ARTICLE IN PRESS

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Radiography (2008) xx, 1e5

available at www.sciencedirect.com

journal homepage: www.elsevier.com/locate/radi

Digital radiography detectors e A technical

overview: Part 1
Luı́s Lança a,*, Augusto Silva b

a
School of Health Technology, Lisbon Polytechnics, Lisbon, Portugal
b
Department of Electronic, Telecommunications and Informatics, Aveiro University, Aveiro, Portugal

Received 14 February 2008; accepted 15 February 2008

KEYWORDS Abstract During the last two decades screen-film (SF) systems have been replaced by digital
CR; X-ray systems. The advent of digital technologies brought a number of digital solutions based
DR; on different detector and readout technologies. Improvements in technology allowed the de-
X-ray detectors; velopment of new digital technologies for projection radiography such as computed radiogra-
Digital technologies phy (CR) and digital radiography (DR). The large number of scientific papers concerning digital
X-ray systems that have been published over the last 25 years indicates the relevance of these
technologies in healthcare.
There are important differences among different detector technologies that may affect sys-
tem performance and image quality for diagnostic purposes. Radiographers are expected to
have an effective understanding of digital X-ray technologies and a high level of knowledge
and awareness concerning the capabilities of these systems. Patient safety and reliable diag-
nostic information are intrinsically linked to these factors.
In this review article e which is the first of two parts e a global overview of the digital
radiography systems (both CR and DR) currently available for clinical practice is provided.
ª 2008 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

Introduction systems and this constitutes a challenge for radiographers

and other healthcare staff.
Advances in digital technology allowed the development of The transition from a SF environment to a digital
full digital X-ray detectors that are currently available for environment is not a simple matter. Technical factors
projection radiography. Computed radiography (CR) and concerning image acquisition, the management of patient
Digital radiography (DR) are digital technologies widely dose and diagnostic image quality are some issues that
spread in healthcare institutions nowadays. These technol- could influence this process. In a transition process from SF
ogies have been replacing traditional screen-film (SF) to digital, patient radiation doses could increase 40e103%.1
When compared to SF, digital technology could increase pa-
tient radiation doses due to the wide dynamic range they
* Corresponding author. have. However, the dynamic range is useful because it con-
E-mail address: [email protected] (L. Lança). tributes for a better clinical image quality when compared

1078-8174/$ - see front matter ª 2008 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.
doi:10.1016/j.radi.2008.02.004

Please cite this article in press as: Lança Luı́s, Silva Augusto, Digital radiography detectors e A technical overview: Part 1, Radiography
(2008), doi:10.1016/j.radi.2008.02.004
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2 L. Lança, A. Silva

