CRDR PRELIM REVIEWER Front side

 Is made of a low atomic number material (e.g.

CONVENTIONAL RADIOGRAPHY
plastic or carbon) to enable ease in passage of
RADIOGRAPHIC FILM x-rays.

Back side
 Is made of a high atomic number material (e.g.
lead) to reduce backscatter.
 has rubber or felt for adequate contact between
the screen film system or with the imaging
plate.

In Conventional Radiography….
 Two screens are mounted, one on each side of
the cassette, except in mammography, where a
Two parts: the BASE and EMULSION single screen is mounted on the back side.
Emulsion  These cassettes must be loaded with film in the
 In most x-ray films, the emulsion is coated on darkroom unlike the cassettes used in CR
both sides; therefore, it is called double which can be loaded with an imaging plate in
emulsion films. the light.
 Is enclosed by a protective covering of gelatin
called the overcoat. INTENSIFYING SCREEN

Overcoat
 It protects the emulsion from scratches,
pressure, and contamination during handling,
processing, and storage.

Adhesive Layer
 Ensures uniform adhesion of the emulsion to
the base.
 Allows the emulsion and the base to maintain
proper contact and integrity during use
and processing.

Thickness
 Approximately 150 to 300 µm
Formation of Radiographic Images:
RADIOGRAPHIC CASSETTE Conventional Radiography
 Are rigid holders used in conventional and
computed radiography (CR) for the screen film
system and imaging plate respectively.
X-ray from X-ray Tube
 X-rays are nearly uniformly distributed in space.

X-ray Interaction with Patient

 X-rays are not uniformly distributed in space
but vary in intensity according to the
characteristics of the tissue through which it has
passed.

Exit X-ray Beam/ Remnant X-rays CR PROCESS IN A NUTSHELL:

 Refers to the x-rays that remain as the useful
beam exits the patient. 1. Image acquisition involves exposing the
 consists of x-rays scattered away from the patient with x-ray and recording the
image receptor and image forming x-rays transmitted x-ray with the PSP detector/
(diagnostically useful information). imaging plate.
2. The resultant latent image is extracted via
Image Receptor (IR) the CR reader device using laser
 The medium that converts the x-ray beam into a stimulation (RED LIGHT LASER) to
visible image. produce photostimulable luminescence
which will be collected and converted into
INNOVATIONS IN RADIOGRAPHIC electric signal by the PMT.
TECHNIQUE
3. These electrical signals will be again
 Film-screen served as a good medium for
converted into digital data with the use of
radiographic images for many decades. It has
many limitations that can be overcome with ADC to process the image for it to be
digital imaging. viewed in the display monitor.

Digital Imaging
 The latent image is stored as digital data must DIGITAL RADIOGRAPHY (DR)
be processed by the computer for viewing on a  It includes several imaging modalities
display monitor that can be accomplished by coupled to the PACS-RIS-HIS image and
using a specialized image receptor that can information systems.
produce a computerized radiographic image.  The imaging modalities include computed
Two types are in use today: radiography (CR), flat-panel digital
1. Computed Radiography (CR) radiography (FPDR), digital mammography
2. Direct digital radiography (DR) (DM), and digital fluoroscopy (DF).

COMPUTED RADIOGRAPHY (CR)

 It is a digital Radiographic imaging
modality.
 Digital detector is used to capture X-rays
transmitted through the patient.
 CR is an indirect capture digital imaging
technology, which means that plates are
used to capture the image before it is
transferred to a computer.
 HISTORICAL DEVELOPMENTS

1603
 Bolognese Stone 1982
(glowing stone)  Picture Archiving
discovered in Italy. and
 Is linked to Communications
Photostimulable System (PACS)
phosphor and the becomes
phenomenon of available.
Photostimulable
Luminescence

1867 1983
 Notion of de-excitation  FUJI’s first
described by Becquerel. commercialized
 Discovery of Radioactivity computed
radiography (FCR
101) followed by
the FCR 201 in
1985 and the FCR
7000 in 1989 (Commercialization of CR
imaging systems for use in diagnostic
1926 radiology began, when Fujifilm (Tokyo,
 Hirsch proposed a way to Japan) introduced their FCR-101 unit).
retain fluorescent image
by using Storage 1984
phosphor-heat to re-  Laser – stimulable phosphors for computed
stimulate and red light to radiography appear (FUJI)
erase.
1992
 KODAK’s first commercial
1975 storage phosphor unit.
 KODAK patented an
apparatus that used infrared-
stimulable phosphor to store
image.

