then used to read out
the latent image from the plate by stimulating it with a very finely focused
laser beam.
During which the trapped electrons absorb the laser energy and they emit
blue light with intensity proportional to the amount of radiation received
during the exposure as they return to their ground state.
The light is collected by a light guide(fiber optics) and transmitted to a
highly sensitive analog device known as a photomultiplier tube (PMT) and
converted to a digital signal using an analog-to-digital converter (ADC).

The generated digital X-ray image can then be digitally stored and viewed
on a computer monitor and evaluated.

After an imaging plate is read, it is erased by a high-intensity light source

that removes residual radiation ( electron) and can immediately be re-used.

 Imaging plates can typically be used up to 1000 times or more depending

on the application.
LIMITATIONS OF CONVENTIONAL RADIOGRAPHY
 Films cannot tolerate a wide range in radiation exposure (OD - log E
curve)

 One has to choose between good contrast and good latitude

 Image cannot be adjusted once taken

 Require space for dark room and film/chemicals storage..

 Price of films and chemicals is constantly going up (4-10% per year)

 Need several exposures to show different tissues (bone vs soft tissue)

 Image developing time is more (manual about 60 minutes)

STEPS INVOVLVED
 X ray image received on phosphor plate subjecting to X ray exposure

 After the image has been captured on an image plate by a standard x-ray system, the plate is
taken to an image-plate reader to extract the image.

 The cassette is loaded (manually or automatically) into the reader.

 Image extracted from phosphor plate by laser (Raw image)

 Raw image processed for quality improvement

 The digital image is then produced in 30-120 seconds and downloaded to an image-processing
system, usually a computer workstation, for display and manipulation.

 Digital imagecan be either printedburned on CD, or sent to PACS(Picture

Archiving and
Communication System)
Computed Radiography Equipment
Cassette The CR cassette looks like the conventional radiography cassette. It
consists of a durable, lightweight plastic material . The cassette is backed by a
thin sheet of aluminum that absorbs x-rays . Instead of intensifying screens inside,
there is antistatic material (usually felt) that protects against static electricity
buildup, dust collection, and mechanical damage to the plate . Front side of
cassette is made up of carbon fiber materials and back side is made up of lead
backing to reduce back scatter of x ray .it generally attenuate the x ray .they
come in varous sizes eg 14x17", 14x14", 11x14", 8x10", 10x12“ etc ( in inches) .
Larger cassette is use for larger anatomy like abdominal , spine imaging etc while
smller cassette is used for imaging smaller anatomy like foot , hand etc. The
cassette also contains a window with a barcode label or barcode sticker on the
cassette that allows the technologist to match the image information with the
patient-identifying barcode on the examination request . For each new
examination, the patient-identifying barcode and the barcode label on the
cassette must be scanned and connected to the patient position or examination
menu. The cassette will also be labeled with green or blue stickers indicating the
top and left side of the cassette or with a label on the back of the cassette
indicating the top and right sides of the patient . These stickers serve to orient
the cassette to the top of the patient and the patient’s right side so that the image
orientation is in line with the computer algorithm.
COMPONENTS OF COMPUTED RADIOGRAPHY
1. IMAGING PLATES

The CR plate has a thin layer of phosphor grains, known as a photostimulable

phosphor. The plates are usually 1 mm thick and are coated with Europium
activated fluorohalide compounds in crystalline formation embedded in organic
binding material.
 Layers of Imaging Plate

i. Protective Layer: A thin layer of transparent plastic layer that protects the
phosphor.

ii. Barium Fluorohalide Phosphor Layer: a closely dispersed of fine-grained,

Photostimulable phosphor plate is coated with europium-activated, barium
Fluoro-halide crystals, that store the latent image until released when re-
stimulated during processing (Thickness is about 0.3 mm).
iii. Light reflective Layer: This layer increases the intensity of light being
emitted from the crystals by reflecting it back toward the reader, instead
of it being absorbed. It is usually black so that it absorb spreading light
.some details is lost during this procedure .
iv. Conductive Layer: This is a light absorbing layer, made up of
conductive needle-like crystals that absorb any unreflected light as well
as any electrostatic charges.
v. Polyester Support Layer: Made from a polyester material, this layer gives
structural rigidity and a base for the coating of all of the other layers.
Polyester is used because of its excellent stabilities well as its durability
and flexibility.
vi. Light Shielding Layer: This is a carbon particle layer that prevents the
light from leaking from the rear of the imaging plate.
vii.Backing Layer: This is a protective layer made from a soft polymer that
prevents scratching when the plates are stacked during the
manufacturing process.
PROTECTIVE LAYER