to traditional SF systems.2 This is an important difference components of digital detectors7: the capture element,
among analogical and digital technologies. The risk of over- the coupling element, and the charge readout element.
exposure with no adverse effect on image quality could be DR detectors can use either a direct or indirect process
present. Digital imaging systems could deliver over or un- for converting X-rays into electric charges. These detectors
der-exposure that influences patient’s dose. Overexposure use direct readout by means of a Thin-film transistor (TFT)
could provide good quality images, but may cause unneces- array despite the conversion process of the X-ray beam.
sary patient dose. Direct conversion detectors have a X-ray photoconductor e
The management of patient dose and the quality of such as amorphous selenium (a-Se) e that converts directly
images involves the relationship between three core as- at only one stage X-ray photons into electric charges.
pects of the imaging process.3 These are determinants for Indirect conversion systems use a two stage technique
the diagnostic quality of the radiographic image: (i) choice for conversion. They have a scintillator, such as Cesium
of radiographic technique; (ii) radiation dose to the patient Iodide (CsI) that converts X-rays into visible light at a first
and; (iii) diagnostic quality of the radiographic image. This stage. That light is then converted e at a second stage e
is a challenge for radiographers because clinical advantages into an electric charge by means of an amorphous silicon
and limitations of digital technologies for projection radiog- photodiode array.8
raphy are also dependent on the radiographer’s options for CR technology uses an indirect conversion process using
a particular patient examination. a two stage technique. X-rays are captured at a storage-
A technical overview about digital radiography detectors phosphor screen (SPS) (ex: BaFBr:Eu2þ) and then a photode-
is provided in this two part review article. In this article e tector captures the light emitted from the SPS and converts
which is the first of two parts e a global overview of the the captured luminescence into a corresponding digital
digital radiography systems (both CR and DR) currently image.
available for clinical practice is provided. Fig. 1 show a general description model for digital X-ray
technologies.
Overview of CR and DR detectors Despite the process of X-ray detection and readout
digital detectors offer several advantages when compared
Several digital systems are currently available for the to SF systems. This includes wide dynamic range, adjust-
acquisition of projection radiographs. These digital systems able image processing, better image quality, rapid image
are traditionally split into two broadly defined categories: acquisition and image access at remote locations.9
computed radiography (CR) and digital radiography (DR).4,5
Although this taxonomy is commonly accepted other classi- Computed radiography
fications are described: direct digital radiography and Indi- Computed radiography (CR) was the first available digital
rect Digital Radiography technologies (including CR).6 In technology for projection radiography. CR technology is
this case, the detector classification is related with the based in storage-phosphor screens (SPS) and its first clinical
conversion process of X-ray energy to electric charge. De- application by Fuji took place at the early 1980s.
spite charge-couple devices (CCDs) could be considered in- This technology uses a photostimulable detector replac-
direct conversion DR systems, they are not flat-panel ing the traditional SF cassettes. The storage-phosphor
detectors and studies dealing with CCD-based digital gen- plates are exposed inside the cassettes with standard
eral radiography are rare.5 This technology is mainly dimensions for typical plain radiography and no change of
related to other applications such as mammography and generator, X-ray tube and Bucky wall or table mounted
digital dental radiography.5 For this reason CCDs will be ex- system is necessary. CR technology allows the radiographer
cluded from this review. to obtain plain radiography images like in a traditional SF
Despite the taxonomy that is used the major difference system. The difference is how the latent image is created
among digital technology systems is how the process of X- and how this image processing is done. The basic CR
ray detection and readout is performed. Concerning CR imaging cycle has three steps6: (i) expose, (ii) readout,
systems they use storage-phosphor image plates with and (iii) erase.
a separate image readout process which means an indirect Inside the radiography cassette an image plate (IP) e or
conversion process; DR technology converts X-rays into SPS e having a detective layer of photostimulable crystals is
electrical charges by means of a direct readout process available. The detective layer consists of a family of
using TFT arrays. These systems can be further divided into phosphors BaFX:Eu2þ where X can be any of the halogens
direct and indirect conversion groups depending on the Cl, Br or I (or an arbitrary mixture of them).10 A typical
type of X-ray conversion used.5 Table 1 shows the differ- SPS can store a latent image for a considerable period of
ences among detector technology concerning three time. However, it will lose about 25% of the stored signal

Table 1 Three components of digital detectors7

Detector technology Capture element Coupling element Charge readout
2þ
CR BaFBr:Eu phosphor
Photostimulated luminescence (PSL) light-guide Photo-multiplier tube;
signal digitization
DR Direct conversion a-Se None TFT array
Indirect conversion CsI or G2O2S phosphor Contact layer a-Si photodiode/TFT array

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(2008), doi:10.1016/j.radi.2008.02.004
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Digital radiography detectors 3

DR CR [4,5] After the X-ray exposure and the creation of the latent
image, the SPS is scanned in a separate CR reader device.
Direct Indirect The readout is a process that follows exposure of the image
conversion conversion [6]
(1 stage) (2 stages)
plate and constitutes the second step of the CR imaging
cycle. A red laser beam scans the photostimulable screen
stimulating the emission of blue light photons under the
excitation of the laser beam. When the detective layer of
- Scintillator
Storage the IP is scanned pixel by pixel with a high-energy laser
Phosphor
+ (CsI) (BaFBr:Eu )
2+ beam of a specific wave length, stored energy is set free as
X-ray absorption X-ray emitted light having a wave length different from that of
photo-
conductor the laser beam.5 This triggers the process of photostimu-
Conversion to (a:Se) Photodiode Photo lated luminescence (PSL) resulting in the emission of blue
electric charge (a-Silicon) detector light in an amount proportional to the original X-ray irradi-
TFT Array TFT Array
ation10 and setting free the excited electrons to their lower
Charge readout
energy level (Fig. 2c and d). This light is collected by pho-
Analog-to-Digital Digital Signal todiodes and converted into electric charge while an ana-
conversion log-to-digital device converts it into a corresponding
digital image. Fig. 3 shows the SPS scanning process.
Figure 1 General description model for digital X-ray technol-
Finally, the third step of the basic CR imaging cycle is
ogies (adapted from8).
the Residual Signal Erasure. Residual latent image electrons
are still trapped on higher energy levels after readout. This
between 10 min to 8 h after an exposure resulting in the energy is erased after the readout process using a high-
loss of energy through spontaneous phosphorescence.11 intensity white light source that flushes the traps without
The phosphor crystals are usually cast into plates into reintroducing electrons from the ground energy level.11
resin material in an unstructured way (unstructured scin-
tillators).5 When the SPS is exposed to the X-ray the inci- Digital radiography
dent radiation excites electrons from the valence band to Digital radiography (DR) flat-panel systems with integrated
the conduction band (Fig. 2a and b). These excited elec- readout mechanisms were introduced in the market at the
trons absorb the X-ray energy and they are trapped at a sta- end of the 1990s.12 Flat-panel systems, also known as large
ble energy level of the atom. The phosphor stores absorbed area X-ray detectors, integrate an X-ray sensitive layer and
X-ray energy in crystal structure and a latent image is then an electronic readable system based on TFT arrays. Detec-
created at these high-energy states giving a spatial distribu- tors using a scintillator layer and a light-sensitive TFT photo-
tion of these electrons at the SP detector. This trapped en- diode are called indirect conversion TFT detectors. Those
ergy can be released if stimulated by additional light using an X-ray sensitive photoconductor layer and a TFT
energy of the proper wavelength by the process of photosti- charge collector are called direct conversion TFT detec-
mulated luminescence (PSL).11 tors.12 The reference to amorphous silicon (a-Si), which is
used in TFT arrays to record the electronic signal, should
not be confused with amorphous selenium (a-Se) the mate-
rial used to capture X-ray energy in a direct digital detector.
X-ray photon The structure of a DR flat-panel system is shown in Fig. 4.
This electronic readable system allows an active readout
process, also called active matrix readout, in opposition to
the storage-phosphor systems where no active readout
elements are integrated within the detector. The entire
readout process is very fast, allowing further developments
in digital real-time X-ray detectors.12
TFT arrays (Fig. 5) are typically deposited onto a glass
substrate in multiple layers, with readout electronics at
the lowest level, and charge collector arrays at higher
a b levels. Depending on the type of detector being manufac-
Photostimulated tured, charge collection electrodes or light sensing
luminescence (PSL)

