DR & CR test
What is spatial resolution? | ability to define or separate 2 objects close togetherspatial resolution of 0.1 mm means that a lesion that is 0.1 mm can be discerned |
Exposure factors are usually (higher/lower) w/ digital systems vs. film-screen systems. | higher |
What is main difference b’twn film-screen systems & digital systems? | method by which radiation is detected after x-rays pass thru patientdigital: x-ray exposure measured on electronic medium & converted to a digital image in DICOM format |
What are the characteristics of CR? | computed radiography $60-100K-CR cassettes are physically similar to film cassettes but contain an imaging plate rather than intensifying screens & film -imaging plates must be read in a plate reader before x-ray exposure information is sent to computer: ~90 s/plate -images better than w/ film (better latitude): as good as DR? |
What are the characteristics of DR? | direct digital imaging $100K+imaging plate is independent of any cassette (built directly into x-ray table or is portable) -imaging plates send signal measured from x-ray beam directly to a computer –> faster image generation than w/ CR -excellent quality image |
What are some advantages of digital radiography systems? | -better image contrast: easier to see some lesions -very forgiving of radiographic technique settings: less retakes d/t exposure -post-processing: can adjust blackness & contrast after the fact -clients will be impressed -can transmit images electronically for consulation -more convenient storage -no more lost images, assuming backup -don’t have to maintain darkroom, buy film, etc. -wide latitude (dynamic range) |
What are some disadvantages of digital radiography systems? | -don’t have degree of spatial resolution possible w/ film-screen radiography: of little clinical relevance -initial investment can be considerable -must be compatible w/ rest of hospital system |
What is PACS? | picture archiving & communication system (PACS): centralized computer storage systemprovides storage, dissemination functions, & links images w/ demographic data |
What is DICOM? | digital imaging communications in medicine (DICOM): specific image file format analogous to JPEG and TIF formats commonly used in manipulation & storage of digital camera images-must have DICOM viewing software to view files -file sizes are very large compared to regular digital photos -make sure your images are really DICOM compliant: some vendors change files slightly so they aren’t compatible w/ all viewers |
Inherent detail in digital rads (is/is not) as good as with film based rads. | is NOTit is the improved contrast resolution that appears to give digital rads more detail |
What is latitude (dynamic range)? | range of exposures that result in useable imageenables the viewing of both soft tissues and bone on the same image without repeat exposures at different techniques, as would be needed for a film-screen system |
More pixels/area = (greater/less) detail | greater |
What is the makeup of a digital image?
-all digital images are composed of a grid of rows & columns (matrix) of tiny picture elements called pixels
-each pixel has a color or shade of gray
-most exposed pixel in a digital rad is assigned black, least exposed pixel is assigned white, regardless of technique
What is digital radiography? | recording a map of x-ray transmission throught patient in a digital file -file is viewed as a digital image -conventional x-ray machines are usedit is not photopgraphing radiographs with a digital camera or running rads through a scanner |
How is a digital image made? | computer prepares a row by colume matrix of digital data file -each row X column intersection is termed a pixel (picture element) -each pixel is assigned a color in a digital camera and a shade of grey in a radiographrows X columns = matrix size more pixels/area = greater detail more pixels = bigger file size |
What is a DICOM file? | Digital Imagine COmmunications in Medicine-need DICOM viewing software to view -very large files |
What is digital radiography | computer radiography – image plate in cassette like housingdirect digital radiography – flat panel detector |
How does computer radiography work? | x-ray -> patient -> detector -> reader -> digital signal -> computer DICOM file output |
How does direct digital radiography work? | x-ray -> patient -> detector -> digital signal – > DICOM file output |
What are the components of computer radiography? | -cassettes appeal similar to film-screen -cassettes must be processed in plate reader; 90sec/plate -images better than film -most labor intensive digital system |
What are the components direct digital radiography? | -no cassette to process -image available immediately -types –CCD (charged couple device) –Flat Panel -indirect digital detector -direct digital detector |
What is the benefit of a CCD system? | -image quality is a function of light collection, lens and number of pixels in camera chip -light collection and lens is most crucial*hard to retrofit so usually have to purchase entire unit including x ray tube and table |
What are the benefits of flat panel digital radiographs? | -no cassettes, camera or lens -immediately after exposure, image is viewable and ready to archive -excellent quality image -image plate is portable but subject to damage |
What is the detail with digital imaging? | detail as good with digital although it looks it at first glance there are other advantages that offset the slight reduction in spatial resolution |
What are the advantages of digital imaging if the detail isn’t better? | -no darkroom, film, envelopes -no exposure latitiude -contrast optimization -post processing -consultation -professional image |
