Image Production and Evaluation - My Notes During Review

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IMAGE PRODUCTION AND EVALUATION

10 REASONS TO FAILURE IMPORTANCE OF PROCESSING ROOM


1. Poor people skill 1.) LOCATION
2. A negative attitude  In proximity/near to exposure room
3. A bad fit 2.) SIZE
4. Lack of focus  15ft x 9.5 ft or greater
5. A weak commitment  200 radiographs/day
6. An unwillingness to change
7. A shortcut mind set Wet and Dry Section
8. Relying on talent alone  4 ft away from each other
9. A response to poor information  To prevent contamination of the dry section
10. No goals
3.) PROTECTS AGAINST RADIATION
RADIATION TECHNIQUE  Darkroom can be adjacent to exposure room
only if:
DARKROOM o CONCRETE: greater than 6 inches
 A scientific laboratory o HOLLOW BLOCKS: filled with
 Where radiography starts and ends cement
o WOOD: with 1.5 mm Pb
OCCUPATIONAL SAFETY AND HEALTH
AGENCY (OSHA) AUTOMATIC PROCESSOR
 It requires RT to wear face mask (24 inches/corner)
 RATIONALE: fumes are carcinogenic A.) TOTALLY INSIDE
 All automatic processor are located inside
DARKROOM DISEASE  ADVANTAGE: jammed films can be
 Hypersensitivity to fumes retrieved without exposure to white light
 DISADVANTAGES:
MAIN FUNCTION OF DARKROOM o Increased heat/temperature, noise
 To prevent/protect film from exposure to and humidity/moist
white light and ionizing radiation during B.) BULK INSIDE
handling and processing  All automatic processor are located inside
but the drop tray is located outside
EXPOSED FILM  More advisable
 2-8 times more sensitive to subsequent  ADVANTAGES:
exposure than unexposed film o Easy retrieval of films
 RATIONALE: it contains the latent image o Decreased heat/temperature, noise
and humidity/moist
LATENSIFICATION C.) BULK OUTSIDE
 Increase in sensitivity after exposure to  Only the feed tray is located inside
white light or ionizing radiation  Used only when the darkroom is small

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IMAGE PRODUCTION AND EVALUATION

 ADVANTAGES: almost no heat, noise and  Uncluttered counter tops


humidity
 DISADVANTAGES: 6.) LIGHT-TIGHT ENTRANCE
o Jammed films can’t be retrieved  SINGLE DOOR DARKROOM
through white light o The simplest type
o Repeat exposure when the films are o Need to provide a passbox
exposed o RATIONALE: avoid RT in entering
4.) VENTILLATION the darkroom
 AIR CHANGES:  LIGHT-LOCK DOOR/DOUBLE DOOR
o 8-10 per hour DARKROOM
o Exhaust fan o Used only when there is darkroom
 AIR MOVEMENT: personnel exclusive in the darkroom
o Air inside the darkroom o If door 1 is open, door 2 is closed
o 15-25 ft/min  LABYRINTH/MAZE
o Fan o Zigzag type
 STORAGE ROOM TEMPERATURE: o Used only when the darkroom is
o 10-21 oC/50-70 oF large
 DARKROOM TEMPERATURE: o RATIONALE: it requires more
o 20 oC/67-83 oF (OLD) space
o 18-24 oC/65-85 oF (NEW)  REVOLVING DOOR
 HUMIDITY FOR STORAGE ROOM o The fast access type
AND DARKROOM: o RATIONALE: can enter and exit at
o 40-60% the same time
o 30-60% (NEW FOR DR)
PASSBOX/FILM CASSETTE TRANSFER
PSYCHROMETER CABINET
 A device used to measure humidity or  Allows the film to transfer without entering
moisture the darkroom
 Has an interlocking/alarm
HYGROMETER
 A device used to measure environmental 7.) ILLUMINATION
moisture  WHITE LIGHT ILLUMINATION
o Overhead light
5.) CLEANLINESS o 2-4 fluorescent lamps
 Avoid SMOKING, EATING and o 48 inches/8 m2
DRINKING o PURPOSE:
 RATIONALE: to prevent artifacts  Maintenance
 Emergency cases
EFFICIENT DARKROOM  Cleaning
 Pertaining to cleanliness
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IMAGE PRODUCTION AND EVALUATION

 SAFELIGHT ILLUMINATION 8.) COLORS OF WALL


o DISTANCE: 3-4 ft  PASTEL AND LIGHT: reflectance of
o WATTAGE: safelight
 7.5 watts (3 ft distance)  ENAMEL AND EPOXY: easy to clean and
 15 watts (4 ft distance) durable
o FILTERS:  MATTE FINISH NOT GLOSSY: it will
 Filters out intensity (strength) not reflect white light
and energy (color)  NEON COLOR: prohibited
o AMBER FILTER  Bright Color vs Dark Color: bright color is
 Filters out Red, Orange and the best choice
Yellow colors 9.) ELECTRICAL WIRING
 APPEARANCE: brownish  Should be appropriately installed
 For monochromatic film
(blue-sensitive film) SAFELIGHT
o WRATTEN 6B FILTER  DIRECT SAFELIGHT
 Filters only the intensity o Fixture type safelight
 For monochromatic film o Light is distributed directly
(blue-sensitive film) o Most common in the hospital
 ALTERNATIVES: Amber
 INDIRECT SAFELIGHT
filter & Kodak Mor-lite
o Ceiling type safelight
o GBX 2 FILTER o Light goes up first, then reflected
 Filters out intensity and color o BULB: Sodium vapor
(Yellow and Orange) o DISTANCE: 6 ft
 For orthochromatic film
o DISADVANTAGE: it takes time to
(blue/green sensitive film) warm up
 Multi-purpose filter
 APPEARANCE: red color
QUALITY CONTROL FOR THE
DARKROOM AND AUTOMATIC
PANCHROMATIC FILM PROCESSOR
 Sensitive to all visible light spectrum A.) DARKROOM ENVIRONMENT
 ADVANTAGE: all kinds of film can be  Daily
used
 Maintained clean, well ventilated, organized
 DISADVANTAGE: no safelight is used and safe
B.) SAFELIGHT TEST
CALCIUM TUNGSTATE  Semi-annual
 For blue-sensitive film  SAFELIGHT FOG: greater than 0.05 OD
o Always check the DISTANCE,
RARE EARTH WATTAGE and FILTERS used
 For green sensitive film o WRATTEN 6B: >550 nm
o GBX 2: > 600 nm
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IMAGE PRODUCTION AND EVALUATION

o ACCEPTABLE: 0.04 OD  ACIDIFIER: Acetic acid and Sulfuric acid


C.) AUTOMATIC PROCESSOR
TEMPERATURE pH RANGE
 Weekly  7-14: alkaline, base chemical
 Greater than ± 0.3 oC/0.5 oF  7: neutral, water
D.) REPLENISHMENT RATE  0-7: acid, acidic chemical
o Weekly
o Within ±5% G.) DEVELOPER SPECIFIC GRAVITY
 Quarterly/Every 3 months/Weekly
OXIDIZED DEVELOPER  Not greater than 0.004
 Old or exhausted developer
 Reducing capacity has been reduced SPECIFIC GRAVITY
 Decreased the activity of developer,  The amount of water versus chemical
activator/buffer, preservative except for
restrainer HYDROMETER
 All solution should be replaced except for  A device that measures specific gravity
restrainer
H.) PROCESSOR CONTROL CHART
RESTRAINER MONITORING
 Controls the activity of the developing agent  Daily
 Early in the morning
CONTAMINATED SOLUTION  After the automatic processor reached its
 Entire solution is ineffective maximum capacity or has been warmed up
 Can’t be replenished  Not greater than 0.15 OD from baseline
 Should be replaced measurements
 Speed and contrast indication
FUNCTION OF REPLENISHMENT RATE
 Maintain or bring back the activity of FILM SENSITOMETRY
chemical on its original activity or  Quantitative measurement of response of
composition film to exposure and development
 DEVICES USED:
E.) DEVELOPER SOLUTION pH o Sensitometer: optical step wedge
 Quarterly/Every 3 months/Weekly o Penetrometer:
 NORMAL pH: 10-11.5 or 9.6-10.6  Aluminum step wedge
 ALKALINIZER: Sodium hydroxide and  Alternative for sensitometer
Sodium carbonate o Densitometer: measures the density
of exposed film
F.) FIXER SOLUTION o Step Table
 Quarterly/Every 3 months/Weekly o Sensitometric strips
 NORMAL pH: 4-4.5 or 4.2-4.9
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MEYNARD Y. CASTRO, RRT
IMAGE PRODUCTION AND EVALUATION

