Image Production and Evaluation: Radiographic Contrast

John Mark de Vera, RRT
IMAGE PRODUCTION AND EVALUATION
RADIOGRAPHIC CONTRAST
What effects do grids have on contrast? Grids improve contrast by removing scatter
radiation before it reaches the film, resulting in a
shorter scale of contrast
How does increasing filtration affect Contrast is decreased slightly because filtration
contrast? increase the average photon energy of the beam.
What factors comprise radiographic  Image receptor (film) contrast

contrast?
 Subject contrast
Influencing factors for Image receptor (film) Characteristics of the film and processing
contrast
What determines subject contrast Size, shape and attenuating characteristics of the
material being irradiated
Define RADIOGRAPHIC CONTRAST The differences between adjacent densities within

the radiographic image.
Primary controlling factor for contrast kVp
What are the two types of contrast seen in Long-scale (low contrast)
medical radiography?
Short-scale (high contrast)
Describe long scale contrast  Many shades of gray
 Also referred as low contrast or
 Decreased contrast
How does kVp relates to differential Differential absorption increases as the kVp is
absorption? decreased; conversely, as kVp increases, more
photons pass through and differential absorption
decreases.
Which of the two types of contrast exhibits a Long-scale contrast

wide exposure latitude?
Which of the two types of contrast is a Short – scale (high contrast)

product of low kVp?
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How does tighter collimation affect  Tighter collimation reduces the number of
contrast? photons available, thus reducing the scatter
and increasing the contrast
 Shortens the scale of contrast
Average gradient Term used to express film contrast numerically
Mathematical equation for average gradient Average gradient = OD2 x OD1
LRD2 – LRD1
OD = Optical Density
LRD = Log Relative Exposure
Which type of contrast will a film with a high High contrast

average gradient exhibit?
A film with a high average gradient will Fast speed

exhibit which kind of speed?
A film with a high average gradient will Narrow latitude?

exhibit what king of latitude?
How will a film with high average gradient It decreases patient dose?
affect patient dose?
DIFFERENTIAL ABDORPTION Different degrees of absorption in adjacent tissues

that result in image contrast
Describe short-scale contrast Few shades of contrast
Mainly black and white image
Also called high contrast or increased contrast
Define contrast improvement factor Ratio on contrast of radiograph made with a grid
to the contrast of radiograph made without grid
Mathematical equation for contrast K = Radiographic contrast with grid

improvement factor
Radiographic contrast without grid
What kVp change is needed to make a 4 – 12%

visible change in contrast?
When making contrast changes on a Changes should be made in increments of 8 or

radiograph, what changes in kVp should be 15%
made?
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RADIOGRAPHIC DENSITY
What effect does halving the SID have on Density is increased 4 times
density?
Do filters have an effect on density? Because filtration alters beam intensity, density
decrease slightly with increase filtration
How does kVp affects density? Directly, as kVp increases, density increases
As kVp decreases, density decreases.
How does increasing grid ratio affect As grid ratio increases, density decreases
density?
What is considered the useful range of 0.25 – 2.5

optical densities?
If a radiograph allow 1 % of the illuminator The film would have an optical density of 2.0
light to pass through, what is the optical
density?
In digital imaging, what effect does mAs, kVp The intensity of radiation reaching the image
and SID have on the intensity of radiation? receptor will be same as in the conventional
radiography.
In digital radiography, what effect does The computer can adjust for errors in
excessive mAs have on density? overexposure, although image quality may be
affected
Because of the anode heel effect, density is Anode – because of the absorption of x-rays by the
less at which end of the x-ray beam? “heel” of the anode.
Which formula is used to maintain density Density maintenance formula:

when making distance changes
mAs1 = D12
mAs2 D22
How does film processing affect density? Density increases as developer temperature,
immersion time, or replenishment rate increases:
Contaminated developer will reduce density
If a radiograph allows 10% of light from the The film would have an optical density of 1.0
illuminator light to pass through, what is its
optical density?
Why should kVp not use dtp control density? Changing kVP also change contrast
How is density expressed algebraically? OD= log10 x I0

3
I1
l0 = light incident on the film
l1 = light transmitted through the film
How do intensifying screens affect density? As the speed of the intensifying screen increases,
density increases
How does tissue thickness affect density? As tissue thickness, average atomic number,
and/or tissue density increases, radiographic
density decreases.
What effect does SID have on density? As SID increases, density decreases and vice versa
(according to the inverse square law)
What effect does doubling SID have on Density is reduced into ¼ (reduce by a factor of 4)
density?
What percent change in mAs makes a visible 30%

difference in density
RECORDED DETAIL
RADIOGRAPHIC DETAIL The sharpness of the structural lines as recorded in

the radiographic image.
RESOLUTION The ability to image an object with accuracy, it is

also referred as recorded detail
What are some alternate terms for DETAIL, SHARPNESS, DEFINITION, RESOLVING
resolution? POWER
DISTORTION Misrepresentation of the size or shape of a

structure recorded in the radiographic image
Define the term unsharpness as it refers to Loss of recorded detail due to use of large focal
the radiographic image spots or intensifying screen.
Describe elongation of an object Elongation projects the object so it appears to be

longer than it really is.
Define the term QUANTUM MOTTLE  Refers to the random nature in which x-rays
interact with image receptor
 It occurs with the use of high-speed screens

with very low mAs and high kVp
How can distortion be reduced? By proper alignment of the tube , part and film
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How is resolution measured? By using a resolution grid: resolution is measures

in lines per millimeter (lp/mm)
How does OID affect recorded detail? OID is inversely related to recorded detail
Recorded detail improves as OID decreases
Define Size distortion Enlargement of the recorded image as compared

to the actual size of the structure
Define shape distortion Misrepresentation (elongation or foreshortened)

of the shape of the structure recorded as
compared to the actual shape of the structure
Effective focal spot The area of the focal spot that is projected out of
the tube toward the object being radiographed.
Line – focus principle The design of the x-ray tube target that allows
increase in heat-loading capacity of the tube while
improving resolution.
How does OID affect size distortion? As OID increases, size distortion increases
MAGNIFICATION The enlargement of the recorded image as