1980/1981
 FUJI patented a process 1994
in which photostimulable  Agfa-Gavaert
phosphor was used to introduces CR
record image by imaging technology.
absorbing radiation and
then releasing stored
imaged when stimulated
by helium-neon laser.
1996 Silicon substrate
 Digital radiography that uses thin – film  Contains the charge storage area.
transistors (TFT’s) is developed.
1998
 Amorphous silicon – CsI image receptor is
demonstrated for digital radiography.
 Sample schematic of amorphous silicon
based flat panel detector:

1997
 Charge – coupled device (CCD) digital
radiography is introduced by Swissray
Amorphous selenium flat panel image 2001
receptor is demonstrated by Rowlands.  Other in CR research include general
electric healthcare, Philips healthcare;
Konica Minolta healthcare, and Canon, etc.

Present
 Fujifilm medical system; Carestream health;
and agfa healthcare are actively engaged in
research and development of state-of-the-
art CR systems.

 A photosensitive receptor and electronics

embedded into a substrate material in a
silicon chip make up a CCD.
 Incident light from a scintillator strikes the
detector and electron/hole pairs are
produced in the silicon. The number of
electron/hole pairs is related to the amount
of light that is absorbed. The electrons are STRUCTURE AND MECHANISM
held by electrostatic forces in the array until
the charge is read out to form the image. CR Imaging Plate
STRUCTURE:
Chip
 Is made up of a polysilicon layer, a silicon
dioxide layer, and a silicon substrate.

Polysilicon layer
 Is coated with a photosensitive material and
contains the electronic gates.
Silicon dioxide layer
 is an insulator.
1.) Protective layer 4.) Conductive Layer
 Very thin, tough, clear plastic that protects  Absorbs and reduces static electricity that
the phosphor layer. may degrade image quality.
 Provides durability.
 Must also allow light from the laser and the 5.) Color Layer
stimulated light to pass through it.  Newer plates may contain a color layer,
located between the active layer and the
2.) Phosphor/ Active Layer
support, that absorbs the stimulating light
 Layer that “traps” electrons during
but reflects emitted light.
exposure.
 Usually made of phosphors from the barium
fluorohalide family. 6.) Support Layer
 The phosphor is mixed with an organic  A semirigid material that gives the imaging
binder (e.g., polymer, such as polyester) sheet some strength.
and coated onto the support layer.
 May contain a DYE (absorbs the stimulating 7.) Backing Layer
light to prevent as much spread as  A soft polymer that protects the back of the
possible) cassette.

Physical characteristics of phosphors used 8.) Barcode

in CR:  Allows the technologist to match the image
information with the patient-identifying
1) Phosphors should have good X-ray
absorption efficiency and must be capable barcode on the examination request.
of being stimulated by a helium-neon (He-
Ne) laser or red-light laser.
2) The luminescence light must be compatible
with the photomultiplier tube (PMT)
phosphor (for proper detection and
capture)
3) and the time for luminescence must be
shorter than 1 μs.
4) finally, these phosphors should be able to
store the latent image for a number of hours
without compromising the signal from the
IP.

