LU 1:

DIGITAL IMAGE RECEPTORS

PART 1

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 Learning Outcomes
• Familiarize the student with image receptors used in X-ray imaging systems.
• Make a distinction between film radiography and digital radiography.
• Describe different digital image receptor types in radiography.
• Understand the process of indirect capture and direct capture in digital
radiography.
• Explain the quantum efficiency of image receptors.
• Explain the process of computed radiography (CR) image processing.
• Describe the role of exposure indicators in CR systems.
• Understand the concept of exposure of latitude in film radiography and
digital radiography.
• Describe the formation of image noise.
• Discuss how exposure factors affect digital image receptors.
• Discuss the sensitivity of scatter radiation in digital radiography.

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 Terminology
• ADC:
An analog to digital converter is used to bridge analog
and digital circuitry. Medical imaging systems use an analog
to digital converter to sample and quantize the image data.

• CHARGE-COUPLED DEVICE (CCD) DETECTORS:

Are used in digital radiography for the indirect conversion of x-
ray photons into an electric charge (indirect because the x-
ray photons are first converted into light via a scintillating screen).

• SPATIAL RESOLUTION:
The greater the number of pixels in a matrix image, the smaller their
size. An image consisting of a greater number of pixels per unit area
or pixel density provides improved spatial resolution.
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 Terminology
• SIGNAL-TO-NOISE RATIO (SNR):
A method of describing the strength of the radiation exposure
(signal) in comparison to the amount of noise apparent in the
digital image.

• THIN-FILM TRANSISTOR (TFT):

Flat panel detectors (FPD) are used in direct
digital radiography (DDR) for the conversion of x-rays to
light (indirect conversion) or charge (direct conversion) which
is read out using a thin film transistor (TFT) array.

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 Thin-Film Transistor (TFT)

• The first thin-film transistor (TFT) flat-panel amorphous

silicon and amorphous selenium detectors were
introduced in 1995. These were the first devices to move
beyond the cassette into detectors that would reside in
the table and wall stand.
• Today these detectors are no longer permanent fixtures
in these two pieces of equipment but can be used
portably as a wireless device.
• With flat-panel detectors, the materials used for
detecting the x-ray signal and the sensors for
recognizing that signal are permanently enclosed inside
a rigid protective housing.
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 Introduction

• Digital
– The transition to digital is almost complete in
the United States.
• Film
– Some facilities still use film-screen.
– This material is still covered in the optional
content area in many countries.

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 Digital Receptors

• Digital imaging is not a new concept.

– Computed tomography (CT), sonography, nuclear
medicine, and magnetic resonance imaging (MRI)
have been digital for some time.
• Digital receptor type
– Computed radiography (CR)
• Systems that use storage phosphors to temporarily store
energy representing the image signal
– Direct radiography (DR)
• Systems that have detectors that directly capture and read
out an electronic image signal

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 Computed Radiography Systems

• Can be integrated with existing

radiographic equipment.
– Automatic exposure control
(AEC) must be recalibrated.
– Preprogrammed techniques in
the anatomically programmed
radiography (APR) and
technique charts must be
adjusted.

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 Computed Radiography Systems

• Primary parts of a cassette-based system:

– Cassette
– Photostimulable phosphor (PSP) plate
– Plate reader
– Computer workstation

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 Computed Radiography Systems

• Cassette
– A container for the PSP plate
– Made of lightweight plastic
– Lined with felt material
– Backed with a sheet of aluminum

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 Computed Radiography Systems

• PSP PLATE LAYERS:

– Protective layer
– Phosphor layer
– Reflective layer
– Conductive layer
– Color layer (in some
newer plates)
– Support layer
– Backing layer

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 Computed Radiography Systems
• Plate response to x-ray exposure
– X-rays ionize phosphor atoms
and ~50% of electrons are trapped
in the conduction band as a latent
image.
– The quantity and distribution of the
liberated electrons is proportional to
the x-ray exposure received in each
particular area of the plate.
– During processing, the energy of
trapped electrons is released by
exposure to a laser.

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 Computed Radiography Systems

• General reader design

– Drive mechanism moves the plate through the laser
scanning process (in some the laser moves)
– Optical system is made up of a laser, beam-shaping
optics, light-collecting optics, and optical filters, to
project and guide a precisely controlled laser
– A photodetector senses the light released during
scanning
– Analog-to-digital converter (ADC) converts light to an
electronic signal
– Computer processes and displays the image

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 Direct Radiography Systems

• DR systems
– Image-forming radiation is
captured and transferred to a
computer from the detector
array for viewing at the
control panel.
• DR categories
– Indirect capture
– Direct capture

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 Direct Radiography Systems

• Charge-coupled device
(CCD), x-ray scintillator,
and optics
– Indirect capture
• Tiling: a process in which
several CCD detectors
abut to create one larger
detector

