RTE 025 Interventional Radiology

Module #8 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

Lesson title: MANUAL SUBTRACTION TECHNIQUE/ ANALOG- Materials:

TO-DIGITAL CONVERTER, PIXEL FORMATION AND Book, pen and notebook, index card/class list
TV/COMPUTER MONITOR
References:
Learning Targets: RENATO M. SORIAO, (2004) Fundamentals
of Digital Subtraction Angiography for
Upon completion of this lesson, the radiologic technology student can: Radiologic Technologists, Echanis Press, Inc
SCOUT FILM
1. Define subtraction technique; https://medical-
2. Discuss the essential steps in the production of a subtraction dictionary.thefreedictionary.com/scout+radiogr
image; aph
3. Actually demonstrate and follow the essential steps in the CONTRAST MATERIAL
production of a subtraction image; and https://www.radiologyinfo.org/en/info.cfm?pg=
safety-contrast
4. To discuss the finished radiograph and make film critics ANALOG-TO-DIGITAL CONVERTER
evaluation
5. Discuss analog-to-digital converter and its functions; https://en.wikipedia.org/wiki/Analog-to-
6. Discuss pixel formation; and digital_converter
PIXEL FORMATION
7. To know the importance TV monitors and it`s historical
aspect https://en.wikipedia.org/wiki/Pixel
TV MONITOR
https://en.wikipedia.org/wiki/Computer_monito
r

LESSON PREVIEW/REVIEW (10 minutes)

After giving you a lecture on Video Signal, it`s time to assess your understanding through answering the following
questions:

1. What is the contribution of video recording in today`s diagnostic interventions?

2. What is/are the difference between continuous and intermittent projections?

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3. List 4 important points you understand about video recording.

A. MAIN LESSON (50 minutes)

You will gain knowledge and learn about this lesson:

The Subtraction Technique was first introduced by Ziedses des Plantes in1961 and makes possible the visualization of
certain information on angiogram by the removal of nonessential structures. The procedure does not add a new information
but enhances patterns of radiopaque contrast material. It is used sometimes in conjunction with direct magnification
radiography. Subtraction has the ability to eliminate structures that overlie the vascular anatomy that is filled with contrast,
thus making the obscured vascular anatomy visible.

A paramount importance in subtraction is the necessity of keeping all radiographic factors constant between the reference
film and the angiograms that should immediately follow. Without the same patient position, the same radiographic distance,
and exposure factors, subtraction is usually impossible. However, with the advent of rapid film changing and the equipment
encountered in the modern day neuroradiographic suite and the advances made in the production of subtraction films, this
valuable diagnostic asset has become a routine.

There are four essential steps in the production of a subtraction image.

The first step is to select a scout film (preliminary film) for the creation of a diapositive mask. The scout film can be defined
as a selected serial film in the angiographic run that has no visible contrast material. In other words, the scout film is a film
that is exposed just before the arrival of the contrast bolus. Depending on the selected injection delay, it is usually one of
the first four films in the serial run.

IMPORTANT TERMS:

Scout Film
Radioraph exposed before contrast medium is given, such as the preliminary film for an angiogram, urogram, or barium c
ontrast gastrointestinal examination.

Contrast Material

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Contrast materials, also called contrast agents or contrast media, are used to improve pictures of the inside of the body
produced by x-rays, computed tomography (CT), and magnetic resonance (MR) imaging. Often, contrast materials allow
the radiologist to distinguish normal from abnormal conditions.

Contrast materials are not dyes that permanently discolor internal organs. They are substances that temporarily change the
way x-rays or other imaging tools interact with the body.

When introduced into the body prior to an imaging exam, contrast materials make certain structures or tissues in the body
appear different on the images than they would if no contrast material had been administered. Contrast materials help
distinguish or "contrast" selected areas of the body from surrounding tissue. By improving the visibility of specific organs,
blood vessels or tissues, contrast materials help physicians diagnose medical conditions.

There are four essential steps in the production of a subtraction image.

The first step is to select a scout film (preliminary film) for the creation of a diapositive mask. The scout film can be defined
as a selected serial film in the angiographic run that has no visible contrast material. In other words, the scout film is a film
that is exposed just before the arrival of the contrast bolus. Depending on the selected injection delay, it is usually one of
the first four films in the serial run.

The second step is to prepare the diapositive mask (reversal film). The mask film produced will be the exact copy of the
scout film, but with the densities reversed. Thus, from a conventional negative radiograph, a positive radiograph or mask is
produced. The black areas are changed to white ones, and the white areas or the attenuated areas of the scout are changed
to black ones. The subtraction mask is created by taking a sheet of mask film, superimposing it in the scout film, and then
exposing it for a selected timed (approximately 5 seconds to light) to interval to white frosted light.

The third step is to select one of the contrast-filled angiogram (series film) films and superimpose that film over the mask a
process that is called registration.

The fourth step, when the (diapositive) mask is superimposed over the contrast filled angiogram film which is then exposed
for approximately 5 seconds to light, the positive and negative image of the bones tend to negate each other, and only the
added contrast vasculature is visualized. This film is known as the subtraction mask (series reversal film).

The fifth step is to make the subtraction print. To obtain a subtraction print, the subtraction mask is placed over the
angiogram as in step 3; a subtraction print film is placed on top of these; and exposed for approximately 35 seconds to light.
The subtraction print is then processed, and an image of only the contrast-filled vessels is visible.