 CONTROLS: ARCHIVAL QUALITY


o Film speed  Permanence of the image
o Film contrast
o Film latitude INTENSIFYING SCREEN
o Contrast using hydroquinone  15-20 times less radiation
 Used since beginning
POWER OF HYDROGEN (pH)  BASE: cardboard and high quality plastic
 Qualitative method of measuring the (polyester)
alkalinity or acidity of the solution  ADVANTAGES:
o Reduces radiation dose
PHENIDONE o Decreases technical factors
 Film speed indicator  DISADVANTAGES:
 First to produced o Increased quantum mottle
 Gray shade o Blurred image
 Dmin = 1.2
 Controls the toe of the characteristic curve NO INTENSIFYING SCREEN
 ADVANTAGE: No quantum mottle
HYDROQUINONE  DISADVANTAGE: Increases patient dose
 Film contrast indicator
 Second to produced REMNANT RADIATION
 Black tones  Radiation that is not absorb by the patient
 Dmax = greater than 1.2 and form the latent image
 Controls the shoulder of the characteristic
curve DUPLITIZED FILM
 Double emulsion film
HISTORICAL BITS  ADVANTAGES:
1895 – photographic plates o Double the film speed
1914 – cellulose nitrate film base o Decreases patient dose
1918 – duplitized films  DISADVANTAGE:
1924 – cellulose triacetate film base o Parallax effect/crossover
1933 – tinted film base
1936 – direct film exposure FACTORS THAT AFFECT FILM SPEED
1940 – film suitable for both direct & indirect  Number and size of silver halide crystals
exposure
1958 – fast light-sensitive film TINTED FILM BASE
1960’s – polyester film base and film for rapid  Decreases the possibility of parallax
processing effect/crossover
 Reduces eye fatigue and eye strain
FILM BASE  Increases contrast under the negatoscope
 Foundation of the radiographic film
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IMAGE PRODUCTION AND EVALUATION

FAST LIGHT SENSITIVE FILM ELECTROMAGNETIC SPECTRUM VS


 Decrease X-ray – Increase Film Speed VISIBLE SPECTRUM
 Increase Patient Dose – Increase Image
Quality – Decrease Parallax Effect ELECTROMAGNETIC SPECTRUM
 Decrease Patient Dose – Decrease Image  The range of frequencies over which an
Quality – Increase Parallax Effect electromagnetic radiation can be propagated
 Note: x-ray films are more sensitive in
PATIENT DOSE visible light than x-rays
 Directly proportional to the image quality
VISIBLE SPECTRUM
 Increase IS Speed – Decrease Patient Dose –
Decrease Image Quality – Increase Quantum  The range of wavelength of the
Mottle electromagnetic spectrum over which an
unaided human eye can perceive changes as
an alteration in color
GRID
 To improve image contrast
SENSITIVITY
 Increase Grid Ratio – Decrease Scattered
 Response of x-ray film to wavelengths of
Radiation – Decrease Fog – Decrease
visible light
Density – Increase mAs
 DISADVANTAGE: increase patient dose
SPECTRAL SENSITIVITY
 The range of wavelength of the
AUTOMATIC PROCESSOR
electromagnetic radiation that the film will
1942
respond
 PAKO
 1st automatic processor
PEAK SENSITIVITY
 Specialized hanger
 The range of wavelength in which the film
1956
will exhibit its highest response
 EASTMAN
 Roller transport system CUT-OFF SENSITIVITY
1965
 The range of wavelength in which the film is
 1st rapid processing no longer sensitive
 90 secs
1987 TYPES OF FILM ACCORDING TO
 KONICA SPECTRAL SENSITIVITY
 45 secs 1.) MONOCHROMATIC FILM
 Special chemicals  COLOR: Blue sensitive
 GRAINS: Globular
 SCREEN PHOSPHOR: Calcium tungstate
(not specific emission)
 Sensitive to spectrum wavelength of photons

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IMAGE PRODUCTION AND EVALUATION

2.) ORTHOCHROMATIC  ADVANTAGES:


 COLOR: Green sensitive o Decreased parallax effect/crossover
 GRAINS: Tabular o Decreased quantum mottle
 SCREEN PHOSPHOR: Rare Earth o Increases image quality
(specific emission)  DISADVANTAGES:
 Sensitive to green light by rare earth o Increased patient dose
3.) PANCHROMATIC FILM o Increased development time
 Sensitive to all visible light spectrum  APPLICATION:
o Intraoral dental radiography
GRAIN TECHNOLOGY 2.) SCREEN FILM
1.) GLOBULAR GRAIN  Indirect exposure o
 Spherical in shape  Uses thinner emulsion
 Has bigger volume  More sensitive to light
 For blue-sensitive film o Light: 90-99%
2.) TABULAR GRAIN o X-ray: 1-10%
 Tabletop-like structure  ADVANTAGES:
 Provides bigger surface o Decreased patient dose
 For green sensitive film o Decreased developing time
 DISADVANTAGES:
CALCIUM TUNGSTATE o Increased quantum mottle
 Broad band colors (Blue, Indigo, Violet) o Blurred image
 LINE EMISSION: not specific emission
CLASSIFICATION OF FILM
RARE EARTH ACCORDING TO USE
 OXYBROMIDE: Blue 1.) MAMMOGRAPHIC FILM
 OXYSULFIDE: Green  For breast examination
 LANTHANUM: Blue  Fine grains
 LINE EMISSION: specific emission  Single emulsion
 Greater detail
LANTHANIDE  High exposure dose
 ATOMIC #: 57-71 o RATIONALE: high mAs
 Yttrium: 39  Increased patient dose – Decreased parallax
 Lanthanum: 57 effect – Increased detail
 Gadolinium: 64  Increased IS speed – Decreased light
emission – Decrease OD – Increased mAs
GENERAL TYPES OF FILM
1.) DIRECT EXPOSURE/NON-SCREEN HIGH RESOLUTION INTENSIFYING
 Uses thicker emulsion SCREEN
 Slow speed
 Outdated technology

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IMAGE PRODUCTION AND EVALUATION

2.) THERAPY LOCALIZATION FILM 5.) PHOTOFLUOROGRAPHIC


 It serves as a guideline  Abreugraphy
 Wide range of exposures  Manuel Diaz Abreu
 Direct exposure  Single emulsion
 Fine grain  For chest x-ray examination
 ADVANTAGE: increase resolution o Mass CXR
 DISADVANTAGE: radiation is o PTB
continuously emitted o Lung cancer
 Miniature fluorography
SIMULATOR 6.) CINE/ROLL FILM
 It used in Cobalt 60  Single emulsion film
 With sprocket holes
LETHAL DOSE  Movie film
 Dose required to kill cancer cells  Angiographic film
 Cardiac catheterization
TOLERANCE DOSE  Width – 16 mm & 35 mm
 It should be greater than lethal dose  Image – 7 x 10 mm & 24 x 35mm
 Uses tagaro viewer
TREATMENT FOR BREAST CANCER  Frame Rate – 30-60 frames/sec
 Surgery – mastectomy  100-300 rolls
 Radiation Therapy – regional  Black and white
 Chemotherapy – metastases  35% actual images
7.) SPOT FILM
PALLIATIVE TREATMENT  For special procedures
 Lengthening the life in short term basis  Width – 100 mm
 Frame Rate – 10 frames/sec
CURATIVE TREATMENT 8.) COPY/DUPLICATING FILM
 Lengthening of life in long term basis
 Reversal film
 Single emulsion
3.) DENTAL X-RAY FILM
 It uses UV lamp and light
 Intraoral Film – for direct exposure
 Black light bulb
o Peripheral Film
9.) DOSIMETER/PERSONNEL MONITORING
o Bitewing/Interproximal
FILM
o Occlusal Film
 Measures radiation absorbed dose
 Extraoral Film – for screen-film
o Panoramic
THEMORLUMINESCENT DOSIMETER
4.) VIDEO FILM
(TLD)
 Single emulsion
 Frequently used
 It uses multiformat camera and laser camera
 Monthly

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IMAGE PRODUCTION AND EVALUATION

 Lithium fluoride o DSA


 No dosimeter film  Red – sensitivity
 Infrared light
OPTICALLY-STIMULATED
LUMINESCENCE (OSL) FILM STORAGE AND HANDLING
 Monthly 1.) UNEXPOSED FILM
 Aluminum oxide  Stored in original packaging
 No dosimeter film  RATIONALE: expiration date
 Expired Film – Decreased Sensitivity/Loss
FILM BADGE Speed – Increased mAs
 It used dosimeter film  Age Fog/Expired Film – Loss Contrast –
 Wear inside the apron Poor Image Quality
2.) EXPIRED FILM
PEN DOSIMETER  Should be discarded
 Daily exposures  Silver recovery
 Reset o Fixer – 50% Ag
o Film – 50% Ag
PHILIPPINE NUCLEAR RESEARCH 3.) ARCHIVAL FILM
INSTITUTE  5 years/10 years
 Where the record of exposure is submitted  Can be sold
4.) SCRAP FILM/SPOILAGE
10.) AUTOMATIC SERIAL CHANGER  50% Ag recovery
 Serial radiography 5.) GREEN FILM
 Angiography  The most precious in terms of Ag recovery
 Special procedure  100% Ag recovery
 Special protective coating  Ag remain intact
o To prevent scratches
11.) INDUSTRIAL FILM VERTICAL/EDGE/STRAIGHT/UPRIGHT
 Mega electron volts  Storage of film
 High energy/radiation radiography  RATIONALE:
12.) POLAROID o To prevent film to stick to one
 Paper-based another
 Thermal paper o To prevent pressure artifacts
 DSA and UTZ
13.) LASER FILM STORAGE TEMPERATURE
 No darkroom, fixer and developing solution  10-21 oC/50-70 oF
 Laser printing  40-60% humidity
o MRI
o CT Scan MAXIMUM STORAGE
o Digital Radiography  30-45 days at 21 oC/70 oF
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IMAGE PRODUCTION AND EVALUATION