IMAGE FORMATION
 It is a Conventional Projection Radiography
in which the image is acquired in digital
format using the Imaging Plate rather than
3.) Reflective Layer film.
 Sends light in a forward direction when
released in the cassette reader.
 May be black to reduce the spread of
stimulating light and the escape of emitted
light.
 Some detail is lost in this process.
PSP Image acquisition and processing IMAGING PLATE
steps:  In CR, Image is captured in thin sheet of
plastic known as imaging Plate.
1. Image acquisition involves exposing the
patient with a study specific x-ray It has several layers:
technique and recording the transmitted
 Protective layer
x-ray flux with the PSP detector.
 Phosphor/ Active layer
2. The resultant latent image is extracted
 Reflective layer
via the reader device using laser
 Electro Conductive layer
stimulation and recording the PSL
 Support layer
intensity.
 Color layer
3. Image pre-processing involves
 Backing layer
correcting systematic variations in the
extraction process and determining the Types of IPs:
range of pertinent information with  Standard Resolution IP
subsequent adjustment of digital values  High Resolution IP
to a normalized output range.
4. Image post- processing translates the
digital values of the raw digital image to Standard Resolution IP
render a grayscale and frequency  Have thick phosphor layers and absorbs
more radiation.
enhancement appropriate for anatomy
 Have faster radiographic speeds. Thick
and study.
phosphor IPs have fast speeds.
5. The output image is displayed on a
calibrated image monitor for High Resolution IP
presentation.  Have thinner phosphor layers and provide
sharper images compared to thick
phosphors.
 The sharpness is because thinner
phosphors reduce the lateral spread of the
laser light.
 Have slower radiographic speeds. Thin
phosphor IPs have slow speeds.
 Will be used for extremity imaging and
other small parts where detail (sharpness)
is critical.

CR CASSETTE 1. EXPOSE
 Looks like a conventional Radiography  The first of a sequence of the events
cassette. that results in an x-ray-induced image
 Made of durable lightweight plastic material forming signal.
 Backed by thin sheet of Aluminum that Acquiring and forming the latent image:
absorbs x ray.  The patient is x-rayed the same way as in
 Instead of Intensifying Screen inside, there conventional radiography. The patient is
is an antistatic material that protects against positioned using appropriate positioning
static electricity build up, dust collection and techniques, and the cassette is placed
mechanical damage to plate. either on the tabletop or within the table
Bucky.
 2. STIMULATE
 The patient is then exposed using the  Stimulation of the latent image results from
proper combination of kilovoltage peak the interaction of the infrared laser beam
(kVp), milliamperage seconds (mAs), and with the photostimulable phosphor (PSP).
distance.
Doping of PSP:
 The difference lies in how the exposure is
recorded.
 In CR, the remnant beam interacts with
electrons in the barium fluorohalide
crystals contained within the imaging
plate.
 This interaction stimulates, or gives Doping Barium Fluorohalide with
energy to electrons in the crystals, Europium:
allowing them to enter the conductive
layer, where they are trapped in an  When Pure crystals of Barium fluorohalide
area of the crystal known as the color are doped with small amount of Europium,
or phosphor center. Crystals develop a tiny defect called
 This trapped signal will remain for hours, metastable sites of F center. (From German
even days, although deterioration begins Farbzentren or Color center).
almost immediately.  F centers act like electronic holes in the
 In fact, the trapped signal is never crystals that can trap electrons.
completely lost.
 That is, a certain amount of exposure
remains trapped so that the imaging
plate can never be completely erased.
 However, the residual trapped
electrons are so few in number that
they do not interfere with subsequent
exposures. 1. A portion of the electrons ejected during
 According to the American Association of x-ray exposure become trapped in F
Medical Physicist in Medicine, it will lose centers within the lattice of the
about 25% of the stored signal between 10 molecule.
min and 8 hrs after an exposure resulting in
the loss of the energy through spontaneous 2. Laser light from the CR reader adds
phosphorescence. energy to these trapped electrons, they
escape the F-centers and fall back into
Action of X-ray exposure: their normal atomic shells, emitting light
 When the X-ray is absorbed by the again in the process. This dimmer light
material, absorbed energy excites the is amplified by the CR reader to form the
europium atoms, causing ionization of Eu image.
+2
atom. Eu+3 +e−¿=Eu ¿ Latent Image Formation and PSL:
 The electrons are raised to a higher energy
 X-ray exposure of the PSPIP creates a
state in the conduction band. Once in the
latent image, and laser scanning of the
conduction band, electrons travel freely
exposed IP produces PSL. The information
until they are trapped in a so-called F-
captured from the PSL is used to create the
center in a metastable state with an energy
CR image.
level slightly below that of conduction band
but higher than that of the valence band.
 When X-rays fall upon the PSPIP, the The Reader
europium atoms are ionized by the
 No chemicals
radiation, and the electrons move from the
and dark room
valence band (ground state) to the
necessary.
conduction band (higher energy).
 Electrons in the conduction band are free to  Cassette is fed
travel to a so-called F-center. F comes from into the reader.
the German Farbe (farbzentren) meaning  Removes IP
color. and scans
 Doping of Europium creates defects in the plate with the
BaFBr/I crystals, that allows electrons to be laser to release
trapped more efficiently. the stored
 When Pure crystals of Barium flurohallide energy.
are doped with small amount of Europium,
Crystals develop a tiny defect called  With CR systems, no chemical processor or
metastable sites of F center. (From German darkroom is necessary. Instead, following
Farbzentren or Color center). F centres act exposure, the cassette is fed into a reader
like electronic holes in the crystals that can that removes the imaging plate and scans it
trap electrons. with a laser to release the stored electrons.

