Digital Radiography CESIUM IODIDE/ CHARGE-COUPLED

DEVICE
• The acceleration to all-digital imaging • One successful approach to DR is shown in last
continues because it slide. This use of tiled CCDs receiving light
provides several significant advantages over from a scintillator allows the use of an area x-ray
screen-film radiography. beam, so that, in contrast to SPR, exposure time
• Screen-film radiographic images require is short.
chemical processing, time that can delay • The scintillation light from a CsI phosphor is
completion of the examination. After an image efficiently transmitted through fiberoptic
has been obtained on film, little can be done to bundles to the CCD array. The result is high x-
enhance the information content. ray capture efficiency and good spatial
resolution—up to 5 lp/mm.

CESIUM IODIDE/AMORPHOUS SILICON

• An early application of DR involved the use of
CsI to capture the x-ray, last image, as well as
transmission of the resulting scintillation light to
a collection element. The collection element is
silicon sandwiched as a TFT. Silicon is a
semiconductor that usually is grown as a crystal.
When identified as amorphous silicon (a-
silicon), the silicon is not crystalline but is a
fluid that can be painted onto a supporting
surface.
CHARGE-COUPLED DEVICE
• The CCD was developed in the 1970s as a
AMORPHOUS SELENIUM
highly light- sensitive device
• The final DR modality is identified by some as
for military use. It has since that time found
direct DR because no scintillation phosphor is
major application in astronomy and digital
involved. The image-forming x-ray beam
photography.
interacts directly with amor- phous selenium (a-
• The CCD, which is the light-sensing element
Se), producing a charged pair as shown last
for most digital cameras, has three principal
image. The a-Se is both the capture element and
advantageous imaging characteristics:
the coupling element.
sensitivity, dynamic range, and size
• Note that the CCD radiation response is linear,
DIGITAL MAMMOGRAPHY
but the screen-film image receptor has the
• Digital radiography received a large boost in
characteristic Hurter and Driffield (H & D)
the late 1990s with the application of DR to
curve response. Although the screen-film image
mammography, called digital mammography
receptor has 3 decades of radiation response
(DM). One might think that DR should have
optical density (OD) from 0 to 3—only
better spatial resolution than screen- film
approximately 30 shades of gray are perceivable
mammography
by the human eye. We attempt to produce
• Light from a radiographic intensifying screen
radiographs low on the linear portion of the H
spreads and exposes a rather large area of the
& D curve to maximize image contrast at an
film. The result is limited spatial resolution. The
acceptable patient radiation dose.
signal emitted during CR also spreads, limiting
• With the use of a CCD image contrast is
spatial resolution. The curves, called line spread
unrelated to image receptor x-ray exposure.
functions, indicate the relative degree of spatial
Furthermore, each of the 4 decades of radiation
resolution.
response—0 to 10,000—can be visualized by
• The use of a-Se for DR should result in the best
image postprocessing.
spatial resolution. However, such is not the case
because spatial resolution in DR is limited by
pixel size, with the result that no DR system can seamless in a RIS which translates to faster
match screen-film radiography for spatial processing of medical images and superior
resolution. quality control.