compared to the actual size of the structure
What formula is used to calculate size MF = SID

distortion?
OID
MF = Magnification factor
What formula is used to calculate the actual Object size = ____Image size____
object size?
Magnification factor
Describe foreshortening of a radiographic Foreshortening projects the object s it looks

image? shorter than it really is
What factor causes foreshortening of the Misalignment of the part

radiographic image?
Define the term CONVERSION EFFICIENCY The rate at which x-rays are transformed into light
in an intensifying screen.
What factors cause elongation of the Misalignment of the tube

radiographic image?
Define MOTION BLUR Loss of radiographic density caused by movement

of the patient or the x-ray tube during exposure
How can a radiographer reduce motion  By using shortest possible exposure time
blur?
 Proper breathing instructions
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 Restraining devices
 A long SID and short OID
What is the most often cause of motion Patient motion: normally motion of the x-ray tube
blur? is not a problem.
What is the formula to calculate for the focal Focal spot blur = effective focal spot x (OID/SOD)
pot blur?
How does the line-focus principle By using steep target angle. This permits a large
accomplished? area of the target to be bombarded with electrons
while maintaining a smaller effective focal spot
How many inches must the SID be increased An increase of 7 inches of SID is required for every
to compensate for each increase in OID 1 inch of OID
In digital imaging, how does focal spot size, The geometric factors alter recorded detail in the
SID and OID affect recorded detail? same fashion as they do in conventional
radiography.
Define heel effect Absorption of x-rays in the heel of the anode,

resulting in decrease x-ray intensity to the anode
side of the central ray
How does focal spot size affect heel effect? Heel effect is more pronounced with small focal
spot
How does target angle affect effective focal The smaller the target, the smaller the effective
spot size? focal spot.
When is heel effect more pronounced? A small target angle, short SID, Large fields with
little or no collimation
Define FOCAL SPOT BLUR It is the unsharp shadow caused by size of the focal
spot.
How does SID affect recorded detail? As SID increases, recorded detail increases,
conversely, as SID decreases, recorded detail
decreases.
Define INHERENT OBJECT UNSHARPNESS The unsharpness that is an inherent part of every
radiographic image resulting from the position and
shape of anatomic structures within the body
Define the term FOCAL SPOT The region of the anode target where electrons
interact to produce x-rays
How does focal spot size affect recorded There is an increase in recorded detail as focal spot
detail? size decrease
What are the types of distortion? Size and shape
Define the term ACTUAL FOCAL SPOT The area of the focal tract that is bombarded by
the electrons from the filament
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What are the factors that control size SID and OID
distortion (magnification)?
How does SID affect size distortion? As SID increases, size distortion decreases
When should a fractional focal spot size be When performing magnification studies
used in radiography?
In digital imaging what factors affect The geometric factors that affect conventional
recorded detail? radiography also affect digital in the same manner.
The factors that affect distortion also apply.
RADIOGRAPHIC FILM
What is the chemical contaminant that Silver sulfide

forms on the surface of silver halide
crystals?
What is the purpose of “sensitivity speck” It provides the location for the formation of the
formed by silver sulfide? latent image
Define LATENT IMAGE The invisible image induced in the silver halide
crystals
What is meant by the term MANIFEST The visible image on the radiograph after
IMAGE? processing
Which types of film are commonly employed Screen film, nonscreen film , and special
in radiography? application film (mammography, laser, video
recording, duplication, subtraction ,
cineradiography))
Describe direct exposure (nonscreen) film Film intended for exposure with x-rays and not
from light from intensifying screens
Describe screen film Film that is designed for exposure with the light
from intensifying screens.
Which type of artifact is caused by bending Crinkle mark (fingernail-appearing artifact)

of the film?
When should direct exposure film be When the radiation exposure risk is low and high
utilized? resolution is required
What are the disadvantages of using High exposure to patients (10X to 100X) and it
nonscreen (direct exposure) type film? cannot be processed in automatic processors
(thicker emulsion)
Define EXIT RADIATION Radiation that remains in the beam after

attenuation by matter (this radiation exposes the
film)
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What are the two basic components of Base ad emulsion

radiographic film?
Describe the FILM BASE Polyester plastic that provides support for the
emulsion usually tinted blue.
Describe the emulsion of radiographic film Microscopic silver halide crystals suspended in a
gelatin
What is the composition if silver halide Primarily silver bromide, along with small amounts
crystals of silver iodide
How is the single-emulsion film loaded in a It must be loaded with the emulsion side (always
cassette? dull) toward the intensifying screen
What determines film resolution? The size of the silver halide crystals
How does tabular-grain film differ from The silver halide crystals are tabular or flat instead
conventional film of round, resulting in more covering power and
lower crossover.
What are the characteristics of Slow speed, high-contrast, extremely fine-grain,

mammography film? single-emulsion film that is used with a single
intensifying screen
How does duplicating (copy) film differ from Duplicating film is solarized (pre-exposed to allow
conventional film it to duplicate the exact image)
Differentiate between double-emulsion film Double-emulsion film has emulsion on both sides
and single-emulsion film (duplitized)
What are the characteristics of double It exhibit increased speed or response to radiation
emulsion film?
What causes the parallax effect Light entering the film emulsion on an image on an
(phenomenon that affects double-emulsion angle, passing through the base and affecting the
film) emulsion on the opposite side of the film
How can parallax effect be lessened? By using film with thinner base
What are the characteristics of single- Slower speed, excellent detail (when used with a
emulsion film? single screen)
What are some causes of artifacts on film? Rough handling, pressure and low humidity
Define the word SPECTRAL MATCHING The response of the film must match the emission
of the screen (if the screens emit blue-green , the
film must be designed to respond to blue-green
light to get an image)
What is contact surgical radiographic film? Non-screen film I sterilized plastic packages used in
surgery.
Why is radiographic film package in a foil To protect it from moisture

