X- RAY FILMS AND RADIOGRAPHIC PROCESSING

FILMS

X-ray Film - Thin sheet of gelatin and cellulose coated with silver halide crystals on both side. This is an
image receptor used for recording.
Types:
Conventional x-ray film
Xeroradiography – uses selenium plates
Computerized Tomography – uses ionization chamber

Parts of X-ray Film

1.Base – foundation of radiographic film

Glass plate, WW1

Cellulose nitrate, flammable
Cellulose triacetate
Polyester, 1960
Resistant to wrapping with age, strong and thin

2. Emulsion
Gelatin – clear, porous. Mechanical support
Silver halide crystals
Crystals 3D geometric form
Silver halide, compounds of silver with halogens
95% silver bromide and
5% silver iodide
Film Construction

Film Characteristics
Photography Density - Quantitative measure of film blackening
Film Contrast -Differences between two densities
Characterestics Curve for film
Film density
Screen or direct exposure
Film processing

Film Characteristics
Film Speed - determines the amount of x-ray required to produce an image on the radiograph
• Fast Film- Large crystals, Grainer image, Less exposure, Poorly developed image, Less exposure
latitude
• Slow Film -Small crystals, Less grainy image, More exposure, Sharply defined image, Greater
exposure latitude

Other Terminologies

Exposure Latitude – degree of over or under exposure but produce an image of acceptable quality
Absorption – is the important consideration in the sensitivity to various colors of light
• Calcium tungstate screen- (emit blue and violet light (blue sensitive film)
• Orthochromatic film – green sensitive film
• Panchromatic film – entire visible light
Film Types
Basis of coating
Single Emulsion
Double Emulsion
Based on used of screen
Non-Screen Type
Screen Type
Single Screen
Double Screen
Based on Sensitivity
Blue Sensitive Films
Green Sensitive Films
Panchromatic Films
Film Types
Screen Type
• Sensitive to fluorescent light
• Les sensitive to direct ionizing radiation
• Less exposure time
• Less image definition
Non-Screen Type
• Direct exposure film
• More sensitive to direct ionizing radiation
• Greater exposure time
• Greater image definition (bone and dental x-ray)
Direct Exposure Film (Non-Screen Film)
• Used in cardboard cassette – no screens
• Thicker emulsion with more silver with more silver content (2-3X thicker than screen film)
• Rarely used due to high doses
Screen Film (Intensifying Screen Film)
• Used in a cassette with an intensifying screen
• Thin emulsion – very sensitive to lights of screens
• Less radiation – less dose
• Allows less exposure time
Other Film Characteristics
Film size
18x43cm 24x30cm 30x35cm
35x35cm 30x40cm 35x43cm
Film packaging – 25, 50,100 sheets/box
Film cost
Film handling and storage
Dark room & cool
Upright position
Improper handling causes artifacts
Film Storage and Handling
Improper storage and handling of x-ray film result in poor radiographs with artifacts that can
interfere with patient care. Improper handling or processing can also cause artifacts on the processed
radiograph. X-ray film is pressure-sensitive, so rough handling or the imprint of a fingernail is reproduced
as an artifact. Creasing the film before processing produces a line artifact. If there is dirt on hands or on
the intensifying screens, the result is an artifact that is speckled in appearance. In a dry environment,
static electricity can cause characteristic artifacts. During automatic processing, wear or dirt on the
transport system causes artifacts. X-ray film is sensitive to the effects of elevated temperature and
humidity, especially for long periods of time. Heat reduces contrast and increases fog on the radiograph.
Film should be stored away from heat sources, ionizing radiation, and darkroom chemistry storage. Film
not in a film bin ideally should be refrigerated. Storage for a year or longer is acceptable if the film is
maintained at 50°F. Film should be stored in its original container box and oriented vertically to prevent
pressure artifacts on the film

