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DIGITAL RADIOGRAPHY
Moderator:
Mr. Ram Singh (Lecturer)
Deptt. of Radio-Diagnosis & Imaging
PGIMER, Chandigarh-160012
Presented By:
Debendra Prasad Gupta
M. Sc. Med. Tech. (Radiodiagnosis) – 1st Year Student
Deptt. of Radio-Diagnosis & Imaging
1
PGIMER, Chandigarh-160012
DIGITAL RADIOGRAPHY:
Definition: -
It is defined as the image data acquired from
the numeric value i.e. in discrete binary
digits by use of computers .
3
INTRODUCTION:
Since the clinical use of x-rays in 1895, majority of
radiographic examinations have been carried out by the
conventional method.
The beam is projected through the patient and the transmitted
beam, which has information about the body structures, is
made to strike the cassette containing the film and the
intensifying screens. This way the latent image is produced on
the film.
The latent image can be made visible and permanent by
processing it with suitable chemicals.
This conventional method of obtaining radiographs has
dominated the field of radiography for many years. But now, it
has been realized that the FS system has its own limitations. 4
LIMITATIONS OF FS:
1. After the film has been exposed, the information contents
cannot be enhanced.
2. If the radiograph is too dark (Over-Exposed) or too light
(Under-Exposed) either by Exposure Factor, Film Fault or
Processing Faults, it has to be repeated i.e. No Post-
Processing option which results in extra exposure to the
patient.
3. The completion of the examination is delayed as the film
has to be processed to convert the latent image into a
permanent one.
4. A magnifying glass may be required to see very small
structures in detail i.e. No Zooming & Panning Option.
5
Cont…
5. Copied radiographs are of inferior quality than original ones.
6. The film is a physical object and so it requires considerable more
space for storage i.e. Storage & Retrieval Cost.
7. Films can only be in one place at a time and they also get
deteriorated with passage of time.
8. Film can not be stored for longer time when required.
9. Dynamic range of x-ray film is limited (i.e. 0.2 – 3).
6
MILESTONE IN DIGITAL
RADIOGRAPHY:
Year Development: -
1980 Scan Projection Radiography (SPR).
1983 Computed Radiography (CR), Storage Phosphors.
1990 Charge-Coupled Device (CCD) Slot-Scan Direct
Radiography (DR).
1994 Selenium Drum Direct Radiography (DR).
1995 Amorphous Silicon - Based–Cesium Iodide ( Scintillator )
Flat-Panel Detector in Indirect DR.
1995 Selenium-Based Flat-Panel Detector in Direct DR.
1997 Amorphous Silicon-Based - Gadolinium ( Scintillator ) Flat-
Panel Detector in Indirect DR.
2001 Dynamic Flat-Panel Detector for Digital Fluoroscopy in
DSA.
7
According to the nature, design and function of the detector the
Digital radiography can be divided mainly in the following way: -
SPR CR DR
Indirect
NaI – Scintillator Conversion Indirect Conversion Direct Conversion
Photodiode
9
SPR Cont…
10
SPR Cont…
PRINCIPLE OF S.P.R.:
X-Ray beam after passing through patient is
detected by detector array. The signal have
been image information of the body parts are
transferred to the computer where they get
digitized & processed to reconstruct the
image.
To obtain a complete image of the body part,
X-Ray tube & detector assembly remains
stationary & the patient is translated through
the X-ray beam or alternatively patient
remains stationary, while the X-Ray tube-
detector assembly translates . 11
SPR Cont…
COMPONENTS OF S.P.R. SYSTEM:
1. X-Ray Tube.
2. Pre-Patient Collimator.
3. Post-Patient Collimator.
4. Detector Array.
12
SPR Cont…
Advantage: -
In SPR X-ray beam is collimated in a fan x-ray beam by Pre-
Patient & Post-Patient Collimators . i.e.: -
1. High Amount of Associated Scatter Rejection.
2. High Radiographic Image Contrast.
3. High Dynamic Range (i.e. Low Contrast Detectibility).
4. Image Manipulation.
Disadvantages: -
1. Scanning Time is More.
2. Poor Spatial Resolution &
3. More Radiation Dose to the patient.
14
ADVANCEMENT:
At the present time, SPR is re-emerging with
some modification as a promising adjunct to
Digital Mammography Tomosynthesis
(DMT).
The purpose of all forms of Tomography is
to improve image contrast, and i.e. the goal
of Digital Mammography Tomosynthesis
(DMT).