What is exposure latitude? | the extent to which a film, image or flat panel can be over or underexposed and still achieve an acceptable result |
What is contrast optimization? | the range of light intensities a medium can capture |
T/FLow exposure image is more grainy appearance or more noise on digital imaging? | true |
What is the advantage of imaging post processing? | ability to change image contrast and blackness after acquisition |
What are still problems of digital imaging like with traditional radiographs? | positioning motion radiation safety |
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The ability to display two or more closely spaced objects as separate images | Spatial Resolution |
The size of the relevant image displayed on the cathode ray tube (CRT) | FOV |
Through application of software programs, possible to assign pixels a different gray scale value | Gray scale enchancement |
Mathematically measures image against original object: 0 represents no image, 1 represents perfect image | Modulation transfer function |
Aberrant movements of electrons in electonic equipment seen as flashes of light (snow) that degrades the image | Electronic noise |
Analog signal sampled twice per cycle by ADC to gain accurate digital signal | Nyquist Criterion |
Displaying small differences in subject contrast | Contrast resolution |
The number of shades of gray assigned to the pixles | Dynamic range |
Determines the number of density values available in each pixle. If affects density (brightness) and contrast of system and is controlled by the ADC | Pixle Depth |
Loss of image quality caused by random variations in the number of photons striking the IR | Quantum Mottle |
The number of densities from black to white on the x axis, the number of each density on the y axis | Histogram |
A pre-set “ideal histogram” for each projection | Look up table (LUT) |
CR provides optimal brightness and enhanced contrast | Normalization |
A high “S” number indicates a need to move the center point (Sm) over ____.a. more b. less |
a. more |
“S” values greater than 400 indicates _______________.a. Overexposure b. Underexposure c. Perfect exposure |
b. Underexposure |
“S” values greater than 400 will demonstrates _________.a. Quantum Mottle b. Improved MTF c. Lose of contrast |
a. Quantum mottle |
Three different type of reference histogram models used for LUT’s include one that must have a direct exposure “spike” to locate S2. This is a:a. Type 1 b. Type 2 c. Type 3 |
a. Type 1 |
Histogram shape is NOT influenced by…a. Type of exam b. Patient positioning c. mAs d. Type of generator |
c. mAs |
Which of the following does NOT use thin film transistors (TFTs).a. Indirect photostimuable phospher imaging plate system b. Direct selenium flat panel imaging plate system c. Indirect silicon flat panel imaging plate system |
a. Indirect photostimulable phospher imaging plate system |
CR or DR? [1] Uses cassettes- more familiarity for technologists [1] More adaptability for positioning and technique |
Computed Radiography |
CR or DR? [1] Direct hookup to the computer- no cassettes [1] Attached to a table/chest bucky, contains a grid, and AEC sensors [1] Flexibility of positioning limited [1] No ability to split fields for multiple views [1] Increased patient throughput [1] Higher detective quantum efficiency (DQE) |
Digital Radiography |
Does comptued or digital radiography use Indirect Photostimulable Phosphor Imaging Plate Systems (Computed Radiography)? |
Comptued Radiography |
The_______ _____ ______ is designed to look and act to perform many functions of standard cassette |
Computed Radiography |
The computed radiographic (CR) cassette….a. Comes in many of the same sizes as standard film cassettes b. Can be used with tabletop or bucky c. Can be used with manual or AEC techniques d. All of the above |
d. All of the above |
Name some features of a CR cassette | Aluminum or plastic Low absorbing carbon front Back panel has lead foil- backscatter Has a memory chip in one corner to download information on the exam and patient Front and back lined with felt to reduce static electricity and cushion plate |
PSP stands for… | Photostimulable phosphor |
IP stands for… | Imaging plate |
How thick is an CR plate? | 1mm in thickness |
Which layer in a CR plate is supported by a firm base and protected by a thin plastic layer? | The active phosphor later |
Name the following Layers | |
The ______ layer and/or __________ layer grounds static charge; reverses light emissions | Refletive and or conductive layer |
What type of emulsion must be facing forward? | Single emulsion |
What are some common phosphers? | Europium activated barium fluorohalides |
What is the average energy (keV) of 80 KVP beam? | 35 |
True or false: Digital screens will absorb more low energy scatter thus the plate is senesitive | True |
Since Photostimulable phosphor (PSP) absorb more low energy radiation than radiographic film they are more…….. |
More sensitive to scatter both before and after exposure than radiographic film. Thus, Masking is needed to achieve optimal images |
In a Latent image, where are the electrons stored? | Electron pattern is stored in active layer of exposed IP |
How is a latent image made? | Energy transferred to photoelectrons Several photoelectrons liberated Liberated electrons have extra energy Blue-violet light given off by fluorescence More electrons freed by photoelectrons |
In a latent image Fluorohalides absorb beam through ____________ interactions | Photoelectric |
In a Latent Image Production, Some electrons get trapped in the fluorohalides to create holes at the Europium site, this is called…? |
Electron Holes |
June 25, 2014 at 10:52 pm
Very good blog article. Awesome.