•What is RIS? PACS

Radiology Information System  Communication networks
•What is PACS?  Images acquired by modalities
Picture Archiving and Communication System  Storage and access to images
•What is DICOM?
Digital Imaging and Communications in What is DICOM?
Medicine • Digital Imaging and Communications in
•What is CIS? Medicine (DICOM) is the globally recognized
(other term HIS for Hospital Information communication and management standard for
System) medical images and other patient data. It is
Clinical Information System frequently utilized throughout the medical field
to store and transmit medical images facilitating
RIS in the Hospital System integration with medical devices and PACS
• RIS is effectively used in hospitals for the tasks systems. Its broad clinical adoption includes
below: hospitals, radiology practices, and most recently,
• Patient Scheduling and Tracking – With a RIS, in doctors’ and dentists’ offices.
clinicians can easily access patient medical
histories, track treatment statuses, process DICOM Image
patient registrations as well as organize • DICOM exists as both a communication
appointment scheduling. Time-savings are protocol as well as a format type.
considerable with the reduction of paper-based Saving medical images under the format
documentation and a simplified, automated safeguards that all the data relating
booking process that a RIS can offer. to a particular study (i.e., patient information,
medical image, etc.) remains together, allowing
• Document Management – Since a RIS system for seamless transmission between DICOM-
is constantly updated, patient data integrity compatible devices translating to easier patient
is assured and always ensures patient files are data sharing between clinicians and a quicker
readily accessible when needed by clinician diagnostic process.
teams. Interactive documents can also be
generated in a RIS which contributes to DICOM File
enhanced inter-physician communication and • A file is an image saved in the DICOM format.
more timely diagnosis facilitation. Within it, a medical image generated from a
modality (e.g., MRI, scanner, ultrasound, etc.) is
• Image Identification – A RIS system ensures enclosed, along with metadata tags. DICOM
patient data is correctly attributed to the files are organized hierarchically as
appropriate corresponding images generated follows:
thereby allowing for easy identification while • Patient – A person or animal (Vet Radiology
minimizing the risk of study mix-ups. and Research)
• Study – A group of related imaging procedures
• Billing and Reporting – A RIS plays a key role • Series – A single series of images, captured
in optimizing radiology-centered billing and sequentially
reporting by way of storing financial records,
facilitating data analytics, automating billing, PACS vs. DICOM?
and processing electronic payments. • The difference between PACS and DICOM is
that PACS is a medical image storage and
• Modality Interfacing – Worklist utilization and archive hub, fed by medical modalities such as
modality intercommunication is made more X-ray scanners and MRI machines.
• DICOM represents the international 5 Types of Networks
communication standard – not • Local Area Network (LAN)
a device or structure – used by healthcare • Metropolitan Area Network (MAN)
professionals in storing, processing, transmitting • Wide Area Network (WAN)
medical images and data • Virtual Private Network (VPN)
• Personal Area Network (PAN)
CIS Benefits
• Enhanced communication between the patient LAN : Local Area Network
and their healthcare teams as well as among the • A Local Area Network is a Computer Network
healthcare professionals themselves that allows Computers to interconnect within a
• Comprehensive knowledge transference to limited area. A LAN can be a single building,
ensure clinicians can make informed, sound any Office, Home, or any Company.
decisions • A LAN can be as simple as only two PCs or it
• The facilitation of easy patient access to x-ray can connect all departments of any company
and scans when required with their peripherals. The most advantage of
• Effective quality improvement of care LAN is resource sharing, Resource means
administration and delivery Hardware, Software, and Data.LAN has a
• An open door to advanced clinical research limited geographical area restricted to
a few KMs. LAN is wholly owned by a
Digital RadiographQuality Characteristics particular Organization.
• LAN is the digital communication system that
 Spatial interconnects computers and shared resources.
 Detail Computers connected to LAN communicate
 Artifact throw a common communication medium.
 Noise
 Contrast WAN : Wide Area Network
• A Wide Area Network is a telecommunication
DR Contrast Characteristics network that connects computers across large
distances and crosses the boundaries of cities
 Xray Beam Spectrum and states.
• In other words WAN is a collection of Local
 Digital Image Processing
Area Networks (LANs) That communicate with
 Window Level & Width
each other. or we can say WAN is a Network of
Networks.
Computers
• By using a WAN Computer user in one
• used binary system.
location can communicate with the user in
• BIT/Binary Digit – can code for 2 values or 2
another location. A Wide Area Network has no
shades of gray which correspond
limit of Area covered
to white and black.
BITS= 1 byte; 2 byte= 1 word (16 BITS)
MAN : Metropolitan Area Network
• A total of 256 shades of gray (2) can be coded
• The extended version of LAN is called
for by 1 byte (8 BITS)
Metropolitan Area Network. The distance
• A total of 4096 shades of gray (2) can be coded
covered by MAN is about 10 to 50 miles.
for by 12 BITS.
This is bigger than LAN but smaller than WAN.
• Storage requirement: KILOBYTES,
For example,
MEGABYTES, GIGABYTES, OR
any company using MAN by connecting all
TERABYTES
offices/branches spread over the city.
PAN : Personal Area Network Matrix-array of numbers in rows and columns.
• Personal Area Network is used in a single • A. Pixel (Picture Element)- is a two
building up to 10 meters only. It is used by a dimensional representation of a corresponding
single person. In PAN electronics tissue volume.
gadgets are used like wireless headphones, Field of View
wireless Printer, wireless keyboard and mice, Formula: Pixel Size= -----------------
IPAD, TV remotes, etc. PAN is a Matrix Size
very small types of computer network. • B. Voxel (Volume Element)- is determined by