The use of photographic subtraction has decreased in many institutions. However, the increasing popularity of digital
subtraction angiography apparatus was increased the speed of image processing and decreased costs to the point where
totally electronic radiographic image detection, storage, and display are beginning to replace film in a number of procedures.

ANALOG TO DIGITAL CONVERTER

In electronics, an analog-to-digital converter (ADC, A/D, or A-to-D) is a system that converts an analog signal, such as
a sound picked up by a microphone or light entering a digital camera, into a digital signal. An ADC may also provide an
isolated measurement such as an electronic device that converts an input analog voltage or current to a digital number
representing the magnitude of the voltage or current. Typically the digital output is a two's complement binary number that
is proportional to the input, but there are other possibilities.

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There are several ADC architectures. Due to the complexity and the need for precisely matched components, all but the
most specialized ADCs are implemented as integrated circuits (ICs). These typically take the form of metal–oxide–
semiconductor (MOS) mixed-signal integrated circuit chips that integrate both analog and digital circuits.
A digital-to-analog converter (DAC) performs the reverse function; it converts a digital signal into an analog signal.

PIXEL FORMATION
In digital imaging, a pixel, pel, or picture element is a physical point in a raster image, or the smallest addressable element
in an all points addressable display device; so it is the smallest controllable element of a picture represented on the screen.
Each pixel is a sample of an original image; more samples typically provide more accurate representations of the original.
The intensity of each pixel is variable. In color imaging systems, a color is typically represented by three or four component
intensities such as red, green, and blue, or cyan, magenta, yellow, and black.
In some contexts (such as descriptions of camera sensors), pixel refers to a single scalar element of a multi-component
representation (called a photosite in the camera sensor context, although sensel is sometimes used), while in yet other
contexts it may refer to the set of component intensities for a spatial position.
Etymology
The word pixel is a portmanteau of pix (from "pictures", shortened to "pics") and el (for "element"); similar formations with
'el' include the words voxel and texel. The word pix appeared in Variety magazine headlines in 1932, as an abbreviation for
the word pictures, in reference to movies. By 1938, "pix" was being used in reference to still pictures by photojournalists.
The word "pixel" was first published in 1965 by Frederic C. Billingsley of JPL, to describe the picture elements of scanned
images from space probes to the Moon and Mars. Billingsley had learned the word from Keith E. McFarland, at the Link
Division of General Precision in Palo Alto, who in turn said he did not know where it originated. McFarland said simply it
was "in use at the time" (circa 1963).
The concept of a "picture element" dates to the earliest days of television, for example as "Bildpunkt" (the German word
for pixel, literally 'picture point') in the 1888 German patent of Paul Nipkow. According to various etymologies, the earliest
publication of the term picture element itself was in Wireless World magazine in 1927, though it had been used earlier in
various U.S. patents filed as early as 1911.
Some authors explain pixel as picture cell, as early as 1972. In graphics and in image and video processing, pel is often
used instead of pixel. For example, IBM used it in their Technical Reference for the original PC.
Pixels, abbreviated as "px", are also a unit of measurement commonly used in graphic and web design, equivalent to
roughly 1⁄96 inch (0.26 mm). This measurement is used to make sure a given element will display as the same size no matter
what screen resolution views it.
Pixilation, spelled with a second i, is an unrelated filmmaking technique that dates to the beginnings of cinema, in which live
actors are posed frame by frame and photographed to create stop-motion animation. An archaic British word meaning
"possession by spirits (pixies)", the term has been used to describe the animation process since the early 1950s; various
animators, including Norman McLaren and Grant Munro, are credited with popularizing it.
Technical Aspect
A pixel is generally thought of as the smallest single component of a digital image. However, the definition is highly context-
sensitive. For example, there can be "printed pixels" in a page, or pixels carried by electronic signals, or represented by
digital values, or pixels on a display device, or pixels in a digital camera (photosensor elements). This list is not exhaustive

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and, depending on context, synonyms include pel, sample, byte, bit, dot, and spot. Pixels can be used as a unit of measure
such as: 2400 pixels per inch, 640 pixels per line, or spaced 10 pixels apart.
The measures dots per inch (dpi) and pixels per inch (ppi) are sometimes used interchangeably, but have distinct meanings,
especially for printer devices, where dpi is a measure of the printer's density of dot (e.g. ink droplet) placement. For example,
a high-quality photographic image may be printed with 600 ppi on a 1200 dpi inkjet printer. Even higher dpi numbers, such
as the 4800 dpi quoted by printer manufacturers since 2002, do not mean much in terms of achievable resolution.
The more pixels used to represent an image, the closer the result can resemble the original. The number of pixels in an
image is sometimes called the resolution, though resolution has a more specific definition. Pixel counts can be expressed
as a single number, as in a "three-megapixel" digital camera, which has a nominal three million pixels, or as a pair of
numbers, as in a "640 by 480 display", which has 640 pixels from side to side and 480 from top to bottom (as in
a VGA display) and therefore has a total number of 640 × 480 = 307,200 pixels, or 0.3 megapixels.
The pixels, or color samples, that form a digitized image (such as a JPEG file used on a web page) may or may not be in
one-to-one correspondence with screen pixels, depending on how a computer displays an image. In computing, an image
composed of pixels is known as a bitmapped image or a raster image. The word raster originates from television
scanning patterns, and has been widely used to describe similar halftone printing and storage techniques.
Sampling Patterns
For convenience, pixels are normally arranged in a regular two-dimensional grid. By using this arrangement, many common
operations can be implemented by uniformly applying the same operation to each pixel independently. Other arrangements
of pixels are possible, with some sampling patterns even changing the shape (or kernel) of each pixel across the image.
For this reason, care must be taken when acquiring an image on one device and displaying it on another, or when converting
image data from one pixel format to another.
For example:

Text rendered using ClearType using subpixels

• LCD screens typically use a staggered grid, where the red, green, and blue components are sampled at slightly different
locations. Subpixel rendering is a technology which takes advantage of these differences to improve the rendering of
text on LCD screens.
• The vast majority of color digital cameras use a Bayer filter, resulting in a regular grid of pixels where the color of each
pixel depends on its position on the grid.
• A clipmap uses a hierarchical sampling pattern, where the size of the support of each pixel depends on its location
within the hierarchy.
• Warped grids are used when the underlying geometry is non-planar, such as images of the earth from space.
• The use of non-uniform grids is an active research area, attempting to bypass the traditional Nyquist limit.
• Pixels on computer monitors are normally "square" (that is, have equal horizontal and vertical sampling pitch); pixels in
other systems are often "rectangular" (that is, have unequal horizontal and vertical sampling pitch – oblong in shape),
as are digital video formats with diverse aspect ratios, such as the anamorphic widescreen formats of the Rec.
601 digital video standard.

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Resolution of Computer Monitors

Computers can use pixels to display an image, often an abstract image that represents a GUI. The resolution of this image
is called the display resolution and is determined by the video card of the computer. LCD monitors also use pixels to display
an image, and have a native resolution. Each pixel is made up of triads, with the number of these triads determining the
native resolution. On some CRT monitors, the beam sweep rate may be fixed, resulting in a fixed native resolution. Most
CRT monitors do not have a fixed beam sweep rate, meaning they do not have a native resolution at all - instead they have
a set of resolutions that are equally well supported. To produce the sharpest images possible on an LCD, the user must
ensure the display resolution of the computer matches the native resolution of the monitor.
Bits Per Pixel
The number of distinct colors that can be represented by a pixel depends on the number of bits per pixel (bpp). A 1 bpp
image uses 1-bit for each pixel, so each pixel can be either on or off. Each additional bit doubles the number of colors
available, so a 2 bpp image can have 4 colors, and a 3 bpp image can have 8 colors:

• 1 bpp, 21 = 2 colors (monochrome)

• 2 bpp, 22 = 4 colors
• 3 bpp, 23 = 8 colors
• 4 bpp, 24 = 16 colors
• 8 bpp, 28 = 256 colors
• 16 bpp, 216 = 65,536 colors ("Highcolor" )
• 24 bpp, 224 = 16,777,216 colors ("Truecolor")
For color depths of 15 or more bits per pixel, the depth is normally the sum of the bits allocated to each of the red, green,
and blue components. Highcolor, usually meaning 16 bpp, normally has five bits for red and blue each, and six bits for
green, as the human eye is more sensitive to errors in green than in the other two primary colors. For applications involving
transparency, the 16 bits may be divided into five bits each of red, green, and blue, with one bit left for transparency. A 24-
bit depth allows 8 bits per component. On some systems, 32-bit depth is available: this means that each 24-bit pixel has an
extra 8 bits to describe its opacity (for purposes of combining with another image).
Subpixels

Geometry of color elements of various CRT and LCD displays; phosphor dots in the color display of CRTs (top row) bear

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no relation to pixels or subpixels.

Many display and image-acquisition systems are not capable of displaying or sensing the different color channels at the
same site. Therefore, the pixel grid is divided into single-color regions that contribute to the displayed or sensed color when
viewed at a distance. In some displays, such as LCD, LED, and plasma displays, these single-color regions are separately
addressable elements, which have come to be known as subpixels. For example, LCDs typically divide each pixel vertically
into three subpixels. When the square pixel is divided into three subpixels, each subpixel is necessarily rectangular. In
display industry terminology, subpixels are often referred to as pixels, as they are the basic addressable elements in a
viewpoint of hardware, and hence pixel circuits rather than subpixel circuits is used.
Most digital camera image sensors use single-color sensor regions, for example using the Bayer filter pattern, and in the
camera industry these are known as pixels just like in the display industry, not subpixels.
For systems with subpixels, two different approaches can be taken:

• The subpixels can be ignored, with full-color pixels being treated as the smallest addressable imaging element; or
• The subpixels can be included in rendering calculations, which requires more analysis and processing time, but can
produce apparently superior images in some cases.
This latter approach, referred to as subpixel rendering, uses knowledge of pixel geometry to manipulate the three colored
subpixels separately, producing an increase in the apparent resolution of color displays. While CRT displays use red-green-
blue-masked phosphor areas, dictated by a mesh grid called the shadow mask, it would require a difficult calibration step
to be aligned with the displayed pixel raster, and so CRTs do not currently use subpixel rendering.
The concept of subpixels is related to samples.

