C HA PTER 10 Concepts of Radiographic Image Quality
The less precise terms detail and recorded detail
R
ADIOGRAPHIC IMAGE quality is the exact-
ness of representation of the patient’s anatomy
on a radiographic image. High-quality images
are required so that radiologists can make
accurate diagnoses. To produce high-quality images,
radiographers apply knowledge of the three major
interrelated categories of radiographic quality: film
factors, geometric factors, and subject factors. Each
of these factors influences the quality of a radio-
graphic image, and each is under the control of
radiologic technologists. The selection of radio-
graphic technique factors is discussed in this chapter.
DEFINITIONS
Radiographic Image Quality
The term radiographic image quality refers to the fidel-
ity with which the anatomical structure that is being
examined is rendered on the radiograph. A radiograph
that faithfully reproduces structure and tissues is identi-
fied as a high-quality radiograph.
The quality of a radiographic image is not easy to
define, and it cannot be measured precisely. A number
of factors affect radiographic image quality, but no
precise, universally accepted measures by which to judge
it have been identified.
The most important characteristics of radiographic
image quality are spatial resolution, contrast resolution,
noise, and artifacts. Artifacts are discussed in Chapter
18. Furthermore, this chapter deals with screen-film
radiography. Digital radiography is covered in Part IV.
Resolution
Resolution is the ability to image two separate objects
and visually distinguish one from the other. Spatial reso-
lution refers to the ability to image small objects that
have high subject contrast, such as a bone–soft tissue
interface, a breast microcalcification, or a calcified lung
nodule. Screen-film radiography has excellent spatial
resolution. The measure of spatial resolution is dis-
cussed more completely in Chapter 28.
Spatial resolution improves as screen blur
decreases, motion blur decreases, and geometric
blur decreases.
Contrast resolution is the ability to distinguish ana-
tomical structures of similar subject contrast such as
liver–spleen and gray matter–white matter. The actual
size of objects that can be imaged is always smaller
under conditions of high subject contrast than under
conditions of low subject contrast.
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sometimes are used instead of spatial resolution and
contrast resolution. These terms refer to the degree of
sharpness of structural lines on a radiograph. Visibility
of detail refers to the ability to visualize recorded detail
when image contrast and optical density (OD) are
optimized.
Noise
Noise is a term that is borrowed from electrical engi-
neering. The flutter, hum, and whistle heard from an
audio system constitute audio noise that is inherent in
the design of the system. The “snow” on television
screens, especially in weak signal areas, is video noise,
and it is also inherent in the system.
Radiographic noise is the random fluctuation in
the OD of the image.
Radiographic noise also is inherent in the imaging
system (Figure 10-1). A number of factors contribute to
radiographic noise, including some that are under the
control of radiologic technologists. Lower noise results
in a better radiographic image because it improves con-
trast resolution.
Radiographic noise has four components: film graini-
ness, structure mottle, quantum mottle, and scatter
radiation. The principal source of radiographic noise—
scatter radiation—is discussed in Chapter 13.
Film graininess refers to the distribution in size and
space of silver halide grains in the emulsion. Structure
mottle is similar to film graininess but refers to the
phosphor of the radiographic intensifying screen. Film
graininess and structure mottle are inherent in the
screen-film image receptor. They are not under the
control of the radiologic technologist, and they contrib-
ute very little to radiographic noise, with the exception
of mammography.
Quantum mottle is somewhat under the control of
the radiologic technologist and is a principal contribu-
tor to radiographic noise in many radiographic imaging
procedures. Quantum mottle refers to the random
nature by which x-rays interact with the image
receptor.
If an image is produced with just a few x-rays, the
quantum mottle will be higher than if the image is
formed from a large number of x-rays. The use of very
fast intensifying screens results in increased quantum
mottle.
The use of high-mAs, low-kVp and of slower
image receptors reduces quantum mottle.