 Greater than 1 year at 10 oC/50 oF o Radiation


 0 oC – stop film aging process o Chemical fumes
o Film can be used but should be warm o Pressure
up to room temperature at 35 oC/85
o
F EXPIRATION DATE
 Increased Temperature – rapid aging process  Adhere First In First Out (FIFO)
 RATIONALE: to beat the expiration date
ENVIRONMENT
 Very important to film HANDLING OF FILM
 AVOID:
POSSIBLE CONSEQUENCES OF STORING o Hand cream
UNEXPOSED FILM IN ENVIRONMENT  RATIONALE: finger print
WITH IMPROPER TEMPERATURE AND marks (negative density
RELATIVE HUMIDITY mark)
 Temperature too high: increased fog level o Rubber gloves
 Temperature too low: increased static  RATIONALE: static
discharges artifacts (positive density
 Humidity too high: increased fog level marks)
 Humidity too low: increased static  Cotton gloves can be used
discharges
KINDS OF FOG THAT CAN
STATIC ARTIFACTS AFFECT THE FILM
 Positive artifacts (black) 1.) AGE FOG – expired film
2.) CHEMICAL/DEVELOPMENT FOG
NECKLACE  Fumes
 Negative artifacts (white)  Contaminated developer solution (0.1 of
fixer)
TEMPERATURE AND HUMIDITY
 Directly related DEVELOPER
 Increased Temperature – Increased Heat Fog  All or none phenomenon
– Increased Possibility of Static Artifacts
RESTRAINER
PACKAGING OF FILM  Prevents chemical fog
 Photo-inert photoethylene bag or metal foil  Increased Restrainer Activity – Increased
o RATIONALE: to protect film from Etol, Metol, Phenidone and Hydroquinone
moisture and light  FUNCTIONS:
o Control
FILM STORED o Restrain
 Must be protected from: o Regulate
o Heat o Prevent development fog
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IMAGE PRODUCTION AND EVALUATION

3.) SAFELIGHT FOG  Decreased kVp – Decreased Scatter


 Most common cause of fog Radiation – Decreased Fog – Decreased
4.) HEAT FOG Density – Increased mAs
 Increased Temperature – Increased Heat Fog
5.) SECONDARY RADIATION FOG POSITIVE-DENSITY ARTIFACTS
 Increased kVp – Increased Scattered  Before processing
Radiation – Increased Fog
 X-ray – polyenergetic heterogenous beam NEGATIVE DENSITY ARTIFACTS
 20-150 energy/kVp  During processing
o 20-70 – produces scatter radiation
o 80-120 – remnant radiation SENSITIZED MARKS
 Development tank
mAs  Wet pressure sensitation
 Controls quantity, amount and number of x-
rays RADIOGRAPHIC FILM

APPEARANCE OF FOG IMAGE FORMING X-RAYS


 Those that exit the patient and interact with
 Gray shades
the image receptor

FACTORS THAT CONTROL SCATTER EXIT BEAM


RADIATION  The x-rays that remain as the useful beam
1.) kVp exits the patient
 Increased kVp – Increased Scatter Radiation
– Increased Fog – Increased Density IMAGE RECEPTOR
 The medium that converts the x-ray beam
2.) PATIENT THICKNESS, SIZE AND
into a visible image
DENSITY
 Increased Thickness, Size and Density – RADIOGRAPHIC FILM
Increased Scatter Radiation  Basic Parts: base & emulsion
3.) BEAM-RESTRICTING DEVICE/  Other Parts: adhesive layer & overcoat
COLLIMATOR
 Thickness: 150-300 μm
 Increased Collimation – Decreased Scatter
 Manufactured in total darkness
Radiation
 Biggest Size: 35 x 43 cm. or 14 x 17 in.
 Smallest Size: 20 x 25 cm. or 8 x 10 in.
PATIENT
 Main source of scatter radiation
PARTS OF RADIOGRAPHIC FILM
1.) TOPCOAT/SUPERCOAT/OVERCOAT
FOG
 A protective covering of gelatin that
 Non information image
enclosed the emulsion
 Unwanted/supplementary density
 Composition: made up of gelatin

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IMAGE PRODUCTION AND EVALUATION

 Purpose:
o Prevent damage to sensitive 3.) ADHESIVE/SUBSTRATUM LAYER
emulsion layer  A thin coating located between the emulsion
o Protects the emulsion from scratches, & base
pressure & contamination  Adheres one layer of the film
o Allows rough manipulation of x-ray  Purpose: allows emulsion & base to
film before exposure maintain proper contact & integrity
2.) EMULSION 4.) BASE
 The heart of the radiographic film  Foundation or framework of the film
 Active layer  Purpose: to provide a rigid structure onto
 Radiation and light sensitive which the emulsion can be coated
 Size: 3-5 or 10-20 micrometer  Composition: polyester/plastic
 Composition: silver halide crystal & gelatin  Size: 175 or 200 or 150-300 micrometer
 Silver Halide Crystal: recording medium
o The active ingredient of the emulsion CHARACTERISTIC OF GOOD FILM BASE
o Characteristic: high atomic number 1.) SUPERIOR PHYSICAL/DIMENSIONAL
(Z) STABILITY
 Composition:  Maintain its size and shape without
o Silver bromide: 98% or 90-99%
contributing to image distortion
o Silver iodide: 2% or 1-10%
2.) TINTED WITH BLUE DYE (1933)
 Shapes: tabular (mostly used), cubic,
octahedral, polyhedral & irregular  To reduce parallax effect/crossover
 Gelatin: mechanical binder  To reduce eyestrain and fatigue
o It holds the silver halide crystal  Increase contrast
uniformly dispersed in place 3.) FLEXIBLE & FRACTURE RESISTANT
o Characteristics: clear & sufficiently  It can be snap in the viewbox/negatoscope
porous 4.) UNIFORM LUCENCY/OPTICAL
o Principal Function: to provide
CLARITY
mechanical support for silver halide
crystals  In order to be seen
 Transparency should be uniform
INCREASED ATOMIC NUMBER (Z)  No unwanted pattern or shading is found on
 Increased the possibility of forming the the image
latent image 5.) SEMIRIGID
 Bromide: 35 Z 6.) INERT TO PROCESSING CHEMICAL
 Silver: 47 Z  Does not change in form
 Iodide: 53 Z 7.) CHEMICAL MEMORY
 Gelatin: 7 Z  Remain flat
 Polyester: 7 Z 8.) NON-FLAMMABLE
9.) WATERPROOF

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IMAGE PRODUCTION AND EVALUATION

1.) FILM SPEED


 Degree to which the emulsion is sensitive to
PARALLAX EFFECT x-rays/light
 Apparent displacement of an image as seen  The exposure required to produce an optical
in the radiograph density of 1.0 above base fog
 Increased Film Speed – Increased
HISTORY OF FILM BASE Sensitivity – Increased Density – Decreased
1.) GLASS PLATE mAs – Decreased Dose
 The original film base
 Characteristic: fragile
FACTORS AFFECTING FILM SPEED
2.) CELLULOSE NITRATE
 Standard base  Number of silver halide crystals
 Characteristic: flammable  The number of sensitivity center per crystals
3.) CELLULOSE TRIACETATE (mid-1920s)  The concentration of crystals in the
 Safety base emulsion
 Characteristic: safety base but easily torn  The size & distribution of the crystals
4.) POLYESTER (1960)
 Film base of choice
FACTORS AFFECTING FILM SPEED IN
 Ethylene glycol & dimethyl terapthalate
INTENSIFYING SCREEN
 Characteristics:
o More resistant  Type/composition of phosphor
o Superior dimensional stability  Thickness of phosphor
 Size of phosphor
BASIC FILM TYPES ACCORDING TO  Reflectance used
CONSTRUCTION
1.) DUPLITIZE/DOUBLE EMULSION FILM 2.) FILM CONTRAST
 Films that have emulsion layer coated on  Refers to the ability of the radiographic film
both sides of the film base to provide a certain level of image contrast
 Screen or non-screen type  The difference in OD b/n 2 areas in the
2.) SINGLE-COATED image
 Films that have emulsion layer on one side  Inherent to film manufacturer
only  High contrast emulsion – good image
 Low contrast emulsion – not good image
HALATION
 Reflection of screen light transmitted SUBJECT CONTRAST
through the emulsion & base
 Differential absorption of tissue
 The halo unsharpness that reduces resolution
 Controlled by RT
 Produced by the light photons that has
already pass through the emulsion layer for
3.) EXPOSURE LATITUDE
single coated film
 Margin of errors
 Range of exposures that produce OD within
FILM CHARACTERISTICS
straight line region of sensitometric curve
13
IMAGE PRODUCTION AND EVALUATION

 Inversely proportional to film contrast  Tinting the film with blue dye
 High contrast emulsion – narrow latitude  Use monochromatic film
o Few factors can be applied  Adding anti-crossover layer
o Near to OD required ORTHOCHROMATIC FILM
 Low contrast emulsion – wide latitude  There is always a parallax effect
o Many factors can be applied  RATIONALE: green is not transparent to
dye
PARTS OF THE CHARACTERISTIC CURVE
 Base plus fog IMPORTANCE OF ADDING CROSSOVER
 Toe CONTROL LAYER
 Shoulder  Separate layer from emulsion
 Straight line portion  Absorb most of the crossover
 Easily dissolved in the solution
HUMAN EYE
 It has a logarithm of response to OD 7.) RECIPROCITY LAW
 OD = Log10 (Io/It)  OD on a radiograph is proportional only to
the total energy imparted to the radiographic
DENSITOMETER film
 It measures density  Applicable only in direct exposure, but not
in screen-film
4.) SPECTRAL SENSITIVITY
 It refers color of light to which particular FILM SENSITOMETRY
film is most sensitive  Quantitative measurement of the response of
film to x-ray and exposure or development
SPECTRAL EMISSION and processing
 Color of light produced by a particular  Frequency:
intensifying screen o Early morning when the processor
reached its maximum capacity or has
5.) SPECTRAL MATCHING been warmed up
 Correctly matching the sensitivity of the
film to the color of emission of intensifying SENSITOMETER
screen  Optical step-wedge
6.) CROSSOVER  A device that produces a constant simulated,
 Disadvantage of screen-film/duplitized film predetermined x-ray exposure
 Light that has been produced by IS  X-ray machine is not utilized
 Crossover to the base and exposing the
emulsion of the opposite side PENETROMETER
 Blurred image  Aluminum step-wedge
 X-ray machine is utilized
WAYS TO REDUCE PARALLAX EFFECT CONTROL FILM/CONTROL BOX
14
IMAGE PRODUCTION AND EVALUATION