15
COMPUTED RADIOGRAPHY:
Definition: -
Digital way of doing General Radiography with
Conventional X-ray machines except Conventional
Screen/Film and dark room is known as Computed
Radiography.
Principle: -
It is based upon Photostimulated Luminescence in
which the radiographic data is captured from a
conventional X-ray machine and processed the data
digitally to produce crisp and high quality
radiographic images.
16
Working:
21
THE IMAGING PLATE (IP):
The Imaging Plate (IP) is also known as Computed
Radiography (CR) Plate or Storage Phosphor Screen
(SPS) or Photostimulable Phosphor (PSP) detector to
record the radiographic image in place of the
conventional film/screen cassette.
The imaging plate is housed in a rugged cassette &
appears similar to a screen/film cassette.
It is available in the same sizes as conventional
cassettes.
It is handled in the same manner as a screen/film
cassette.
22
Cont…
It is not loaded & unloaded in a dark room. Rather, it is
handled in the manner of a screen/film daylight loader.
A typical IP can store a latent image for a considerable
period of time. However, it will lose about 25% of the
stored signal b/w 10 min. to 8 hrs after an exposure
resulting in the loss of energy through spontaneous
phosphorescence.
It retains the image for 24 hours, but some degradation
may occur with passage of time.
Imaging plate shows a linear response to the intensity
of x-ray exposure over a broad range.
23
CONSTRUCTION OF IMAGING
PLATE (IP):
PROTECTIVE LAYER
Protective layer : - PHOSPHOR LAYER
Backing Layer: -
- Protects the base from damage &
reduces back scatter X-rays.
24
- 150 μm lead.
THE IMAGING PLATE:
A Protective Layer composed of “Fluorinated Polymer”
which make resistant to the abrasion, damaged & scratches
caused on the IP during storage and transfer.
The Phosphor Layer consist of a family of Photostimulable
Phosphor crystals i.e. BrFX:Eu2+ where X can be any of
halogens i.e. Chlorine (Cl), Bromine (Br) or Iodine (I) or an
arbitary mixture of them.
A typical Phosphor Layer composed of about 85% - BaFBr
& 15% - BaFI, activated with a very small quantity of
Europium (Eu) as activator in crystal.
This Europium activation procedure, also called doping,
creates defects in the BaFBr crystals that allow electrons to
trapped more efficiently i.e. increases more DQE of crystal.
Te Reflecting Layer lies b/w phosphor & base layer. which
prevents the reflection of light is also applied. 25
Cont…
The Base Layer composed of “Polyethylene
Teraphtalate Resign” over which a layer of
photostimulable phosphor (Europium doped Barium
Fluoro Bromide crystals- BaFBr:Eu+2) is coated.
The next is Backing Layer composed of “Lead”
which prevents the base from damage & reduces back
scatter X-rays.
The last is the Bar-Code Label which contains the
number assigned to the imaging plate.
This Bar-Code provides a mechanism for associating
each imaging plate with Patient identification,
Related examination & Positioning Information.
The imaging plate is flexible and less than 1mm
thick. 26
LATENT IMAGE FORMATION IN IP:
To prepare the imaging plat for an x-ray exposure, the
plate is exposed to the intense light to erase any
previous image.
For X-ray imaging, the IP is placed in a cassette and is
used just like a film/screen cassette with standard
radiographic equipment.
When exposed to X-ray, the Europium atoms in the
phosphor crystalline lattice are ionized & converted
from Eu2+ - Eu 3+ by librating a Valance Electron:
Eu2+ - X-ray Irradiation - Eu3+ + e-
These electron are raised to Higher Energy state in the
Conduction Band where they can moved through out
27
the crystal lattice.
Cont…
The presence of impurities (e.g Bromine) introduce energy
level in the Forbidden Zone called F – centre.
Once in the Conduction Band, the electron travel freely
until they trapped in the F – centre in the Metastable State
with an energy level slightly below that of Conduction
Band but higher than that of Valance Band.
The no. of trapped electron is proportional to the amount
of X-ray absorbed locally.
The trapped electron in the form of metastable state
constitute the Latent Image.
Due to thermal motion electron will slowly be liberated
from traps, and the Latent Image should there for be read
without too much delay.
At room temp, the image should, however, be readable up
to 8 hrs. after exposure. 28
LIFETIME OF THE IP: -
One of the major advantages of CR is that the imaging
plate is reusable and thousands of exposures can be
made on it.However, there are a number of factors that
may affect the lifetime of an imaging plate: -
The plates are subjected to normal wear and tear from
scratches, scuffs, cracks, and contamination with dust
and dirt, which may interfere with the production of a
good image.
