LU 1

DIGITAL RADIOGRAPHIC SYSTEMS:

PART 2

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 LEARNING OUTCOMES

• Understand a transition from analogue (Screen-film radiography) to

digital radiography.
• Describe various digital radiography image receptor systems.
• Explain critical elements used in the different digital radiography
systems.
• Describe both indirect and direct conversion processes in DR systems.
• Describe the steps followed in digitizing x-ray image with CR system.
• Explain why DR systems have significantly greater latitude than
conventional film-screen radiography systems.
• Discuss limitations inherent in each of the digital radiography systems.
• Discuss patient dose considerations with digital systems.
• Explain the causes of several digital radiography artefact problems .

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 TERMINOLOGY
• 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).
• 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.
• SCINTILLATOR:
A scintillator is a material such as Gadolinium Oxysulfide or Caesium
iodide (Capture Element) that converts an X-ray photon into a light
photon.
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 TERMINOLOGY
• EXCITATION AND DE-EXCITATION?
• FLUORESCENCE:
• The instantaneous emission of a light photon when
electrons in the excited state (Conduction band) falls back
to the ground state (Valence Band) without applying
energy.
• PHOTOSTIMULATED LUMINESCENCE (PSL) is the
release of stored energy (carried by electrons) within a
phosphor by stimulation with energy (e.g., visible light), to
produce a luminescent signal (light photon). X-rays may
induce such energy storage.
• (Very important to understand)
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 INTRODUCTION

• Screen-film radiography requires chemical processing,

time that can delay completion of the examination.
• Little can be done to enhance the image after the film is
processed.
• X-ray films are available in the form of hard copy film that
must be transported, and stored for future review.
• X-ray films can only be viewed in a single place at one
time.
• WHAT ABOUT IN DIGITAL RADIOGRAPHY?

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 INTRODUCTION

• Transition to a filmless environment and electronic requires all

image acquisition to provide digital output.
• All-digital imaging provides several significant advantages
over screen-film radiography.
• Picture Archiving and Communications System (PACS) and
Radiology Information System (RIS) are essential in Digital
radiography.
• The RIS is the system that provides patient demographics,
scheduling, reporting, and maintains the database from which
the PACS reconcilesthe patient information (reports, images)
for display.

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 SCREEN-FILM (SF) VS CR

• In SF radiography, the radiographic intensifying screen is

a scintillator that emits light in response to an x-ray
interaction.
• In CR, the response to x-ray interaction is seen as
trapped electrons (stored energy) in a higher energy
metastable state.

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 COMPUTED RADIOGRAPHY

• Involves capturing radiographic data from a conventional X-

ray machine and processing the data digitally to produce
crisp and high-quality radiographic images.
Any radiography imaging technique has following
steps –
1. Image acquisition
2. Image processing
3. Image display
4. Image storage

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 COMPUTED RADIOGRAPHY

• CR using photostimulable storage phosphors (PSP).

• PSP have a very wide dynamic range, being able to
record photon intensities varying by a factor of about 10
000:1.
• CR system, i.e., range of doses that can be imaged, is
very much greater than for conventional radiography.

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CASSETTE WITH IMAGING PLATE
 TWO TYPES OF DIGITAL RADIOGRAPHY
SYSTEMS
• Digital radiography imaging systems replace traditional film
with a reusable detector.
• COMPUTED RADIOGRAPHY (CR)
– Photostimulable imaging plates (PSPIP)
• DIGITAL RADIOGRAPHY (DR)
– Flat-panel detectors
– Direct conversion without scintillator
– Indirect conversion with scintillator
• Approach to describing and identifying the various DR
imaging systems — capture element, coupling element,
and collection element.

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 OVERVIEW OF DIGITAL RADIOGRAPHY

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 CAPTURE ELEMENT

• The capture element is that in which the x-ray is captured.

• In CR the capture element is the PSP.
• In the other DR modes, the capture element may be
sodium iodide (NaI), Cesium Iodide (CsI), Gadolinium
oxysulfide (GdOS), or Amorphous Selenium (a-Se).

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 COUPLING ELEMENT

• The coupling element is that which transfers the x-ray–

generated signal to the collection element.
• The coupling element may be a lens or fiberoptic
assembly, a contact layer, or Amorphous Selenium (a-
Se).

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 COLLECTION ELEMENT

• The may be a photodiode, a charge-coupled device

(CCD), or a thin-film transistor (TFT).
• The photodiode and the CCD are light-sensitive devices
that collect light photons.
• The TFT is a charge sensitive device that collects
electrons.