 The film used  Film contrast, Exposure latitude,


 Exclusively used for film sensitometry Speed/Sensitivity, Automatic processing,
Phenidone & Hydroquinone
AUTOMATIC PROCESSOR
 Develop film BASE DENSITY
 The density from the manufacturer of the
SENSITOMETRIC STRIP/STEP TABLET film
 Made by exposing successive areas on a  It is inherent in the film base
film with one exposure  Average: 0.14 OD
 The image from least to maximum OD
 11 or 24 strips BASE PLUS FOG
 Dmax to Dmin  Inherent fog cause by processing conditions
 Acceptable B+F: 0.18 OD
DENSITOMETER/TRANSMISSION
DENSITOMETER MINIMUM DENSITY/Dmin
 A device that measures the percentage of  Low density & midpoint density
light transmittance  The TOE of the characteristic curve
 Base Density/Manufacturer’s Film Density:  Slightly higher than B+F density
0.14 OD
 Light Transmitance: 100% (0 OD), 10% (1 MAXIMUM DENSITY/Dmax
OD), 1% (2 OD) & 0.1% (3 OD)  Higher density & darkroom density
 The SHOULDER of the characteristic curve
GRAPHING PAPER/CONTROL CHART
 For plotting the H & D curve AVERAGE GRADIENT
 Hurter & Driffield  Reflects the film contrast which is measured
at 0.25 density units above B+F density and
OPTICAL DENSITY 2.0 density units above B+F
 Human eyes has a logarithm of response  The more vertical this line, the greater the
 Noticeable film contrast
 Formula: Log10 (Ii/It) or Log10 (Io/It)
REJECT FILM ANALYSIS
SENSITOMETRIC CURVE  Monthly: a reject rate of 10% or more
 The product of sensitivity should be considered unacceptable
 Film characteristic curve or H & D curve  A reject rate of 5-10% justifies continued
 Base Plus Fog: lowest portion (0.18 OD) monitoring
 Toe: Dmin, Phenidone
 Shoulder: Dmax, Hydroquinone INTENSIFYING SCREEN
 Straight Line Region: Film gamma  It converts x-ray energy to light which
o Steeper = good contrast exposes the radiographic film

15
IMAGE PRODUCTION AND EVALUATION

 It intensifies or amplifies the energy to CHARACTERISTICS OF A GOOD


which they were exposed PHOSPHOR
 Advantage: decrease patient dose 1.) DETECTIVE QUANTUM EFFICIENCY
 The ability of the phosphor to interact with
x-ray
LAYERS OF INTENSIFYING SCREEN 2.) CONVERSION EFFICIENCY
1.) PROTECTIVE COATING  The ability of the phosphor to convert x-ray
 It gives physical protection to the delicate into light
phosphor layer  Rare earth = high CE
 It provides a surface which can be cleaned 3.) SPECTRAL MATCHING
without damaging the phosphor  Specific color
 It helps prevent static 4.) MINIMUM AFTERGLOW/LAG
 Transparent to x-ray  Useless but it is use in fluoroscopy
 Size: 10-20 micrometer
2.) PHOSPHOR AMBIENT TEMPERATURE
 The active layer of IS  Increase temperature
 It emits light during stimulation by x-ray  >30o C/85o F
 Size: 50-300 micrometer or 60 mg/cm2  KE increases = changes color
3.) REFLECTIVE LAYER
 Intercepts light photons headed in other PHOSPHOR MATERIAL
direction & redirects them to the film 1.) CALCIUM TUNGSTATE (CaWO4)
 Shiny Substances: Magnesium oxide &  Introduced by Thomas Alba Edison
Titanium dioxide  Scheelit: natural tungstate
 Size: 25 micrometer 2.) BARIUM LEAD SULFATE
 Crystal Size: 5-15 micrometer  For high kVp techniques
 2x Film Speed – 2x Density – ½ mAs  It was used to decrease patient dose
4.) BASE  Increase scatter radiation – Increase fog –
 Made of high grade cardboard or polyester Increase density – Decrease mAs
 It provides support to the phosphor layer 3.) ZINC SULFIDE
 Size: 1000 micrometer or 1 mm  For low kVp techniques
 Characteristics:  It was used for high resolution image quality
o Rugged & moisture resistant  Decrease quantum mottle – Increase mAs
o Does not suffer radiation damage nor 4.) RARE EARTH CRYSTALS
discoloration  Speed: 1000-1200
o Chemically inert & not interact with  Increase quantum mottle – Decrease mAs
the phosphor layer  Quantum mottle: salt and pepper
o Flexible but not elastic appearance
o Does not contain impurities that  Disadvantage: Increase quantum mottle
would be image by x-rays
WILHELM CONRAD ROENTGEN
16
IMAGE PRODUCTION AND EVALUATION

 Died in colon cancer FACTORS DETERMINING SPEED OF THE


 Wife: Anaberta Ludwig SCREEN
 Type of phosphor
 Phosphor thickness
 Phosphor size
LUMINESCENCE  Reflectance of the screen backing
 Emission of light from the screen when SCREEN FACTOR
stimulated by radiation 1.) THICKER PHOSPHOR LAYER
 Increase screen speed – Increase quantum
FLUORESCENCE mottle – Decrease recorded detail
 The ability of phosphor to emit visible light  Increase screen speed – Increase light
only while expose to x-ray emission – Increase density – Decrease mAs
 During x-ray exposure or while/promptly – Decrease patient dose
emitted or within 10-8 2.) LARGE PHOSPHOR CRYSTAL SIZE
 Important to Radiography  Same as above
3.) REFLECTIVE LAYER
PHOSPHORESCENCE  2x screen speed – Increase quantum mottle –
 Continue to emit light even after x-ray Decrease recorded detail
exposure  2x screen speed – 2x light emission – 2x
 When x-ray exposure ceases or stopped density – Decrease mAs – Decrease patient
 Somewhat after 10-8 dose
 Delayed emission 3.) ABSORBING LAYER
 Important to Fluoroscopy  Decrease screen speed – Decrease quantum
mottle – Increase recorded detail
INTENSIFYING SCREEN PHOSPHOR  Decrease screen speed – Decrease light
MATERIAL AND THEIR RESPONSE emission – Decrease density – Increase mAs
1.) CALCIUM TUNGSTATE (CaWO4): BLUE – Increase patient dose
2.) RARE EARTH 4.) DYE IN PHOSPHOR LAYER
 Lanthanum oxybromide: BLUE  Same as above
 Yttrium tantalite: UV/BLUE/GREEN
 Gadolinium oxysulfide: GREEN INTENSIFICATION FACTOR
 Intensifying action of the screen
SCREEN SPEED  A measure of screen speed
 The capacity of the screen to produce visible  Formula:
light o Exposure w/o screens ÷ Exposure w/
 Increase screen speed – Increase light screens
emission – Increase density – Decrease  Increase IF – Increase intensifying action
density
SPEED VALUE

17
IMAGE PRODUCTION AND EVALUATION

 The most common method of designating


screen speed QUANTUM MOTTLE/IMAGE NOISE
 Formula: New mAs = (Old mAs x Old  Statistical fluctuation in the quantity of x-ray
Relative Speed Value) ÷ New Relative photons that contributes to image per mm2
Speed Value  Low x-ray photons – Increase
 Fast speed – Increase light emission – mottled/splotchy appearance
Decrease sitting requirement
 Slow speed – Decrease light emission –
Increase sitting requirement SCREEN MAINTENANCE
 Decrease screen speed – Decrease light  Frequency: regular cleaning
emission – Decrease density – Increase mAs  Anti-static compound/solution or 70%
– Increase patient dose isoprophyl alcohol or mild/body soap
 Increase screen speed – Increase light  Do not use detergent
emission – Increase density – Decrease mAs  Cotton balls: for even cleaning
– Decrease patient dose  UV light: to identify stain
 Increase crystal size – Thicker phosphor –  Compression layer/Contact felt: maintain
Increase screen speed proper screen-film contact
 Poor screen-film contact: blurry image
INTENSIFYING SCREEN SPEED  Common cause: foreign matter under the
25 – Ultra Detail skin
50 – Slow/High Resolution/Detailed  Wire Mesh Test: used to evaluate proper
100 – Standard/Medium/Par screen-film contact
200 – Fast/High Speed
300 – Ultrafast/Hi-plus CAUSES OF POOR SCREEN-FILM
1200 – Rare Earth CONTACT
 Worn contact felt
RELATIVE SPEED  Loose, bent or broken latches (lock)
 The ability of the screen to produce light and  Loose, bent or broken hinges
density  Warped screen cause by excessive moisture
 Formula: mAs1/mAs2 = relative  Warped cassette front
speed2/relative speed1
 Spring or cracked cassette frame
 Foreign matter under the screen (most
WATER TEMPERATURE
common cause)
 >2.8-3.0o C/5o F than developer temperature
 If water temperature is greater than
FILM CASSETTE
developer temperature, developer activity
CASSETTE FRONT
increases
 Low atomic number
 No x-ray interaction (radiolucent)
90 SECONDS AUTOMATIC PROCESSOR
 Composition: Bakelite/Carbon fiber
 33.8-35o C/90-95o F
LEAD FOIL
18
IMAGE PRODUCTION AND EVALUATION