TWO TYPES OF CR SYSTEM

1. Cassette-Based Systems
 These systems use individual IPs of
different sizes analogous to cassette-based
film-screen radiography.
 An exposed IP must be physically taken to
a CR reader unit for scanning to acquire an
image from the IP, followed by erasure of
the IP and subsequent transport of the IP in
A. Normal Atom
the unit itself for reuse.
 Electron energy levels consist of a filled
 This means that the IP is in contact with
band, valence band, and a conduction band
various transport mechanisms that may in
which lies outside the atom’s binding
time result in plate/ phosphor damage.
influence.
B. Atom in BaFH molecule
2. Cassette-less Systems
 When barium fluorohalide crystals are
 These systems evolved to overcome some
doped with europium, the molecular
of the problems with cassette-based
structure results in the creation of F
systems.
centers, which consist of an additional
 One such problem, for example, is related
energy band which is created between the
to the physical task of taking an exposed IP
valence and conduction bands. In the CR
to the CR reader for processing, as well as
reader, exposure to the laser beam causes
mechanical transport of the IP itself in the
electrons in this band to fall back into their
reader.
normal shells.
 It incorporates a fixed stationary single IP that is of a much different wavelength than
that is encased in a special housing that the stimulating laser light.
forms a part of the unit. 2. Secondly, the emitted light from the IP is
 There is also no contact with the IP in the optically filtered and collected by the light
unit when it is read. The single fixed IP can channeling guide or light collection optics
accommodate various exposure sizes as it is sometimes referred to as. This light
ranging from 17′′ × 17′′ and 14′′ × 14′′ to 10′′ (PSL) is then sent to the photodetector (a
× 12′′ and 8′′ × 10′′ or 10′′ × 8′′. These photomultiplier tube) or charge-coupled
varying sizes will have varying matrix sizes device (CCD) which converts the PSL into
as well. Once the fixed stationary IP is an electrical signal (analog signal) that is
exposed, the patent image is acquired first amplified and subsequently digitized
using a scanning technology appropriate to by the ADC.
the system. 3. Finally, the analog signal from the
photodetector is sent to the ADC for
digitization. Digitization involves both
sampling the analog signal and
CR READERS SCANNING quantization. Depending on the
TECHNOLOGIES amplification, the ADC will produce 8–16
 Acquiring the image from the exposed IP bits of quantization per pixel, providing
can be accomplished by point-scan (P-S) discrete gray levels ranging from 28 to 216.
CR readers or by line-scan CR readers.