The establishment of a well organised quality control
program will play an important role in assessing the
clinical quality of the imaging plate. This may easily
be carried out by artefact assessment and uniformity
evaluation across the plate. 29
IMAGING PLATE CLEANER:
43
NEWER PHOSPHORS FOR IP :
Commercially available IP have unstructured phosphor
like Rubidium Chloride (RbCl) or BaFX:Eu
These are scanned in a raster pattern.
A needle – shaped phosphor RbI, CsBr, has been
newly; introduced, e.g. Konica Minolta’s Regius 370
Upright DR & is considered more efficient due to its
structural configuration of crystals.
This crystal structure reduces lateral light diffusion
because of the needle shaped configuration that acts as
light guide.
In addition the newer phosphors are more efficient with
an increased DQE.
44
Cont…
45
MOBILE CR SYSTEM:
Bedside radiography of critically ill patients with conventional CR
involves physical transport of the cassettes to the CR reader, often
located far away.
The situation gets worse as the no. of ‘portable ‘ films increase.
To save Labor, Time & Improve Workflow, portable compact CR
system have been introduced in late 2007, with FugiFilm (FCR
Carbon XL CR Reader) & Carestream Health Inc (Pointof –
CAreCR-ITX 560) machines.
These system basically have a mobile X-ray unit with an integrated
CR reader.
So, they are easy to use & offer quick image availability in less than
25 sec.
46
47
DUAL-ENERGY IMAGING:
It is done by two methods: -
1.) Subtraction Technique &
2.) Double Expose Technique.
1.) Subtraction Technique: -
In this method, x-ray energies are separated by the insertion
of a copper filter b/w two image plates which are then given
a single exposure.
the low energy image is recorded on the front image plate &
a high energy image is recorded on the back.
Owing to the difference in energy the absorption ratio of X-
ray through bone & soft tissue will differ for the two images.
By subtracting these two images using weighted factors,
bone or soft tissue detail can be selectively displayed.
48
Cont…
49
AUTOMATIC IMAGE STICHING:
This is useful in determining precise measurement in lengthy
anatomical regions like- whole spine, lower limbs or upper
limb in a skeletal survey.
Now a days, the largest flat panel DR plates are available in 43
X 43 cm.
Using these detectors, only a limited portion of the body part
can be imaged at a time in a single exposure, thus making these
detectors inadequate for studying the whole spine or the entire
lower limb.
To over come this problem, multiple sequential exposures at
different patient positions are acquired in a still patient.
Automatic stitching is then performed to reconstruct a larger
composite image.
This special software enables pixel shift and overlap.
50
CR-BASED FFDM
With the recent approval of the Clear View digital
mammography products, FUJIFILM Medical Systems USA
(Stamford, Conn) becomes the first vendor to offer a full-field
digital mammography (FFDM) system based on CR technology
in the United States.
51
The CR Reader, the Clear View CSM, has a unique dual-side reading
capability that permits the capture of x-ray information from both sides of
the Imaging Plate (IP) simultaneously. The 50-µm laser excites the
phosphor, which has a thicker coating compared to standard CR IPs. Light
is emitted from both sides due to a clear base and is captured with dual
light guides. 52
SLOT SCAN SYSTEM:
This system uses narrow fan beam X-ray of about 5
mm & linear CCD array detector system.
It has mechanically linked x-ray tube & collimator
opposite the narrow CCD array with few rows of
detector and scan along the long axis of the patient
anatomy.
It has two precisely aligned moving slit collimators,
one on either side of the patient.
Due to which this system provides the ultimate in
scatter rejection & detector efficiency .
53
Cont…
54
CCD Slot Scan Direct Radiography
55
ADVANTAGES:
Scatter radiation almost totally absent.
No grid is required.
Radiation dose is reduced as grid no required.
Detector efficiency is more with lower image noise.
Longer & large anatomical regions are well covered.
DISADVANTAGES:
High initial cost.
Longer acquisition time due to narrow fan beam.
So, requirement of equipment with high rating of
generator & X-ray tubes. i.e. high tube loading.
Poor Spatial Resolution, due to Patient motion which
degrade image quality during scanning.
It is a fixed modality method with bulky design.
Bedside Radiography is not possible. 56
SELENIUM DRUM DR SYSTEM:
Rotating selenium-dotted drum, which has a positive electrical surface charge, is
exposed to x-rays. During exposure, a charge pattern proportional to that of the
incident x-rays is generated on the drum surface and is recorded during rotation
by an analog-to-digital converter .
