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RADIOGRAPHIC

TECHNIQUE AND FILM


PROCESSING
& ANALYSIS
1&2

(RT 103/103.1)
EMETERIO R. LONGALONG,RRT
Instructor

CHAPTER 9
SCREEN-FILM
RADIOGRAPHIC
ARTIFACTS

RADIOGRAPHIC
ARTIFACTS
ARTIFACTS
are
undesirable
optical densities or blemishes on a
RADIOGRAPH or
any other medical
image that decrease
RADIOGRAPHIC
QUALITY.

HIGH-QUALITY
CHEST RADIOGRAPH

POOR-QUALITY
CHEST RADIOGRAPH
with
radiation fog artifact

FOR
STUDENT
RADIOGRAPHERS/RADIOLOGIC
TECHNOLOGIST, one of the most
interesting areas of study is the
identification
of
IMAGE
ARTIFACTS.

However, ARTIFACTS must be


prevented. Identification of the
ARTIFACT and its cause is critical
for screen-film radiography quality
control (QC). It is important for
everyone radiographer to be alert to
ARTIFACTS and their
origin.

The cause of the ARTIFACT must be


removed to prevent recurrence of the
same problem in subsequent radiographs.
Finally, records of artifacts must be kept
to indicate trends; for example if sludge
artifacts show up more than
once before
processor cleaning,
consider cleaning
the processor more
frequently.

RADIOGRAPHIC
ARTIFACTS
ARTIFACTS
are
undesirable
optical densities or blemishes on a
RADIOGRAPH or
any other medical
image that decrease
RADIOGRAPHIC
QUALITY.

An ARTIFACT is something in the


image that looks like it was
created by the object but was in
fact created by the process.

Screen-Film
Radiographic
Artifacts can interfere with the
visualization of
anatomical
structures and can lead to
misdiagnosis.

ARTIFACTS can be controlled


when their CAUSE is identified.
Generally
Radiographic
Artifacts occur in three areas:
EXPOSURE, PROCESSING and
HANDLING & STORAGE.

CLASSIFICATION
OF ARTIFACTS
in

Screen-Film Radiography
EXPOSURE Artifacts
PROCESSING Artifacts
HANDLING & STORAGE
Artifacts

EXPOSURE ARTIFACTS
Exposure ARTIFACTS generally
are associated with the manner in
which
the
RADIOGRAPHER
conducts
the
EXAMINATION.
INCORRECT screen-film match, poor
screen-film contact, and improper
positioning of the
grid can lead to
such ARTIFACTS.

IMPROPER patient position,


patient motion, double exposure,
and
incorrect
screen-film
radiographic technique can result
in very poor images that some
would call ARTIFACTS.
Such
examples of poor technique have
been shown to result in the
largest
number
of
repeat
examinations.

COMMON EXPOSURE
ARTIFACTS

Appearance
radiograph

on

the

CAUSE

Unexpected FOREIGN OBJECT


such as jewelry

Improper patient
preparation

Double Exposure

Reuse of cassettes
already exposed

Blur

Improper
movement,
breathing

patient
including

Grid cut off artifacts

Improper
positioning

patient

COMMON EXPOSURE
ARTIFACTS

Appearance
radiograph

on

the

Unexpected FOREIGN OBJECT


such as jewelry

CAUSE

Improper patient
preparation

IMPROPER preparation of the


patient
can
lead
to
disturbing
ARTIFACTS. However,
these do not occur
when

the

RADIOLOGIC TECHNOLOGIST properly


instructs and prepare the patient.
PATIENT
PREPARATION
is
essential for producing ARTIFACTFREE IMAGES.

ARTIFACTS on or worn by the


patient
often
are
concealed
by
CLOTHING. Among these items are
necklaces. pendants, hearing aids,
chains, earrings, body and facial
piercings, zippers and catches, and a
variety of jewelry.

In case of trauma, pins, fasteners,


dressings, and splints often have to remain
in place because their removal could be
dangerous to the patient.
INTERNAL ARTIFACTS from prostheses
to dental fillings obviously cannot be
removed and, similar to trauma cases,
this should be
noted on the
examination
request form.

This is particularly important


for the patient who is to undergo
Magnetic
Resonance
Imaging
(MRI) examination later.

