Digital Radiology

Digital Radiology

• Aim: To become familiar with the digital

imaging techniques in projection
radiography and fluoroscopy.

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 Transition from conventional to digital
radiology

 Digital images can be numerically processed

 Digital images can be easily transmitted through

networks and archived

 Attention should be paid to the potential increase

of patient doses due to tendency of :
 producing more images than needed
 producing higher image quality not
necessarily required for the clinical purpose

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 ?”What is “dynamic range

 Wide dose range to the detector, allows a

“reasonable” image quality to be obtained

 Flat panel detectors (discussed later) have

a dynamic range of 104 (from 1 to 10,000)
while a screen-film system has
approximately 101.5

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 Characteristic curve of CR
system
3.5
HR-III
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CEA Film-Fuji Mammofine
2.5
2
Density

1.5 CR response

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0.5
0
0.001 0.01 0.1 1
5
Air Kerma (mGy)
 Analogue versus digital
Analogue: A given Digital: A given
parameter can have parameter can only
continuous values have discrete values

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10 10

C1 5
0
1 2 3 4 5 6 7 8 9 10
0
1 2 3 4 5 6 7 8 9 10

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 ?What is digital radiology
 In conventional radiographic images, spatial position
and blackening are analogue values
 Digital radiology uses a matrix to represent image
 A matrix is a square or rectangular area divided into
rows and columns. The smallest element of a matrix
is called ”pixel”
 Each pixel of the matrix is used to store the
individual grey levels of an image, which are
represented by positive integer numbers
 The location of each pixel in a matrix is encoded by
its row and column number (x,y)
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 Digital radiology process
 Image acquisition
 Image processing
 Image display
 Importance of viewing conditions
 Image archiving (PACS)
 Image retrieving
 Importance of time allocated to retrieve
images

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 Digitizing conventional films

 Conventional radiographic images can be

converted into digital information by a
“digitizer”, and electronically stored

 Such a conversion also allows some

numerical post-processing
 Such a technique cannot be considered
as a “ digital radiology” technique.
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 Different number of pixels per image: original was
3732 x 3062 pixels x 256 grey levels (21.8
.Mbytes). Here, resized at 1024 x 840 (1.6 MB)

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 Scintillation-based DR

Gadolinium Oxy-sulphide Detector

 Digital Radiography Systems
 Phosphor photostimulable plates (PSP).
– So called CR (computed radiography)
– Conventional X-ray systems can be used

 Direct digital registration of image at the

detector (flat panel detectors).
– Direct conversion (selenium)
– Indirect conversion (scintillation)

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 Computed Radiography (CR)
CR utilises the principle of photostimulable 
phosphor luminescence
Image plate made of a suitable phosphor 
material are exposed to X-rays in the same
way as a conventional screen-film combination
The CR image plate retains most of the 
absorbed X-ray energy, in energy traps,
forming a latent image

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 Computed Radiography (CR)
A scanning laser is then used to release the 
.stored energy producing luminescence

The emitted light, which is linearly proportional to 

the locally incident X-ray intensity is detected by
a photo multiplier/ADC configuration and
converted to a digital image

The resultant images have a digital specification 

of 2,370 x 1,770 pixels (for mammograms) with
1,024 grey levels (10 bits) and a pixel size of 100
mm corresponding to a 24 x 18 cm field size
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 The principle of PSP
PMT
ADC

CB

Trap

Excitation Storage Emission

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 ‫كــريــستــال هــالـيــد فــلــوريــد بــاريــم فــعــال شــده بـا يــوروپــيــوم‬
)Europium Activated Barium FluoroHalide(
BaFX:Eu , (X= Cl, Br, or I)

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 PSP digitizer Casette and PSP

(Images courtesy of AFGA)

18 Workstation
 DR Detecting Systems

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 • Direct vs indirect conversion detectors
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 CCD Based Detection System

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 Digital detector

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 Amorphous Selenium Detector

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 Digital fluoroscopy
Digital fluoroscopic systems are mainly based 
on the use of image intensifiers (I.I.)

In conventional systems the output screen of 

the I.I. is projected onto a video camera
system or a CCD camera

The output signals of the camera are 

converted into a digital image matrix (1024 x
.1024 pixel in most systems)

Some new systems start to use flat panel 

.detectors instead of image intensifier
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 ? Tendency to increase dose

For digital detectors, higher doses result in 

a better image quality (less “noisy” images)
When increasing dose, the signal to noise 
ratio is improved

Thus, a certain tendency to increase doses 

could happen specially in those
examinations where automatic exposure
.control is not usually available

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 The digital radiology department
In addition to the X-ray rooms and imaging 
systems, a digital radiology department has
:two other components

A Radiology Information management System 

(RIS) that can be a subset of the hospital
information system (HIS)

A Picture Archiving and Communication System 

.(PACS)

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 Results
• Modality Worklist Information To Webserver

DICOM

Radiologist WorkStation

Images
Verified
Broker Voice Rec. Server

HL7

HL7 HL7 Transcription

Pool
E-gate
32 HIS RIS
 Data management
PACS RIS

!We write a report •

Link both PACS and •
.RIS

Report compares •
Orders on RIS with
.Images on PACS

Report highlights RIS •

orders with No
!images

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 DICOM
DICOM (Digital Imaging and Communications in •
Medicine) is the industry standard for transferal of
radiological images and other medical information
between different systems

All recently introduced medical products should •

therefore be in compliance with the DICOM standard

However, due to the rapid development of new •

technologies and methods, the compatibility and
connectivity of systems from different vendors is still
a great challenge

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 :DICOM format images
Radiology images in DICOM format contain in 
addition to the image, a header, with an
:important set of additional data related with

the X ray system used to obtain the image 

the identification of the patient 
the radiographic technique, dosimetric details, 
.etc

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