Megapixel

Diagram of common sensor resolutions of digital cameras including megapixel values

A megapixel (MP) is a million pixels; the term is used not only for the number of pixels in an image but also to express the
number of image sensor elements of digital cameras or the number of display elements of digital displays. For example, a
camera that makes a 2048 × 1536 pixel image (3,145,728 finished image pixels) typically uses a few extra rows and columns
of sensor elements and is commonly said to have "3.2 megapixels" or "3.4 megapixels", depending on whether the number
reported is the "effective" or the "total" pixel count.
Digital cameras use photosensitive electronics, either charge-coupled device (CCD) or complementary metal–oxide–
semiconductor (CMOS) image sensors, consisting of a large number of single sensor elements, each of which records a
measured intensity level. In most digital cameras, the sensor array is covered with a patterned color filter mosaic having
red, green, and blue regions in the Bayer filter arrangement so that each sensor element can record the intensity of a single

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primary color of light. The camera interpolates the color information of neighboring sensor elements, through a process
called demosaicing, to create the final image. These sensor elements are often called "pixels", even though they only record
1 channel (only red or green or blue) of the final color image. Thus, two of the three color channels for each sensor must be
interpolated and a so-called N-megapixel camera that produces an N-megapixel image provides only one-third of the
information that an image of the same size could get from a scanner. Thus, certain color contrasts may look fuzzier than
others, depending on the allocation of the primary colors (green has twice as many elements as red or blue in the Bayer
arrangement).
DxO Labs invented the Perceptual MegaPixel (P-MPix) to measure the sharpness that a camera produces when paired to
a particular lens – as opposed to the MP a manufacturer states for a camera product, which is based only on the camera's
sensor. The new P-MPix claims to be a more accurate and relevant value for photographers to consider when weighing up
camera sharpness. As of mid-2013, the Sigma 35 mm f/1.4 DG HSM lens mounted on a Nikon D800 has the highest
measured P-MPix. However, with a value of 23 MP, it still wipes off more than one-third of the D800's 36.3 MP sensor. In
August 2019, Xiaomi released Redmi Note 8 Pro as the world's first smartphone with 64 MP camera. On December 12,
2019 Samsung released Samsung A71 with also a 64 MP camera. In late 2019, Xiaomi announced the first camera phone
with 108MP 1/1.33-inch across sensor. The sensor is larger than most of bridge camera with 1/2.3-inch across sensor.
One new method to add megapixels has been introduced in a Micro Four Thirds System camera, which only uses a 16 MP
sensor but can produce a 64 MP RAW (40 MP JPEG) image by making two exposures, shifting the sensor by a half pixel
between them. Using a tripod to take level multi-shots within an instance, the multiple 16 MP images are then generated
into a unified 64 MP image.

TV/COMPUTER MONITOR
A computer monitor is an output device that displays information in pictorial form. A monitor usually comprises the visual
display, circuitry, casing, and power supply. The display device in modern monitors is typically a thin film transistor liquid
crystal display (TFT-LCD) with LED backlighting having replaced cold-cathode fluorescent lamp (CCFL) backlighting. Older
monitors used a cathode ray tube (CRT). Monitors are connected to the computer via VGA, Digital Visual
Interface (DVI), HDMI, DisplayPort, Thunderbolt, low-voltage differential signaling (LVDS) or other proprietary connectors
and signals.
Originally, computer monitors were used for data processing while television sets were used for entertainment. From the
1980s onwards, computers (and their monitors) have been used for both data processing and entertainment,
while televisions have implemented some computer functionality. The common aspect ratio of televisions, and computer
monitors, has changed from 4:3 to 16:10, to 16:9.
Modern computer monitors are easily interchangeable with conventional television sets and vice versa. However, as
computer monitors do not necessarily include integrated speakers nor TV tuners (such as Digital television adapters), it may
not be possible to use a computer monitor as a TV set without external components.
History
Early electronic computers were fitted with a panel of light bulbs where the state of each particular bulb would indicate the
on/off state of a particular register bit inside the computer. This allowed the engineers operating the computer to monitor
the internal state of the machine, so this panel of lights came to be known as the 'monitor'. As early monitors were only
capable of displaying a very limited amount of information and were very transient, they were rarely considered for program
output. Instead, a line printer was the primary output device, while the monitor was limited to keeping track of the program's
operation.

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As technology developed engineers realized that the output of a CRT display was more flexible than a panel of light bulbs
and eventually, by giving control of what was displayed in the program itself, the monitor itself became a powerful output
device in its own right.
Computer monitors were formerly known as visual display units (VDU), but this term had mostly fallen out of use by the
1990s.
Technologies
(Comparison of CRT, LCD, Plasma, and OLED and History of display technology)