bag?
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What kind of artifact result from a dirty or Dirty or warped rollers can cause emulsion pick-off
warped rollers? and gelatin buildup, which result in sludge deposit
on film
What causes chemical fog on radiographic Improper or inadequate processing chemistry (the
film chemical fog is called dichroic stain)
What causes guide-shoe marks on a film? Sprung or improperly positioned guide shoes;
guide shoe marks run the same direction of the
film
What is the cause of Pi lines on a film Dirt or chemical stain on a roller causes Pi lines
(the lines occur 3.1416 inches apart because a
roller is 1 inch in diameter)
What does the GBX stand for when referring Green-blue x-ray
to GBX filter
If a single –emulsion film is loaded into a There will be decrease in density

cassette incorrectly, how will the radiograph
be affected?
What is the proper safelight distance from 3-4 feet from feed trays or loading counters
the working area in a darkroom
How long can a typical radiographic film At least 40 seconds

remain in safelighting without becoming
fogged?
How often should the bulbs be changed in Every 2 years they should all be changed at the
the viewbox illuminators? same time multiple illuminators (bulbs should be
from the same manufacturer, and same lot and
color)
How much light should a standard viewbox Normal viewboxes emit 1700 NIT
emit?
Mammography viewboxes should emit 3500 NIT
How often should the viewboxes be Once a week with antistatic , nonabrasive cleaner
cleaned?
Which type of static is caused from Tree static

removing the film from the cassette too
rapidly?
What causes smudge static? Rough handling
Film should be stored at what humidity? Between 40% - 60% humidity
Over 60% - reduces contrast and increases fog
Under 40% - results in static artifact
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What is the usual shelf life of radiographic Usually 1 year after purchase (expiration date is on
film? film box)
How does excessive temperature affect Excessive temperatures can cause a loss of
radiographic film? contrast and an increase in film fog
What factor determines whether an artifact If it is before exposure, a minus-density results; if it

is a minus-density artifact or a plus-density is caused after exposure, a plus-density artifact
artifact? usually results.
Define FILM LATITUDE It is the emulsion’s ability to record a long range of

densities from black to white (long-scale contrast)
What factor cause film fog? Outdate film
Excessive safelight exposure
Excessive processor temperature
Which type of safelight is safe with green- GBX

sensitive film emulsion?
Which type of safelight should be sued with GBX or written 6B

blue-sensitive film?
What causes small white spots on Dirt or dust on screens

radiograph?
How will dust and scratches on an There will be little or no density in those areas
intensifying screen appear on a finished
radiograph?
What are the advantages of using screen- Requires less radiation exposure, patient dose is
type film? reduced, allows shorter exposure times, thus
reducing motion.
When is film more sensitive, before or after After exposure?

exposure?
What causes crown static? Pulling the film from the film bin too rapidly
What are the applications of subtraction Angiography (although with the increasing
film? application in digital fluoroscopy, its use is
declining)
Where should radiographic film be stored In a cool, dry place (not excess of 68% degrees F)
Between 40-60% humidity
How should be radiographic film boxes be On edge, rather than lying flat
stored?
What are the three kinds of static artifact? Crown, tree and smudge static
RADIOGRAPHIC GRID
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What is e advantage of increasing grid It reduces the visibility of grid lines

frequency?
What is the disadvantage of increasing grid Requires an increase in exposure

frequency?
When is it necessary to use a very high Mammography (because of low kVp techniques
frequency grid? and the desire to minimize the possibilities of
seeing grid lines)
What are the various types of grid patterns? Parallel, focused or crosshatch
Which is the simplest type of grid? Linear (parallel) grid
How does grid improve radiographic quality? It absorbs a large percentage of scatter radiation
before it reaches the film, thus increasing contrast.
What is the most common radiolucent Aluminum (more commonly used than fiber
material used in grid construction? because it is easier to use in manufacturing and is
more durable)
Define grid ratio The ratio of the light of the lead strips to the
distance between them.
What is grid frequency? The number of grid strips or grid lines per inch or
per centimeter
What is the average grid frequency? 85 – 103 lines per inch
33 – 41 lines per cm
What is radiographic grid? A device that reduces the amount of scatter and
secondary radiation reaching the film
As a general rule, when should grid be When the body thickness exceeds 10 cm and
employed? tissue density is primarily soft tissue and bone: kVp
above 60
Who invented the grid? Dr. Gustav Bucky in 1913
How is grid constructed? Lead foil trips separated by aluminum interspace
How does grid work? The lead absorbs scatter and the primary beam
passes through the spacers
How is a linear (parallel) grid constructed? Lead strips are parallel to each other and
perpendicular to face the grid (if they were
extended in space, they would never meet)
What is the disadvantage of parallel grids? Grid cutoff occurs at short distances (they function
best at long distances)
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Define grid cutoff The undesirable attenuation of the primary beam
How is crosshatch grid constructed? Two linear grids placed perpendicular to each
other.
What is the major disadvantage of a They require accurate alignment of CR and do not
crosshatch grid? allow for angulation
What are the two types of moving grids?  Reciprocating (moves back and forth during
exposure)
 Oscillating (moves in circular motion)
Describe the air gap technique and its effect The patient is placed at a greater OID, creating an
on scatter radiation reaching the film. air gap between the patient and film. This
technique reduces the amount of scatter reaching
the film.
Describe the reverse-cassette technique for Because of its structural makeup, the Kodak X-
reducing the amount of scatter reaching the Omatic cassette can be reversed to act as a low-
film. ratio grid.
What causes Moire effect or zebra pattern It is caused by placing a grid cassette in the Bucky
on finished radiograph? (it is two sets of grid lines)
What is meant by grid selectivity? Grids that absorb greater percentage of scatter
than primary radiation are described as having a
greater degree of selectivity.
What factor primarily influence the Lead content ( the more lead, the more effective
selectivity of a grid? cleanup of scatter)
When selecting a grid, what is the most Grid ratio

important consideration?
When do grid lines appear on the When the lead strips attenuate the primary beam
radiograph? and are imaged on the radiograph
Who invented Potter-Bucky diaphragm? Hollis E. Potter, MD. In 1920
Define the term grid focusing distance Distance from the lead strips of a focused grid to
the point where they converge.
What are two criteria used to measure a Selectivity and contrast improvement ability
grid’s performance?
Define the term contrast improvement Relationship of contrast with a grid divide by the
factor (K) contrast without grid
Which grids have higher contrast Higher-ratio grids