Dual-sided reading technology

1. Firstly, the IP is removed from the cassette
 has become available in more recent CR
and is placed on the transport mechanism
units.
for scanning by a laser beam. While the
 It is apparent that two sets of
movement of the IP is referred to as the
photodetectors (dual light collection
“slow-scan” direction, the laser beam
system) are used to capture PSL from the
movement across the IP is called the “fast-
front and back side of the IP.
scan” direction. The laser beam is used to
 In this way, more signal is obtained to
stimulate the trapped electrons (latent
improve the signal-to-noise ratio and,
image) in the exposed IP. In the past, gas
hence, improve image quality.
lasers such as a helium-neon (He-Ne)
 Additionally, a thicker phosphor layer can
laser were used; however, current CR
be used to increase the absorption of X-
readers use solid-state laser diodes that
rays, hence improving system efficiency.
emit a red laser beam having wavelengths
of about 630 nm/ 670–690 nm. The laser
stimulation of the IP causes it to emit light
(by photostimulable luminescence (PSL) PHENOMENON OF LASER LIGHT
 The cassette is placed in the reader where digital computer for processing and CR
the IP is extracted and faster- scanned with image creation.
a highly focused and intense laser light of
LASER IN IMAGING PLATE
low energy (~2 eV).
 To render the latent image visible, the
PSPIP is taken to the CR
reader/processor to be scanned by a
laser beam. This process is referred to
as photostimulated excitation.
 The laser light used must be capable of
being absorbed by the “F-centers.”
 This absorption causes the trapped
electrons to move up to the conduction
band, where they are free to return to
the valence band, thus causing the
Eu3+ to return to the Eu2+ state.
 Laser light is absorbed at the F-center
(Farbzentren center) and, thus, stimulates
the trapped electrons up to conduction
band where they are free to move to
Europium atom thereby leaving high energy
conduction band to lower energy valence
band.
 This transition of the electrons from a
higher energy state to a lower energy
state (ground state) result in an
emission of bluish purple light (~415 nm
wavelength).
 This is referred to as photostimulable
luminescence (PSL) in the PSPIP.
 When these electrons become reabsorbed  The extracted imaging plate is scanned with
by trivalent Europium, trivalent Europium is gas laser and gives energy to trapped
transferred back into divalent Europium electron and energizes them.
atom. This involves the liberation of high  Extra energy allows the trapped energy to
energy (~3 eV) and this is done by emission escape the active layer where they emit
of blue - purple light. blue light at energy of 3 eV.
 The lasers used today for PSL in CR  Photomultiplier tubes are only
units are semiconductor lasers that sensitive to blue light.
produce light with a 680 nm wavelength  Laser scans IP multiple times.
compared to He-Ne lasers that produce  Scanning produces lines of light intensity
light with a 633 nm wavelength used in information that are detected by
earlier CR units. photomultiplier tube that amplifies and
 The PSL from the IP is collected by a sends it to digitizer.
special light collection device and sent
to a photomultiplier tube that produces
an electrical signal. This signal is
subsequently digitized and sent to a IMAGING PLATE MOVEMENT
  It employs a photocathode plate which
Fast Scan Direction  The direction as a emits electrons (by ionization) when
PSP plate moves through the CR reader struck by light.
(processor) is the crosswise laser beam scan  The electron stream by a series dynode
direction. which sequentially boosts the signal.
 A photomultiplier tube, useful for light
Slow Scan/ Sub-scan Direction  Direction
detection of very weak signals, is a
of the plate movement.
photoemissive device in which the
absorption of a photon results in the
emission of an electron.
3. READ
 These detectors work by amplifying the
 The light signal emitted after stimulation
electrons generated by a
is detected and measured.
photocathode exposed to a photon
Photomultiplier Tube flux.