Multiple technologies have been used for computer monitors. Until the 21st century most used cathode ray tubes but they
have largely been superseded by LCD monitors.
Cathode Ray Tube
The first computer monitors used cathode ray tubes (CRTs). Prior to the advent of home computers in the late 1970s, it was
common for a video display terminal (VDT) using a CRT to be physically integrated with a keyboard and other components
of the system in a single large chassis. The display was monochrome and far less sharp and detailed than on a modern
flat-panel monitor, necessitating the use of relatively large text and severely limiting the amount of information that could be
displayed at one time. High-resolution CRT displays were developed for the specialized military, industrial and scientific
applications but they were far too costly for general use.
Some of the earliest home computers (such as the TRS-80 and Commodore PET) were limited to monochrome CRT
displays, but colour display capability was already a standard feature of the pioneering Apple II, introduced in 1977, and the
speciality of the more graphically sophisticated Atari 800, introduced in 1979. Either computer could be connected to the
antenna terminals of an ordinary colour TV set or used with a purpose-made CRT colour monitor for optimum resolution
and colour quality. Lagging several years behind, in 1981 IBM introduced the Color Graphics Adapter, which could display
four colours with a resolution of 320 x 200 pixels, or it could produce 640 x 200 pixels with two colours. In 1984 IBM
introduced the Enhanced Graphics Adapter which was capable of producing 16 colors and had a resolution of 640 x 350.
By the end of the 1980's colour CRT monitors that could clearly display 1024 x 768 pixels were widely available and
increasingly affordable. During the following decade, maximum display resolutions gradually increased and prices continued
to fall. CRT technology remained dominant in the PC monitor market into the new millennium partly because it was cheaper
to produce and offered to view angles close to 180 degrees. CRTs still offer some image quality advantages over LCDs but
improvements to the latter have made them much less obvious. The dynamic range of early LCD panels was very poor,
and although text and other motionless graphics were sharper than on a CRT, an LCD characteristic known as pixel lag
caused moving graphics to appear noticeably smeared and blurry.
Liquid crystal display and Thin-film-transistor liquid-crystal display
There are multiple technologies that have been used to implement liquid crystal displays (LCD). Throughout the 1990s, the
primary use of LCD technology as computer monitors was in laptops where the lower power consumption, lighter weight,
and smaller physical size of LCDs justified the higher price versus a CRT. Commonly, the same laptop would be offered
with an assortment of display options at increasing price points: (active or passive) monochrome, passive color, or active
matrix color (TFT). As volume and manufacturing capability have improved, the monochrome and passive color technologies
were dropped from most product lines.
TFT-LCD is a variant of LCD which is now the dominant technology used for computer monitors.
The first standalone LCDs appeared in the mid-1990s selling for high prices. As prices declined over a period of years they
became more popular, and by 1997 were competing with CRT monitors. Among the first desktop LCD computer monitors
was the Eizo FlexScan L66 in the mid-1990s, the Apple Studio Display and the ViewSonic VP140 in 1998. In 2003, TFT-

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LCDs outsold CRTs for the first time, becoming the primary technology used for computer monitors. The main advantages
of LCDs over CRT displays are that LCDs consume less power, take up much less space, and are considerably lighter. The
now common active matrix TFT-LCD technology also has less flickering than CRTs, which reduces eye strain. On the other
hand, CRT monitors have superior contrast, have a superior response time, are able to use multiple screen resolutions
natively, and there is no discernible flicker if the refresh rate is set to a sufficiently high value. LCD monitors have now very
high temporal accuracy and can be used for vision research.
High dynamic range (HDR) has been implemented into high-end LCD monitors to improve color accuracy. Since around
the late 2000s, widescreen LCD monitors have become popular, in part due to television series, motion pictures and video
games transitioning to high-definition (HD), which makes standard-width monitors unable to display them correctly as they
either stretch or crop HD content. These types of monitors may also display it in the proper width, by filling the extra space
at the top and bottom of the image with a solid colour ("letterboxing"). Other advantages of widescreen monitors over
standard-width monitors is that they make work more productive by displaying more of a user's documents and images, and
allow displaying toolbars with documents. They also have a larger viewing area, with a typical widescreen monitor having a
16:9 aspect ratio, compared to the 4:3 aspect ratio of a typical standard-width monitor.
Organic light-emitting diode
Organic light-emitting diode (OLED) monitors provide higher contrast, better color reproduction and viewing angles than
LCDs but they require more power when displaying documents with white or bright backgrounds and have a severe problem
known as burn-in, just like CRTs. They are less common than LCD monitors and are often more expensive.
Measurements of Performance
The performance of a monitor is measured by the following parameters:

• Luminance is measured in candelas per square meter (cd/m2 also called a Nit).
• Color depth is measured in bits per primary color or bits for all colors. Those with 10-bits or more are HDR monitors,
which can display more shades of colors (approx. 1 billion shades) than traditional 8 bit monitors (approx. 16.6 million
shades or colors), and can do so more precisely without having to resort to dithering, which would also reduce image
sharpness. HDR monitors are required to be brighter than conventional monitors while simultaneously showing deeper
blacks (higher contrast ratios). The minimum brightness and contrast ratios are defined by the HDR standard the
monitor adheres to.
• Gamut is measured as coordinates in the CIE 1931 color space. The names sRGB or AdobeRGB are shorthand
notations.
• Aspect ratio is the ratio of the horizontal length to the vertical length. Monitors usually have the aspect
ratio 4:3, 5:4, 16:10 or 16:9.
• Viewable image size is usually measured diagonally, but the actual widths and heights are more informative since they
are not affected by the aspect ratio in the same way. For CRTs, the viewable size is typically 1 in (25 mm) smaller than
the tube itself.
• Display resolution is the number of distinct pixels in each dimension that can be displayed. For a given display size,
maximum resolution is limited by dot pitch or DPI.
• Dot pitch is, in CRTs, the distance between sub-pixels of the same color in millimeters. In LCDs it is instead measured
in pixels per inch or dots per inch (PPI or DPI), In general, the smaller the dot pitch, or the higher the PPI or DPI, the
sharper the picture will appear.
• Refresh rate is (in CRTs) the number of times in a second that the display is illuminated. (The number of times a second
a raster scan is completed) In LCDs it is the number of times the image can be changed per second. Measured in Hertz
(Hz). Maximum refresh rate is limited by response time. Determines the maximum number of frames per second (FPS)
a monitor is capable of showing.