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 Direct Radiography Systems

• Scintillator with cesium iodide or

gadolinium oxysulfide as the
phosphor, photodetectors, and a
thin-film transistor (TFT) array
– Indirect capture

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 Direct Radiography Systems

• Indirect capture methods

cause a loss of
resolution.
• The direct capture
method avoids this
problem by not using a
scintillator.
– Photoconductor and TFT
Amorphous selenium (a-Se)
array

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 CR: Extraction and Processing
• When the plate is processed, it is removed from the
cassette by the reader and moved through the scanning
• Image Extraction: area at a very precise speed by the drive system.
• This movement through the reader is called a “slow
Slow Scan/Fast Scan scan”

• As the plate moves through the reader, it is exposed to a

laser that sweeps back and forth across the plate,
releasing the trapped electrons.
• The laser is deflected back and forth by a rotating
polygon or oscillating mirrors and blanked on each
retrace.
• This scanning movement by the laser is called a “fast
scan.”

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 CR: Extraction and Processing

• As the electrons, liberated by the laser, return to

their shells, they release excess energy as light
that is directed to the photodetector via a
fiberoptic bundle or a solid, light-conducting
material.
• The photodetector then amplifies the light energy
and converts it to an electronic signal.
• This signal is then passed through an analog-to-
digital converter (ADC) where it is digitized.

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 CR: Extraction and Processing

• In digitising the analog signal, it is divided into a

matrix.
• The size of the matrix determines the resolution:
the larger the matrix, the greater the number of
pixels and the greater the resolution.
• The scanning of the plate results in a continuous
signal being sent to the photodetector and onto
the ADC for sampling and quantization.

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 CR: Extraction and Processing

• The image is digitised by both location (spatial

resolution) and intensity (grayscale) of each part of
the signal.
– Grayscale is assigned during the process of
digitising the image.
– Bit depth is the available grayscale (Bit depth refers
to the color information stored in an image).
– The number of photons detected within a given
pixel determines the shade of gray it displays.
– The computer of the CR reader puts the image
data through a series of steps to create the
displayed image.
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 DR: Extraction and Processing

• Image extraction for DR systems

– There are two indirect methods and one direct
method.
– One indirect method uses a cesium iodide
phosphor plate as the scintillator coupled to a
CCD (charge-coupled device) by a fiberoptic
bundle or optical lenses.
• The x-ray energy is absorbed by the scintillator and
converted to light.
• The light is transmitted to the CCD and an electronic
signal is created.
• This analog signal is passed through an ADC where it
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 DR: Extraction and Processing

• The other indirect method uses either cesium iodide or a

gadolinium oxysulfide scintillator coupled to a
photodetector and a TFT.
 The panel is configured as a network of pixels with each
pixel containing a photodetector and TFT.
 The x-rays are absorbed by the scintillator and
converted to light.
 The light is absorbed by the photodetectors and
converted to an electronic signal that is collected by the
detector elements (DELs) and then digitized by an ADC.

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 DR: Extraction and Processing

• The direct method uses an amorphous selenium

photoconductor and a TFT array.
– Before exposure, an electric field is applied via the
bias electrode across the surface of the amorphous
selenium layer.
– During exposure, x-rays are absorbed by the
amorphous selenium and electric charges are
created in proportion to received x-ray exposure.
– The charges are stored in storage capacitors
attached to TFTs where they are amplified and
converted to digital code.
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 DR: Extraction and Processing

• From this point all three DR systems go through the

same basic image-forming steps previously described:
– A histogram is created and analysed.
– The exposure field is recognized, and the histogram
analysis occurs.
– Automatic rescaling takes place.
• However, with these systems only the detector pixels
that were exposed contribute to the image.
• A Histogram is a graphical display of the pixel intensity
distribution for a digital image.
• A Histogram plots the number of pixels found at each
pixel value
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 Display

• The display of a digital image

illustrates the most significant
difference between digital
detectors and film.
– Exposure latitude
– Film latitude
– A: film
– B: represents the linear response
line of a digital receptor

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 Display

• With digital receptors, the response to exposure is

linear and the range of exposures is very wide
(dynamic range).
• Ultimately this means that digital receptors can
respond to exposure levels much lower and much
higher than film and are processed to display them
as visible shades of gray.
• The result is that more anatomic information can be
captured and displayed.

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 Display

• Postprocessing functions are computer software

operations available to the radiographer and
radiologist that allow manual manipulation of the
displayed image.
• The windowing-leveling function allows the
radiographer to expand any region of the grayscale
to one that can be seen and differentiated .
• Caution: Overuse of these functions can negatively alter the
digital image data set.

