DIGITAL

RADIOGRAPHY
Moderator:
Mr. Ram Singh (Lecturer)
Deptt. Of Radio-Diagnosis & Imaging
P.G.I.M.E.R

Presented By:
Krishna Sharma
B. Sc. Med. Tech. (X-Ray) – 3rd Year Student
Deptt. Of Radio-Diagnosis & Imaging
P.G.I.M.E.R 1
 DEFINITION
:
 It is defined as the image acquired from the
numeric that is discrete binary digits by
use of computers .
 Whereas in conventional radiography
information is represented in the analog or
continuous form rather than a discrete
fashion.

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ANALOG IMAGE DIGITAL IMAGE

56 56 57 56

56 56 57 56

57 57 57 59

58 58 58 60

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 INTRODUCTION:
 In 1982, the first computed Radiography System was
developed by the “Fugi Film Corporation”. This used
“Photo-stimulable Phosphors” as a image receptor.
 In 1990, Direct Capture Radiography (DR) or Flat
Panel System started , which used Amorphous Silicon or
Selinium as detectors.
 As the newer technology are being introduced, there
has been progressive & evolutionary growth in the
medical field. The pathological conditions can be
diagnosed more clearly, acurately & in comparatively
less time, resulting in increased patient cure rate.
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 Cont……
 Digital technology has increased the image processing
speed & decreased cost to the patient where totally
electronic radiographic image detection, storage &
display are beginning to replace film in a no. of
procedure.
 More importantly radiographic image stored in a
digital memory can be manipulated in many ways that
have been impossible with film. Such an image
manipulation enables the radiologist to isolate the
image information i.e. which can not be recognized on
a conventional radiograph.
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 CONVENTIONAL
METHOD:
 Since the clinical use of x-rays in 1895,majority of
radiographic examinations have been carried out by
the conventional method.
 The beam is projected through the patient and the
transmitted beam, which has information about the
body structures, is made to strike the cassette
containing the film and the intensifying screens. This
way the latent image is produced.

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 The latent image can be made visible and
permanent by processing it with suitable
chemicals.

 This conventional method of obtaining

radiographs has dominated the field of
radiography for many years. But it has been
realized that the film-screen system has its own
limitations.

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 LIMITATIONS OF CONVENTIONAL
RADIOGRAPHY:
1. After the film has been exposed,the information
contents cannot be enhanced.
2. If the radiograph is too dark or too light,it has to be
repeated. This results in extra exposure to the patient.
3. The completion of the examination is delayed as the
film has to be processed to convert the latent image
into a permanent one.
4. A magnifying glass may be required to see very
small structures in detail.
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5. Copied radiographs have an inferior quality as
compared to original ones.
6. The film is a physical object and so it requires
considerable space for storage.
7. Films can only be in one place at a time and they
also get deteriorated with passage of time.
8. Film can not be stored for longer time when
required.
9. Faults in the film can lead to repeat the
examination.
10. Dynamic range of the x-ray film is limited.
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 COMPUTED RADIOGRAPHY:
PRINCIPLE:
 -In the C.R. system we use an imaging plate
made of a photostimulable phosphor.
 -The cassette is exposed to x-rays in a similar
fashion as the conventional cassette.
 -The latent image is produced in the phosphor
layer of the imaging plate.
 -Then the cassette is transferred to the reader
system where the imaging plate is scanned with
a red helium-neon (633nm) beam.
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 Cont………
 - This stimulates luminescence proportional to the x-
ray energy absorbed. These light signals are
converted into electrical signals by using
photomultiplier tubes.
 - These electrical signals are converted into digital
information by an ANALOG TO DIGITAL
CONVERTER (ADC).
 -The digitized data is transferred to the digital image
processor in the computer, from where it can be
processed and viewed on the monitor.

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VARIOUS DIGITAL TECHNIQUE:

1) Slit scan system.

