KUALITAS RADIOGRAF

(PENGANTAR KRITISI RADIOGRAFI)

Rini
RiniIndrati
Indrati

JURUSAN TEKNIK RADIODIAGNOSTIK DAN RADIOTERAPI

POLITEKNIK KESEHATAN SEMARANG

07/12/21 Rini Indrati 1

 IMAGE
IMAGECLARITY
CLARITY

CONTRAST IMAGE
IMAGEQUALITY
QUALITY
CONTRAST

1. Thickness Difference
2. Density Difference
Subject Contrast
3. Atomic Number Difference
4. Radiation Quality
Film Contrast
Radiograhic Mottle
Fog and Scatter
Sharpness

Resolution

Distortion

07/12/21 Rini Indrati 2

 RADIOGRAPHIC QUALITY COMPONENT

Radiographic Mottle

Screen Mottle Resolution

Structure Mottle
Spatial Resolution
Quantum Mottle
Contrast Resolution
Film Graininess

Sharpness
Geometric unsharpness
Motion unsharpness
Absorbtion unsharpness
Screen unsharpness
07/12/21 Rini Indrati 3
Parallax unsharpness
 RADIOGRAPHIC QUALITY FACTOR

Film Factor
Characteristic Curve Subject Factor
Density Contrast
Contrast Thickness
Speed Density
Latitude Atomic Number
Processing Motion
Time
Temperature

Geometric Factor
Distortion Shape
Distortion Size (Magnification)
Unsharpness (Penumbra)
07/12/21 Rini Indrati 4
 Radiographic Image Quality
• Image visibility or the
Photographic Properties
• Density: The overall
blackness of the image.
• Contrast: the difference
between adjacent
densities on a radiograph.

5
 Density
• If the image is too dark, it
has too much density.
• If the image is too light, it
lacks density.
• X-rays are like toast. If it
is dark it is over cooked
or overexposed.
• If it is light, it is
underexposed.
6
 Contrast
• The difference between
density of adjacent
structures is contrast.
• Contrast is controlled by
the energy of the beam.
• High contrast is too black
and white.
• Low contrast is too gray.

7
 Contrast and Density
• Contrast and Density are
controlled by the
exposure factors and the
film processing.

8
 X-ray Exposure Factors
• Setting controlled by the operator used to
produce the radiograph.
• Will impact the amount of radiation
exposure to the patient .
• Type of x-ray machine and screen film
combination will impact the exposure
factors.

9
 X-ray Exposure Factors
• Single phase machines require more
exposure due to the increased amount of
low energy rays. Exposure time is limited to
1/60 to 1/120 second.
• Three phase or single phase high frequency
machine are more efficient due to less
ripple of the current.

10
 X-ray Exposure Factors
• Three phase or single phase high frequency
allows us to reduce exposure about 35%.
• Conversion of the technical factors from
single phase to high frequency is done by
reducing the mAs 50%.

11
 mAs
• Product of mA times the exposure time
• 100 mA @ .10 seconds = 10 mAs
• 200 mA @ 0.05 seconds = 10 mAs
• As long as the product of the mA and time
are the same, the exposure should be the
same if the Ma and timer calibration is
accurate.
12
 mAs
• mAs determines the quantity of x-ray
photons.
• mAs establishes the density on the image.
• Density is the blackness of the image.
• It takes a change of 25% to 30% in mAs to
make a significant change in the density of
the image.
13
 Poor mAs Reciprocity
• This is an example of poor
calibration of the x-ray
generator.
• The small and large focal
spot mA setting are not
calibrated.
• This was a new unit that
the service engineer failed
to calibrate.

14
 Proper mAs Reciprocity
• This is an example of
proper calibration of the
machine.
• Each exposure is virtually
identical. If you need to
adjust a technique on this
machine, you can do it
reliably.

15
 Wrong mAs
• This image is
under exposed.
Not enough mAs
was used.

16
 Wrong mAs
• This image is
overexposed for
the patella. Too
much mAs was
used.

17
 mAs Properly Calibrated
• The mA setting and
Timer are properly
calibrated because the
exposures are the
same.

18
Change the mAs and Change the
Density of the Image
• The center image has
the mAs decreased by
25%. Density is
decreased.
• The image on the right
has the mAs increased
by 25% above the
image on the left.
Density is increased.
19
 Observations
• 1. Are the densities of the first four images
the same? Yes If there were a change,
what part of the machine would need
calibration? The mA stations and Timer
• 2. What happened to the density on image #
5 compared to the first four images? When
the mAs is reduced, density is reduced.

20
 Observations
• 3 .Is image # 5 under exposed or over
exposed compared to image #4? Under
exposed
• 4 .What happened to the density of image # 6
compared to image # 4? When the mAs is
increased, the density increased.
• 5.Is this image over exposed or under
exposed? Over exposed
21
 30-50 Rule
• Relatively large changes in mAs are needed
to change the density of the image.
• It take a change of 20 to 30% to make any
change in the density of the image.
• It needs to be changed by 50% to make a
significant change.
• This is the 30-50 Rule

22
Changing mAs
• As the mAs is
increased, the density
of the image changes
from under exposed to
over exposed.
• Remember x-rays are
like toast. Light is
under. Dark is over.

