Image

Acquisition
& Evaluation
45 Questions

Courtney Nance,
Morgan Leach
and Erin Dockstader

Objectives
Identify

affecting factors of radiographic quality

Define density and controlling factors
Describe distance and controlling factors
Explain contrast and controlling factors
Compare long scale and short scale contrast
Define geometric factors
Contrast grids versus beam restrictors
Review grid characteristics and problems associated
Compare collimation versus filtration
Explain detail and its influencing factors
Correlate shape and size distortion
Break down film versus digital terminology
Give examples of changing technical factors due to patient pathology
Identify acceptable range of exposures using the exposure index
Explain correct marker placement and patient identification
Review the causes of fog on the radiographic image
Discuss exposure errors like noise, mottle, and underexposure
Provide patient considerations for change in technical factors
Demonstrate knowledge of associated formulas

SELECTION OF
TECHNICAL FACTORS
20 Questions

Factors Affecting Radiographic Quality

Category
An increase in

Exposur
e/
Density

1. mAs

2. kVp

3. OID
4. SID

Contras Detail/
t
Spatial
Resolution

Distortio
n

(air
gap)

5. Focal Spot Size

6. Grids*

7. Filtration

8. Beam
Restriction/Collimation

9. Motion

10. Anode Heel Effect

11. Patient Factors (size,

pathology)

mAs
Quantity
Primary
30%

of x-ray photons

controlling factor for Density

change in mAs for visible density change

Mainly

responsible for patient dose

Density/ IR Exposure
Degree of blackening -or- Brightness (digital)
by metallic silver (film)

Directly proportional to mAs

Factors Air Gap Technique: OID = Scatter, Contrast, Detail

Law of Reciprocity, Anode Heel Effect, Line Focus Principle,
Inverse Square Law

Densitometer, Optical Density = .2-2.5

Characteristic Curve, H&D Curve, DlogE,

Sensitometric Curve

Other Density Controlling Factors

kVp = Density Scatter *15% Rule*
SID = Density
OID= Density *Air Gap Technique*
Grid Ratio = Density
Collimation (FOV) = Density
Filtration = Density
Screen Speed = Density
Patient Size = Density
Processing Temperature = Density

Law of Reciprocity
With mAs remaining constant, any
combination of mA and exposure time will
give the same film density.
10 mA x 1 sec = 10 mAs
20 mA x .5 sec = 10 mAs
40 mA x .25 sec = 10 mAs

Anode Heel Effect

Intensity

of x-ray beam
greater at the cathode
end, but has less detail

Use

on: AP T-Spine,
Femur,
AP Foot

Factor:

SID
see best on Large IR
and short SID (40)

Line of Focus
Principle

Larger anode target angle = effective focal spot,

detail, anode heal load, anode heel effect
Smaller anode target angle = effective focal spot,
detail, anode heat load, anode heel effect

Distance: SID & OID

Source to Image Distance & Object to Image Distance

*Inverse

Square Law* As distance

doubles, intensity of the beam decreases
4 times.

Formulas:

kVp
Quality/Penetration
Primary

controlling factor of Contrast

Controlling
15%

of x-ray photons

factor of Density

Rule: 15% kVp increase = doubling exposure

Contrast
Difference between adjacent densities
(makes detail visible)

High Contrast

kVp
Few shades of gray
Contrast
Long wavelength
Short scale of contrast
Narrow (short) dynamic
range/window width

Low Contrast

kVp
Many shades of gray
Contrast
Short wavelength
Long scale of contrast
Large (wide) dynamic
range/window width

Contrast Cont.

Factors affecting Contrast

Compton

Scatter Radiation

kVp, Body Part Thickness = Compton Scatter =

Contrast
Occupational Dose (patient source of scatter)

Photoelectric

contrast

Effect: Patient Dose, necessary for

(differential absorption)

Other Contrast Controlling Factors

kVp = Contrast
OID = Contrast (Air Gap)
Grid Ratio = Contrast
Collimation (FOV) = Contrast
Filtration = Contrast
Screen Speed = Contrast
Patient Size = Contrast
/Developer Temperature = Contrast

Film Contrast vs.

The

inherent ability of the film emulsion to react

to radiation and record a range of densities.

Receptor
Contrast
The fixed characteristic of the receptor. Most
digital receptors have an essentially linear
response to exposure. This is impacted by
contrast resolution (the smallest exposure change
or signal difference that can be detected).
Ultimately, contrast resolution is limited by the
dynamic range and the quantization (number of
bits per pixel) of the detector.

Subject Contrast
Film

The

difference in the quantity of

radiation transmitted by a particular
part as a result of the different
absorption characteristics of the tissues
and structures making up that part.

Digital
The magnitude of the signal difference
in the remnant beam.