 Absorbs backscatter radiation  A chemical contaminant responsible for the


CASSETTE BACK physical imperfection of the silver halide
 Steal of light weight of metal crystal
 Composition: Magnesium/Magnesium TYPES OF IMPERFECTION
PHOTOTIMER CASSETTE 1.) POINT DEFECT
 Radiolucent back to permit the radiation  Occur when silver ions moves out from the
reaching the film to continue in the AEC cubical lattice formation
 No lead foil
GURNEY-MOTT THEORY
2.) SENSITIVITY SPECK/CENTER
 Before exposure, silver halide (AgBr & AgI)
 Occurs when silver ions are trapped because
is suspended in gelatin in the emulsion layer of chemical impurities in the gelatin
 Sensitivity specks (latent image center) exist 3.) LATENT IMAGE CENTER
as a physical imperfection  Refers to clumping or grouping of silver
 Exposure to x-ray and light ionizes the silver ions
halide 4.) FRANKEL DEFECT
 Negative charged electrons and positive  Physical imperfection
charge silver ion float freely in the emulsion  Consists of interstitial silver ions and silver
gelatin ion vacancies
 Sensitivity specks trap electrons
 Each trapped electron attracts a silver ion IMAGE PROCESSING
1.) LATENT/POTENTIAL IMAGE
 Silver clamps around the sensitivity specks
o 4-10 silver atom pairs  Refers to the image that exists on film after
it has been exposed but before it has been
GURNEY-MOTT THEORY processed
2.) VISIBLE/MANIFEST IMAGE
 The only accepted theory in the explanation
of photographic effect  Black metallic silver
 Indicates that x-rays and visible light cause  Exists on film after exposure and processing
ionization of the atoms in the crystal
DEVELOPMENT OF VISUAL IMAGE
 Ionized crystal are said to be exposed
 “Without interaction, there is no
MITCHELL THEORY development”
 Modern theory  The developer provides electrons for the
reduction of the SHC
SENSITIVITY CENTER o By giving up electrons, the developer
 Physical imperfection in the lattice of the is oxidized
emulsion layer that occurs during the film o By gaining electrons, the SH is
manufacturing process reduced
 Latent image center or the focal point  REDOX = EUR/OPE (Electrons are Used in
Reduction; Oxidation Produces Electrons)
SILVER SULFIDE

19
IMAGE PRODUCTION AND EVALUATION

PROCESSING OF RADIOGRAPH  Sodium bromide/iodide or Potassium


1.) DEVELOPER bromide/iodide
 Convert latent image to visible image  Decreases activity of developing agent
 To amplify the amount of metallic silver on  REGULATOR: controls activity of
the film by increasing the number of silver reducing agents
 To reduce the exposed SHC into metallic  ANTI-FOGGANT: tends to prevent fog
silver  STARTER SOLUTION: first to take effect
to reduce developer activity

A. REDUCING AGENTS
 Elon/Metol/Phenidone/Hydroquinone D. PRESERVATIVE/CYCON
 Reduced exposed AgBr crystals to black  Same with fixer
metallic Ag  Prevent rapid oxidation of the reducing
 Metol (Manual) & Phenidone (Automatic) agent
o Build up detail quickly in 1st half of  Reacts with QUINONE (by produce of
the development process Hydroquinone which is a dye), capable of
o Speed indicator staining the film and form colorless
o Rapid reducing compound called HYDROQUINONE
o 1.2 OD MONOSULFATE
 Hydroquinone  STABILIZER: to promote equilibrium of
o Builds up contrast slowly during chemicals
development period  ANTI-OXIDANT: prevents internal
o Principal component oxidation
o Contrast indicator  pH = 3-4 (Preservative, Restrainer &
o Sensitive to light and temperature Hardener)
o PQ: for automatic processing
o MQ: for manual processing E. SOLVENT
 Drinking water
B. ACTIVATOR/ALKALINIZER/BUFFERING  Not tap water
AGENT/ACCELERATOR/WETTING AGENT o It creates artifacts
 Sodium hydroxide/bicarbonate & Potassium
hydroxide/bicarbonate OTHER COMPONENTS
 Maintain alkalinity 1.) HARDENER/TANNING AGENTS
 Provides necessary alkaline medium  Dialdehyde/Glutaraldehyde
 Swells gelatin emulsion so that reducing  For automatic processing only
agents can attack AgBr crystals  Added for developer solution to prevent
 pH = 9-6-10-6 or 10-11.5 or 10-12 swelling of emulsion
 Reduces film transportation problems &
C. RESTRAINER preventing damage to the emulsion
 Developer: weak/temporary hardener
20
IMAGE PRODUCTION AND EVALUATION

 Fixer: strong/permanent hardener  Product of developing as increased


2.) BENZOTHIOSOLE monosulfate
 An organic restrainer which added to PQ  All agent’s activity are decreased, except for
developer Restraining Agent
o Prevent action of phenidone on the
unexposed crystals, since phenidone REPLENISHMENT
is not restrained by bromide  Physical and chemical means of maintaining
 1956: first roller transport system uses the level of processing solution
hardener

3.) SEQUESTERING AGENTS


 Prevent precipitation of calcium sludge REPLENISHER
 Oily substance & precipitate of aluminum  A solution containing more reducing agents,
 EDTA: sodium salt of Ethylene Diamine activator and preservative but without
Tetra Acetic Acid restrainer to maintain chemical activity of
 CALGON: sodium hexametaphosphate the processing solution to the original & in
 CHELATES: boric acid/salts proper dilution with water
4.) WETTING AGENTS  MQ Replenisher: without restrainer
 Sodium hydroxide/carbonate  PQ Replenisher: with restrainer
 Stimulate uniform development (BENZOTHIOSOLE)
5.) ANTIFROTHANT/ANTI-FOAMING
 Prevent bubble formation in the solution FLOOD VOLUME REPLENISHMENT
 Prevents aerial and external oxidation SYSTEM
o Closefitting lids  25-50 pcs of 14x14 or 14x17 films
o Mixing paddle developed/day
o Hose should not be used
6.) FUNGICIDES MICROSWITCH
 Fungi: develop in complete darkness and  A device located at the entrance of the
moisture automatic processor which controls the
 Virus, bacteria & protozoa replenishment rate of processing chemicals
7.) BUFFER  Replenishment rate are normally established
 Developer: Sodium hydroxide/carbonate on the basis how much chemistry is required
per 14 in of film travel
 Fixer: Acetic acid/Sulfuric acid
 Developer: 60-70 cc or 4-5 mL/in
 Maintains pH value of the solution
 Fixer: 100-110 cc or 6-8 mL/in
OXIDIZED DEVELOPER  14x14 or 14x17 in: replenishment occurs
 Old or exhausted developer  8x10 in: no replenishment occurs
 Decrease reducing property (aerial/chemical  Oxidized developer: many big films are
oxidation) developed

21
IMAGE PRODUCTION AND EVALUATION

 Overreplenishment: many big films are o Increase agitation – Increase


developed; increases density interaction – Shorter DT
 Exhaustion of the developer:
FLOOD/TIMED/STANDBY/TITUS o Decrease developer activity – Longer
REPLENISHMENT SYSTEM DT
 Donald Titus of Kodak
 Replenish every 10 mins or 1 hour 2.) FIXING
 <25-50 14 in films  STOP BATH/SHORT STOP/ACID RINSE
 No microswitch but with timer BATH
 Many films are replenished  1% of acetic acid
 PRIMARY:
o Removes, dissolves & clears away
SUPERADDITIVITY/SYNEGISM silver halide from film
 Activity of each individual component of o To permanent the image
reducing agent in solution is less that the  SECONDARY:
activity when two components are o To stop development process
combined o To further hardens the emulsion
 It serves to clear the film of the undeveloped
CLASSIFICATION OF DEVELOPER crystals, forming a Ag complex of
1.) MQ DEVELOPER thiosulfate technically called
 Elon/metol-hydroquinone developer MONOARGENTO-DI-THIOSULFURIC
2.) PQ DEVELOPER ACID
 Phenidone-hydroquinone developer
 15 times more superadditivity than MQ A. CLEARING AGENT/FIXING AGENT
developer combination  Sodium thiosulfate (Manual Processing)
 Ammonium thiosulfate/hypo (Automatic
FACTORS AFFECTING DEVELOPMENT Processing)
TIME  Dissolves unexposed AgBr crystals, thereby
 Temperature of the solution: producing a permanent visible image
o Increase temperature – Increase  Oxidized developer: strong ammonia odor
activity – Decrease time of  Hyporetention/Thiosulfate retention:
development o Silver sulfide stain
 Size of film: o Pale yellow or brown color (brown
o Big film size – Longer DT stain)
 Size of grains of the film:
o Larger/thicker SHC – Increase WASHING
development time (Same as direct  Very important to archival quality
exposure)  Prevent hyporetention
 Agitation: circulation system
THIO
22
IMAGE PRODUCTION AND EVALUATION