improvement factor?
What does the contrast improvement factor The grid’s ability to improve contrast.
measure?
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What is the major advantage of a crosshatch Excellent cleanup

grid?
When is crosshatch grid used to the best Simultaneous biplane angiography due to high
advantage? scattered radiation produced.
How is focused grid constructed? Lead strips are designed to match the divergence
of the x-ray beam.
What is the advantage of the focused grid? It is designed to minimize grid cutoff
What are the limitation of the focused? Their use is limited to specific SID range
What is the purpose of moving grid? To eliminate grid lines by moving the grid during
the exposure
What is reciprocating Bucky? Bucky operated by motor-driven mechanism:

oscillates during exposure.
How will off-center grid-cutoff (lateral Grid cut-off visible, more to one side of film:
decentering) be demonstrated on a film?
There will be an overall decreased density on the
film.
What are the common ways of expressing Grid ratio and grid frequency
grid efficiency
How will grid that is placed upside down be There will be a strip of density down the middle
demonstrated on a film? with no density on the sides
What are the mAs grid conversion factors of Grid Conversion factor
various grid ratios?
No grid 1
5:1 2
6:1 3
8:1 4
10:1/12:1 5
16:1 6
What are the kVp limitations on an 8:1 grid? Below 90 kVp
What are the kVp limitations on a 12:1 grid? Up to 110 kVp
What are the kVP limitation on a 16:1 grid? Above 100 kVp
How will off-distance grid cut-off be Both sides of a film will be underexposed.
demonstrated on a film?
How does grid ratio affect patient exposure? As grid ratio increases, patient exposure increases
With which grid ratio is proper alignment of High ratio grids

the grid is critical?
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With which grid ratio is focal range most High ratio grids
critical?
Define FOCAL RANGE The range of distance with which a focused grid
can be safely used
What is the advantage of moving grids over Moving grids eliminate the visibility of grid lines
stationary grids?
PATHOLOGY AND DENSITY
What is pneumoconiosis and how does it It is the inhalation of dust particles that cause
affect the density of tissue? fibrotic (scarring) changes, thus increasing tissue
density of lung.
Describe Pneumonia (pneumonitis) and its Inflammation of the lung tissues causing fluid to fill
effect on tissue density in the alveolar spaces, thus resulting in greater
tissue density.
What is pneumonectomy and how does it The removal of a lung causing the affected side to
affect tissue density? demonstrate an increase in density, since normal
air-filled lung tissue is removed.
Describe pulmonary edema and its effect on Fluid filling the interstitial lung tissue and the
tissue density alveoli increasing tissue density
Describe atelectasis and its effect on the A collapse of the lung that results in airlessness of
tissue density all or part of lung tissue (causes increase in lung
tissue density)
Describe bronchiectasis and its effect on A chronic dilatation of the bronchi: can result in
tissue density bronchial thickening and small areas of atelectasis
(causes increase in ling tissue density)
What is cardiomegaly and how does it affect Enlargement heart causes an increase in thickness
tissue density? of part
Describe congestive heart failure (CHF) and Heart is inn failure and cardiac output is
its effect on the density of tissue. diminished, resulting in increased venous
congestion in lungs (lung tissue density is
increased)
What is hydrocephalus and how does it A dilatation of the fluid-filled cerebral ventricles
affect the tissue density? causing an enlargement of the head, resulting in
an increased tissue thickness
What I osteoblastic metastasis and how The spread of cancer to bone, resulting to
does it affect bone density? uncontrolled new bone growth, increasing density
What is osteochondroma and how does it A tumor arising in the bone and cartilage; it will
affect density? result in an increased thickness of the bone
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What is Paget’s disease and how does it An increase in bone cell activity which leads to
affects density? new bone growth (increasing density)
Define osteosclerosis and its effect on bone Hardening of the bone resulting in chronic
density inflammation, increasing the density of bone
Describe an aortic aneurysm and its effect A large dilatation of the aorta that result in
on tissue density? increased thickness of the affected part
Describe ascites and its effect on tissue Fluid accumulation within the peritoneal cavity
density causing an increase in tissue thickness
What is cirrhosis of the liver and how does it Fibrotic changes in the liver causing liver
affect tissue density? enlargement (increase tissue density)
What is acromegaly and how does it affect Enlargement of the hands, feet, face and jaw
tissue density? resulting from hypersecretion of growth hormone
in the adult: it increases bone mass
Describe chronic osteomyelitis and its effect A chronic bone infection resulting in new bone
on tissue density growth (increases tissue density)
What I emphysema and how does it affect Overdistention of lung tissues by air will result in a
the lung tissue density? decrease in lung tissue density
Describe pneumothorax and its effect on the Free air in the pleural cavity displaces normal lung
tissue density of lung? tissue and results in decrease density within the
thoracic cavity.
Describe pleural effusion (eg., hemothorax, The filing of the pleural cavity with blood or serous
hydrothorax) and how they affect tissue fluid displacing normal tissue (results in an
density increased tissue density)
What is tuberculosis and how does it affect An infection of the lung caused by the
tissue density? mycobacteria (increases density)
What is emaciation and how does it attract A generalized wasting away of tissue, resulting in
thickness of the body? reduced thickness of the body
What is atrophy and how does it affect the A wasting away of tissue resulting in reduced
body thickness? thickness of the body
What is aseptic necrosis and how does it Death of bone tissue resulting in a decrease of
affect tissue thickness? adjoining bone tissue, decreasing density
Describe fibrosarcoma and its effect on the A malignant tumor of the bone that causes an
density of tissue osteolytic lesion, resulting in decreased density of
bone
What is osteoporosis and how does it affect A defect in bone mineralization that causes a
tissue density decrease in density
IMAGE PROCESSING
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What factor control the action of the Immersion time

developer?
Solution temperature and
Chemical activity
What causes chemical fog on a radiograph? Developer temperature or the concentration of

the solution is too high
What is the function of the solvent (water) Dissolves the other chemical for use
in developer?
What is another term used for developing Reducing agents