Advantage:-
It provide good image quality that is
superior to that provided by screen-film
or CR systems.
Disadvantage:-
Because of their mechanical design,
selenium drum detectors are dedicated
for chest stand systems only with no
mobility at all.
57
DIRECT RADIOGRAPHY (DR):
DR technology converts x-rays into electrical charges by
means of a direct readout process using CCD/TFT arrays.
Scintillator + CCD
CsI:Tl or CsI:Na &
Selenium Drum
Gd2O2S:Tb3+
Scintillator +
Photoconductor (a:Se)
Photodiode (a:Si) +
+ TFT (DFPD)
TFT (IFPD)
58
INDIRECT DR:
In this case, X-ray energy is first converted into
light photons by an phosphor scintillator (CsI:Tl,
Gd2o2S:Tb).
Then the light photons are converted in electric
charge by Photodiode Phosphor (a:Si).
The electric charge is converted in electrical
signal by CCD/TFT which is digitized by ADC in
digital signal & stored in computer.
The stored digital signal in computer is processed
and converted in analog signal by DAC to see on
the monitor.
The whole process will take only 1.3 – 3 sec. 59
Cont…
Convert X-rays into light photon
after then electronic signals for
digital image formation.
Uses 3 step process : -
X –rays CsI:Tl, Gd2o2S:Tb
Visible Light
61
Cont…
Convert X-rays into electronic
signals for digital image formation
Electronic Signals
TFT & ADC
Image formation
62
63
64
CONSTRUCTION & WORKING
OF FPD SYSTEM:
The physical dimensions of the detector array are 40 x
50 x 4 cms with 2560 x 3072 pixel matrix.
The matrix is covered with a scintillator layer of CsI:Tl
or Gd2O2S:Tb in case of Indirect FPD only.
The matrix array consists of a glass substrate onto
which a layer of a:Si is evaporated in the case of
Indirect FPD & a:Se in case of Direct FPD.
The a:Si or a:Se is structured in a matrix of individual
photo sensors and switching elements, either a TFT or a
CCD which allows the connections of the sensor with
the read out line in column direction.
65
Cont…
66
ADVANTAGES of DR SYSTEM:
Increasing Workflow Efficiency, Saving Time & Labor.
Integrating high power X-ray system of 30 – 1000 KW Rating, very
Short Exposure Time , Eliminating Motion Blur.
Variable Speed Acquisition possible (speed class 100 – 800) depending
on acceptable SNR.
Most DR system have presets available for various anatomical studies
including optimized post processing e.g. chest, spine etc.
Automatic tube detector positioning for selected study.
Auto selection filter & Focal Spot Size a/c to the anatomical part.
Automatic tracking for easy positioning.
Immediate availability of image for Quality Check & Diagnosis.
The examination becomes quick as no cassettes have to be fetched from
the storage area, taken to the examination site, or to the processing unit
after exposure.
Radiography as well as fluoroscopy can be performed.
Post processing can be done. 67
DISADVANTAGES OF DR
SYSTEMS:
High initial cost.
Some radiographic view are difficult to obtain as
the detectors are generally not free to be placed in
any position.
Careful handling is required due to fragile nature
of most detectors.
Due to its inflexibility, portable or ward
radiography is not possible.
Different equipment is required for different kinds
of work.
68
DIGITAL FLUOROSCOPY:
It provides Real Time Imaging of anatomic
structures. As maximum image detail is
required, so image brightness must be high.
Image intensifier was developed to replace
the conventional fluoroscopic screen.
With the introduction of computer
technology into fluoroscopy, digital images
with better detail can be obtained.
69
EQUIPMENT:
70
ADVANTAGES:
71
DEVELOPMENTS IN D.F. :
Flat panel detector system has replaced the I.I.T.V. system.
X-rays passing through the patient are converted into
electrical signals by the F.P.D. These are then passed
through the amplifier and ADC where they are converted
into digital signals.
The digital image data is directly transferred to an image
storage PC via an optic fiber link at the rate of 30 f/s
This system permits high speed digital image acquisition,
processing and display.
Images are of excellent resolution.
72
DYNAMIC FPD FLUOROSCOPY:
Dynamic Detector 73
INNOVATIONS & NEWER
APPLICATIONS IN DR:
74
PHOTON COUNTING TYPE DR SYSTEM:
It is similar to Slot Scanning Type system but uses a
different types of multi slit detector made up of
Crystalline Silicon (Si) which is some what similar to
the one used in direct type of Flat Panel Detectors
System.
A voltage of about 100 volts is applied across the
array of thin (50µm) Si crystals.