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 COMPUTED RADIOGRAPHY

- Uses PSP imaging plates.

- Can be used in bucky or for portable exams.

- PROCESS OF CREATING A DIGITAL X-RAY IMAGE:

• PSP exposed to x-ray photons
• Cassette goes into the reader to be processed
• An image is developed and displayed on the monitor.

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 STORAGE PHOSPHOR PRINCIPLE…NB!!!

• Incident X-rays excite electrons into a higher energy

level (Conduction band) (electron traps).
• A latent image is created in the form of “stored energy”
• Stimulation with a scanning laser beam releases
electrons.
• Typical wavelength of the stimulating laser is 633 nm.
(De-excite trapped electrons)
• Falling back, electrons emit luminescent light.
• Typical wavelength of the emitted light is 390 nm

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 STORAGE PHOSPHOR SCREENS

• Some storage phosphor screens (SPSs) incorporate phosphors grown as linear

filaments that increase the absorption of x-rays and limit the spread of
stimulated emission.

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 EXCITATION AND DE-EXCITATION

 When phosphors are stimulated with X-ray photon

energy, electron hole pairs are produced.
 In effect, Europium is excited to a higher energy level
(excited state) leaving behind a hole / vacancy
( Excitation)
 .

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 EXCITATION AND DE-EXCITATION

In effect, Europium is excited to a • Typical wavelength of the stimulating laser is

higher energy level (excited state) 633 nm (usually helium-neon laser)
leaving behind a hole/ vacancy • Typical wavelength of the emitted light is 390
nm (BLUE)

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 CR READER IMAGE PROCESSING

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 CR READER IMAGE PROCESSING

• Energy absorbed by the imaging plate must be transformed into

electrical charges, which are then recorded and digitized.
• The next slides focuses on the process of CR image processing.

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 CR: LIGHT STIMULATION–EMISSION

• X-ray beam exposes a PSP, the energy

transfer results in excitation of electrons STEP 1
into a metastable state, see Figure 15-
7.
• About 50% of these electrons return to
their ground state immediately, resulting
in prompt emission of light.
• The remainder of metastable electrons
return to the ground state over time.
• This causes the latent image to fade
and requires that the IP must be read
soon after exposure. FIGURE 15-7 Expose: The first of a
• CR signal loss is objectionable after sequence of events that results in an x-ray–
induced image forming signal.
approximately 8 hours.

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 EXCITATION AND DE-EXCITATION

• Typical wavelength of the stimulating laser is

In effect, Europium is excited to a
633 nm (usually helium-neon laser)
higher energy level (excited state)
• Typical wavelength of the emitted light is 390
leaving behind a hole/ vacancy
nm (BLUE)

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 PHOTOSTIMULATED LUMINESCENCE

• When a scintillator is irradiated, some of the electrons in the valence

band (ground state) receive sufficient energy to be raised to the
conduction band.
• Electron fall back to ground state (Valence bad) after losing energy.
• Or until they fall into a metastable state (trapped electrons)
• If electrons transition to ground state instantaneously, a light is
emitted, and the phenomenon is called FLUORESCENCE.
• If a trapped electron requires energy to get out of the trap and fall to
the valence band, the emission of light in this case is called
PHOSPHORESCENCE (DELAYED FLUORESCENCE).
• If the applied energy is light the phenomenon is called
PHOTOSTIMULATED LUMINESCENCE

• SEE THE NEXT TWO SLIDES FOR FURTHER DETAILS

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 PHOTOSTIMULATED LUMINESCENCE

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 PHOTOSTIMULATED LUMINESCENCE

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 PHOTOSTIMULABLE LUMINESCENCE (PSL)

• Some materials such as barium fluorohalide with Europium

(BaFBr : Eu or BaFI : Eu) emit some light promptly in the
way that a scintillator does following x-ray exposure.
• They also emit light some time later when exposed to a
different light source.
• Such a process is called photostimulable luminescence
(PSL).
• The Europium (Eu) is present in only very small amounts.
• It is an activator and is responsible for the storage property
of the PSL.
• The activator is similar to the sensitivity center of a film
emulsion because without it, there would be no latent image.