 A device sensitive to electromagnetic Photomultiplier Tube (continued)

radiation, consisting of a photocathode,
 But this electronic signal is too small to
from which electrons are released by
be detected by most other types of
incident photons, and an electron
electronic devices, so it needs to be
multiplier, which amplifies and produces
amplified.
a detectable pulse of current.
 This is accomplished through a series of
 When the laser beam in the CR reader
dynode plates.
stimulates the PSP plate, the visible light
emitted from it is directed through a light- Dynode plates
channeling guide onto a photocathode layer
on the input side of a PM tube.  An electrode in an electron tube that
functions to produce secondary
 Electrons are emitted from the
emission of electrons.
photocathode.
 The dynode is made of a metal plate
Photocathode containing a substance on the surface
such as a bialkali compound, which emits
 A cathode that emits electrons when
secondary electrons upon impact with
exposed to radiant energy and
accelerated electrons. The acceleration of
especially light.
the photoelectrons and the impact of these
 The photocathode converts the light
on the dynode produce multiple secondary
photons emitted by the entrance
electrons.
phosphor to photoelectrons via the PE
 Dynodes are electrodes which can be
effect: electrons are produced in direct
switched back and forth between positive
proportion to the brightness of the input
and negative charges.
screen.
 With each strike, the dynode plate switches
from positive to negative, repelling the
 stream of electrons toward the next plate,  Each phosphor storage is scanned and the
but with increasing effect such that the electrons enters the digitizer where the
number of electrons in the stream is analog image is converted into square
multiplied. matrix and assigns each matrix a number
 Each collision of an incident electron with a based on the amount of signal .
dynode plate releases about 5 electrons  Analog refers to a device or system that
from the plate. represents changing values as
 By having the electron beam pass through continuously variable physical
10–12 of these dynodes in succession, the quantities.
electronic signal can be amplified by more  The typical number of pixels in a matrix
than a million times. range from about 512 × 512 to 1024 ×
1024 for CT but can be as large as 2500
Electrode × 2500 for radiography.
 is an electrical conductor used to make  The more pixels there are, the greater
contact with a nonmetallic part of a the image resolution.
circuit (e.g. a semiconductor, an
electrolyte, a vacuum or air). Electrodes are  More Pixel = greater resolution.
essential parts of batteries that can consist  The number of Photons detected
of a variety of materials depending on the determines the Grey level.
type of battery.  Grey level will determine the Quality of
 An electric conductor, usually metal, Image.
used as either of the two terminals of an  Pixel (Picture Element) - a minute area
electrically conducting medium; it of illumination on a display screen, one
conducts current into and out of the of many from which an image is
medium, which may be an electrolytic composed.
solution as in a storage battery, or a solid,  The image is digitized both by position
gas, or vacuum. (spatial location) and by intensity (gray
level). Each pixel contains bits of
information, and the number of bits per
DIGITALIZING THE SIGNAL pixel that define the shade of each pixel
is known as bit depth.
 It is the assigning of numerical value to
each light photon.
 In the process of digitizing the light
DIGITAL IMAGES
signal, each phosphor storage center is
scanned, and the released electrons
enter a digitizer that divides the analog
image into squares (matrix) and assigns
each square in the matrix a number
based on the brightness of the square.
 Each square is called a pixel or picture
element.
 In digital radiography, a digital image is a
numerical representation of the patient, for
digital radiography, the following points are
noteworthy:
1. The digital radiography detector outputs an  Not all electrons have came back to the
analog signal (electrical signal). initial phase after reading.
2. This signal is sent to an analog-to-digital  The process of reading the image
converter (ADC). returns most but not all of the electrons
3. The ADC changes the continuous analog to a lower energy state, effectively
signal into discrete digital data. This is an removing the image from the plate.
important step in generating a digital image, However, imaging plates are extremely
simply because a digital computer requires sensitive to scatter radiation and should
discrete data (0s and 1s) for operation. be erased to prevent a buildup of
4. The result of computer processing is a background signal.
digital image.  The plates should be run at least once a
5. Since radiologists and technologists do not week under an erase cycle to remove
view numerical representations (digital background radiation and scatter.
images), these must be converted into a
form suitable for human viewing. Hence,  The system automatically erase the plate
the digital image is converted into a visible by flooding it with light to remove any
physical image, an analog image. electron still trapped after initial plate
reading.
 CR readers have an erasure mode that
4. ERASE allows the surface of the imaging plate
 Before reuse, any residual metastable to be scanned without recoding the
electrons are moved to the ground state by generated signal. Systems automatically
intense light. erase the plate by flooding it with light to
 One of the advantages of CR is that the remove any electrons still trapped after
IP can be used repeatedly for several the initial plate reading.
hundreds of exposures.  Cassettes should be erased before
 IP is erased using a high intensity light to using if the last time of erasure is
remove any residual energy after the IP unknown.
has been scanned by the laser beam.
 The erased IP is now ready to be used
again. IMAGE QUALITY IN CR