FOREIGN OBJECTS

FOREIGN OBJECTS

FOREIGN OBJECTS

COMMON EXPOSURE
ARTIFACTS

Appearance
radiograph

Double Exposure

on

the

CAUSE

Reuse of cassettes
already exposed

DOUBLE EXPOSURE

Double Exposures are also


avoidable. When RADIOGRAPHERS
mix up cassettes, double exposures
can occur; repeat examination is
required.

COMMON EXPOSURE
ARTIFACTS

Appearance
radiograph

Blur

on

the

CAUSE

Improper
movement,
breathing

patient
including

A
radiograph
with
MOTION
appears BLURRED. The patient may
have moved or may not have
breathed
according
to
the
radiographers instruction. CLEAR
INSTRUCTIONS
are
required
to
encourage
understanding
and
cooperation in
patients.

COMMON EXPOSURE
ARTIFACTS

Appearance
radiograph

on

Grid cut off artifacts

the

CAUSE

Improper patient
positioning

POSITIONING ERRORS can cause


ARTIFACTS.
If
the
patient
is
positioned for examination when the
x-ray tube is not centered to the table
or
Bucky
tray,
GRID
CUTOFF
ARTIFACTS may occur.

COMMON EXPOSURE
ARTIFACTS

Appearance
radiograph

Obscured detail

on

the

CAUSE

Poor screen-film contact

Radiographic Cassettes that


have not checked for PROPER
SCREEN-FILM
CONTACT
produce
smoothness in the area of POOR
CONTACT that obscures DETAIL and
constitute an
ARTIFACT.

PROCESSING ARTIFACTS
Any number of artifacts can be
produced during processing. Most are
pressure type artifacts caused by the
transport system of the processor.
Pressure-type
artifacts
usually
sensitize the emulsion and appear as
higher optical density (OD).
Those that scrape or
remove
emulsion
appear
as
lower
optical density.

COMMON FILM PROCESSING


ARTIFACTS
Appearance on the
radiograph

Cause

Guide shoe marks

Improper springing of guide


shoes in turnaround assembly

Pi lines

Dirt or
rollers

Sharp increase or decrease in


OD

Dirty or warped rollers, which


can leave sludge deposits in
film

chemical

stains

on

Appearance
radiograph

on

the

Cause

Dichroic stain or curtain


effect

Improper
processing
film

squeezing
chemicals

of
from

Small circular patterns of


increased OD

Pressure caused by irregular


or dirty rollers

Yellow brown drops on film

Oxidized developer

Milky appearance

Under replenished fixer

Greasy appearance

Inadequate washing

COMMON FILM PROCESSING


ARTIFACTS
Appearance on the
radiograph
Guide shoe marks

Cause

Improper springing of guide


shoes in turnaround assembly

GUIDE SHOE MARKS occur


when the guide shoes in the turn
around assembly of the processor
are sprung or improperly positioned.

G shoe marks

COMMON FILM PROCESSING


ARTIFACTS
Appearance on the
radiograph

Pi lines

Cause

Dirt or
rollers

chemical

stains

on

Pi LINES occur at 3.1416-inch


intervals because of dirt or a chemical
stain on a roller which sensitizes the
emulsion. Because the rollers are 1
inch in diameter, the artifact
appears perpendicular to the films
Pi line
direction of travel through
the
processor.

COMMON FILM PROCESSING


ARTIFACTS
Appearance on the
radiograph

Cause

Sharp increase or decrease in


OD

Dirty or warped rollers, which


can leave sludge deposits in
film

Dirty or warped rollers can cause


emulsion pick-off and gelatin build-up,
which result in sludge deposits on the
film. These artifacts usually appear as
SHARP AREAS of INCREASE or
DECREASES optical density (OD).

COMMON FILM PROCESSING


ARTIFACTS
Appearance on the
radiograph

Uniform dull, gray fog

Cause

Improper or inadequate
processing chemistry

Improper
or
inadequate
processing chemistry can result in
UNIFORM DULL GRAY FOG.

COMMON FILM PROCESSING


ARTIFACTS
Appearance
radiograph

on

Dichroic stain or curtain


effect

the

Cause

Improper
processing
film

squeezing
chemicals

of
from

DICHROIC STAIN is a chemical fog


or stain on a radiograph can appear
yellow, green, blue or purple. In slow
processors, the chemistry may not be
squeezed properly from the film, and it
either runs down the leading edge.
Both events are referred to as a
CURTAIN EFFECT.