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 CR: LIGHT STIMULATION–EMISSION

• The laser light is used to stimulate the PSP is monochromatic, see

Figure 15-8.
• A HeNe gas laser used to be the stimulating source of choice, but
this has been largely replaced by a solid state laser.
• The resulting emission has a polychromatic spectrum.
• The emitted light intensity has many orders of magnitude lower
than that of the stimulating light; this poses additional challenges
to the entire process.
• Solid-state lasers produce longer wavelength light and therefore
are less likely to interfere with emitted light.
• Even so, optical filters are necessary to allow only emitted light to
reach the photodetector while blocking the intense stimulated
light.

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 STIMULATING LASER
• The second step in CR imaging is STEP 2
stimulation, see Fig. 15-8.
• The finely focused beam of infrared
light with a beam diameter of 50 to 100
μm is directed at the PSP.
• As laser beam intensity increases, so
does the intensity of the emitted signal.
• Note that as the laser beam penetrates,
it spreads.
• The amount of spread increases with
PSP thickness.
FIGURE 15-8 Stimulate: Stimulation of the latent
image results from the interaction of an infrared laser
beam with the photostimulable phosphor (PSP).

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 LIGHT EMISSION

• Third step involve detecting

(reading) the stimulated emission,
Figure 15-9.
STEP 3
• Laser beam causes metastable
electrons to return to the ground with
emission of a shorter wavelength light.
• (Blue light of the visible spectrum).
• Through this process, the latent image
is made visible.
• Some signal is lost as the result of:
(1) scattering of the emitted light
(2) the collection efficiency of the
photodetector.
FIGURE 15-9 Read: The light signal emitted
• Photodiodes (PDs) are the light detectors
after stimulation is detected and measured.
of choice for CR.

31
 CR READER IMAGING

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 ERASE
• The final step in PSL signal production is
shown in Figure 15-10.
• The stimulation cycle of PSL signal
acquisition does not completely
transition all metastable electrons to
the ground state.
• Some excited electrons remain.
• If residual latent image remained,
ghosting could appear on subsequent
use of the IP.
• Any residual latent image is removed by
STEP 4 flooding the phosphor with very intense
white light from a bank of specially
designed fluorescent lamps.
FIGURE 15-10 Erase: Before reuse, any residual metastable electrons are moved to
the ground state by an intense light. 33
 DIGITAL X-RAY IMAGE

- Digital images are those that were converted into numerical

values for transmission and processing.
- A matrix is a series of boxes laid out in rows and columns
that gives form to an image.
- Individual matrix boxes are known as elements or pixels.
- To calculate the number of pixels in an array, multiply the
number of rows in a matrix by the number of columns in a
matrix.
- Each pixel can represent a wide range of different shades of
grey from pure white through out total black.
- Number of shades of grey is determined by grayscale bit
depth.

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 OVERVIEW OF DIGITAL
RADIOGRAPHY

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 CESIUM IODIDE/AMORPHOUS SILICON

• An early application of DR involved the use of CsI to capture

the x-ray, Figure 16-9, as well as transmission of the resulting
scintillation light to a collection element.
• The collection element is silicon sandwiched as a TFT.
• Silicon is a semiconductor that usually is grown as a crystal.
• When identified as amorphous silicon (a-silicon), the silicon
is not crystalline but is a fluid that can be painted onto a
supporting surface.
• CsI has a high photoelectric capture because the atomic
number of Cesium is 55 and that of iodine is 53.
• Therefore, x-ray interaction with CsI is high, resulting in low
patient doses.
 DIGITAL RADIOGRAPHY (DR)

- Uses reusable detectors instead of films.

- With DR systems, image is acquired and directly sent to
the display monitor.

• N.B. There are numbers of detector configurations used in

DR system:

• Indirect conversion (with scintillator)

• Direct conversion ( without scintillator)

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 INDIRECT CONVERSION DETECTOR (IDD)

- Use two-part processes involving a scintillator which converts

x-ray photons into light and a photodetector converting light
into an electronic signal.
- Indirect systems include those used in CR (PSP) and those
used in DR, including either a charged coupled device (CCD)
or amorphous silicon with a thin film transistor (TFT).
- The light photons can be recorded by a normal CMOS or CCD
camera.
- Light photons travel in all directions, causing a loss of
accuracy in spatial resolution.
- Scintillation technologies are not as efficient as CdTe at
absorbing X-rays (USED IN DIRECT CONVERSION
DETECTOR).