2) Scan projection system.
3) Image intensifier system.
4) Imaging plate system.
5) Flat panel detector system.

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 1. SLIT SCAN SYSTEM:
 -This system uses single line pencil beam about 5
mm & linear detector system.
 - It has mechanically linked x-ray tube, collimator,
opposite the detector array. There are different
possible movement of mechanical linked system &
patient couch movement.
 - This system provides the ultimate in scatter
rejection & detector efficiency .

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ADVANTAGES:

 Scatter radiation almost totally absent.

 Detector efficiency is more.

DISADVANTAGES:

 Time factor, more exposure time required.

 Tube loading increased.
 Poor resolution.
 Bedside radiography is not possible.
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2. SCAN PROJECTION SYSTEM:

 Based on CT–Technology, another projection

radiography technique was developed using a
narrow fan beam of X-Rays intercepted by
linear array of detectors called “Scan
Projetion Radiography”. Basically, SPR
involves the use of the existing CT-Gantry &
Computer to generate an image that looks
surprisingly like Conventional Radiography.

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 Cont……
…
The X-ray beam is shaped into a fan by collimators that
confine the beam to a 2-10 mm thickness through on
arch of 300 – 450. There are two collimators. The pre-
patient collimators shape the beam, reduced scatter
radiation & control patient dose. The post-patient
collimators further reduce the scatter radiation.

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 PRINCIPLE OF S.P.R.:
X-Ray beam after passing through patient is detected
by detector array. The signals having image
information of the body parts are transferred to the
computer where they get digitized & processed to
reconstruct the image.
To obtain a complete image of the
body part, X-Ray tube & detector assembly remains
stationary & the patient is translated through the X-
Ray beam or alternatively patient remains stationary,
while the X-Ray tube-detector assembly translates .

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COMPONENTS OF S.P.R. SYSTEM:
1. X-Ray Tube.
2. Pre-Patient Collimator.
3. Post-Patient Collimator.
4. Detector Array.

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 X-RAY TUBE DETECTOR
ASSEMBLY:
 -X-Ray tube of high heat loading capacity usually
above 1 MHu is required because of long imaging
time & detector efficiency. Usually 20 – 50 cm
body part of patient is imaged at a translation speed
of 1 – 2 cm/second
Two types of detector can be used: -
1. A Gas Filled.
2. Scintillation detectors couple to solid state
photodiode.
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 A GAS FILLED DETECTOR
• A gas filled detector consists of a volume of gas
between two electrodes, with a n electrical
potential difference(voltage) applied between the
electrodes.
• Ionizing radn prduces ion pairs in the gas.
• Positive ion attracted to negative
electrode(cathode), elctrons attracted to positive
electrode(anode).
• In most detectors, cathode is the wall of the
container that holds the gas and anode is a wire
inside the containers.
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There are 3 types of gas filled detectors in
common use:
• Ionization chambers
• Proportional counters
• Geiger Mueller counter

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 Scintillation detectors
• Scintillators are used in conventional film
screen radiography, many digital
radiographic receptors, fluoroscopy,
scintillation cameras, most CT scanners and
PET scanners.
• Scintillation detectors consist of a
scintillator and a device, such as a PMT that
converts the light into electrical signals.

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ADVANTAGE:

1. High radiographic contrast.

2. Low contrast detectibility.
3. Image manipulation.

DISADVANTAGE:

1. Poor spatial resolution.

2. Scanning time is more.
3. More radiation dose to the patient.
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 IITV-SYSTEM:

 -It uses large field & high quality image

Intensifier Television System. The scanning
lines should be at least 1024.

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ADVANTAGES:

1. Radiation dose in 25% less than the conventional

Radiography.

DISADVANTAGES:

1. A spatial resolution is poor.

2. Different units required for different types of
work.
3. Bedside Radiography is not possible.
4. Dedicated unit should have at least 1024 scanning
line
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COMPUTED RADIOGRAPHY (CR)

 Digital way of doing general radiography

with Conventional X-ray machines.
 It is a process of capturing radiographic
data from a conventional X-ray machine and
processing the data digitally to produce crisp
and high quality radiographic images.