Film Bin
Other considerations:
• The proper room temperature for storing film is 50–70°F with a relative humidity of 40–60%.
• Use out-of-date film as clean up film to maintain your processor chemistry replenishment.
• Processing chemicals must be kept away from film and film-handling areas to prevent exposure and
contamination of these areas.
• Film fogging will occur with age so it is a good practice to use older film first.
• Post-processed radiographs should be stored between 60°F and 80°F and between 30% and 50%
relative humidity.
• Radiographs are legally part of the patient’s medical record, giving ownership and responsibility for
those records to the practice that produced them.
• Though x-ray film has a safety designation as technically nonflammable, the jackets they are stored in
are flammable so films should be stored in a nonsmoking area and on metal shelving to further
decrease the fire hazard.
Darkroom Setup
The darkroom is an integral part of any veterinary practice using a film-screen system. Film
processing is as important as technique and positioning in making a quality radiograph. Processing the
invisible latent image creates the visible manifest image. Processing converts the light-exposed silver ions
in the silver halide crystal to microscopic black grains of silver. Following good darkroom maintenance
practices is necessary to producing good quality images. Darkrooms must be free from all outside white-
light exposure. The color of the interior walls should be light to reflect the small amount of light available
from safelights. The paint should be semi-gloss or flat in texture. Floors should be made of a material that
makes them nonslippery when wet in the event of chemical or water spills or leaks inside the darkroom.

The darkroom should be wiped clean daily to minimize artifacts on film by maintaining the
cleanest possible conditions in the room. The floor should be mopped with a damp mop. All unnecessary
items should be removed from countertops and work surfaces. A clean damp towel should be used to
wipe off the processor feed tray and all countertops and work surfaces. If a cassette pass box is present,
it should be cleaned daily as well. Hands should be kept clean to minimize fingerprints and handling
artifacts. Overhead air vents and safelights should be wiped or vacuumed weekly before other cleaning
procedures are performed. The ceiling tiles should be cleaned to prevent flaking on a monthly basis. Eating
and drinking in the darkroom should be prohibited. Nothing should be on the countertop except for items
used for loading and unloading cassettes because they will collect dust. There should be no shelves above
the countertops in the darkroom since these too serve as a site for dust collection.

Silver Recovery Cartridges

A silver recovery cartridge should be connected to the processor to filter the used fixer from the
processor because the fixer solution contains a high concentration of accumulated silver. Silver is
considered a heavy metal, and disposing of it is regulated by local and state agencies. The company that
repairs or maintains your processor should check, pick up the silver cartridge when it has reached capacity,
and replace with a new silver recovery cartridge

Silver Recovery Cartridge

Safelights
The safelight filters should be checked daily for cracks that may allow white light exposure to film.
In the darkroom, safelight filters are placed in safelights to produce a particular color of light for
illumination. It is important to use the correct safelight filter in all darkroom safelights based on the
spectral sensitivity of the film being processed in the darkroom. The GBX filter is safe for both blue- and
green-sensitive films. GBX simply stands for green/blue x-ray. The Wratten 1A safelight filter is safe for
green sensitive films only and the Wratten 6B safelight filter is safe for blue-sensitive film only.

An incorrect match between the type of safelight filter and the spectral sensitivity of film results
in a high incidence of safelight fogging on the film. This fogging appears radiographically as a film with
increased density and decreased contrast. Exposed radiographic films are eight times more sensitive to
fog than unexposed film. The effect on x-ray film of exposure to the illumination from safelight lamps is
referred to post-exposure. The quality of a radiograph may be impaired by unnecessary exposure to
safelight illumination, which is the reason for variations in density encountered in routine radiographs and
for the lack of brilliancy that is frequently attributed to scattered radiation. If it appears this is a problem
in your practice, reduce the intensity of the safelight illumination by using lower wattage bulbs, increase
the distance between the safelight lamps and the top of the film-loading counter, or reduce the number
safelight lamps in the darkroom.

Patient Identification Labeling

Patient information should be imprinted on film prior to processing to provide permanent patient
identification. The most prevalent way to imprint the information is to use a photo imprinting device,
sometimes referred to as a film ID printer.
Film cassettes can be ordered with a patient ID blocker manufactured. You can also order a regular
cassette with intensifying screens and cover a corner on both the front and back intensifying screen with
special tape that does not allow the screen crystals to be affected by x-rays. Patient information is printed
on a card and the card is placed in a slot on the printer with a corner of the film overlying the card. The
printer is closed and a light flashes under the card and imprints the patient information on the film prior
to being placed on the entry tray to the processor.
Removable lead letters and numbers that fit into a holder is another method of identifying a
patient. The holder is placed on the cassette and exposed to x-rays with the patient during imaging.
A less expensive method of permanently imprinting patient information on the film is to use lead
impregnated tape. This method is also used prior to exposing the film. The technician writes the
identifying information on the tape and then the tape is placed on the cassette prior to the exposure.