Absorbed X-ray produce electrons & holes. Each of
these event is counted in a timer meter with time
corresponding to the spatial location along the
direction of X-ray fan beam sweep.
75
Cont…
Disadvantages: -
Exposure time is long.
Patients motion may degrade image quality.
Requirement of equipment with high rating of generators
& X-ray tubes.
78
DIGITAL TOMOSYNTHESIS:
In this technique multiple low dose exposure are
given from various angles while the x-ray tube
moves in an arc & the detector remains stationary.
Multiple images with different focal zones are
possible to be created by addition of these low dose
images after pixel shift.
It emphasize contrast in a particular layer of a region
of body.
Generated images can be viewed singly or as a cine
loop.
It is also considered to useful in Mammography,
Chest, IVU studies.
79
DIGITAL MAMMOGRAPHY
TOMOSYNTHESIS (DMT):
It is a recent advanced application of
DM.
In this technique, an area X-ray beam
interacts with the digital
mammographic image receptor,
producing a digital mammogram.
This digital mammogram is repeated
several times at different angles.
Each images is available in digital
form & can be reconstructed as a 3D
Matrix of values, each representing a
Voxel.
With these digital data available, a
tomographic section can be
reconstructed with enhanced image
contrast at acceptable patient
radiation dose. 80
MOBILE /PORTABLE DR:
Now a days flat panel detector portable radiography
is also possible.
This method was first invented by Canon.
The FPD are available in 17” X 17” with a cable for
portable/mobile radiography.
As a general a FPD connected by a cable to a mobile
or portable unit having a monitor.
The use of portable DR system hampered by the
fragility of the FPDs & the high costs.
A portable DR system, when compared with an FSR
system, avoids all problems related to the
availability, storage, transportation, disposed of films
& chemicals. 81
WIRELESS FPDs:
With the introduction of the model Pixium 3543 from Thales,
wireless portable DR system is now a reality.
After exposure, it wirelessly transfer image data to the DR
system.
Alternatively the image data can be transferred to DR console
via an Ethernet cable.
It has no cables & does not interfere with surrounding
machines. So, it is easy to handle as a CR cassettes.
Typically a 17” X 14” image size is made available within 3s.
It is particularly well suited for use with immobilized
patients, in operating rooms, intensive care units, emergency
situations, and rooms for exams requiring difficult or unusual
X-ray projections.
82
WIRELESS FPD SYSTEM:
Pixium RAD 4600 Pixium Portable 3543
Power supply
WiFi (or back-up cable)
Optical Fiber RS 232 Pixium Portable
Docking Station
Power supply
Ethernet
Cable
Acquisition Ethernet
X-Ray Generator
board Board
PC
PixRad software
83
FLUOROSCOPY:
Real – time digital imaging in DR is possible with
the invention Pixium RF 4343, from Thales.
It facilitates high-quality radiography &
fluoroscopy (up to 30 images/sec.)
This fluoroscopy feature is use in Gastroenterology,
Urology & Vascular applications.
Newer FPDs like Pixium 4700 & Pixium 4800 from
Thales are used for Vascular & Cardiovascular DSA
applications by permitting low – dose fluoroscopy.
84
Integris Allura Flat Dynamic
Detector for Cardio
85
IMAGE QUALITY PARAMETERS:
Pixel Size, Matrix & Detector Size.
Dynamic Range & Contrast.
Spatial Resolution.
Limiting Spatial Resolution (LSR).
Signal to Noise Ratio (SNR).
Modulation Transfer Function (MTF).
Detective Quantum Efficiency (DQE). 86
DYNAMIC RANGE & CONTRAST:
Contrast levels or film Dynamic range is a measure
densities generated over a of the signal response of a
range of x-ray exposure levels. detector that is exposed to x-
rays.
Narrow Dynamic Range Wide Dynamic Range
Image Brightness
Image Brightness
Straight Straight
Toe Part
Shoulder
Shoulder
Toe Part
Low Contrast
High Contrast
Film-Screen
Detector
88
LIMITING SPATIAL RESOLUTION
(LSR):
so l u ti o n
Re
Contrast Ratio
Increasing Contrast
Signal
Noise
Decreasing Noise 90
IMPACT OF NOISE:
Quantum and Electronic noise are unavoidable in a
digital imaging chain. The effect, often expressed as
Signal-to-Noise Ratio (SNR), can vary widely from
system to system.
94
Technical Features Of Various DR
System:
Feature X-ray
Converter
Readout Detector
size
Pixel Size Matrix Size
Converter size
99
100