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 COMPONENTS OF THE C.R.
SYSTEM:
Cassette With Imaging Plate Image Processor.

Image Reader Image Recorder.

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 THE IMAGING PLATE:
 -It consists of a polyester base over which a layer
of photostimulable phosphor (europium doped
barium fluoro bromide crystals- BaFBr:Eu 2) is
coated.
 -A protective layer composed of fluorinated
polymer material is applied over it. A supporting
layer which prevents the reflection of light is also
applied.
 -Next is the backing layer. This prevents the
scratching on the imaging plates during storage and
transfer. Therefore it has a protective action.
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 Cont………
 -The next is the bar-code label which contains
the number assigned to the imaging plate.
 -This bar-code provides a mechanism for
associating each imaging plate with patient
identification, related examination and
positioning information.
 -The imaging plate is flexible and less than
1mm thick.
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OTHER CHARACTERISTICS
OF IMAGING PLATE:

 -It retains the image for 24 hours, but some

degradation may occur with passage of time.
 -Imaging plate shows a linear response to the
intensity of x-ray exposure over a broad range.
 -It shows superior performance capability i.e. it
provides more information.
 -It is available in the same sizes as conventional
cassettes.
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 Cont…….

 -High resolution imaging plates are also

available which help in reducing the radiation
dose to the patient considerably.

 -Imaging plates are reusable and thousands of

exposures can be made on it.

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 THE IMAGE READER:
 -The image reader converts the continuous
analog information (latent image) into a digital
format.
 -In the reader the imaging plate is scanned
sequentially by a red helium-neon [633nm] laser
beam.
 -The laser beam induces photostimulable
luminescence from the phosphor. The intensity of
the emitted luminescence is proportional to the
amount of x-ray energy absorbed in the crystal
layer.
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 Cont……..
 -This emitted light is directed by highly efficient
light guides to the photomultiplier tubes, where it
is converted into electrical signals.
 -The electrical signals are sampled and digitized
by an A.D.C.
 -The digital data is stored on the hard disk of a
work station from where it can be processed,
viewed, printed or distributed via a network to
peripheral stations.

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 Cont………

 -The image reader has a capacity to read 110

plates per hour.
 -Therefore one reader can serve several
radiographic rooms and the data input is
stored on an easy image workstation.

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 THE IMAGE
RECORDER:

 The work station provides a DICOM

compliant output which maybe directed
to a laser printer for hard copies, or
networked to other viewing stations.

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 ARCHIVAL OF C.R. IMAGES:
 -A 12 bit output of the A.D.C. is converted into
10 bits within the reader; discarding the
information which is irrelevant to the exam
being performed.
 -This change reduces the size of the image
data files, increasing the speed of the system
and also increasing the storage space.
 -For bulk and long storage, optical discs,
jukebox system, storage shelves etc. may be
used.
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ADVANTAGES OF C.R. SYSTEM:

 -No special equipment is required.

 -The exposure latitude is wider and so more
information from the x-ray beam can be
extracted as compared to a conventionally
acquired image.
 -Repeats are extremely few due to positioning
and not exposure factors.
 -All types of radiography is possible with the
C.R. system.
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 Cont……….
 -The image displayed on the monitor can be
manipulated in a variety of ways: contrast
enhancement, edge enhancement, black/white
reversal etc.
 -The process of filing the images does not require
separate rooms and is relatively easier.
 -The acquired image can be transferred to many
monitors for viewing in separate places.