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• Response time is the time a pixel in a monitor takes to go from active (white) to inactive (black) and back to active
(white) again, measured in milliseconds. Lower numbers mean faster transitions and therefore fewer visible image
artifacts such as ghosting.
• Display lag is the time (measured in miliseconds (ms) it takes for a monitor to display an image after receiving it.
• Contrast ratio is the ratio of the luminosity of the brightest color (white) to that of the darkest color (black) that the
monitor is capable of producing simultaneously. For example, a ratio of 20,000:1 means that it’s brightest white can be
20,000 times brighter than its darkest black. Dynamic contrast ratio is measured with the LCD backlight turned off.
• Power consumption is measured in watts.
• Delta-E: Color accuracy is measured in delta-E; the lower the delta-E, the more accurate the color representation. A
delta-E of below 1 is imperceptible to the human eye. Delta-Es of 2 to 4 are considered good and require a sensitive
eye to spot the difference.
• Viewing angle is the maximum angle at which images on the monitor can be viewed, without excessive degradation to
the image. It is measured in degrees horizontally and vertically.
Curved monitors also have an R value; the lower the R value, the more curved the monitor. The R value is the radius in
milimeters of a theoretical circle formed by tiling several equal monitors end to end.
Size
On two-dimensional display devices such as computer monitors the display size or view able image size is the actual
amount of screen space that is available to display a picture, video or working space, without obstruction from the case or
other aspects of the unit's design. The main measurements for display devices are: width, height, total area and the
diagonal.
The size of a display is usually by monitor manufacturers given by the diagonal, i.e. the distance between two opposite
screen corners. This method of measurement is inherited from the method used for the first generation of CRT television,
when picture tubes with circular faces were in common use. Being circular, it was the external diameter of the glass envelope
that described their size. Since these circular tubes were used to display rectangular images, the diagonal measurement of
the rectangular image was smaller than the diameter of the tube's face (due to the thickness of the glass). This method
continued even when cathode ray tubes were manufactured as rounded rectangles; it had the advantage of being a single
number specifying the size, and was not confusing when the aspect ratio was universally 4:3.
With the introduction of flat panel technology, the diagonal measurement became the actual diagonal of the visible display.
This meant that an eighteen-inch LCD had a larger visible area than an eighteen-inch cathode ray tube.
The estimation of the monitor size by the distance between opposite corners does not take into account the display aspect
ratio, so that for example a 16:9 21-inch (53 cm) widescreen display has less area, than a 21-inch (53 cm) 4:3 screen. The
4:3 screen has dimensions of 16.8 in × 12.6 in (43 cm × 32 cm) and area 211 sq in (1,360 cm2), while the widescreen is
18.3 in × 10.3 in (46 cm × 26 cm), 188 sq in (1,210 cm2).
Aspect ratio
Until about 2003, most computer monitors had a 4:3 aspect ratio and some had 5:4. Between 2003 and 2006, monitors
with 16:9 and mostly 16:10 (8:5) aspect ratios became commonly available, first in laptops and later also in standalone
monitors. Reasons for this transition was productive uses for such monitors, i.e. besides widescreen computer game
play and movie viewing, are the word processor display of two standard letter pages side by side, as well as CAD displays
of large-size drawings and CAD application menus at the same time. In 2008 16:10 became the most common sold aspect
ratio for LCD monitors and the same year 16:10 was the mainstream standard for laptops and notebook computers.
In 2010 the computer industry started to move over from 16:10 to 16:9 because 16:9 was chosen to be the standard high-
definition television display size, and because they were cheaper to manufacture.

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 RTE 025 Interventional Radiology
Module #8 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

In 2011 non-widescreen displays with 4:3 aspect ratios were only being manufactured in small quantities. According to
Samsung this was because the "Demand for the old 'Square monitors' has decreased rapidly over the last couple of years,"
and "I predict that by the end of 2011, production on all 4:3 or similar panels will be halted due to a lack of demand."
Resolution
The resolution for computer monitors has increased over time. From 320x200 during the early 1980s, to 1024x768 during
the late 1990s. Since 2009, the most commonly sold resolution for computer monitors is 1920x1080. Before 2013 top-end
consumer LCD monitors were limited to 2560x1600 at 30 in (76 cm), excluding Apple products and CRT monitors. Apple
introduced 2880x1800 with Retina MacBook Pro at 15.4 in (39 cm) on June 12, 2012, and introduced a 5120x2880 Retina
iMac at 27 in (69 cm) on October 16, 2014. By 2015 most major display manufacturers had released 3840x2160 resolution
displays.
Gamut
Every RGB monitor has its own color gamut, bounded in chromaticity by a color triangle. Some of these triangles are smaller
than the sRGB triangle, some are larger. Colors are typically encoded by 8 bits per primary color. The RGB value [255, 0,
0] represents red, but slightly different colors in different color spaces such as AdobeRGB and sRGB. Displaying sRGB-
encoded data on wide-gamut devices can give an unrealistic result. The gamut is a property of the monitor; the image color
space can be forwarded as Exif metadata in the picture. As long as the monitor gamut is wider than the color space gamut,
correct display is possible, if the monitor is calibrated. A picture that uses colors that are outside the sRGB color space will
display on an sRGB color space monitor with limitations. Still today, many monitors that can display the sRGB color space
are not factory adjusted to display it correctly. Color management is needed both in electronic publishing (via the Internet
for display in browsers) and in desktop publishing targeted to print.
Mounting
Computer monitors are provided with a variety of methods for mounting them depending on the application and environment.