Photo
detector

Laser beam
Analog electronics

Analog-to digital
c d conversion

Figure 2 SPS exposure and PSL. Figure 3 SPS scanning process.

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4 L. Lança, A. Silva

TFT array
Photodiode or charge collector Collects charges from
Converts x-rays to light the upper layer
or to electric charges

Electronic control
Triggers the switching diodes

in

Switching diodes
Connects each pixel to readout device
out

Analog-to digital
conversion
Multiplexer
Readout the electronic signal

Figure 4 Flat-panel structure.

elements are deposited at the top layer of this ‘‘electronic Large area direct conversion systems
sandwich.’’13 Large area direct conversion systems use amorphous sele-
The advantages of this design include compact size and nium (a-Se) as the semiconductor material because of its X-
immediate access to digital images. The performance of DR ray absorption properties and extremely high intrinsic
systems greatly exceeds the performance of CR systems, spatial resolution.12,13
which have efficiencies of 20e35%, and of screen-film Before the flat-panel is exposed to X-rays an electric
systems for chest radiography, which have nominal effi- field is applied across the selenium layer. Then the X-ray
ciencies of 25%.13 exposure generates electrons and holes within the a-Se
layer: the absorbed X-ray photons are transformed into
electric charges and drawn directly to the charge-collecting
electrodes due to the electric field. Those charges e
Out Analog-to digital proportional to the incident X-ray beam e are generated
conversion
and migrate vertically to the both surfaces of the selenium
layer, without much lateral diffusion. At the bottom of the
a-Se layer, charges are drawn to the TFT charge collector,
where they are stored until readout. The charge collected
at each storage capacitor is amplified and quantified to
a digital code value for the corresponding pixel. During the
readout, the charge of the capacitors of every row is
conducted by the transistors to the amplifiers.
In

Large area indirect conversion systems

Large area indirect conversion systems use cesium iodide
(CsI) or gadolinium oxisulphide (Gd2O2S) as an X-ray detec-
tor. The scintillators and phosphors used in indirect conver-
sion detectors can be either structured or unstructured
(Fig. 6). Unstructured scintillators scatter a large amount
of light and this reduces spatial resolution.7 Structured
scintillators consist of phosphor material in a needlelike
photodiode
structure (the needles being perpendicular to the screen
TFT switch
or + surface). This increases the number of X-ray photon inter-
charge collector TFT Array actions and reduces the lateral scattering of light photons.7
When the scintillator layer is exposed to X-rays the beam
is absorbed and converted into fluorescent light. At a second
stage that light is converted into an electric charge by
means of an a-Si photodiode array.8 Indirect conversion de-
tectors are constructed by adding an a-Si photodiode cir-
cuitry and a scintillator as the top layers of the TFT
Figure 5 TFT array. sandwich. These layers replace the X-ray semiconductor

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Digital radiography detectors 5

unstructured structured

Figure 6 Unstructured or structured cintilator.

layer used in a direct conversion device.13 The active area evolution of patient radiation doses at projection radiography
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imaging systems. In: Report of AAPM task group 10. AAPM; 2006.
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Please cite this article in press as: Lança Luı́s, Silva Augusto, Digital radiography detectors e A technical overview: Part 1, Radiography
(2008), doi:10.1016/j.radi.2008.02.004