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 LIMITATIONS OF THE C.R.
SYSTEM:
 -Lesser spatial resolution as compared to
conventional radiography.
 -C.R. systems are not inherently low dose
systems as compared to the conventional rare
earth screen-film systems.
 -Radiological technologists receive no direct
feedback on the accuracy of their selection of
exposure factors as the resultant images are of
consistent quality regardless of the exposure.
This may lead to undesirable and undetected
over exposure to the patient. 45
 DIRECT RADIOGRAPHY:

FLAT PANEL DETECTOR SYSTEMS:

 -This system uses x-ray detectors of

photoconductive materials such as amorphous
Se or Si for direct acquisition of projection
radiographs.

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 METHODS:

Essentially, two methods have been

developed for direct capture radiographs:
-
1. Indirect Method.
2. Direct Method.

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 1. INDIRECT METHOD:
 -Here we use CsI scintillation phosphors coated over
an active matrix array of amorphous silicon
photodiodes.
 -The x-ray beam emerging from the patient interacts
with the cesium iodide producing light.
 -This light interacts with the amorphous silicon
producing electrical charge.
 -Thin film transistors store the signal until
read out, one pixel at a time.
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 INDIRECT DETECTORS:

Uses two step process :

X –rays

Visible light

Electronic signals

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 DIRECT METHOD:

Convert X-rays into electronic

signals.

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 2. DIRECT METHOD:
 -In this case we do not use the phosphor coating,
thus eliminating the intermediate light producing
step.
 -Hence amorphous selenium directly acts as the
x-ray detector.
 -The x-ray beam directly interacts with a thin
layer of amorphous selenium creating electron-
hole pairs, which being charged, travel directly to
the electrodes.
 -From here, the charge pattern is read out to form
the image.
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 Cont………
 -The advantage of the amorphous selenium
approach is that there is no light spreading in
the phosphor and so there is improved spatial
resolution.
 -On the other hand, the cesium iodide
phosphor has a high detective quantum
efficiency and so it results in lower radiation
dose.

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54 54
 CONSTRUCTION & WORKING
OF FLAT PANEL DETECTOR
SYSTEM:
 -The physical dimensions of the detector array
are 40 x 50 x 4 cms with 2560 x 3072 pixel
matrix.
 -The array consists of a glass substrate onto
which a layer of amorphous silicon is
evaporated.
 -The matrix is covered with a cesium iodide
scintillator layer.
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 Cont………..
 -The amorphous silicon is structured in a
matrix of individual photo sensors and
switching elements, either a thin film
transistor or a diode which allows the
connections of the sensor with the read out
line in column direction.
 -Thin film transistors or switching diodes are
controlled via address lines in the horizontal
direction, in order to read out the single
charge values of photodiodes.
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 Cont………..
 -These signals are multiplexed and converted
into digital signals by an A.D.C. inside the
detector housing.
 -The 2-D image data is directly transferred to
the image processing computer via an optic
fiber link.
 -So the image is available in digital form
shortly after the exposure has been made.

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 CHARACTERISTICS OF
AMORPHOUS SILICON:

 -It is a good photo detector in thin film form.

 -Its easy to deposit on large glass substrates.
 -They are very sensitive to light with an
efficiency close to 100%

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 ADVANTAGES OF FLAT
PANEL DETECTOR SYSTEM
 -Less radiation dose to the patient.
 -The examination becomes quick as no
cassettes have to be fetched from the storage
area, taken to the examination site, or to the
processing unit after exposure.
 -Radiography as well as fluoroscopy can be
performed.
 -Post processing can be done.
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 DISADVANTAGES OF F.P.D.
SYSTEMS:

 -Different equipment is required for

different kinds of work.

 -They are quite costly.

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 DIGITAL FLUOROSCOPY:

 -It provides real time viewing of anatomic

structures. As maximum image detail is
required, so image brightness must be high.
 -Image intensifier was developed to replace
the conventional fluoroscopic screen.
 -With the introduction of computer
technology into fluoroscopy,digital images
with better detail can be obtained.
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 EQUIPMENT:
 -D.F. requires the same fluoroscopy
equipment in addition to a computer, 2 video
monitors, and a more complex operating
console.
 -A high voltage generator.
 -A video system.
 -A charge couple device.