Desktop
A desktop monitor is typically provided with a stand from the manufacturer which lifts the monitor up to a more ergonomic
viewing height. The stand may be attached to the monitor using a proprietary method or may use, or be adaptable to,
a Video Electronics Standards Association, VESA, standard mount. Using a VESA standard mount allows the monitor to be
used with an after-market stand once the original stand is removed. Stands may be fixed or offer a variety of features such
as height adjustment, horizontal swivel, and landscape or portrait screen orientation.
VESA Mount
The Flat Display Mounting Interface (FDMI), also known as VESA Mounting Interface Standard (MIS) or colloquially as a
VESA mount, is a family of standards defined by the Video Electronics Standards Association for mounting flat
panel monitors, TVs, and other displays to stands or wall mounts. It is implemented on most modern flat-panel monitors and
TVs.
For Computer Monitors, the VESA Mount typically consists of four threaded holes on the rear of the display that will mate
with an adapter bracket.
Rack mount
Rack mount computer monitors are available in two styles and are intended to be mounted into a 19-inch rack:
Fixed
A fixed rack mount monitor is mounted directly to the rack with the LCD visible at all times. The height of the unit is measured

This document is the property of PHINMA EDUCATION

 RTE 025 Interventional Radiology
Module #8 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

in rack units (RU) and 8U or 9U are most common to fit 17-inch or 19-inch LCDs. The front sides of the unit are provided
with flanges to mount to the rack, providing appropriately spaced holes or slots for the rack mounting screws. A 19-inch
diagonal LCD is the largest size that will fit within the rails of a 19-inch rack. Larger LCDs may be accommodated but are
'mount-on-rack' and extend forward of the rack. There are smaller display units, typically used in broadcast environments,
which fit multiple smaller LCDs side by side into one rack mount.
Stowable
A stowable rack mount monitor is 1U, 2U or 3U high and is mounted on rack slides allowing the display to be folded down
and the unit slid into the rack for storage. The display is visible only when the display is pulled out of the rack and deployed.
These units may include only a display or may be equipped with a keyboard creating a KVM (Keyboard Video Monitor).
Most common are systems with a single LCD but there are systems providing two or three displays in a single rack mount
system.
Panel Mount
A panel mount computer monitor is intended for mounting into a flat surface with the front of the display unit protruding just
slightly. They may also be mounted to the rear of the panel. A flange is provided around the LCD, sides, top and bottom, to
allow mounting. This contrasts with a rack mount display where the flanges are only on the sides. The flanges will be
provided with holes for thru-bolts or may have studs welded to the rear surface to secure the unit in the hole in the panel.
Often a gasket is provided to provide a water-tight seal to the panel and the front of the LCD will be sealed to the back of
the front panel to prevent water and dirt contamination.
Open Frame
An open frame monitor provides the LCD monitor and enough supporting structure to hold associated electronics and to
minimally support the LCD. Provision will be made for attaching the unit to some external structure for support and
protection. Open frame LCDs are intended to be built into some other piece of equipment. An arcade video game would be
a good example with the display mounted inside the cabinet. There is usually an open frame display inside all end-use
displays with the end-use display simply providing an attractive protective enclosure. Some rack mount LCD manufacturers
will purchase desktop displays, take them apart, and discard the outer plastic parts, keeping the inner open-frame LCD for
inclusion into their product.
Security Vulnerabilities
According to an NSA document leaked to Der Spiegel, the NSA sometimes swaps the monitor cables on targeted computers
with a bugged monitor cable in order to allow the NSA to remotely see what is being displayed on the targeted computer
monitor.
Van Eck phreaking is the process of remotely displaying the contents of a CRT or LCD by detecting its electromagnetic
emissions. It is named after Dutch computer researcher Wim van Eck, who in 1985 published the first paper on it, including
proof of concept. Phreaking more generally is the process of exploiting telephone networks.

Check for Understanding (25 minutes)

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to correct
answer and another one (1) point for the correct ratio. Superimpositions or erasures in you answer/ratio is not allowed. You
are given 25 minutes for this activity:

Multiple Choice

This document is the property of PHINMA EDUCATION

 RTE 025 Interventional Radiology
Module #8 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

1. Subtraction technique was first introduced in 1961 by:

a. Ziedses des Plantes
b. Thomas Alva Edison
c. Neils Bohr
d. Marie Curie
ANSWER: ________
RATIO:___________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

2. It is a technique utilized in angiography wherein visualization of vessels takes place through the removal of nonessential
structures:
a. Valsalva technique
b. Seldinger technique
c. Subtraction technique
d. Addition technique
ANSWER: ________
RATIO:___________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

3. It is a technique introduced by Ziedses des Plantes that has a great contribution in today`s interventional studies:
a. Subtraction technique
b. Relativity theory
c. Angiography
d. PTCA
ANSWER: ________
RATIO:___________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

4. It refers to the ability to eliminate structures that overlie the vascular anatomy that is filled with contrast:
a. Aliasing
b. Masking
c. Subtraction
d. All of the above
ANSWER: ________
RATIO:___________________________________________________________________________________________
_________________________________________________________________________________________________
_______________________________________________________________________________________________