agents?
What is the function of the reducing agents Produces black tones slowly and shades of gray
in the developer? rapidly
What is the function of the fixer? To remove the undeveloped silver halide crystals
and permanently fix the film
What is the function of clearing agent in the It removes undeveloped silver bromide from the
fixer? emulsion, thereby clearing the film
What is the function of preservative in the Maintain chemical balance

fixer?
What is the function of activator in the fixer? It provides an acidic pH, stops the reduction
process
What occurs during the washing step of The water removes al the fixer in the emulsion
automatic processing?
How must time and temperature relate to Inversely: as on increases, the other must decrease
each other to maintain the same rate of
development?
What is the purpose of replenishment? Maintain constant levels of chemical activity
What determines the amount of Number and size of the films processed
replenishment?
Which chemical is not present in the Potassium bromide

developer replenishment?
Why is potassium bromide intentionally left Potassium bromide is a byproduct of development

out of the developer replenisher?
What results if the radiographic film is not Poor archival quality

washed properly?
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At what temperature should the wash water 5 degrees below the developer temperature
be maintained in an automatic processor?
What takes place during the drying process The water is removed from the emulsion,
in the automatic processor? therefore hardening it
What is the usual cause of damp films from The depletion of glurataldehyde, the hardener in
the processor? the developer
What two factors control the rate of Time and temperature

development?
What is the purpose of radiographic To convert the latent image into manifest image
processing?
What are the major steps in processing of Developing, fixing, washing, and drying
radiographic film?
Which of the major steps in processing are Washing and drying

archiving steps?
What is the primary function of the To convert the latent image into manifest image
developer?
What are the six major components used in  Solvent

the developer solution?
 Developing agents
 Activators
 Restrainers
 Preservatives
 Hardener
What is the function of the activators in the  Helps swell gelatin;

developing solution?  produces alkalinity,
 controls PH
What is the function of the restrainer? Antifog agent: keeps unexposed crystals from
being chemically attacked.
What is the function of sodium sulfite in the Prevents oxidation of the developer
developer?
What is the function of the hardener in the Hardens the emulsion, reducing artifacts and film
developer? transport problem in the processor
What are the two types of silver recovery Metallic replacement and electrolyte units
units?
What is the proper way to dispose a They should be stored and disposed by hazardous
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processing chemicals? material professionals
What information should be permanently Date, full name of patient, institution where
identified on all radiograph? exposure was made, referring physician,
permanent ID number and exam ordered, right
and left markers should also be visible.
How should processed radiograph be 70 degrees F and 60% humidity

stored?
What is the purpose of the crossover It bends and turns the film when it reaches the top
network in an automatic processor? of the transport rack so that it is directed down
into the tank section.
Which roller start the film traveling from the Entrance rollers that are part of the crossover
feed tray? network
How should films be fed into the automatic With the short axis along the feed tray side guide
processor?
What is the function of the drive system in To turn the numerous rollers in the processor from
an automatic processor? power supplied by a single motor
Which system replaces depleted chemicals Replenishment system

in the developer and fixer?
How does an increased in replenishment A significant decreased in contrast will result

rate affects contrast?
How does a decreased replenishment rate A slight increase in contrast will result
affect film contrast?
What are principal components of an Transport system, replenishment system,

automatic processor? circulation system, temperature control system,
dryer system
What are the three subsystems of the Transport rack, crossover networks, and drive
transport system in an automatic processor? system
What is the purpose of the transport system Moves the film through the developer, fixer, wash
in an automatic processor? and dryer section of the processor
What is the optimal temperature for the 95 degrees F (30 degrees C)

developer solution?
What is e function of the dryer system in an To remove excess water, shrinks and seal the
automatic processor? emulsion
What is the function of the circulation Provides constant agitation for the developer and
system? fixer tanks, ensuring uniformity in development
and fixing
How often should the automatic processor Daily

be monitored?
18
What is the function of the temperature To maintain the solution temperatures

control system in an automatic processor?
How will a decrease in developer Density will decrease

replenishment rate affect density?
What are some causes of a milky Exhausted fixer, inadequate washing

appearance on a finished radiograph?
What are some causes of pinkish stain Contamination of the developer by fixer, developer
(dichroic fog) on a finished radiograph? or fixer underreplenishment
What is the cause of brown stain on a Inadequate washing

finished radiograph?
What would cause a greasy appearance on a Inadequate washing

finished radiograph?
How often should a processor be cleaned? Weekly
Define SYNERGISM The action of two agents working together is

greater than the sum of the action of each agent
working independently
When is extended processing used? It is used in mammography
What are the advantages of extended It increases the contrast by 15% as well as
processing? increasing the receptor sensitivity by at least 30%
(allowing reduction in patient dose)
How will an increased developer Density will increase

replenishment rate affect density?
INTENSIFYING SCREEN
What is the purpose of intensifying screen? To amplify the incoming x-ray beam and reduce
patient exposure
What is the principal advantage of using The reduction inn radiation dose
intensifying screens?
What is the disadvantage of using A slight blurring of the image

intensifying screens?
What are four layers of an intensifying  Base

screen?
 Reflective layer
 Phosphor layer
 Protective layer
The base of an intensifying screen is Polyester

19
composed of what material?
Define the term conversion efficiency The ability of the phosphor to emit as much light
per x-ray photon as possible (this is measurement
of speed)
Define SPECTRAL EMISSION An indication of the precise wavelength of light

emitted by the phosphor
What relationship is there between screen There is an inverse relationship: as screen speed
speed and detail? increases, detail decreases.
Rare earth converts x-ray to light how much Four times

more efficiently than calcium tungstate?
Define luminescence It is the ability of phosphor to emit light when

struck by x-ay
What is the purpose of base layer of an Provides support for other layers of the screen
intensifying screen?
The reflective layer of the intensifying screen White reflective substance such as titanium
is made up of what material? dioxide or magnesium oxide
What is the purpose of reflective layer of the It reflects the light away from the film back toward
intensifying screen? the film
How does adding a reflective layer to an It increases screen speed

intensifying screen affect the screen speed?
How does adding a reflective layer to an It reduces detail due to diffusion of light
intensifying screen affect the recorded
detail?
Define the term fluorescence Emission of light when the phosphor is stimulated
(within 1011 second)
Define the term screen resolution The ability to image an object accurately or with
fidelity
When using an intensifying screen, how More than 98%