Grids

*Never radiation protection*

Pb strips and Al/Plastic interspace
Grid Ratio = H/D (Higher Grid Ratio= better scatter clean up)
Grid Frequency= number of Pb Stips per inch or cm
Use Grid when body part greater than 10 cm
mAs with grid use which PT Dose

Grids

Movement = Single Stroke, Reciprocating, Oscillating

Types = Crosshatch, Linear/Parallel, Focused

Factors Morie Effect

Grid Selectivity
Contrast Improvement Ability

Grid Alignment
Problems

Off Level, Off Center & Grid Cut Off = Overall

Density
Off Focus & Upside Down = Periphery Density

Beam Restrictors

Aperture Diaphragm
Easy, inexpensive, but penumbra & off focus radiation

Cones, Cylinders
Easy, inexpensive, use on head, spine, gallbladder, dental work,
but cone cut off (incorrect positioning), and penumbra

Collimator

Variable Aperture
Positive Beam Limitation (PBL)

Lead Blockers

Grid Conversion Formula

No grid = 1
5:1 = 2
6:1 = 3
8:1 = 4
12:1 = 5
16:1 = 6

Grid Conversion Formula

Understanding Check
What new technique would you use if you were using 75kVp
and 30 mAs with no grid, then needed to switch to a 5:1 Grid
to maintain density?

30 mAs x 5:1 grid

no grid
30 mAs x 2 = 60 mAs
1

Hardening the
Beam

Filtration
Removing Low Energy (Soft) X-ray Photons
Coherent

(1.5mm Al) = Glass Envelope, Dielectric Oil Bath,

Glass Window, and Tube Aging (vaporized

Tungsten)
Added
Total

(1mm Al) = Mirror, Tube Housing, Collimator

Filtration = 2.5mm Al if unit operates at or greater

than 70kVp
Filtration

= Density, Contrast
Compensating Filters: Wedge, Trough

Detail

Film: degree of geometric sharpness -or- Digital: spatial resolution

#1

controlling factor: Motion

Voluntary: fear, age, equipment Fix with good instruction &

immobilization
Involuntary: breathing, peristalsis, heart rate, shivering
Fix with short exposure time

Measure Detail: Resolution Tool

Unit

of resolution = Line Pairs/mm

mAs Maintenance Formula:

Detail Controlling Factors

Motion

= Detail
SID = Detail
OID = Detail
Focal Spot Size = Detail
Noise = Detail *Quantum Mottle*
Patient Size = Detail
Screen Speed = Detail
Film Screen Contact = Detail
Mesh Test*

*Wire

Distortion
Misrepresentation of Size or Shape caused by
OID, SID & Angling
Magnification

Factor

MF = SID/SOD

(SID-OID=SOD)

Formulas:
Object Size= Image Size/MF
Image Size= MF x Object Size
% of Magnification= (OID/SOD)x100

Distortion Controlling Factors

Size Distortion

SID = Magnification
OID = Magnification
PT Thickness= Magnification

Shape Distortion

CR/IR/Part Angle = Shape Distortion (Elongate or

Foreshorten)
Improper CR Alignment
Improper Anatomical Part Alignment
Improper Direction of CR Angle
Improper Degree of CR Angle

(+)
Patient Pathology
Additive Conditions

Tissue Thickness, Atomic #/Density,

Attenuation/Absorption=

kVp

(to penetrate thicker body parts)

Examples:

Edema, Atelectasis, Cardiomegaly, CHF,

Pleural Effusion, Pneumoectomy,
Pneumonia, TB, Ascites, Cirrhosis,
Hydrocephalus, Osteoblastic Metastases,
Pagets (Osteoitis Deformans), Sclerosis

(-)
Patient Pathology
Destructive Conditions

Tissue Thickness, Atomic #/Density,

Attenuation/Absorption

mAs (to maintain contrast)

Examples:
Emphysema, Pneumothorax,
Bowel Obstruction, Osteoporosis, Anorexia,
Osteomyelitis, Gout, Multiple Myeloma,
Osteolytic Metasteses, Osteomalacia

Criteria for Image

Evaluation
13 Questions

Receptor Exposure vs
Film & Digital

The amount of radiation striking the image

receptor

Exposure Latitude
Film

The range of exposure factors which will

produce a diagnostic radiograph

Digital
The

range of exposures which produces

quality images at appropriate patient dose.

Film Latitude vs

The inherent ability of the film to record a long

range of density levels on the radiograph. Film
latitude and film contrast depend upon the
sensitometric properties of the film and the
processing conditions, and are determined
directly from the characteristic H and D curve.

Dynamic Range

The range of exposures that may be captured

by a detector. The dynamic range for digital
imaging is much larger than film.

Exposure Indicator Determination

Numerical value on digital image to indicate

exposure to the detector
Provides visual cue for optimal suggested
exposure
Dose/Exposure Creep

Contrast/ Gray Scale

Recorded Detail/ Spatial Resolution

Distortion

Demonstration of Anatomical
Structures

Identification of Markers
Anatomical
Patient
Date
Legal

Identification: PT ID, Facility, Date,

Anatomical Marker

Patient Considerations
Pathologic

Conditions
Adult, Pediatric, Geriatric
Involuntary Movement
Patient Thickness

Artifacts Film & Digital

Fog
Age

(Outdated Film)
Chemical
Radiation

Scatter (From PT, High kV, Thick body

part)

Temperature
Safelight

**Fog = Contrast**
Density

&

Noise
SNR

(Signal to Noise Ratio)

Quantum

Mottle

Acceptable Range of Exposure

Exposure

Index

Density
Contrast
Classification:

Optimal
Acceptable
Repeatable

Gross Exposure Error

Mottle
Light/Dark
Low

Contrast

The End!
Questions?