BARIUM FLUOROHALIDE PHOPHOR LAYER

REFLETIVE LAYER

CONDUCTIVE LAYER

POLYSTER BASE SUPPORT LAYER

LIGHT SHIELDING LAYER

BACKING LAYER
 IMAGING PLATES TYPES
STANDARD RESOLUTION IP :such ip has
thicker phosphor layer and absorb more
radiation thus has higher speed in
comparision to high reolution ip thus will
be used for larger antomy body part or
general imaging .
HIGH RESOLUTION IP: such types of ip
has thin layes of phosphor which has less
light diffusion which reduces the latral
spread of light hence produces the sharp
resolution image. They are use for
extremity imaging .
X-RAY EXPOSURE
• When the X-ray is absorbed by the material, absorbed energy excites
the europium atoms, causing ionization of Eu atom.
• The electrons are raised to higher energy state in the conduction band.
Where electrons travel freely until they are trapped in a so called F-centre
in a metastable state with an energy level slightly below that of
conduction band but higher than that of the valence band.
• The number of trapped electrons per unit area is proportional to
intensity X-rays incident at each location. These trapped electrons
constitute the latent image.
• Due to the thermal motion the trapped electrons will slowly be liberated
from the traps, and so at room temperature the image should, however,
be readable up to 8 hours after exposure
IMAGE SCANNING
 Plate is scanned by the laser causing the emission of blue light from the plate which is then
detected by the photomultiplier. Plate is erased with light (not laser) and returned to the cassette
Scanner components consist of following parts
1. Laser sources :previously we use he-ne laser system which produces
the light ifrared light to stimulate the electorn in f center to jolt through
the conduction band . But now days we use solid state diode laser
which produce the phtotons to stimulate the electonr in the F center .
This process excites the elctrons .
2. Ip transport mechanism : transport sytem move the ip while scanning
and move ip plate inside and out and vice versa after scanning and
erasing respectively.
PHENOMENON OF LASER LIGHT
 The cassette is placed in the reader where the Image Plate is extracted and raster
scanned with a highly focused and intense laser light of low energy (~2 eV).

 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.

 When these electrons become reabsorbed by trivalent Europium, trivalent Europium is

transferred back into divalent Europium atom. This involves the liberation of high energy
(~3 eV) and this is done by emission of green light. Since, there is a larger energy
difference between conduction band, valence band and F- center, the green light
emitted has a higher energy than the laser light needed to stimulate the trapped
electrons.
 The difference in wavelength between the two light is critical for the detection of emitted light.
Incident x-rays form an “electron” latent image in a metastable “F” center site that can be
stimulated with a low energy laser beam (~2.0 eV), producing the desired luminescent signals
(~3.0 eV).
PHOTOMULTIPLIER TUBE
• A photomultiplier tube (PMT) useful for light detection of very weak signals, is a
photo emissive 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.
ERASING PROCESS
• Residual latent image information is erased by using an intense light
(consisting of wavelengths that remove electrons in traps without
stimulating further electron trapping), and the image plate is reinserted into
the cassette for reuse.
• Exposure to a bright fluorescent light removes the remaining information
in 10-15 sec.
• Ghosting - if the residual latent image remained,it produces the ghost
image which alter the image information of upcoming patients, so it should
be removed by flooding with intense white light.
 ADVANTAGES

• CR technology can be considered as the digital replacement of conventional X-ray

film.
• Post-processing, manipulation & storage of images is easy.
• Repeat examinations are reduced due to wide exposure latitude.
• Image Plate is reusable.
• Ability to produce consistent high quality images.
• Ability to deliver images quickly to those who need to make critical decisions.
• Decreased time to acquire images thereby increasing patient throughput in
medical diagnosis.
• Increased Radiologist reading capacity and the ability to have instant
comparison images along with previous reports.
• Ability to print on paper or make CD media instead of film, economically
profitable.
• Increased savings: no film, chemicals, dark room and storage room
required
• Computer processing of raw image brightness, contrast, sharpness
enhancement, zooming, measurements…
• Reduction in exposure and processing time
• Software based evaluation and reporting
• Digital magnification allows better detail viewing
• Special analysis tools: e.g. for automated wall thickness
measurement
DISADVANTAGE
S
• Initial cost
• Additional cost (Service and maintenance)
• Plate is sensitive to fogging: use grid, need to be erased daily
• Dose-creep: since, exposure latitude is wide, high exposure technique
is used which increases the patient dose which is called dose-creep.
sources
1. DIGITAL RADIOGRAPHY:PHYSICAL PRINCIPLE AND QUALITY CONTROL
2. Radiologic Science for Technologists: Physics, Biology, and Protection