much of the latent image is actually
produced by light?
What is the purpose of adding dye to the To reduce the diffusion of light
phosphor layer of an intensifying screen?
What is the disadvantage of adding dye to Reduce speed

an intensifying screen?
What is the mAs conversion formula that mAs1 = Relative Screen speed2
20
mAs2 Relative Screen speed1
should be used when changing intensifying
screen system speed?
What is the purpose of the cassette? It provide a rigid holder for the film and screen
What are some of the materials that Bakelite, magnesium, graphite carbon and even
compose the front of cassette? plastic
What material must be included in the back A thin sheet of lead foil
of a cassette to reduce the residual beam
and absorb backscatter?
How should cassette be stored? On end like a book
What color of light do screens composed of Blue

lanthanum oxybromide emit?
What color of light do screens composed of Green

gadolinium oxysulfide emit?
What are the common causes of the white Pitted screens or dust on the screens
spots (low density) on radiograph?
What are three way to measure resolution?  Line pairs per millimeter (lp/mm)
 Line speed function (LSF)
 Modulation transfer function (MTF)
What is modulation transfer? It is the most accurate way to measure resolution

of screen/film combinations. It measures the
information lost between the subject and the film
How is the screen speed measured? By the intensification factor of the screen
Define the term INTENSIFICATION FACTOR Exposure without screen

Exposure with screen
How does temperature affect screen speed? The intensifying factor decreases as temperature
increases (this is only concern with temperature
over 100 degrees F)
How does kVp affect screen speed? An increase in kVp increase screen speed
What are rare earth phosphors used in Gadolinium, Lanthanum and Yttrium
modern intensifying screens?
What factors determine screen resolution? Size of phosphor crystal, thickness of the layer, and
the concentration of the crystals
What is the common screen resolution Film/screen contact

problem?
How does poor film/screen contact manifest The image appear blurred
21
itself on a radiograph?
What test tool is used to evaluate Wire mesh test tool

film/screen contact?
What factors determine screen speed? The same factor that control resolution, size of
phosphor, thickness of the layer and concentration
of the crystals
What are two types of luminescence? Fluorescence and phosphorescence
What phosphor material is used in new, Rare earth

faster intensifying screens
Define the term phosphorescence Afterglow, continued emission of light (longer than
108 second
What are some other term for  Screen lag

phosphorescence
 Afterglow
What are the four characteristics that a  High atomic number

phosphor must possess to be used as
intensifying screens?  High conversion efficiency
 Appropriate spectral emission and
 Minimal phosphorescence
SENSITOMETRY
Define sensitometry The study of the response of film to exposure and

processing
How sensitometry is accomplished? By exposing and processing a film and then

measuring and evaluating the resulting densities
What kind of equipment do you need to  Penetrometer or sensitometer and

accomplish sensitometry?
 Densitometer
Describe a penetrometer A series of increasing thick, uniform absorbers,

usually aluminum steps (referred to as a step
wedge)
What is a sensitometer A device designed to expose a reproducible

uniform optical step wedge onto a film
What is densitometer? An instrument that provides a readout of the

amount of blackening on film
What is sensitometric curve? A graphic relationship between the amount of

22
exposure and the resultant density on the film
What are some other terms used for the  Characteristic curve
sensitometric curve?
 D log E curve
 H and D curve
 Hurter and Driffield curve
Define base plus fog The density at no exposure, or the density

inherent in the film
What is included in base plus fog? The density of the film base, its tints and dyes, plus
any fog the film has experienced
What are the three distinct regions of the  Toe region

sensitometric curve?
 Straight-line region
 Shoulder region
What does the toe region represents? Area of low density
What does the straight-line region Area where the diagnostic or most useful range of
represents? densities is produced
What does shoulder region represent? The point where changes in exposure intensity no
longer affect optical density.
Define the term OPTICAL DENSITY The numerical value that compares the amount of
light transmitted through an area of the
radiographic film to the amount of light originally
striking (incident) the film
SCATTER RADIATION AND BEAM-RESTRICTING DEVICES
How can the reduction of scatter radiation By using collimators, grids and compression
reaching the film be accomplished?
How does compression affects patient dose Compression reduces patient dose and increases
and image contrast? contrast
What is the primary source of scatter The patient

radiation?
How does scatter affect the radiographic It impairs image quality by placing density on the
image? film which is unrelated to the patient anatomy
Define the term beam-restricting device? A device that controls the size and shape of the
primary beam
23
What three factors contribute to an increase Increased kVp, increased x-ray field size, and
in scatter radiation? increased anatomic part thickness
How does an increase in kVp affect scatter Scatter increases as kVp increases
radiation
How does field size affect the level of scatter As field size decreased, scatter radiation decreases
radiation?
How does increase in anatomic part As anatomic part thickness increases, scatter
thickness affect scatter radiation radiation increases
Which two kinds of x-rays are responsible Those that pass through the patient without
for optical density on a radiograph? interacting and those that are scattered in the
patient through Compton Interaction
How does restricting the x-ray beam As the beam is restricted, fewer primary photons
decrease the amount of scatter reaching the are emitted from the tube and collimator and
film? fewer photons are created (this is also results in
less patient dose)
What are the three basic types of beam  Aperture diaphragm

restricting devices?
 Cones/cylinders
 collimators
Which type of beam-restricting device is the Aperture diaphragm, (it is the simplest in design
simplest? and application)
What is the principal disadvantage of Increase in image blur

aperture diaphragm?
What are three application for aperture  x-ray head units

diaphgram?
 dedicated chest radiography
 dental units
What are the disadvantages of using Difficulty in alignment and fixed field size
cones/cylinders?
What are some applications of  Skull

cones/cylinders in radiography?
 Spine
 Dental radiography
 Cholecystography
 mammography
What are positive beam-limiting collimator Automatic collimator that sense the size of the
(PBL)? image receptor and adjust the collimating shutters
to that area
24
How does scatter radiation affect the digital Failure to use a grid or collimate results in
image? excessive scatter reaching the IR. This reduces
image quality
What are tow advantages of collimators over X-ray field is illuminated and it can be adjusted to
other type of beam restrictors? infinite sizes
AUTOMATIC EXPOSURE CONTROL SYSTEMS
What is automatic exposure control (AEC) A system used to consistently control radiographic
system? density by terminating the length of exposure
based on the amount of radiation reaching the
image receptor
What are the two types of automatic Phototimers and ionization chamber devices
exposure controls (AECs) (primarily used today)
Where is the ionization chamber positioned The cassette and film are positioned under the
in relationship to the cassette and film? ionization chamber (ion chamber is between the
patient and film)
What devices are used to measure radiation Detectors (also called sensors, cells or pick-ups)
in an AEC system?
Which type of automatic exposure control Ionization chambers