Film ID printer and darkroom counter space.

Care and Maintenance of Film Cassettes
An intensifying screen is a device found in radiographic cassettes that contain phosphors that convert x-
ray energy into light, which then exposes the radiographic film. The purpose of intensifying screens is to
decrease the radiation dose needed to expose the radiographic film. The screen mounted in the tube side
of the cassette is called the front screen and the screen mounted on the opposite side of the cassette is
called the back screen.

The care and maintenance of intensifying screens is extremely important because radiographic quality
depends in large part on how well the screens are continuously maintained. Dust, hair, or other foreign
material is transferred to the screens when the cassette is opened. If left on the screen, it can eventually
penetrate the screen surface, leaving a permanent artifact. Regularly clean the intensifying screens with
a commercially available antistatic intensifying screen cleaner with gauze pads. Cleaning intensifying
screens twice a month is a good practice and will prolong the life of the screen.

Check the cassettes for film-screen contact. Poor film-screen contact degrades recorded detail and is
usually seen as a localized area of unsharpness somewhere on the radiographic image. Common causes
of poor screen-film contact are worn contact felt; loose, bent, or broken hinges or latches; warped screens
resulting from excessive moisture; warped cassette front; sprung or cracked cassette frame; and foreign
matter under the screen.

A good practical tip is to number your cassettes by writing the cassette number using a permanent black
marker on the surface of one of the screens in a corner out of the way. The same number needs to be
written on the outside of the cassette. The screen number will show up on images produced with that
cassette and will make it easier to test the cassette in question.

The test to check film-screen contact requires a special wire mesh test tool. The wire mesh tool is simply
placed on the cassette in question and radiographed using the technical factors 50 kVp at 5 mAs and a SID
of 40 inches. The resulting radiograph is then viewed at a distance of about 6 feet to determine whether
there are any areas of unsharpness. Areas of poor contact will appear darker, cloudy, or blurred when
compared to areas of good contact because of the increased spreading out of the light photons.

Cassettes should be checked frequently to make sure the screens are adhered securely to the cassette;
the felt is not worn, allowing light leaks; and the latches and hinges are in good condition. Luminescence
was defined as the emission of light from the screen when stimulated by radiation. Intensifying screens
may luminesce in two ways, fluorescence or phosphorescence. Fluorescence refers to the ability of
phosphors to emit visible light only while exposed to x-rays. Phosphorescence occurs when screen
phosphors continue to emit light after the x-ray exposure has stopped. This is also referred to as screen
lag and will cause general overall fogging of the radiographic image and degrading of the scale of contrast
in the radiographic image. Screen lag is generally due to old, worn-out screens. To test for lag, make a
normal exposure of an object with the cassette empty of any film. Immediately take the cassette to the
darkroom and place a film in it, close the cassette, and allow the film to remain in the cassette for 5
minutes. Develop the film in the same manner as a normally exposed radiograph. If the image of the
object is transmitted onto the film, then the screens have lag and need to be replaced.
 Radiographic Processing

Radiographic Processing
1.Manual Processing
2.Automatic Processing

Manual Processing
The manual processing darkroom should have designated dry and wet areas to facilitate keeping the room
as clean and clutter-free as possible. The dry area is used to store undeveloped film and film hangers, for
loading and unloading film from cassettes, and for placing films on hangers for processing. The wet area
will contain the processing tanks and space for drying film post-processing. The processing tank system
will consist of a developer, rinse, fixer, and wash tanks. Dry towels should be kept in the darkroom to wipe
up spills. Use a timer when manual processing to avoid overdeveloping or underfixing a film.