5. It is a paramount importance in subtraction technique to maintain image quality:

a. Increase factors by two
b. Keeping radiographic factors constant
c. Decrease factors by two
d. None of the above

This document is the property of PHINMA EDUCATION

 RTE 025 Interventional Radiology
Module #8 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

ANSWER: ________
RATIO:___________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

6. Following are factors that would make subtraction impossible, except:

a. Same contrast media utilized
b. Same patient position
c. Same radiographic distance
d. Same exposure factors
ANSWER: ________
RATIO:___________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

7. It is the first step in the production of a subtracted image:

a. Patient identification
b. Sedation
c. Scout film selection
d. Setting up technical factors
ANSWER: ________
RATIO:___________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

8. It is defined as a selected serial film in the angiographic run that has no visible contrast material:
a. Radiograph
b. Scout film
c. Electromagnet
d. Photo paper
ANSWER: ________
RATIO:___________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

9. These are used to improve pictures of anatomical structures produced by the diagnostic imaging modalities:
a. Crayons
b. Contrast materials
c. Coloring
d. VR tool
ANSWER: ________
RATIO:___________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

10. It is a special type of transformer used in x-ray machine that decreases the output voltage:
a. Autotransformer
b. Step up transformer

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 RTE 025 Interventional Radiology
Module #8 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

c. Step down transformer

d. Automatic transformer
ANSWER: ________
RATIO:___________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

11. It can be defined as a selected serial film in the angiographic run that has no visible contrast material:
a. Scout film
b. First film
c. Radiographic film
d. None of the above
ANSWER: ________
RATIO:___________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

12. It is the exact copy of the scout film but the densities are reversed:
a. Radiographic film
b. Seldinger film
c. Mask film
d. Addition film
ANSWER: ________
RATIO:___________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

13. It is created by taking a sheet of mask film, superimposing it in the scout film and then exposing it for selected time:
a. Subtraction mask
b. Addition mask
c. Angiograph
d. PTCA
ANSWER: ________
RATIO:___________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

14. It is the third of the four essential steps in the production of subtraction image:
a. Aliasing
b. Masking
c. Subtraction
d. Registration
ANSWER: ________
RATIO:___________________________________________________________________________________________
_________________________________________________________________________________________________
_______________________________________________________________________________________________

This document is the property of PHINMA EDUCATION

 RTE 025 Interventional Radiology
Module #8 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

15. It is the fifth of the four essential steps in the production of subtraction image:
a. Masking
b. Subtraction print
c. Subtraction
d. Registration
ANSWER: ________
RATIO:___________________________________________________________________________________________
_________________________________________________________________________________________________
_______________________________________________________________________________________________

16. It is a system that converts an analog signal, such as a sound picked up by a microphone or light entering
a digital camera, into a digital signal:
a. Rectifier
b. Analog-to-digital converter
c. High voltage generator
d. Digital-to-analog converter
ANSWER: ________
RATIO:___________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

17. This device converts digital signal into an analog signal:

a. Rectifier
b. Analog-to-digital converter
c. High voltage generator
d. Digital-to-analog converter
ANSWER: ________
RATIO:___________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

18. It is the smallest controllable element of a picture represented on the screen:

a. Pixel
b. Picture
c. Pixy
d. None of the above
ANSWER: ________
RATIO:___________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

19. Which of the following colors is/are representation/s of component intensities in imaging systems?
a. Red
b. Green
c. Blue
d. All of the above

This document is the property of PHINMA EDUCATION

 RTE 025 Interventional Radiology
Module #8 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

ANSWER: ________
RATIO:___________________________________________________________________________________________
_________________________________________________________________________________________________
_______________________________________________________________________________________________

20. This was first published in 1965 to describe picture elements of scanned images from space probes to the moon and
mars?
a. Pixel
b. Heat units
c. Pixy
d. Picture
ANSWER: ________
RATIO:___________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

RATIONALIZATION ACTIVITY (THIS WILL BE DONE DURING THE FACE TO FACE INTERACTION)
The instructor will now rationalize the answers to the students. You can now ask questions and debate among yourselves.
Write the correct answer and correct/additional ratio in the space provided.
1. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________
2. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________
3. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________
4. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________
5. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________
6. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________
7. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________

This document is the property of PHINMA EDUCATION

 RTE 025 Interventional Radiology
Module #8 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

8. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________

9. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________

10. ANSWER: ________

RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________

11. ANSWER: ________

RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________
12. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________
13. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________
14. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________

15. ANSWER: ________

RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________
16. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________
17. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________
18. ANSWER: ________

This document is the property of PHINMA EDUCATION

 RTE 025 Interventional Radiology
Module #8 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________
19. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________

20. ANSWER: ________

RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________

C. LESSON WRAP-UP (10 minutes)

You will now mark (encircle) the session you have finished today in the tracker below. This is simply a visual to help you
track how much work you have accomplished and how much work there is left to do.

You are done with the session! Let’s track your progress.

AL Strategy: CAT 3-2-1

(To develop habits on thinking about learning, teacher writes a question or two that may ask students about their learning
experience, if they met the learning target, what they found difficult / easy about the topic or experience, what strategies
worked for them or not, etc. You can use AL strategy like CAT 3-2-1, Muddiest point and the like.)

This document is the property of PHINMA EDUCATION