COMPUTED RADIOGRAPHY

Dawn Guzman Charman, M.Ed., R.T. RAD TECH A

filmless radiology departments

Diagnostic radiographers

have traded their film and chemistry for a computer mouse and monitor
advance for Rad c! Prof, "#$#$$

%ha& I' D!(!&a) Ima(!n(*

Digital imaging is the acquisition of images to a computer rather than directly to film.

+ew Techno)o(,
Ha' !m-ac&ed -rac&!c!n( rad!o)o(!c &echno)o(!'& educa&or' Adm!n!'&ra&or' '&uden&' !n &he rad!o)o(!c 'c!ence'.

Man, )oca) area ho'-!&a)' and med!ca) cen&er'

have &h!' e.u!-men& +O% CR Y TEM COMPO+E+T CASSETTES (phosphor plates) ID STATION IMAGE PREVIEW (QC) STATION DIGITIZER VIEWING STATION

H!'&or, of CR
I+DU TRY Theor, of /f!)m)e'' rad!o(ra-h,0 f!r'& !n&roduced !n 1$23 1$"1 4u(! !n&roduced '-ec!a) ca''e&&e' w!&h P P -)a&e' 5re-)ace' f!)m6 Techno)o(, cou)d no& 'u--or& ','&em 4!r'& c)!n!ca) u'e !n 7a-an 8 1$"9

Pred!c&!on' 1$"3 : ;e)) <a=' =e)!eved &ha& Un!> wou)d =e &he wor)d'

dom!nan& o-era&!n( ','&em 1$"? : ;!)) Ga&e' &hou(h& @A3B of ma!n memor, wou)d 'uff!ce for worC-)ace o-era&!n( ','&em'
5 Th!' -re'en&a&!on !' "3,333 C=6

1$"A : I;M -red!c&ed &ha& -er'ona) com-u&er' wou)d no& amoun& &o an,&h!n(

H!'&or, of CR ;, 1$$" : over D333 CR ','&em' !n u'e na&!onw!de 1$$" : <oca) area ho'-!&a)' =e(!n &o !ncor-ora&e CR ','&em' !n &he!r de-ar&men&' 5R!ver'!de Co. Ho'=u!)d' new ho'-!&a) !n Moreno Ea))e,6 :

com-)e&e), CR ','&em '& : 1 (enera&!on e.u!-men& TERMI+O<OGY F/S 4!)m# creen 5curren&), u'ed me&hod6 CR Com-u&ed Rad!o(ra-h,

DR D!(!&a) Rad!o(ra-h, DDR D!rec& &o D!(!&a) Rad!o(ra-h,

IMAGE CREATIO+

AME RADIOGRAPHY EFUIPME+T U ED THE DI44ERE+CE I HO% IT I CAPTURED STORED !E"ED And POST #PROCESSED CO+EE+TIA< v' DIGITA< IMAGI+G
Curren&),, mo'& >8ra, !ma(!n( ','&em' -roduce

an ana)o( !ma(e 5rad!o(ra-h', G f)uoro'co-,6. U'!n( >8ra, &u=e : f!)m' !n ca''e&&e'

CO+EE+TIA< v' DIGITA< IMAGI+G

D!(!&a) rad!o(ra-h, ','&em' re.u!re &ha& &he e)ec&ron!c '!(na) =e conver&ed &o a d!(!&a) '!(na) : U'!n( >8ra, &u=e : ca''e&&e' w!&h -ho'-hor -)a&e OR DR ','&em' 8 &ran'!'&or'

COMPUTED RADIOGRAPHY G DIRECT RADIOGRAPHY G 4I<M CREE+ IMAGE CAPTURE 4 8 4!)m !n'!de of ca''e&&e CR 8 PHOTO TIMU<A;<E
PHO PHOR P<ATE

DR5DDR6 8 T4T 5THI+ 4I<M

TRA+ I TOR6

Ca''e&&e w# f!)m CR w -'- -)a&e

D!rec&ed D!(!&a) Rad!o(ra-h, 5DDR6

D!rec&ed d!(!&a) rad!o(ra-h,, a &erm u'ed &o de'cr!=e &o&a) e)ec&ron!c !ma(!n( ca-&ur!n(.

E)!m!na&e' &he need for an !ma(e -)a&e a)&o(e&her.