23
Over exposed
• This was taken with
60 mAs.
• To correct the density
of the image, 30 mAs
would be used.
• mAs reduced by 50%.

24
Under exposed
• This image was taken
at 30 mAs.
• To darken the image,
60 mAs would be
used.
• For under exposed
films double the mAs.

25
 Scatter Radiation
• When we x-ray larger body parts or use
higher kVp, more scatter radiation is the
result.
• Scatter radiation is the result of the
interaction of the primary beam with the
matter being exposed.

26
 Scatter Radiation
• Scatter radiation does not follow the same
path as the primary radiation.
• Scatter radiation results in a loss of contrast
and sharpness of the image.
• More radiation + more tissue material
equals more scatter radiation.

27
 Grids Control Scatter Radiation
• Grids are constructed with lead strips that are
aligned with the path of the primary
radiation.
• Between the lead strips is aluminum or other
materials that allows the primary beam to
pass.
• Much of the scatter radiation is absorbed by
the lead
28
 Grid Ratio and Frequency
• The ability of the grid to control scatter
radiation is dependent upon the ratio and
frequency of the grid.
• Grid ratio is the height of the lead strip
compared to the width of the space between
the strips.
• Frequency is the number of strips per inch.

29
 Grid Ratio and Frequency
• The higher the ratio and frequency, the
more radiation is needed to produce the
image.
• Low ratio grids are limited to low kVp. A
5:1 grid is limited to below 90 kVp.
• High ratio grids can be used up to 125 kVp.

30
 Grid Ratio and Frequency
• Low frequency grids have prominent grid
line on the image. They are used in true
Buckies. The grid moves during the
exposure to blur the lines.
• High frequency grids produce almost
invisible line and do not need to move
during the exposure.

31
 Grid Ratio and Technique
• 8 mAs @ 74 kVp was used to produce the
image of the lumbar spine without the grid.
• 15 mAs @ 74 kVp was used to produce the
image with the 5:1 grid. If 16 mAs was
available on the control, it would be used.
• The conversion factor would be 2 for
adjusting the mAs for the 5:1 grid

32
 Grid Ratio and Technique
• The 5:1 grid required doubling the mAs.
• The conversion factor is determined by
dividing the new mAs by the old mAs.
• The conversion factor is 2.
• What would be the conversion factor for the
10:1 grid? Old mAs = 8 New mAs = 40

33
 No Grid Used
• The Lumbar Spine
needs the use of a grid.
• There is too much
scatter radiation due to
the size of the body
part and technical
factors needed to
visualize this area.

34
 Low Ratio & Frequency Grid
• For the A-P Lumbar
Spine, a 5:1 80 line
grid will remove much
or the scatter radiation.
• Going from Non-Grid
to a 5:1 ratio requires
doubling the mAs.
• Grid lines are very
noticeable.
35
 High Ratio & Frequency Grid
• A 10:1 grid with 100
lines will provide
excellent clean-up of
scatter radiation.
• The grid line are
nearly invisible.
• Requires 5 times more
radiation.

36
 High Ratio & Frequency Grid
• A 10:1 grid with 100
lines will provide
excellent clean-up of
scatter radiation.
• The grid line are
nearly invisible.
• Requires 5 times more
radiation.

37
 Air-gap Vs Grids
• When the body part is
far away from the
film, the scatter
radiation disperses in
the air before it can act
with the film.
• This is called the Air-
gap method to control
scatter.

38
 Air-gap Vs Grids
• By not using the
grid, we reduce
the radiation
exposure five fold
with no loss of
image quality.

39
 Observations
• 1. How does the image taken without a grid
(A) compare to the high ratio and high
frequency image (C)?
• Image A lacks contrast compared to image
C.

40
 Observations
• 2. Compare the film( B) taken with the 5:1
grid to the image taken with the 10:1 grid.(C).
• The grid line are more apparent on the 5:1
grid.
• 3. How much was the exposure factors
increased for the 10:1 grid?
• Increased to 40 mAs.

41
 Observations
• What would be the conversion factor for the
10:1 100 line grid? Multiply the mAs time
5

42
 Grid Cut-off
• When high frequency and ratio focused
grids are used, the lead strips must be
perfectly aligned with the primary beam.
• A minor misalignment will result in the grid
removing primary radiation. Misalignment
of more than 2° will result in grid cutoff.

43
 Grid Cut-off
• Is the density of the
image of both knees
the same?
• This is an example of
grid cut-off. Some of
the primary beam is
being removed by the
grid.

44
 Grid Cut-off Wrong SID
• If the grid lines are not
parallel to the primary
radiation due to the
tube being too close or
too far from the grid,
there will be grid cut-
off.

45
 Grid Cut-off Beam Angled
• If the tube is
angled
against the
grid lines,
grid cut-off
will result.

46
 Grid Cut-off Grid Angled
• If the grid is is
not
perpendicular
to the beam,
grid cut-off
will result.
• Most common
problem.

47
 Grid Cut-off Grid Backwards
• If the grid is
backwards, only the
center of the beam
will pass though the
grid.
• Proper alignment
must be maintained.

48
 The End

Return to Lecture Home Page

49