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RAD 216 ADVANCED IMAGING MODALITIES BASICS OF DIGITAL IMAGING DIGITAL IMAGING Computer-assisted imaging has been around since the 70’s and found application in such imaging modalities such as computed tomography (CT) and MRI. DIGITAL IMAGING Conventional radiography involves recording a projected image onto a film recording medium. Using this method, the film (radiograph) is at once the recording, processing and display medium. 1 DIGITAL IMAGING Computer-assisted imaging separates the recording, processing and display elements. This separation gives imaging far more flexibility. Each element can also be improved independently. DIGITAL IMAGING • COMPUTED RADIOGRAPHY • DIGITAL RADIOGRAPHY – DIRECT CAPTURE – INDIRECT CAPTURE COMPUTED RADIOGRAPHY In order to have a meaningful discussion of computed radiography, we should take a few moments to review the basic steps in digital imaging process. 2 COMPUTED RADIOGRAPHY LATENT IMAGE IMAGE DISPLAY SCAN LATENT IMAGE DAC ADC IMAGE PROCESSING PACS COMPUTED RADIOGRAPHY An imaging plate consisting of “photostimulable” phosphors (e.g., BaFI:Eu or BaFBr:Eu) captures a latent image by means of photoelectric interaction. PHOTOSTIMULABLE IMAGING PLATE (IP) 3 COMPUTED RADIOGRAPHY The next step involves scanning the latent image. A laser scans the plate in a “raster” pattern. Laser interaction with the plate at points where x-ray interaction occurred will release light. That light is detected and converted into an amplified electrical signal using a photomultiplier device (PM). DIGITIZATION COMPUTED RADIOGRAPHY The amplified electrical signals are then sent to device called an “analog-to-digital” converter. What this does is convert the electrical signal into a form that a computer can process. This means transforming a continuous data set into a discrete data set consisting of 1’s and 0’s. 4 COMPUTED RADIOGRAPHY Once the latent image has been digitized, the data is processed by a computer. The computer uses a mathematical technique or “algorithm” using an image profile that has been entered into its memory. This profile is called a “histogram.” HISTOGRAM COMPUTED RADIOGRAPHY The processed image – still in digital form – must be converted back into a form that can be seen by the human eye. This is accomplished using a device called a “digital-to-analog” converter. 5 COMPUTED RADIOGRAPHY Provided that the correct histogram was applied and that the image was exposed correctly, the resulting image should be displayed showing the proper level of image brightness and contrast. IMAGE DISPLAY The resulting image is displayed on a video display monitor. This is accomplished by arraying the screen into a series of rows and columns consisting of discrete squares or rectangles. These tiny boxes are called “pixels,” or picture elements. The entire array is called a “matrix.” EVALUATING IMAGE QUALITY Because of the increased exposure latitude of CR imaging systems, we need a quantitative method of determining quality. Also, we need an indirect method of determining the amount of radiation received by the patient in generating an image. 6 EXPOSURE LATITUDE: FILM EXPOSURE LATITUDE: DIGITAL IMAGING 7 EXPOSURE INDICES Each of the major manufacturers of computed radiographic equipment has developed a method to indirectly measure exposure received by the imaging plate and are reviewed on the next slide. Note: this is not a perfect correlation. EXPOSURE INDICES Exposure Index Numbers Relative to Imaging Plate Exposure Agfa LgM Speed Class 2 Fuji S Value Kodak Exposure Index mR 100 2.95 2.15 1.45 20 200 2,000 20,000 2750 2,000 1,250 10 1 0.1 0.01 EXPOSURE INDICES Acceptable Exposure Ranges Manufacturer Exposure Range Agfa 2.05-2.35 (log M) logarithmic median Fuji 200-300 (S-value) sensitivity range Kodak 1850-2150 exposure index 8 DEVIATION INDICES = 10 ∗ log DEVIATION INDICES (ACTION LEVELS) DI ACTION RANGE > +3.0 Excessive patient radiation exposure. Repeat only if relevant anatomy is clipped or “burned out.” Require immediate management followup. +1.0 to +3.0 Overexposure: repeat only if relevant anatomy is clipped or “burned out.” -0.5 to +0.5 Target Range <1.0 Underexposure: Consult radiologist for repeat. <-3.0 Repeat From Understanding Exposure and Deviation Indices, by D. Leong, and M. Butler (AAPM, 2011) PACS Transmission of image data from the technologist’s workstation to the radiologist’s workstation is achieved by means of a high-speed network called “Picture Archiving and Communication System.” Permanent storage of image data is also achieved by use of this network. 9 DIGITAL RADIOGRAPHY Another method of capturing and processing images does not involve the use of imaging plates, but a built-in system of electronics. In this fashion, a separate image reading device is not needed. DIGITAL RADIOGRAPHY • Amorphous silicon (a-Si) arrays • Amorphous selenium (a-Se) arrays INDIRECT CAPTURE: AMORPHOUS SILICON DETECTOR ARRAYS This type of system uses a cesium iodide (CsI) scintillator and silicon (a-Si) diode array. The CsI converts x-rays to light. The a-Si converts the light into an electrical impulse (signal) that is then stored in a matrix of thin-film transistors (TFT’s). 10 AMORPHOUS SILICON ARRAY AMORPHOUS SILICON ARRAY DIRECT CAPTURE: AMORPHOUS SELENIUM ARRAY This system directly converts x-rays into electrical signals using a thin layer of amorphous selenium (a-Se). The interaction with selenium by x-rays produces so-called “ion hole pairs” that charge thin-film transistors. 11 AMORPHOUS SELENIUM ARRAY DIGITAL RADIOGRAPHY Regardless of DR system used, the data contained in each TFT is systematically read and converted into digital form using the ADC, then processed. The image data is converted back into analog form using a DAC, then displayed on a computer screen. 12 ADVANTAGES OF DIGITAL IMAGING • • • • • INCREASED CONTRAST RESOLUTION FASTER TURNAROUND TIME SMALLER SPACE REQUIREMENTS POTENTIAL DOSE REDUCTION GREATER EXPOSURE LATITUDE EXPOSURE LATITUDE DISADVANTAGES OF DIGITAL IMAGING • LOWER SPATIAL RESOLUTION (CR) COMPARED WITH FILM-SCREEN IMAGING • STARTUP COSTS • LAX STANDARDS INCREASE DOSE 13 COMPARING SPATIAL RESOLUTION • DIGITAL RADIOGRAPHY – AMORPHOUS SELENIUM ARRAYS (a-Se) – AMMORPHOUS SILICON ARRAYS (a-Si) • FILM-SCREEN RADIOGRAPHY • COMPUTED RADIOGRAPHY 14