 Function is to dissolve silver  Maintains equilibrium of the chemical in the


 Thio silver sulfate: Ag enter to thio solution
 Hyporetention  Prevents internal oxidation
 Prevent aerial oxidation of fixing agent
HYPOKIT  Prevent decomposition and precipitation of
 A chemical that is dropped to the film sulphur from the thiosulfate fixing agent
 Presence of thiosulfate = changes color  Responsible in removing silver to thio
 Many thiosulfate = brown color  Oxidized developer: increase monosulfate
 Chemical used = acetic acid, silver nitrate &  Oxidized fixer: increase sulfurization
solvent

AMMONIUM THIOSULFATE VS SODIUM D. HARDENER / STRONG HARDENER /


THIOSULFATE TANNING AGENT / PERMANENT AGENT
 Ammonium: for automatic processing;  Potassium aluminium/Chromium
better than sodium aluminium/Alum chloride
o Fixes the film more rapidly than Na  Major component
thiosulfate when present equivalent  Raises temperature at which gelatin softens
concentration  Prevents too much absorption of water by
 Sodium: for manual processing gelatin
 Makes the film less susceptible to physical
B. NEUTRALIZER/ACTIVATOR/ACIDIFIER change
/BUFFERING AGENT  Increase temperature, aluminium enters
 Acetic acid/Sulfuric acid
 Provides an acid medium and neutralized the E. SOLVENT
developer carried over on the film  Water
 To activate Thio to enter and get Ag
o It will not function when the medium SEQUESTERING/BUFFERING AGENT
is not acid  Boric acid/salts
 pH = 4.2-4.9 o An anti-sludging agent which delay
 Increase carryover of alkaline from precipitation of Al hydroxide
developer (alkaline)
 Alkaline: low H+ high OH-; potential  Increases pH
hydrogen  Hyponeutralizer
 Acid: high H+ low OH- o Solution used between fixing stage
and the final washing cycle to
C. PRESERVATIVE / STABILIZER / CYCON / decrease the washing time of the film
ANTI-OXIDANT to prevent hyporetention
 Sodium sulfite/Potassium sulfite  Clearing

23
IMAGE PRODUCTION AND EVALUATION

o The process by which the fixing


agent acts on the unexposed to form GROSS CONTROL TEMPERATURE/WARM
soluble complexes which eventually WATER PROCESSOR
diffuses out of the film into fixing  Used HOT WATER
solution  Affected by WATER-MIXING VALVE, a
o Fixing Time = 2x Clearing Time device that interconnect the incoming hot
(OLD) and cold water
o Fixing Time = Clearing Time +
Hardening Time (NEW) FINE CONTROL/THERMOSTATICALLY-
CONTROLLED TEMPERATURE
3.) WASHING PROCESSOR
 Removes residual processing (thio) and Ag  Uses COLD WATER
salts from the radiograph  Occurs within the developer tank itself
 Water through a thermostatically-controlled
 < 2.8o C/5o F of developer temperature heating element by means of heat exchanger
 MAIN FUNCTION: to stabilize developer  Thermostat: controls temperature
temperature  Heating element or heat exchanger or metal
 Change = 0.3o C tube
 Important to archival quality to prevent  More advisable than gross control
hyporetention temperature

4.) DRYING PROCESSING SYSTEM TANKS


 Final process  Automatic processor has 3 tanks
 Removes 85-90% of moisture from the film 1.) Developer Tank
so that it can be handle easily and stored 2.) Fixer Tank
while maintaining quality of the diagnostic 3.) Water Tank
image
 10-15% remaining CASCADE COMPARTMENT
 Consuming more electricity (60-80%  2 wash tank
electrical consumption)
 Rationale: AUTOMATIC PROCESSOR
o Filament = 1500-2500 W  A device that has roller transport system
o Air blower = 100-300 cu-ft/min  A device that comprises chemical tanks
 A dryer system for processing of
TEMPERATURE CONTROL radiographic film
 Tempering system
 Increase and decrease in developing PROCESSING CYCLE/DRY-TO-DROP TIME
temperature can adversely affect the quality  Time to process a single piece of film
of radiographic image  45 seconds to 3.5 minutes
 90 secs = 33.8-35o C/93-95o F
24
IMAGE PRODUCTION AND EVALUATION

PROCESSING CAPACITY  Disadvantage: stand by control


 Number of film that can be processed per o An electric circuit that shuts off
hour power to the roller assembly
 Belt and pulley
TRANSPORT SYSTEM
1.) VERTICAL TRANSPORT SYSTEM RADIOGRAPHIC APPEARANCE
 Used in automatic processor
 Advance the film through different stages DECREASE IN DENSITY
 All rollers & feed tray  Developer exhausted
A. ENTRANCE ROLLER  Developer underreplenishment
 Grab the film  Processor running too fast
 Covered with corrugated rubber (rubberized)  Low developer temperature
 Plexi glass, Polyester & Phenolic  Developer improperly mix
B. TRANSPORT/PLANETARY ROLLER
 Vehicle transport INCREASE IN DENSITY
 Moves the film through the chemical tanks  Developer overreplenishment
and dryer  Increase developer temperature
 Size: 1 inch  Light leak in processor
C. TURNAROUND/SOLAR/MASTER  Developer improperly mixed
ROLLER
 Bottom of the roller assembly PINKISH/DICHROIC STAIN
 Turns the film from moving down the  Contamination of developer by fixer
transport assembly to moving up the (chemical fog)
assembly  Developer or fixer underreplenishment
D. CROSSOVER ROLLER
 Moves the film from one tank to another BROWN STAIN/THIOSULFATE
 From fixer to developer  Inadequate washing
E. SQUEEGEE ROLLER
 Specialized rubber area EMULSION REMOVED BY DEVELOPER
 Insufficient hardener in developer
GUIDE PLATES
 Slightly curved metal plates MILKY APPEARANCE
 Properly guide the leading edge of the  Fixer exhausted
moving film through  Inadequate washing

MOTOR DRIVE STREAKS


 An electric motor  Dirty processor rollers
 Provides power for the roller assembly to  Inadequate washing and drying
transport the film through the processor
 On/off switch provides electric power ALTERNATIVE PROCESSING METHODS
25
IMAGE PRODUCTION AND EVALUATION

1.) RAPID PROCESSING  Scratches/Abrasions: scrapping or


 30 seconds removing emulsion
 Useful for angiography, special procedure,  Foreign objects: some unintended object in
surgery & emergency room the imaging chain
 More concentrated chemicals  Non-specific decrease: dirty screens or
 Higher developer and fixer temperature cassette
2.) EXTENDED PROCESSING
 3 minutes SILVER RECOVERY
 Mammography 1.) PRECIPITATION OF THE SILVER
 For single emulsion only  Oldest form of silver recovery
 Advantages: greater image contrast &  Chemical precipitation
lower patient dose  Involves chemical reaction
 Disadvantage: longer dry-to-drop time  Ag in fixer solution is precipitated as Ag
sulphide by adding Na sulphide to the
3.) DAYLIGHT PROCESSING solution
 2 minutes 2.) METALLIC REPLACEMENT /
 Receive film in 15 seconds DISPLACEMENT
 Uses microprocessor  Used of aluminum steel wool
 Advantages: no darkroom required & speed  Cartridge
 Least expensive and simplest
RADIOGRAPHIC ARTIFACTS 3.) ELECTROLYTIC RECOVERY UNITS
 Unwanted image  Most common
 An electric current is passed through an
POSITIVE DENSITY ARTIFACT ionized solution
 Radiolucent appearance  Two electrodes: Anode (Carbon) &
 Halfmoon marks: bending & kinking of Cathode (Stain-steel)
film  Ag is retrieved in the cathode
 Scratching/Abrasion: fingernail/scratch
 Static discharge: sliding films over flat TROY OZ
surface  Unit of silver recovery
 Fogging: exposure to white light, ionizing
radiation, heat, safelight fog & expired film USE OF SILVER RECOVERY
 Density outside collimation area: off- 1.) Photographic Industry: 30%
focused/off-skin radiation 2.) Electric Industry: 20%
3.) Sterling Industry: 15%
NEGATIVE DENSITY ARTIFACT
 Radiopaque appearance RADIOGRAPHY
 Finger print: moisture on finger transferred  Used of ionizing radiation
to the film before exposure
RADIOGRAPH
26
IMAGE PRODUCTION AND EVALUATION

 Image produced with good quality  Length of exposures


 Number of photons exposing the patient
TECHNICAL COMPETENCY with mA-timer relationship
 Operation of the control panel
 Selection of appropriate accessories DISTANCE
 Use of terminologies in evaluation of  FFD/SID: distance from the focal spot to
radiograph the recording medium
 Measurement  Affects blackening of film
 Evaluation of result  Inverse square law

CHARACTERISTIC OF RADIOGRAPH
 Exposure factor is adequate
 Adequate penetration
 Sufficient density and contrast RADIOGRAPHIC QUALITY
 Field size selection is appropriate
 No motion A. PHOTOGRAPHIC ASPECT/VISIBILITY
o Voluntary: good communication  Density: overall blackening of the film
o Involuntary: decrease exposure  Contrast: variation in the density level that
time makes detail visible
B. GEOMETRIC ASPECT/SHARPNESS
KILOVOLTAGE PEAK (kVp)  Definition: clarity and sharpness of
 Controls energy of the beam structural lines
 Penetrating ability  Distortion: undesired change in the size and
 Accelerates the electron shape of the anatomic part
 Wavelength of photon
 Affects blackening of film by 15% rule RADIOGRAPHIC DENSITY
 Determines the amount of density on
 Affects the production of scattered radiation
finished radiograph
 Controls radiographic contrast
 Acceptable Range: 0.25-2.0 OD
 Affects exposure to patient
 Directly related to mAs
MILLIAMPERAGE (mA)
FACTORS AFFECTING DENSITY
 Number of electrons
 Controlling factor: mAs
 Number of x-ray photons
 kVp, Distance, Grids, Film Screen Speed,
 Blackening
Collimation, Anatomic Part, Anode Heel
 Influences focal spot blooming
Effect, Reciprocity Law, Generator Output,
o Increase actual focal spot size when
Filtration & Film Processing
the tube current is increased