(AEC) is primarily used in radiography today?
In computed radiography, the sensitivity of A 200 speed-film system

the system is equivalent to which film-
screen system?
When using AECs, what does minimum It is the shortest exposure time that a particular
response time mean? system can produce
When using AECs, what effect will changing None, but changing kVp will change the scale of
the kVp have on density? contrast.
When using AECs, to what does backup Maximum length of time the x-ray exposure will
time refer? continue
What is the appropriate setting for backup 150% to 200% of the expected exposure time
time when using AEC?
How important is AEC when using digital If AEC is used inappropriately and the IR is
radiography? underexposed, quantum mottle will result. If there
is overexposed, there will be decreases contrast
and overexposure to the patient
Is collimation an important factor when The additional scatter radiation produced by

25
using AEC? inadequate collimation may cause the defect to

terminate the exposure prematurely
What role should the density controls play They can be used to tune density, but not to
on as AEC system? compensate for patient thickness of kVp changes
What is anatomically programmed It is a radiographic system that combines an AEC

radiography? (APR) system with a technique chart that is
computerized to correspond to anatomical
procedures.
What role dose backup time play when using It acts as safety mechanism when the AEC is not
AEC system? functioning properly
What probably is the most important skill a Good positioning skills

radiographer should possess when using an
AEC system?
What is the result when AEC are not used Overexposure to the patient or an image that is of
accurately with digital imaging system? poor quality
RADIOGRAPHIC TECHNIQUE
What are the prime factors in radiography?  mAs
 kVp
 Distance (d)
Which of the prime factors is radiography mAs

control radiographic density
Describe the term x-ray quantity Measurement of the number of x-ray photons in
the useful beam
Describe the term x-ray quality Measurement of the penetrability of x-ray beam
Define the term half-value layer (HVL) The thickness of absorbing material needed to
reduce the x-ray intensity (quantity) to half of its
original value
Which prime factors primarily controls kVp

contrast but also has an effect on
radiographic density?
Which of the prime factors in radiography mAs

control the quantity of the x-ray beam?
Which of the primary factors determine the kVp

quality of the x-ray beam?
26
Define the optimal kVp The kVp high enough to penetrate the part and
produce images with appropriate contrast
Describe a fixed kVp chart The kVp is held constant for a given range of
subject densities while the mAs is varied to
achieve an appropriate image density
When would variable kVp/fixed mAs When small extremities, such as hands, toes, and
technique charts be effective? feet are being imaged.
How is kVp adjusted to accommodate part 2 kVp should be added for each centimeter
thickness? increase in part thickness
How is mAs adjusted to accommodate part For every 4 to 5 cm, the mAs should be adjusted by
thickness? a factor of 2
What is the general rule for measurement Measurements should be done along the path of
patients with calipers? the central ray; if the central ray is angled, the
measuring calipers should be angled.
What are the three types of technique  Fixed-kVp chart

charts commonly used today?
 Hight-kVp chart
 Automatic exposure chart
What are some advantages of fixed kVp Decrease in patient dose, more information on the
technique charts? image, consistency in image density and contrast,
lengthened exposure latitude, reduced tube wear,
shorter exposure times, decreased motion
What is the disadvantage of fixed-kVp chart? Overall decreased in contrast
Describe variable kVp/fixed mAs technique kVp adjusted for changes in part thickness while
chart maintaining a fixed mAs
What is the advantage of using variable Permits small incremental changes in exposure to
kVp/fixed mAs chart? compensate for the variation in body part
thickness
What is a major disadvantage of using When adjusting the kVp to change density, the
variable kVp technique charts? scale of contrast also changes.
What kVp levels should be used for barium High kVp, usually 90 and above
studies?
What kVp levels should be used when Medium (70-80)

performing procedures that require
iodinated solutions?
What changes in kVp should be made when kVp should be adjusted by at least 15%
compensating for pathologic conditions?
To visualize soft tissue structures, what kVp kVp should be decreased by 15%
adjustments should be made?
27
What adjustments should be made when Decrease the kVp by 15%

performing skull radiography on pediatric
patients younger than 6 years old?
What adjustment should be made for Adjustment should be made for increased
fiberglass cast materials when performing thickness of the body part exactly as if an uncasted
orthopedic radiography? part of the sae size were being radiographed
How should exposure factors be adjusted for Increase the mAs 50% only if the splints (wood,
splints when performing orthopedic aluminum and plastic) are in the path of the
radiography? primary beam; no adjustment is needed if the
splints are made of fiberglass or are inflatable air
Why is it usually not advised to use AEC It is necessary to choose fast exposure time to stop
when dong pediatric chest radiography? diaphragm motion inpatients who will not or
cannot stop breathing (this eliminates the
possibility of using AEC)
What exposure time will minimize the 1/120 sec. (0.0083 sec.)
appearance of motion when performing
pediatric chest radiography?
What adjustment should be made for plaster At least 2x the mAs or increase in kVp by 15%
casts?
DIGITAL IMAGING
Define the term digital imaging Images constructed from numerical data
What are the steps in obtaining the The exit radiation is absorbed by the input
fluoroscopic image in digital fluoro? phosphor, converted to electrons, sent to the
output phosphor, released as visible light , and
then converted to an electronic video signal for
transmission to the television monitor
In digital fluoroscopy, how is the analog By using an analog-to-digital converter (ADC)

video signal converted into digital signal?
How is the digital fluoroscopic image On a high-resolution monitor