 Comparison of the radiographic film, H&D

response curve to linear plate response
Dynamic Range  Film Screen Radiography: 10 lp/mm
 CR: 2.5-5 lp/mm
 Excellent linear response to the intensity of
X-ray. Speed
 DYNAMIC RANGE is the range of tonal
difference between the lightest light  CR system “speeds” reflects the amount of
and darkest dark of an image. photostimulable luminescence (PSL)
given off by the imaging plate while being
 The higher the dynamic range, the more
scanned by the laser.
potential shades can be represented,
 For example, Fuji Medical Systems reports
although the dynamic range does not
that a 1-mR exposure at 80 kVp and a
automatically correlate to the number of
source-to-image distance of 72 inches will
tones reproduced.
result in a luminescence value of 200,
 Information’s available in high and low
hence the “speed” number.
exposure regions too.
 In CR, most cassettes have the same
 Wider dynamic range
“speed”; however, there are special
extremity or chest cassettes that produce
Wider Dynamic Range greater resolution. These are typically 100
relative “speed.”
 Great care must be taken when converting
to a CR system from a film/screen system
to adjust technical factors to reflect the new
“speed.”

ADVANTAGES AND DISADVANTAGES OF

CR
Advantages:
 Improved and expanded diagnostic scope.
A. Film-screen AP projection of the Knee  X ray dosage reduction.
Radiograph  Repeat rate reduction.
B. CR AP Projection of the knee image  Teleradiographic transmission
 The difference in the amount of soft tissue  Picture Archival and Communication
shown in detail with CR image. System possible.
 Faster image receptor, so lower patient
dose is possible.
Spatial Resolution  Post-processing, manipulation & storage of
 is a measure of the smallest object that can images.
be resolved by the sensor, or the ground area  Repeat examinations are reduced due to
imaged for the instantaneous field of view wide exposure latitude.
(IFOV) of the sensor, or the linear dimension  IP is reusable, no need to reload the
on the ground represented by each pixel. cassette.
 Elimination of repeat exposures.
 Amount of detail present in any image is  Ability to produce consistent high-quality
known as spatial resolution. images.
 Determined by Phosphor layer  Ability to deliver images quickly to those
thickness and Pixel size. who need to make critical decisions.
 Low cost of storage, retrieval and  Many newer CR readers now use solid-
expansion. state semiconductor laser diodes rather
 The ability to interface with the Radiology than helium-neon gas lasers. These emit
Information System. a slightly different wavelength of light but
 Decreased time to acquire images thereby are more reliable and consistent in the long
increasing patient throughput. run.
 Increased Radiologist reading capacity and  Solid state: produces longer wavelength of
the ability to have instant comparison light.
images along with previous reports.
 Ability to have wide are distribution to
EFFICIENCY OF CR PHOSPHORS
doctors’ offices.
 Ability to print on paper or make CD media Absorption Efficiency
instead of film, saving thousands of dollars.
 is the ratio of x-ray photons absorbed by the
Disadvantages: phosphor crystals to the x-ray photons incident
upon the phosphor layer.
 Dose-creep: since exposure latitude is
wide, high exposure technique is used  Elements with high atomic numbers, thicker
which increases the patient dose which is phosphor layer are good in Absorption.
called dose-creep.  The more x-rays are absorbed by the
 This can be reduced by exposure indicator phosphor layer, the more light is emitted
or exposure index which gives the user when the plate is stimulated by a laser