multiplying the pixel size by the thickness of the
VPN : Virtual Private Network CT scan slice
• Virtual Private Network enables the user to use
their private network resources from a remote VOXEL SIZE (mm3) = Pixel Size (mm2) x
location. It creates a secure connection over the Slice Thickness (mm)
Internet. Many companies and organizations use
VPNs to enable its employee to securely use SPATIAL RESOLUTION
company resources from a remote location. • Refers to the degree of blurring
• Suppose any employee goes out of the country • Number of line pairs per centimeter
and suddenly he requires company resources
then he can connect and access their resources Pixel Size and Spatial Resolution
by using VPN. • When an image is in digital form, it is actually
blurred by the size of the pixel. This is because
Digital Processing all anatomical detail within an individual pixel is
• A Histogram is a graphical display of the pixel "blurred together" and represented by one
intensity distribution for a digital image. A number.
Histogram plots the number of pixels found at • Small pixel size produced better spatial
each pixel value. The left side of the graph resolution
typically represents the lower signal values (less
exposure) and the right side represents the Matrix Size and Spatial Resolution
higher signal values (more exposure) • Matrix size is the number of pixels that make
up the image.
• Histogram analysis is also employed to • Increasing the matrix size, for example from
maintain consistent image brightness despite 1024 to 2048 pixels, without changing the image
overexposure or underexposure of the IR. This field of view, will produce smaller pixels. This
procedure is known as automatic rescaling. The will generally reduce blurring and improve
computer rescales the image based on the image detail.
comparison of the histograms, which is actually
a process of mapping the grayscale to the VOI to Field of View and Spatial Resolution
present a specific display of brightness • When the field of view (FOV) is reduced, but
• Although automatic rescaling is a convenient not changing the matrix size, the pixels become
feature, radiographers should be aware that smaller and the visibility of detail is improved.
rescaling errors occur for a variety of reasons A practical issue is that larger images (such as a
and can result in poor-quality digital images. chest radiograph) require a larger matrix (more
pixels) than a smaller image in order
Image Characteristics to have good detail
• Image Matrix
-CT scan image format consists of many cells, Subject contrast
each assigned a number and displayed as a • Subject contrast is the ratio of the radiation
density or brightness level on the video monitor. intensities in different parts of an image due to
-Current scanners provide matrices of 512 by the quality of the subject being imaged. The
512, which results in 262,144 cells of contrast is due to the differential attenuation by
information. the tissues.
• Improved contrast The focal spot is not infinitely small. There
• Thicker structure will be areas of the image that are:
• Greater attenuation between objects • High signal: all x-ray photons reach detector
• Decreasing kV • Low signal: no x-ray photons have passed
• Increasing difference in Z of objects through the object to reach the detector
• Increasing difference in density of objects • Intermediate: not all photons have passed
• Reduced contrast through the object. The size of this area
• Increased scatter determines the unsharpness and is called the
• No effect penumbra.
• Overlying tissue
How about Moving an Object?
CONTRAST RESOLUTION
• Ability to distinguish material of one Image receptor unsharpness
composition from another w/out regarding the • Digital images: if a detector element lies across
size and shape the border between a light and a dark area the
pixel displayed will be an average of these two
General considerations values creating a blurred border.
• Noise is a fundamental limit on the quality of
computed tomography image Movement unsharpness
• If an object moves during the acquisition the
• Noise can be classified into three types edge will be blurred resulting in unsharpness.
o Quantum noise
o Electronic noise Edge unsharpness
o Structural noise
Algorithm
• Quantum noise is due to random variations in • the proper reconstruction algorithm must be
the number of photons detected, this is in turn used to mathematically filter unwanted artifacts.
related to the tube current, scan time, kilovoltage •Reconstruction Algorithm determines raw data
peak and slice width are filtered in the reconstruction process
• Electronic noise is related to the electronic
measuring system Smoothing Filters
• Structural noise is due to the reconstruction • Image smoothing is a digital image processing
algorithm used technique that reduces and suppresses image
noises. In the spatial domain, neighborhood
Factors that don’t reduce noise averaging can generally be used to achieve the
• Amplification: attaining a higher signal from purpose of smoothing.
each absorbed photon, either by using a faster Commonly seen smoothing filters include
film-screen combination or gain of an image average smoothing, Gaussian smoothing, and
intensifier would just amplify the signal adaptive smoothing.
from noise as well
• Using a narrower window to produce a high Sharpening Filters
contrast image • Image sharpening filters highlight edges by
removing blur. It enhances the grayscale
Unsharpness in Digital Radiography transition of an image, which is the opposite of
There are four causes of unsharpness: image smoothing. The arithmetic operators of
1.Geometric unsharpness smoothing and sharpening also testifies the fact.
2.Image receptor unsharpness While linear smoothing is based on the
3.Movement unsharpness weighted summation or integral operation on the
4.Edge unsharpness neighborhood, the sharpening is based on the
derivative (gradient) or finite difference.
• How to distinguish noises and edges still
matters in sharpening.
The difference is that, in smoothing we try to
smooth noise and ignore edges and in
sharpening we try to enhance edges and ignore
noise.

Smoothing vs Sharpening
Both are very useful software's in Digital setting
and have different purpose based on usage:
Smoothing is useful for higher density and
contrast image.
Sharpening is useful for enhancement of detail.