viewed?
What are the two distinct advantages of The speed of the image acquisition and the post-
digital fluoroscopy over conventional processing that can enhance image contrast
fluoroscopy?
How is contrast adjusted in digital By using window width. A narrow window width
radiography? increases contrast, while a wide window width
decreases contrast.
Describe indirect acquisition systems Uses a two-part process which converts incoming
x-ray photons to light (using a scintillation) and
photodetector that converts light into an
28
electronic signal
Describe direct acquisition systems These system directly convert incoming x-ray
photons to an electronic signal
How is brightness controlled in digital By changing the window level, increasing window
radiography? level increases brightness, while decreasing the
window level decreases brightness
What are the difference in conventional The digital system is filmless, it is capable of much
radiography and digital imaging? wider exposure latitude than conventional
radiography and the computer
What is meant by the term postprocessing The capability to manipulate the image by
image enhancement? adjusting contrast ad density, and perform
subtraction and edge enhancement
What type of image receptor is used in Imaging plate (IP)

computed radiography in place of the film or
screen?
The imaging plate (IP) used in computed A photostimulable phospohor material;

radiography is composed of what material?
Barium fluorohalide crystals coated with europium
What are some ways in which conventional In both instances, the radiographer selects the
radiography and digital imaging are similar? technique, accurate positioning is critical and the
image receptor can be easily transported to distant
areas
When using CR, how will images that are They will exhibit low contrast
overexposure be manifest on a radiograph?
What is an advantage of CR A decrease in repeat exposures due to incorrect

technique
In CR, to what does the S number refer? It refers to the sensitivity of the image receptor.
The S number is inversely related to exposure in
mR
What is the S number value for a properly 150 – 250

exposed film?
In digital fluoroscopy, what device is used to An analog-digital converter (ADC). This allows
convert the analog video signal to digital manipulation of the digital image
data?
How is latent image processed in computed By loading the cassette into an image reader
radiography (CR)? device (IRD) where imaging plate is scanned by a
laser beam, digitized, and sent to the computer for
processing.
What is a matrix? It is a combination of rows and columns that make

29
up the display of digital image
What is the smallest component of a matrix? A pixel (picture element)
What does the acronym PACS refer to? Picture Archiving and Communication System
(PACS) are computerized storage and transmission
system for digital images of all types.
When using CR, how will images that are There will be quantum mottle.
underexposed be manifested on a
radiograph?
References:
Adler,A.M., & Carlton, RR (2003). Introduction to Radiologic Sciences and Patient Care
(3 ed.). Philadelphia:W.B. Saunders
rd
Bushong.S.C (2009). Radiologic Science for Technologists: Physics biology and protection
(9 ed.). St. Louis. MO: Mosby.
th
Carlton, R.R., & Adler, A.M. (2001). Principles of Radiographic Imaging (3rd ed.).
Albany,N.Y: Delmar
Fauber,T.L.(2004). Radiographic Imaging and exposure (2nd ed.). St. Louis, MO: Mosby
30

Image Production and Evaluation: Radiographic Contrast

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Image Production and Evaluation: Radiographic Contrast

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John Mark de Vera, RRT

IMAGE PRODUCTION AND EVALUATION

What factors comprise radiographic  Image receptor (film) contrast

Define RADIOGRAPHIC CONTRAST The differences between adjacent densities within

Primary controlling factor for contrast kVp

Describe long scale contrast  Many shades of gray

 Also referred as low contrast or

Which of the two types of contrast exhibits a Long-scale contrast

Which of the two types of contrast is a Short – scale (high contrast)

 Shortens the scale of contrast

Average gradient Term used to express film contrast numerically

Mathematical equation for average gradient Average gradient = OD2 x OD1

LRD = Log Relative Exposure

Which type of contrast will a film with a high High contrast

A film with a high average gradient will Fast speed

A film with a high average gradient will Narrow latitude?

DIFFERENTIAL ABDORPTION Different degrees of absorption in adjacent tissues

Describe short-scale contrast Few shades of contrast

Mainly black and white image

Also called high contrast or increased contrast

Mathematical equation for contrast K = Radiographic contrast with grid

What kVp change is needed to make a 4 – 12%

When making contrast changes on a Changes should be made in increments of 8 or

As kVp decreases, density decreases.

What is considered the useful range of 0.25 – 2.5

Which formula is used to maintain density Density maintenance formula:

Contaminated developer will reduce density

How is density expressed algebraically? OD= log10 x I0

l0 = light incident on the film

l1 = light transmitted through the film

(according to the inverse square law)

What percent change in mAs makes a visible 30%

RADIOGRAPHIC DETAIL The sharpness of the structural lines as recorded in

RESOLUTION The ability to image an object with accuracy, it is

DISTORTION Misrepresentation of the size or shape of a

Describe elongation of an object Elongation projects the object so it appears to be

 It occurs with the use of high-speed screens

How is resolution measured? By using a resolution grid: resolution is measures

Recorded detail improves as OID decreases

Define Size distortion Enlargement of the recorded image as compared

Define shape distortion Misrepresentation (elongation or foreshortened)

MAGNIFICATION The enlargement of the recorded image as

What formula is used to calculate size MF = SID

Describe foreshortening of a radiographic Foreshortening projects the object s it looks

What factor causes foreshortening of the Misalignment of the part

What factors cause elongation of the Misalignment of the tube

Define MOTION BLUR Loss of radiographic density caused by movement

 A long SID and short OID

Define heel effect Absorption of x-rays in the heel of the anode,

What are the types of distortion? Size and shape

What is the chemical contaminant that Silver sulfide

Which type of artifact is caused by bending Crinkle mark (fingernail-appearing artifact)

Define EXIT RADIATION Radiation that remains in the beam after

What are the two basic components of Base ad emulsion

What are the characteristics of Slow speed, high-contrast, extremely fine-grain,

Why is radiographic film package in a foil To protect it from moisture

If a single –emulsion film is loaded into a There will be decrease in density

How long can a typical radiographic film At least 40 seconds

Which type of static is caused from Tree static

What causes smudge static? Rough handling

Film should be stored at what humidity? Between 40% - 60% humidity

Over 60% - reduces contrast and increases fog

Under 40% - results in static artifact