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66
 ADVANTAGES:

 D.F permits high speed digital image

acquisition,processing & display
 -Better image quality.

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 DEVELOPMENTS IN D.F.
SYSTEM:
 -Flat panel detector system has replaced the
I.I.T.V. SYSTEM.
 -X-rays passing through the patient are
converted into electrical signals by the F.P.D.s.
These are then passed through the amplifier
and ADC where they are converted into digital
signals.
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 Cont………..

 -The digital image data is directly transferred

to an image storage PC via an optic fiber link
at the rate of 30 frame/s
 -This system permits high speed digital
image acquisition, processing and display.
 Images are of excellent resolution.

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 SIMILARITIES B/W DIGITAL &
CONVENTIONAL RADIOGRAPHY
Same X-Ray tube & generator system is
required in both, for exposing the patient.
Selection of similar required exposure factors
ma, Kv etc.
 Both required, accurate positioning of patient
for deferent projections.
 Latent image is produced in both & then later
processed.
 Use of Collimators, Cones, Grids required in
both.
 Imaging Plates like film cassette can be
transported easily to distant areas like OT,
Patient Bedside.
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 DIFFERENCE B/W DIGITAL &
CONVENTIONAL RADIOGRAPHY:

1. No use of radiographic film.

2. The latent image on IP is scanned by laser
beam, than digitized & sent to computer
for processing.
3. IP is capable of much wider exposure
latitude then conventional.
4. IP can be reused after erasing unlikely
conventional.
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 Cont……….
1. Digital image is displayed as a combination of
rows & column called matrix, where as in
conventional, it is made up of minute strands of
black metallic silver.,
2. Size of matrix i.e. no. of pixel affect image
quality. In conventional, it is grain size of
emulsion in film or speed of screens.
3. Once image is converted to digital data,
computer can performed post processing image
enhancement like subtraction contrast, edge-
contrast.
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 IMAGE QUALITY IN C.R.:
1. RESOLUTION:
- Digital Radiography: - 2.5 lines pair/mm.
- Conventional Radiography: 6-10 line
pair/mm.
2. DENSITY:
- Digital Radiography: -
a) Provide wider exposure latitude.
b) Improve visualization of anatomical
structure.
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3. CONTRAST:
Primary dependent on Kv & can be
increased by use of Collimators, Cone, Diaphragm
& Grid.

4. NOISE:
- Signal that contributes no useful diagnostic
information.
- Degrades the quality.
- In digital radiography, it is dependent.

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 QUALITY
CONTROL:
Three levels of system performance for quality
control and system maintenance: -
1. Routine: Technologist level
- no radiation measurements.
2. Full inspection: Physicist level
- radiation measurements; non-invasive
adjustments.
3. System adjustment: Vendor service level
- hardware and software maintenance.
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PERIODIC QUALITY CONTROL:
 -Daily (technologist): -
– General inspection.
– Film processor / Laser printer.
– Erase imaging plates.
– Verify digital interfaces and network
transmission.
 -Weekly (technologist): -
– Test phantom images.
– System cleanliness.
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 Cont……
…

 Monthly (Technologist): -
– Film processor maintenance (if any).
– Inspect and clean image receptors.
– Review film retake rate.

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 Cont……
.
 Semi-Annually / Annually (Physicist): -
– Evaluate image quality.
– Acceptance tests to re-establish baseline
values.
– Review.
 QC records.
 Service history.

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 CONCLUSION:
 With the advent of computed radiography
diagnostic radiology is advancing towards a film
less system
 The replacement of film by detectors and storage
devices eliminated several inherent drawbacks
of conventional radiography and decreases the
radiation exposure to the patient and radiographer
 Very soon digital imaging will become more
common and affordable for all aspect of
radiography.
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