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Postprocessing Functions

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 Exposure Indicators:
• Exposure indicators: in CR systems, the exposure
indicator value represents the exposure level to the PSP
plate and the values are vendor specific.
– Fuji, Philips, and Konica use sensitivity (S) numbers
and the value is inversely related to the exposure to
the plate (Philips also has an EI value and S is not
equal to EI).
– Carestream (Kodak) uses exposure index (EI) numbers,
and the value is directly related to the exposure to the
plate and the changes are logarithmic expressions.
– Agfa uses log mean (lgM) numbers and the value is
directly related to exposure to the plate and changes
are also logarithmic expressions.
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 Exposure Indicators

• CR systems: use exposure indicator values as a

guide for optimum technique.
– If the value is within the acceptable range, then
postprocessing functions will not degrade the image.
– If the exposure is outside the acceptable range, the
postprocessing functions will not correct for improper
receptor exposure and may result in noisy or
suboptimal images.
– For CR systems, histogram analysis is the basis for
determining the exposure indicator value.

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 Using Digital Receptors

• DR systems use dose area product (DAP) as an

indicator of exposure.
– DAP is a measure of exposure in air measured by a
DAP meter embedded in the collimator.
– The DAP value depends on the exposure factors and
field size and is expressed in centigray-meter squared
(cGY-m2).
– DAP reflects both the dose to the patient and the total
volume of tissue being irradiated.

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 Using Digital Receptors

• Standardization of exposure values:

– Exposure index (EI): represents the exposure at the

detector relevant to the region being imaged and is
defined by the signal-to-noise ratio (SNR)
– Target exposure index (EIT): the target reference
exposure obtained from a properly exposed image
receptor
– Deviation index (DI): a measure of the deviation of
the EI from projection-specific EIT values.

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 Using Digital Receptors

• Detective quantum efficiency (DQE): an expression of

the potential “speed class” or radiation exposure level that
is required to produce an optimal image.

– DQE is evaluated by comparing the image noise of a

detector with that of an “ideal” detector with the same
signal-response characteristics.
– DQE is a measure of how well the signal-to-noise ratio
(SNR) is preserved in an image.

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 DETECTIVE QUANTUM EFFICIENCY (DQE):

• DQE is a measurement of the efficiency of an image

receptor in converting the x-ray exposure it receives to a
quality radiographic image.
• If an image receptor system can convert x-ray exposure into
a quality image with 100% efficiency (meaning no
information loss), the DQE would measure 100% or 1.0.
• However, no imaging system has 100% conversion
efficiency.
• The higher the DQE of a system, the lower the radiation
exposure required to produce a quality image, thereby
decreasing patient exposure.
• DQE “predicts” patient dose.
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 Using Digital Receptors

• Speed originated with film-screen systems and

represented the exposure necessary to produce a
desired level of density.
– The term speed is inaccurate in digital systems.
• Speed class is the exposure level at which the
system is operated; digital systems can be operated
at almost any speed class.
– With digital systems, as the operating speed class
increases, the potential for image noise increases,
but as the operating speed class decreases,
patient dose increases.
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 Film-screen

• Film-screen versus digital imaging

– mAs no longer controls density of the image
• The role of mAs is still important and still
ultimately determines the quantity of
radiation exposing the patient and patient
dose.
• An optimum mAs should be selected to
provide sufficient quanta to expose the
receptor and avoid excessive noise.

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 Image Noise
– Any undesirable fluctuation in image
brightness
– Electronic components of digital
imaging systems contribute
undesirable noise
– A, Excessive noise caused by an
insufficient mAs.
– B, The same part with a sufficient
mAs.
– An optimum mAs should be selected
to provide sufficient quanta to expose
the receptor and avoid excessive
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 Kilovoltage Peak (kVp)

• Kilovoltage peak (kVp) still controls contrast, but digital

image receptors have a much wider dynamic range and
a linear response to exposure.
– Because more shades can be clearly displayed, the
matching of kVp to the subject and receptor is less
important with digital systems.
– Digital receptors are much more sensitive to scatter
radiation and low-energy radiation in general;
increasing kVp increases the opportunities for scatter
production.

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 Scatter Control

• Scatter control is more important in digital imaging

than in film-screen imaging.
– Digital receptors are more sensitive to low-energy
radiation.
• There are two ways to effectively control scatter
radiation’s effect on the image: collimation and grid
use.

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 Factors Affecting Image Quality

• The sharpness factors that affect image quality remain

the same for digital systems.
– The smaller the focal spot, the sharper the image.
– Minimize object-to-image receptor distance (OID)
and maximize source-to-image receptor distance
(SID)
– Changes in distance require adjustments in the
mAs.
– Accurate positioning of the part and proper
alignment of the part with the AEC (if used) also
remains critical.
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 Image Processing Errors

• Recognise image processing errors that can

degrade image clarity.

– Pay attention to the exposure indicator values

as an indicator of proper exposure.
– Review factors that may result in a histogram
analysis error.
– Evaluate proper positioning and tube-part-
receptor alignment.

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