1.Stir developing solution

2.Check temperature - The optimal developer temperature is 20°C or 68°F for most film types.
At 68°F, the developing time should be 5 minutes. Use a thermometer to check the temperature
prior to processing film.
Developer sol’n Temp Developing Time (min.)
75 º F – 24 º C 3¼
70 - 21 4½
68 - 20 5
65 - 18 6
60 - 16 8½
Using higher than recommended developer temperatures followed by placing the film in too
cool fixer will make the film’s emulsion swell and thicken unevenly, causing it to slip or fall off
the film base, creating a wrinkled or corrugated appearance called reticulation.

3.Load film in hanger, immerse in developer and agitate vertically (raise up and down)
Care must be taken when placing a film in or removing a film from the developer tank to prevent
scratching the film. Always gently agitate the film when first immersed to remove any air bubbles
so the developer solution can reach the film surface.

4.Rinse the film in the bath or stop bath.

When the film is removed from developer and placed in the rinse bath, gently agitate the film for
30 seconds to remove the developing chemistry to minimize contamination before placing the
film in the fixing solution tank. Circulating water works well or a stop bath solution, which is 1.5%
acetic acid, can be used. The stop bath solution will quickly stop the action of the developer as
well as neutralize the alkali of the developing solution and protect the acidity of the fixing solution.

5.Remove film from stop bath and immerse in a fixer (30 sec)
The fixing solution consists of a fixing agent, an acidifier, a hardener, a preservative, and a solvent.
The fixer will clear undeveloped silver crystals from the film, neutralize the developer solution,
and shrink and harden the film emulsion. Gently agitate the film for about 15 seconds to avoid
streaks and stains on the film when first immersed in the fixing tank. The fixing time can be
determined by the clearing time. The clearing time is the length of time it takes for the film
appearance to change from cloudy to clear. This is dependent upon the age and strength of the
 fixing solution. The fixing solution is exhausted and should be replaced when clearing time
exceeds 3 minutes. After the film is cleared, leave in the fixing solution twice as long as the clearing
time. If it takes 2 minutes for the film to clear, the total fixing time should be 6 minutes. If the film
is not left in the fixing solution long enough or if the fixing solution is too weak, the image on the
film will fade and discolor with age.

5.Rinse in water

The next step is to place the film in the wash tank. Some manual darkrooms may have a post-fixer
rinse bath set up prior to placing film in the wash tank. If so, gently agitate the film for 30 seconds
in the second rinse and then place in the final rinse or wash tank. The wash tank contains
circulating water, which will wash away remaining chemicals from the film. The length of time film
is left in the wash bath is dependent upon the number of water changes per hour. Typically, films
should be washed for about 20 minutes in circulating water in which the flow is 10 times the
volume of the tank per hour. If films are left in the wash tank too long, the emulsion will swell and
fall off the film base.

6.Dry
The last step is drying the processed film. After being removed from the wash, films should be
hung in a dry place where water can drain off of them either into a sink or tray. It takes
approximately 2 hours for film to dry. Film will dry more efficiently in a film dryer, a cabinet that
blows warm air over film placed on a rack. It is not recommended to just use a fan to blow air
onto the drying film due to the possibility of blowing dust onto the film. A wetting agent bath can
be used just after removing the film from the wash to decrease drying time. The film is briefly
immersed into a tank containing a commercial wetting agent before being placed in a dryer. After
the film has dried, cut off the corners of the film where the hanger attached with scissors or a film
corner cutter, and place in the patient’s film jacket.

Darkroom chemistry solutions lose strength and volume during use. Replenisher solutions can be added in
quantities to restore to proper levels and the product instructions will help with this process. Remember
replenisher solutions are not the same as regular solutions and repeated use and time will eventually
exhaust darkroom chemistry solutions, even when replenishers are added. Darkroom chemistry solutions
should be changed monthly and earlier if the developer solution turns green or brown and/or the clearing
time in the fixing bath takes as long as 2–3 minutes. Make sure to clean the chemistry tanks before refilling
with fresh chemistry solutions. Water tanks should be drained and cleaned at least weekly to prevent algae
from growing. Placing a filter on incoming water will also help eliminate algae. If algae appear, clean the
water tanks and the water lines to the tanks with an algaecide or diluted laundry bleach solution.
Automatic Processing
Transport system
Temperature-Control System
Circulation System
Replenishment System
Dryer System
Electrical System

In the automatic x-ray film processing, the sequence consists of developing, where the emulsion
swells and the developing chemical changes the silver ions of the exposed crystals into metallic silver. The
next step is fixing, where the silver halide that was not exposed to radiation is dissolved and removed
from the emulsion and the gelatin portion of the emulsion is hardened at the same time to make it
structurally more sound. The next step is washing any remaining chemicals from the film. Last, the film is
transported through the dryer to remove the water used to wash it and to make the film acceptable for
handling and viewing.