FACTORS TO REMEMBER IN DENSITY


TIME (s)
 Increase mAs: great density
27
IMAGE PRODUCTION AND EVALUATION

 Fastest screen film combination: great  To make detail visible


density  Attenuation and differential absorption
 Lowest grid ratio: great density
 Direct exposure technique: least density TYPES OF CONTRAST
 Shortest distance: great density 1.) SUBJECT CONTRAST
 Longest time: great density  Differential absorption of adjacent structures
 Highest kVp: great density  Affects by kVp, tissue composition & CM
 Smallest area of collimation: least density 2.) FILM CONTRAST
 Inherent in the film base
INFLUENCING FACTORS  Affects by film (IR), film type & direct/IS
 15% kVp rule exposure
 Increase Density: original kVp + 15%
 Decrease Density: original kVp –15%
 Maintain Density: original kVp + 15%,
mAs ÷ 2 CHARACTERISTIC OF CONTRAST SCALE
 Decrease Patient Dose: original kVp + 1.) SHORT SCALE
15% and mAs ÷ 2  Few number of useful densities on the
 Increase Image Quality: original kVp – radiograph
15% and mAs x 2  Abrupt change from one density to another
 High contrast, more contrast & narrow
ANODE HEEL EFFECT latitude
 Used long FFD and shortest/smallest field  Low kVp technique
size
 Anode Side: 75% 2.) LONG SCALE
 Cathode Side: 120%  Large number of useful densities on the
 Difference: 45% radiograph
 Little change from one density to another
INVERSE SQUARE LAW  Low contrast, less contrast & wider latitude
 Intensity of x-ray is inversely proportional to  High kVp technique
the square of distance
HIGH kVp LOW kVp
RECIPROCITY LAW Long scale contrast Short scale contrast
 States that OD on a radiograph is Low contrast High contrast
Less contrast More contrast
proportional only to the total energy
Wide latitude Narrow latitude
imparted to the radiographic film
 Accurate only on direct exposure
CONTRAST
 Fails in screen-film
 Influencing factor: kVp
 Grids, Collimation, OID, CM, Processing &
RADIOGRAPHIC CONTRAST
Air-gap Technique
28
IMAGE PRODUCTION AND EVALUATION

o Increase FFD – Decrease OFD –


CASTS Decrease magnification
 Fiber glass: no increase in exposure factor  Foreshortening/Elongation:
 Wet Plaster: increase mAs 3x o Irregular magnification
 Dry Plaster: increase mAs 2x o Distortion in shape
o Affected by CR part-film alignment
SPLINTS
 Fiber glass: no increase in factor RELATIONSHIPS
 Inflatable (Air): no increase in factor  Increase mAs – Increase Density
 Wood, Aluminum & Plastic: increase  Decrease mAs – Decrease Density
exposure if they are in the path of primary  Increase kVp – Increase Density – Decrease
beam Contrast
 Decrease kVp – Decrease Density – Increase
Contrast
 Increase SID – Decrease Density – Increase
PATHOLOGY Detail – Decrease Distortion
1.) ADDITIVE DISEASES  Decrease SID – Increase Density – Decrease
 Increases absorption characteristic Detail – Increase Distortion
 Increase kVp  Increase OID – Decrease Density – Increase
 Aortic aneurysm, Ascites, Atelectasis, Contrast – Decrease Detail – Increase
Cirrhosis, Hypertrophy, Metastases, Pleural Distortion
effusion, Pneumonia & Sclerosis  Decrease OID – Increase Density –
2.) DESTRUCTIVE DISEASES Decrease Contrast – Increase Detail –
 Decreases absorption characteristic Decrease Distortion
 Decrease kVp  Increase Grid Ratio – Decrease Density –
 Active TB, Atrophy, Bowel obstruction, Increase Contrast
Cancer, Degenerative arthritis, Emphysema,  Decrease Grid Ratio – Increase Density –
Osteoporosis & Pneumothorax Decrease Contrast
 Increase Film-Screen Speed – Increase
RADIOGRAPHIC DEFINITION/RECORDED Density –Decrease Detail
DETAIL  Decrease Film-Screen Speed – Decrease
 Clarity and sharpness Density – Increase Detail
 Umbra: true image  Increase Collimation – Decrease Density –
 Penumbra: geometric unsharpness; the Increase Contrast
blurred areas around the umbra  Decrease Collimation – Increase Density –
Decrease Contrast
DISTORTION  Increase Focal Spot Size – Decrease Detail
 Used to removed superimposition  Decrease Focal Spot Size – Increase Detail
 Magnification:  Increase CR Angle – Decrease Density –
o Distortion in size Decrease Detail – Increase Distortion
29
IMAGE PRODUCTION AND EVALUATION

TAKE NOTE:
CONTROL OF SCATTER RADIATION  Approximately 1% of x-rays incident on the
patient reach the image receptor
PRODUCTION OF SCATTER RADIATION
FIELD SIZE
 Increase Field Size: increases scatter
TWO TYPES OF X-RAYS RESPONSIBLE
radiation
FOR THE OPTICAL DENSITY & CONTRAST
ON A RADIOGRAPH  Reduce Scatter Radiation: lowers
1.) X-rays that pass through the patient without radiographic optical density
interacting o Effect: increased radiographic
2.) X-rays that are scattered within the patient technique to increase OD
through Compton interaction
PATIENT THICKNESS
REMNANT X-RAYS  Increased Thickness: increases scattered
 X-rays that exit from the patient radiation
o Rationale: more x-rays undergo
multiple scattering
IMAGE-FORMING X-RAYS
 X-rays that exit & interact with the image  Compression Paddle:
receptor o Used to reduce scatter radiation to
the image receptor
PROPER COLLIMATION  Compression of anatomy:
o Improves spatial resolution &
 Effects:
o Less scatter radiation contrast resolution
o Reduces patient dose o Lowers patient dose
o Improves contrast resolution o Important to mammography

THREE FACTORS CONTRIBUTE TO CONTROL OF SCATTER RADIATION


INCREASED SCATTER RADIATION
1.) kVp CONTRAST
2.) Field Size  One of the most important characteristics of
3.) Patient Thickness image quality
 The visible difference between light & dark
kVp areas on an image
 Increase kVp: increases scattered radiation  The degree of difference in OD between
o Rationale: the relative number that areas of a radiographic image
undergo Compton interaction
increases CONTRAST RESOLUTION
o Result: reduced image contrast  The ability to image & distinguish soft
 Decreased kVp: decreases scattered tissues
radiation
o Results: EFFECT OF SCATTER RADIATION ON
 Minimum scatter radiation IMAGE CONTRAST
 Improved image contrast  High Contrast: use of only transmitted &
 Increased patient dose unattenuated x-rays
 Due to increased mAs o Appearance: sharp image
 No Contrast: use of only scattered x-rays
30
IMAGE PRODUCTION AND EVALUATION

o Appearance: dull gray image  Device used to reduce the intensity of scatter
 Moderate Contrast: use of both transmitted radiation in the remnant x-ray beam
& scattered x-rays  Principal Function: to improve image
contrast
DEVICES THAT REDUCED SCATTERED  Secondary function: to absorb scattered
RADIATION radiation
1.) Beam Restrictors
 Used when:
2.) Grids
o Anatomical part >10 cm
BEAM RESTRICTION o >60 kVp is used
 Purpose:  Advantage: improved image contrast
o Limiting patient exposure  Disadvantages:
o Reducing scattered radiation o Higher technical factors used
o High patient dose
BEAM RESTRICTORS
 Position: between the patient & IR
1.) APERTURE DIAPHRAGM
 Simplest type
 A flat piece of lead that has hole in it
2.) CONE/CYLINDER GRID CONSTRUCTION
 Modification of aperture diaphragm 1.) GRID STRIPS/LINES
 Radiopaque material
 Has an extended flange attached to it
 Purpose: it absorbs scattered radiation
3.) COLLIMATOR  Composition: lead (Pb)
 Best type o Advantages:
 Useful and accepted type of beam-restricting  Easy to shape
device  Inexpensive
4.) AUTOMATIC COLLIMATOR  High atomic number
 High mass density
 Positive beam limiting devices (PBL)
 Characteristics: thin & high absorption
 Automatically limits the size and shape of properties
primary beam to the size and shape of the IR  Size: 50 μm wide
2.) INTERSPACE MATERIAL
RESTRICTING THE PRIMARY BEAM  Radiolucent material
Increased Result  Purpose: to maintain a precise separation
Decreased patient dose between the delicate lead strip of the grid
Decreased scattered radiation  Compositions:
COLLIMATION o Aluminum (Al)
Increased radiographic contrast
Decreased radiation density  Advantages Over Fiber:
Increased patient dose  High atomic number
Increased scattered radiation  Produces less visible
FIELD SIZE
Decreased radiographic contrast grid lines
Increased radiation density  Nonhygroscopic:
does not absorb
RADIOGRAPHIC GRID moisture
 Easier to manufacture
31
IMAGE PRODUCTION AND EVALUATION