COMMON FILM PROCESSING


ARTIFACTS
Appearance
radiograph

on

Small circular patterns of


increased OD

the

Cause

Pressure caused by irregular


or dirty rollers

SMALL CIRCULAR PATTERNS of


INCREASED OPTICAL DENSITY (OD) is
a processing artifact caused by
IRREGULAR or DIRTY ROLLERS.

COMMON FILM PROCESSING


ARTIFACTS
Appearance
radiograph

on

the

Yellow brown drops on film

Cause

Oxidized developer

YELLOW-BROWN DROPS ON FILM


is a processing artifact caused by
OXIDIZED DEVELOPER.

COMMON FILM PROCESSING


ARTIFACTS
Appearance
radiograph

Milky appearance

on

the

Cause

Under replenished fixer

MILKY
APPEARANCE
is
a
processing artifact caused by UNDER
REPLENISHED FIXER.

COMMON FILM PROCESSING


ARTIFACTS
Appearance
radiograph

Greasy appearance

on

the

Cause

Inadequate washing

GREASY APPEARANCE is a
processing
artifact
caused
by
INADEQUATE WASHING.

COMMON FILM PROCESSING


ARTIFACTS
Appearance
radiograph

Brittle appearance

on

the

Cause

Improper dryer temperature or


hardener in the fixer

BRITTLE is a processing artifact


caused
by
IMPROPER
DYER
TEMPERATURE OR HARDENER ON
THE FIXER.

HANDLING AND STORAGE


ARTIFACTS

A number of artifacts are caused


by
IMPROPER
FILM
STORAGE
CONDITION. Image fog can result if
the temperature or the humidity is too
high or if the film bin is not shielded
adequately from radiation. Pressure
marks
can occur if the film is
stacked too high.

COMMON HANDLING
and STORAGE ARTIFACTS
Appearance on
Radiographic Film
Light or X-radiation fog

Pressure or kink marks

Cause
The temperature or humidity is too
high. The film bin is inadequately
shielded from radiation.
The safelight is too bright, is too
close to the processing tray, or has
improper filter.
The film has been left in the x-ray
room
during
exposures.
The film
is other
improperly
or roughly
handled. The film is stacked too
high in storage (the weight causes
marks)

Appearance on
Radiographic Film

Cause

Streaks of increased OD

The darkroom or cassette has light


leaks.

Crown, tree, and


smudge static

The temperature or humidity is


too low.

Yellow-brown stain
(Hypo Retention)

Thiosulfate is left on the film


because of inadequate washing.

COMMON HANDLING
and STORAGE ARTIFACTS
Appearance on
Radiographic Film
Light or X-radiation fog

Cause
The temperature or humidity is too
high. The film bin is inadequately
shielded from radiation.
The safelight is too bright, is too
close to the processing tray, or has
improper filter.
The film has been left in the x-ray
room during other exposures.

WHITE-LIGHT
LEAKS
in
the
darkroom or within the cassette cause
streak-like
artifacts
of
increased
OPTICAL DENSITY (OD). If the safelight
has an improper filter, the safelight is
too bright, or the safelight is too close to
the film processing tray,
the imaged
may be
fogged.

COMMON HANDLING
and STORAGE ARTIFACTS
Appearance on
Radiographic Film

Pressure or kink marks

Cause

The film is improperly or roughly


handled. The film is stacked too
high in storage (the weight causes
marks)

ROUGH HANDLING
before processing can
cause scratches and
PRESSURE/KINK
MARKS.

OF

FILM

COMMON HANDLING
and STORAGE ARTIFACTS
Appearance on
Radiographic Film

Cause

Streaks of increased OD

The darkroom or cassette has light


leaks.

STREAK OF INCREASED OPTICAL


DENSITY (OD) is a handling and
storage artifact caused by LIGHTLEAKS
in
the
DARKROOM
or
CASSETTE.

COMMON HANDLING
and STORAGE ARTIFACTS
Appearance on
Radiographic Film

Crown, tree, and


smudge static

Cause

The temperature or humidity is


too low.

STATIC (crown, tree, or smudge)


is
probably
the
most
obvious
ARTIFACT. It is caused by the buildingup of electrons in the emulsion and is
most noticeable during the winter and
during the periods of extremely low
humidity.

COMMON HANDLING
and STORAGE ARTIFACTS
Appearance on
Radiographic Film

Yellow-brown stain
(Hypo Retention)

Cause

Thiosulfate is left on the film


because of inadequate washing.

The YELLOW-BROWN STAIN that


slowly appears on a radiograph after a
long storage time indicates a problem
with hypo retention from the fixer.