Tabletop automatic x-ray film processor.

Principles in Radiographic Processing

1.Developing
2.Fixing
3.Washing
4.Drying

Principles in Radiographic Processing

1.Developing - Changes the silver ions exposed crystals into metallic silver. Consider time (15min- ideal),
temperature, concentration of developing chemicals
Composition of Developer
Developing Agent
Metol hydroquinone – produces black tones slowly
Phenidone – seldomly used, produces shades of gray rapidly
Activator - Sodium Carbonate (NaCO3) – swells and soften emulsion
Restrainer
Potassium Bromide (KBr)
Potassium Iodide (KI)
Antifog agents, suppress reducing agent
Composition of Developer
Preservative - Sodium sulfite (NaSO3) - Controls oxidation
Hardener - Glutaraldehyde - Controls emulsion, swelling and helps in preserving quality
Solvent- H2o

2.Fixing - Converts under developed silver bromide crystals left on the film into soluble compound. Fixed
the image on the film to have an archival quality

Composition of Fixer
Fixing agent- Ammonium thiosulfate – clears and removes unexposed silver bromine crystal
Activator/ acidifier -Acetic acid or sulfuric acid - neutralizes developer and stops its action
Preservative - NaSO3 – maintains chemical balance of fixers and suppress sulfur deposition
Hardener
Aluminum chloride (AlCl)
Aluminum sulfide (AlS)
Stiffens and shrink emulsion
Solvent - H2o
Clearing time/Fixing time – time required to change film hazy-clear
Fixing time for screen film – 10-15 min
Fixing time for non-screen film – 20 min

3.Washing - Removes the remaining silver complexes and excess fixing agent
4. Drying - Should be done in clean cabinet or room

Major Processing Problems

1.Exhaustion of Developer
Decline in strength
Milky appearance of a developer
Change every three months
2.Artifacts
Irregular density on a radiograph
Occurs as a fog
Exposure artifacts
Processing artifacts
Radiographic Technique
Definition: combination of settings selected on the control panel of the x-ray machine to produce a
desired effect on the radiograph.

Includes:
1.Geometry and position of an x-ray tube
2.Patient
3.X-ray film

Exposure technique factors

1.Kilovoltage
2.Milliamperage
3.Time
4.Distance

Image quality factors

1.Density
2.Contrast
3.Detail
4.Distortion

Radiographic Quality
Resolution/ sharpness - Ability to image two separate objects and detect one from the other
Low contrast resolution -Liver and pancreas
High contrast resolution -Bone and tissues

Radiographic noise - Undesirable fluctuation in the optical density of the image

Film graininess -
Structure mottle -
Quantum mottle -
Radiographic density
Too dark
Too light
Controller of density
mAs
Too low mAs , loss density, low contrast
High mAs , increase density. Loss contrast

Factors Affecting Density

Radiographic Contrast
• Film contrast
• Subject contrast
• Attenuation
Speed
Latitude

Geometric Factors
Magnification - Symmetric enlargement of the image plus blurring
Factors
Object-film distance
Focal film distance
Enlargement
Reduction

Distortion - Unequal magnification of different portions of the body

Due to size of the object
Position of the object
Elongation foreshortening

Radiographic Detail
Definition: Sharpness of small structures on the radiograph
Controls by: Geometric factors, focal spot size, SID, SOD

Unsharpness:
Lack of perfect sharpness in radiograph
Motion screen absorption
 Improving Radiographic Image

Higher kVp

Controller of Density
mAs – milliamperage x time -Determines radiation quantity
Too low mAs – insufficient density - Reduce radiographic contrast
High mAs – increase density - Loss of radiographic contrast