 Disadvantages Over Fiber:  High Frequency: less distinct grid lines on


 Increases absorption a radiograph
of primary beam  Range: 25-45 lines/cm or 60/110 lines/inch
 Results: higher mAs
& higher patient dose 10,000 μm/cm
o Plastic fiber Grid Frequency =
 More preferred than Al (T+D) μm/linepair
 Size: 350 μm wide
 T = grid strips thickness/width
THREE IMPORTANT GRID DIMENSIONS  D = interspace width
1.) Grid Strip Thickness (T)  High Frequency Grids:
2.) Interspace Material Width (D) o Requires radiographic technique
3.) Grid Height (h) o Result: higher patient radiation dose

GUSTAVE BUCKY (1913) GRID PERFORMANCE


 He invented stationary grid
 He demonstrated the technique for reducing 1.) CONTRAST IMPROVEMENT FACTOR
the amount of scatter radiation that reaches  Ratio of radiographic contrast with a grid to
the IR that without a grid
GRID SURFACE X-RAY ABSORPTION  Best measure of how well a grid performs
 Purpose: measures improvement in image
width of grid strip quality when grids are used
% X-ray =
x 100  Symbol: k
Absorption width of grid strip + width of interspace image contrast with grid
k =
GRID CONTRUCTION CAN BE image contrast without grid
DESCRIBED BY:  Most Grids: k=1.5-2.5
1.) GRID RATIO  k=1: no improvement
 The height of the grid divided by the  Use of Grid: double the image contrast
interspace width
 High Grid Ratio: high k
 Formula: grid ratio = h/D 2.) BUCKY/GRID FACTOR
o h = the height of the lead strips
 Ratio of incident radiation to transmitted
o D = the distance between lead strips radiation through a grid
 High Ratio Grid:  Ratio of patient dose with & without a grid
o Advantage Over Low Ratio Grid:
 Purpose:
 More effective in cleaning up
o To measure how much of an increase
scatter radiation
in technique will be required
 Rationale: angle of deviation
compared with nongrid exposure
is smaller
o Indicates how large an increase in
o Disadvantage: increases patient
patient dose will accompany the use
dose
of a particular grid
 General Radiography: 8:1 to 10:1
 Symbol: B
 Mammography: 4:1 to 5:1 incident remnant x-rays
2.) GRID FREQUENCY
B =
 The number of grid strips per centimeter or transmitted image-forming x-rays
inches
32 patient dose with grid
B
patient dose without grid
IMAGE PRODUCTION AND EVALUATION

 Possible only if x-ray tube &


= the table are properly aligned
o Exposure technique required is
 Higher Grid Ratio: higher Bucky factor substantial
o Rationale: penetration of scatter  Result: higher patient dose
radiation becomes less likely  Advantages Over Parallel Grid:
 Increasing kVp: increases Bucky factor o More efficient in cleaning up scatter
o Rationale: more scatter radiation is radiation
produced & it has more difficult time o Higher contrast improvement factor
of penetration than parallel grid with twice grid
 Increased Bucky Factor: ratio
o Effects: o Advantage increases with increasing
 Increase radiographic kVp
technique
 Increase patient dose TAKENOTE!!!
 The main disadvantage of parallel & crossed
GRID PATTERN grids is grid cutoff
 Refers to the linear pattern of the lead lines
of a grid
TWO TYPES OF GRID PATTERN GRID FOCUS
1.) LINEAR/PARALLEL GRID  Refers to the orientation of the lead lines to
 Simplest type one another
 It has lead lines that run into one direction
 It cleans up scatter radiation in one direction TWO TYPES OF GRID FOCUS
 Grid Strips: parallel 1.) FOCUSED GRID
 Most popular in terms of grid pattern  Grid Strips: parallel to primary x-ray path
o Rationale: allows angulation of the  Purpose: to minimize grid cutoff
x-ray tube  Advantage: reduce grid cutoff
 Advantage: easiest to manufacture  Disadvantages:
 Disadvantage: grid cutoff o Difficult to manufacture
o Occur at: short SID & large area IR o Geometric limitations
 Optical Density: decreases toward the edge  Intended focal distance
of IR  Side of the grid should face
2.) CROSSED/CROSS-HATCHED GRID the x-ray tube
 It is fabricated by sandwiching two parallel  Characteristics: same with parallel grid but
grids together exhibit no grid cut off
 It has lead lines that run at right angle to one 2.) PARALLEL/NON-FOCUSED GRID
another  Grid Strips: parallel to one another
 Grid Strips: perpendicular  Applications: fluoroscopy & mobile
 Advantages: imaging
o Not too difficult to manufacture
o Not excessively expensive TYPES OF GRIDS
1.) WAFER GRID
 Disadvantages:
o Grid cutoff  Matches the size of cassette
o Critical grid positioning  Use by placing on top of the image receptor
o Tilt table techniques 2.) GRID CASSETTE
33
IMAGE PRODUCTION AND EVALUATION

 An image receptor that has a grid o Improperly positioned x-ray tube


permanently mounted to its front surface o Grid is shifted laterally (lateral
3.) GRID CAP decentering)
 It contains a permanently mounted grid  Results:
 It allows the image receptor to slide behind o Partial grid cutoff across image
it o Underexposed
o Light image (low OD)
GRID CUTOFF 3.) OFF-FOCUS GRID
 The undesirable absorption of primary x-ray  Occurs when using an SID outside of the
by the grid recommended focal range
 Cause: improper grid position  Problem in focused grid
 Primary Radiographic Effects:  Cause: improper focal distance
o Further reduction in the number of  Effect: grid cutoff toward edge of image
photons reaching the IR  Proper Focal Distance: more important
o Decrease in radiographic density with high ratio
 Most common to parallel grid o Rationale: less positioning latitude
 Distance To Grid Cutoff: SID ÷ Grid ratio than low ratio grid
4.) UPSIDE-DOWN GRID
 Occurs when a focused grid is place upside
TYPES OF GRID CUTOFF ERRORS down on the image receptor
(GRID PROBLEMS)  Problem in focused grid
 Cause: improperly positioned grid
CENTRAL RAY  Effect: severe/complete grid cutoff toward
 The x-ray that travels along the center of the edge of image
useful x-ray beam 5.) OFF-CENTER, OFF FOCUS GRID
 Most common improper grid position
1.) OFF-LEVEL GRID  Effect: grid cutoff on one side of image
 Occurs when the x-ray beam is angled
across the lead strips GRID LINES
 Only problem in parallel & crossed grid  The images made when primary x-rays are
 Central Ray: not perpendicular to the grid absorbed within the grid strips
 Cause: improperly positioned x-ray tube &  Visibility: directly related to the width of
grid the grid strips
 Results:
o Grid cutoff across image HOLLIS E. POTTER (1920)
o Underexposed  He invented the moving grid
o Light image (low OD)
2.) OFF-CENTER GRID MOVING GRID
 Occurs when the central ray of the x-ray  A Potter-Bucky diaphragm or Bucky
beam is not aligned from side to side with  Grid Used: focused grids
the center of focused grid  Advantage: minimize grid lines
 Problem in focused grid  Disadvantages:
 Also called lateral decentering o Requires bulky mechanism
 Central Ray: perpendicular to the grid  Effect: subject to failure
 Causes:

34
IMAGE PRODUCTION AND EVALUATION

o Increase distance between the patient 5:1 x2


& IR 6:1 x3
 Effect: unwanted increase in 8:1 x4
magnification & image blur 10:1 or 12:1 x5
(undetectable) 16:1 x6
o Introduce motion into cassette-
holding device
PATIENT DOSE
 Effect: additional image blur
 Moving Grid: 15% more radiation to
(undetectable)
patient than stationary grid
 High- kVp & High-ratio Grid: lower
TWO BASIC TYPES OF MOVING GRID
patient dose than low-kVp & low-grid ratio
1.) RECIPROCATING
 A moving that is motor-driven back and
GRID SELECTION FACTORS
forth several times during x-ray exposure
1.) Patient dose increases with increasing grid ratio
 Total Drive Distance: approximately 2 cm 2.) High-ratio grids are used for high-kVp
2.) OSCILLATING 3.) Patient dose at high kVp is less than that at low
 The grid oscillates in a circular fashion kVp
around grid frame
 Coming to rest after 20-30 seconds AIR-GAP TECHNIQUE
 An alternative to the use of radiographic
grids
 IR Distance: 10-15 cm from the patient
GRID SELECTION
 Advantages:
 Depends of Three Interrelated Factors: o Reduces scatter radiation
o kVp o Enhances image contrast
o Degree of cleanup
 Disadvantages:
o Patient dose
o Image magnification
 Focused Grid: most commonly used o Focal-spot blur
o Considerations: must have properly
 Applications:
adjusted
o Chest radiography
 SID indicator
 From 180 to 300 cm SID
 STD indicator
 Effects: little magnification
 Collimators
& sharper image
 Higher Ratio Grid: o Cerebral angiography
o For high kVp technique
o Increase cleanup
o Increase patient dose
 THE END 
 8:1 Grid Ratio: used when kVp is below 90
“BOARD EXAM is a matter of PREPARATION. If
 Above 8:1 Grid Ratio: used when kVp is
above 90 you FAIL to prepare, you PREPARE to fail”
04/12/14
APPROXIMATE CHANGE IN
RADIOGRAPHIC TECHNIQUE FOR
STANDARD GRIDS
Grid Ratio mAs Increase
No grid x1
35

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