fiverrr23Jz
February 11, 2014 at 3:11 am
HIMSS 2014: Proposed Medicare Imaging Rule May Boost Need for Clinical Decision Support Software
January 28, 2014 by Carestream Health
Dave Fornell, editor, Imaging Technology News (ITN) and Diagnostic and Interventional Cardiology (DAIC)
Dave Fornell, editor, Imaging Technology News (ITN) and Diagnostic and Interventional Cardiology (DAIC)
As an editor for two medical technology magazines, I am always on the lookout for the next big trend in radiology or cardiology. This is especially true when legislation prompts action. This year at the Healthcare Information and Management Systems Society (HIMSS) annual meeting in late February, I will be on the search for new software to help physicians meet appropriate use criteria guidelines in medical imaging.
Stage 2 meaningful use guidelines for electronic medical records (EMRs) suggest use of clinical decision support (CDS) software to help clinicians choose appropriate labs, diagnoses, therapies and imaging exams. A draft policy to replace the sustainable growth rate (SGR) formula being considered by the a joint U.S. Senate Finance and House Committee on Ways and Means Committee might make this suggestion a requirement in the future. The draft policy would deny Medicare payment for the exam if the ordering physician did not consult appropriateness criteria and require prior authorization for outlier providers whose ordering is inconsistent with that of their peers.
The American College of Radiology (ACR) applauded the proposal in early November. “This landmark step by Congress is a validation of a cornerstone of the College’s Imaging 3.0 initiative that increases quality of imaging care and preserves healthcare resources,” said Paul Ellenbogen, M.D., FACR, chair, ACR Board of Chancellors. “We strongly urge Congress to follow this approach which helps medicine transition from volume-based to quality-based care without interfering in the doctor-patient relationship.”HIMSS14
The policy draft would require the Secretary of the Department of Health and Human Services to specify appropriateness criteria from among those developed/endorsed by national professional medical specialty societies. The secretary must also identify mechanisms, such as clinical decision support (CDS) tools, by which ordering professionals could consult these appropriate use criteria (AUC) CDS systems in Minnesota and at Massachusetts General Hospital have been shown to cut down on duplicate and/or unnecessary scanning and their associated costs.
Studies show that imaging exams reduce unnecessary hospital admissions, shorten length of stay and are directly linked to greater life expectancy. ACR said Medicare imaging use and imaging costs are down significantly, the same levels as it was in 2003, and that imaging is the slowest growing of all physician services among the privately insured. ACR contends the use of appropriateness criteria can help streamline the ordering of these services.
If this policy is enacted, and it appears to be that it would be a no-brainer decision to help cut the staggering costs of Medicare, I predict it will result in a rapid explosion in and adoption of new CDS systems.
This software is not yet widely offered by PACS, CVIS or EMR vendors because it is difficult to keep up-to-date with the latest data from multiple societies, clinical trials and studies regarding all specialties. To stay current, vendors will have to issue a large number of updates each year, including rapid software revisions each time societies update their AUC. For this reason, AUC/CDS software might be best managed as a Web/cloud-based application, which makes regular software updates much easier.
It will be interesting to see what CDS solutions vendors introduce at HIMSS and other conferences throughout 2014.
Dave Fornell is an editor for Imaging Technology News (ITN) and Diagnostic and Interventional Cardiology (DAIC).