Technical Factors Affecting Radiographic Density

Factor Increased Effect

mAs Increased density
kVp Increased density
Development time Increased density
Image Receptor Increased density
Thickness of part Decreased density
Mass Density Decreased density
Beam Restriction Decreased density
Grid Ratio Decreased density
Image Receptor Decreased density
Source Image Receptor Distance Decreased density

Radiographic Contrast
Visible difference between adjacent densities resulting from subject and film characteristic. It makes
anatomic detail more visible

Scale of Contrast – range of optical densities from the lightest to the blackest part of the radiograph

Is the result of differences in the attenuation of the x-ray beam as it passes through various tissues of
the body
Attenuation – total reduction in the number of x-rays remaining in the x-ray beam following penetration
through a given thickness of matter

Radiographic Contrast is a Product of 2 Separate Factors

1.Film Contrast – inherent in the film and influenced by film processing

2.Subject Contrast – determined by size, shape and x-ray attenuating characteristic of the subject being
examined

Factor Increased Effect

mAs Decreased contrast
kVp Decreased contrast
Development Time Decreased contrast
Screen Film Use Increased contrast
Beam Restriction Increased contrast
Grid Ration Increased contrast
Mass density Increased density
Beam restriction Increased density
Grid ratio Increased density
Image receptor Increased density
Source-image receptor distance (SID) Decreased density

Speed/ / Sensitivity
Ability of an x-ray film to respond to a minimum quantity of x-ray exposure
Also influences resolution and noise

Fast film – low resolution, high noise

Slow film – high resolution, low noise

Speed of the film is reciprocal of the exposure, in roentgens, needed to produce a density of 1.
Film A is faster than film B

Latitude
Range in exposure factors that will produce a diagnostic radiographic image
Inversely proportional to contrast

Film Processing
Contributing Factors
Composition of processing chemicals
Degree of film agitation
Development time – decreased film contrast
Development temperature
Geometric Factors
1.Magnification
2.Distortion
3.Characteristic of the x-ray tube

Magnification - Symmetric enlargement of the image on the radiograph. It is accompanied by a degree

of blurring.
2 factors:
1. Object-film distance
2. Focal-film distance
Enlargement:
Increased object-film distance
Decreased focal-film distance
Reduction:
Decreased object-film distance
Increased focal-film distance

Application of Magnification
1. Emphasize certain bone sections
2. Emphasize hairline fractures or other suspected lesions

Distortion - Perversion of shape in a radiographic image. Unequal magnification of different portion of

the same object.

2 factors:
1.Size and shape of the object
2. Position of the object

Manifestations
Elongation – poor alignment of the film or x-ray tube
Foreshortening – poor alignment of anatomic parts

Characteristic of the X-ray Tube

1.Penumbra – geometric unsharpness. Image blurring caused by the measurable size of the focal spot
producing halo effect
2.Umbra – region properly imaged

3 Conditions Causing High Penumbra

1. Large effective focal spot
2. Short Subject Image Distance
3. Long Object Image Distance

Subject Factors
1. Patient thickness
2. Tissue density
3. Effective atomic number
4. Object shape
5. Kilovoltage
Types of Unsharpness
1. Geometric unsharpness
2. Motion unsharpness
3. Screen unsharpness
4. Absorption unsharpness
➢ Due to shape of the structure radiographed. Round or oval objects have the greatest degree of
unsharpness.
Density
1.Controlled by: mAs
2.Influenced by:
kVp thickness of part
distance mass density
dev’t time film speed
grid ratio beam restriction

Contrast
1.Controlled by: kVp
2.Influenced by:
mAs
dev’t time
screen film combination
grid ratio
beam restriction
Detail
1.Controlled by: focal spot size
2.Influenced by:
Subject Image Distance
Object Image Distance
Motion
all factors related to density and contrast

Distortion
1.Controlled by: Patient Positioning
2.Influenced by:
Alignment of tube
Anatomic part
Image receptor

Radiographic Quality Problems

1.Dark or black radiograph
2.Gray non-contrast radiograph
3.Light or white radiograph
4.Dark spots on the radiograph
5.White or light spots
6.Streaks on the film
7.Finger prints
8.Crescent marks
9.Misc. problem