feedback about the actual dose. beam in the digital reader (processor).
 Exposure latitude  is the extent to
which a light-sensitive material can Conversion Efficiency
be overexposed or underexposed  Is the percentage of energy from absorbed
and still achieve an acceptable result. x-ray photons that is converted into light rather
This measure is used for digital and than into infrared or heat energy.
analogue processes, e.g. optical
microlithography or photography. Emission Efficiency
 Is the ability of the light produced by the
phosphor crystals to escape the phosphor
RECENT DEVELOPMENT IN CR layer and reach the light guides in the CR
 Dual Sided reading: there are two sets of reader that direct it to the light detector, a
detectors in the reader that capture light photomultiplier tube.
from both sides of the plate upon
stimulation by the laser beam. Combined
with a thicker phosphor layer on the plates,
the signal to-noise ratio is improved in
these systems.
 New Line scan Reader: have increased
the speed of processing. They use a laser
line source and a shaping lens to refine the
beam into a fine line rather than a point.
Stimulated light is then emitted from the
phosphor line-by-line, captured by a lens
array and fed to a CCD photo detector
array.
BACKGROUND AND SCATTER RADIATION  Stored energy is set free with the emission
of blue light equivalent to the absorbed
 Approximately 10 times more sensitive than
remnant beam.
the older film/screen.
 Blue light is captured by photodiode and
converted to electric charge.
 Analog to digital converter converts it into a
corresponding digital image.
 Residual latent image electron is flushed
with high intensity white light.
 and erased without reintroducing electrons
from the ground energy level.
Demonstration of the extreme sensitivity of CR
plates to both background and scatter
radiation. References:

 Image A- processed from a CR plate that  Carter C, Veale B, Cassette-Based

was erased and then stored behind the Equipment: The Computed radiography
control booth during an abdomen exposure. Cassette, Imaging Plate and Reader,
 By comparison, for density from natural Digital Radiography and PACS, Texas,
background radiation can be made our on- 2011 ,63-76.
image B from a CR plate which had not  Ballinger P, Frank E, Computed
been erased after two days of protected radiography, Merill’s Radiographic
storage. Positioning and Radiologic procedure,
 Image C is from a plate set 2 meters away Ohio, 2007 Vol: 3, 360-371
from an abdomen phantom that was  Lanca L, Silva A, Digital Radiography
exposed to 80 kVp and 30 mAs. Scatter Detectors: A technical overview, Digital
radiation is readily apparent. Imaging Systems for plain Radiography,
Portugal, 2013, 12-3
SUMMARY:
 Carrol Q, Creating the Digital Image:
The basic CR imaging cycle has three steps: Radiography in Digital Age, Illinois, 2011,
1. Expose 369
2. Readout  STEWART BUSHONG, Radiologic
3. Erase Sciences for Technologist, 10th edition,
Elsevier Texas, 2013: MOSBY
 When the PSP is exposed to the X-ray the  RICHARD R. CARLTON, Principles of
energy of the incident radiation is absorbed Radiographic Imaging: an art and a
and excites electrons to high-energy levels. science, 3rd edition, Delmar: 2001
 These excited electrons remain trapped at  EUCLID SEERAM, Digital Radiography:
unstable energy levels of the atom. An Introduction, Delmar: 2011
 This trapped energy can be released if
stimulated by additional light energy of the
proper wavelength by the process of
photostimulated luminescence (PSL).
 The PSP is scanned in a separate CR
reader device.
 A GAS laser beam scans the
photostimulable screen stimulating the
emission of the blue light photons.