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CESIUM IODIDE/AMORPHOUS SILICON
 CHARGE-COUPLED DEVICE

• The CCD was developed in the 1970s as a highly light

sensitive device.
• CCD sensors ‘capture’ an image by converting light into
electrical charge.
• It has since that time found major application in astronomy and
digital photography.
• The CCD, which is the light-sensing element for most digital
cameras, has three principal advantageous imaging
characteristics: (higher) sensitivity, (wide) dynamic range,
and (small) size.
• The CCD is a silicon-based semiconductor and as shown in
Figure 16-5.

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 CHARGE-COUPLED DEVICE

• Sensitivity is the ability of a detector to

respond to very low levels of visible
light.
• This sensitivity is important for low
patient dose in digital imaging.
• Dynamic range is the ability of the
digital image detectors i.e. CCD to
respond to a wide range of light
intensity, from very dim to very bright.
• Unlike radiographic film

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 DYNAMIC RANGE/FILM LATITUDE

• Film has limited dynamic range which is

generally referred to as the film latitude.

• The latitude (or dynamic range) is the

range of receptor exposures over which
an image and contrast will be formed.

• Relationship between receptor

exposure and the resulting film density
is usually described by the film
characteristic (or H & D) curve as we see
here.

• The shoulder of the curve shows no

significant contrast formed and this
corresponds to areas of overexposure.
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 CESIUM IODIDE/
CHARGE-COUPLED DEVICE

• One successful approach to DR is

shown in Figure 16-7.
• This use of tiled CCDs receiving
light from a scintillator.
• The image receptor shown in Figure
16-7 is of this type.

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 CCD TECHNOLOGY (INDIRECT DR PROCESS)

• The scintillation light from a CsI

phosphor is efficiently transmitted
through fiberoptic bundles to the
CCD array.
• The result is high x-ray capture
efficiency and good spatial
resolution—up to 5 lp/mm.
• Figure 16-8 shows a versatile
imaging system that is based on CsI
and CCD technology.

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 DIRECT CONVERSION DETECTOR (DCD)

- The final DR modality is identified as direct DR because

no scintillation phosphor is involved.
- Directly converts x-ray photons to an electronic signal.
- E.g., CdTe (Cadmium and Tellurium) is a direct
conversion X-ray capture element without a need to convert
X-ray photon into a light photon before recording it.
- Since the atomic number of both materials is high (Cd:48,
Te:52).
- So CdTe can absorb radiation more effectively.

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 AMORPHOUS SELENIUM

• The image-forming x-ray beam interacts directly with

amorphous selenium (a-Se), producing a charged pair as
shown in Figure 16-13.
• The a-Se is both the capture element and the coupling
element.
AMORPHOUS SELENIUM
 AMORPHOUS SELENIUM

• The a-Se is approximately 200 μm thick and is sandwiched

between charged electrodes.
• X-rays incident on the a-Se create electron hole pairs through
direct ionisation of selenium.
• The created charge is collected by a storage capacitor and
remains there until the signal is read by the switching action of
the TFT.
 THE BENEFITS OF DIRECT DR

• The benefits include fast acquisition, long

lifetime, improved resolution and contrast.

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 SCANNED PROJECTION
RADIOGRAPHY
• In SPR, the x-ray beam is collimated to a fan by prepatient
collimators.
• Shortly after the introduction of third-generation computed tomography
(CT), scanned projection radiography (SPR) was developed by CT
vendors to facilitate patient positioning, Figure 16-2.
• It remains in use with virtually all current multislice helical CT
imaging systems.
• The patient is positioned on the CT couch and then is driven through
the gantry while the x-ray tube is energised.
• The x-ray tube and the detector array do not rotate but are
stationary, and the result is a digital radiograph.
• Postpatient image-forming x-rays likewise are collimated to a fan that
corresponds to the detector array—a scintillation phosphor, usually NaI or
CsI—and is married to a linear array of CCDs through a fiberoptic light
path.

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SCANNED PROJECTION RADIOGRAPHY
 SCANNED PROJECTION RADIOGRAPHY

• X-ray tube and detector remain

stationary
• Patient table moves continuously whilst
the x-beam is “on”
• Produces a three-dimensional x-ray
image

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 SCANNED PROJECTION
RADIOGRAPHY

• SPR is re-emerging with some modification as a promising

adjunct to digital radiographic tomosynthesis (DRT).
• The purpose of all forms of tomography is to improve
image contrast, and that is the goal of DRT.
 ACTIVITY

UNDERSTAND A STEP BY STEP PROCESS OF CR READER IMAGE

PROCESSING

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