IMAGE CAPTURE CR P P: -ho&o'&!mu)a=)e -ho'-hor -)a&e REP<ACE 4I<M I+ THE CA ETTE DR : +O CA ETTE : PHOTO+

CAPTURED DIRECT<Y O+TO A TRA+ I TOR E+T DIRECT<Y TO A MO+ITOR CR v' 4

CR PSP !" #assette D!$!tal !%a$e S#a""e& ' rea& CR rea&er COMP(TER I%a$e store& o" #o%p)ter V!e*e& o" a Mo"!tor +ar& #op, (-!l%) #a" .e %a&e *!th laser pr!"ter FI/M

F!l% !" #assette loa&e& !" a &ar0roo% Pro#esse& !" a pro#essor FI/M +ar& #op, !%a$e 1 stores the !%a$e V!e*.o2es 1 3!e* the !%a$es

CASSETTES *!th I"te"s!-,!"$ S#ree"s

The CA ETTE ho)d' &he f!)m !n a )!(h& &!(h& con&a!ner I& con'!'& of fron& and =acC !n&en'!f,!n( 'creen'

CR ;A IC E)!m!na&e' &he need for f!)m a' a record!n(,

'&ora(e G v!ew!n( med!um. P P P)a&e : rece!ver Arch!ve Mana(er : '&ora(e Mon!&or 8 E!ew!n(
Genera) Overv!ew CR

P P ca''e&&e e>-o'ed =, conven&!ona) H8ra, e.u!-men&.

<a&en& !ma(e (enera&ed a' a ma&r!> of &ra--ed e)ec&ron' !n &he -)a&e. CR : P P -)a&e -ho&o'&!mu)a=)e -ho'-hor 5P P6 -)a&e Ca-&ure' -ho&on' &ored !n &ra-' on -)a&e 5)a&en& !ma(e6

P<ATE 'canned !n CR READER CR : P P -)a&e &!mu)a&ed =, a RED <IGHT Ener(, !' RE<EA ED !n a form of ;<UE )!(h& <IGHT ca-&ured =, PMT : chan(ed &o a d!(!!a) '!(na)

How CR worC' Re)ea'ed )!(h& !' ca-&ured =, a PMT 5-ho&o mu)&!-)!er &u=e6 Th!' )!(h& !' 'en& a' a d!(!&a) '!(na) &o &he com-u&er The !n&en'!&, 5=r!(h&ne''6 of &he )!(h& : corre)a&e' &o &he den'!&, on &he !ma(e Den'!&!e' of &he IMAGE

The )!(h& !' -ro-or&!ona) &o amoun& of )!(h& rece!ved d!(!&a) va)ue' are &hen e.u!va)en& 5no& e>ac&), &he 'ame6 &o a va)ue of o-&!ca) den'!&, 5OD6 from a f!)m, a& &ha& )oca&!on of &he !ma(e

ERA I+G P<ATE Af&er !ma(e !' recorded P)a&e !' era'ed w!&h h!(h !n&en'!&, wh!&e )!(h&

and re8u'ed CR E DR
CR -!ndirect capture where &he !ma(e !' f!r'& ca-&ured on -)a&e and '&ored I &hen conver&ed &o d!(!&a) '!(na) DDR #Direct capture where &he !ma(e !' ac.u!red !mmed!a&e), a' a ma&r!> of -!>e)' : 'en& &o a mon!&or

DIRECT RADIOGRAPHY u'e' a &ran'!'&or rece!ver 5)!Ce =ucC,6 &ha& ca-&ure' and conver&' >8ra, ener(, d!rec&), !n&o d!(!&a) '!(na) 'een !mmed!a&e), on mon!&or &hen 'en& &o PAC # -r!n&er# o&her

worC'&a&!on' 4OR EIE%I+G CR v' DR

CR !%a$!"$ plate pro#esse& !" a D!$!tal Rea&er S!$"al se"t to #o%p)ter V!e*e& o" a %o"!tor DR tra"s!stor re#e!3er (l!0e .)#0,) &!re#tl, !"to &!$!tal s!$"al

see" !%%e&!atel, o" %o"!tor 1

Ima(e Re'o)u&!on :
5how 'har-), !' &he !ma(e 'een6
CR A333 > A333 !ma(e on), a' (ood a mon!&orJ D?D v' 1333 )!ne more -!>e)' I more memor, needed &o '&ore CR ? 8D )-#mm RAD 98@ )-#mm DR * IMAGE APPEAR HARPER ;ECAU E CO+TRA T CA+ ;E AD7U TED ;Y THE COMPUTER : 5DI44ERE+CE I+ DE+ ITY6

ADEA+TAGE O4 CR#DR
Can o-&!m!ze !ma(e .ua)!&, =, man!-u)a&!n( d!(!&a) da&a &o !m-rove v!'ua)!za&!on of ana&om, and -a&ho)o(, A4TER EHPO URE TO PATIE+T

ADEA+TAGE O4 CR#DR

CHA+GE MADE TO IMAGE

A4TER THE EHPO URE CA+ E<IMI+ATE THE +EED TO REPEAT THE EHPO URE

ADEA+TAGE O4 CR#DR v' 4 Ra-!d '&ora(e re&r!eva) of !ma(e' +O <O T 4I<M K

PAC 5'&ora(e mana(emen&6 Te)erad!o)o(, 8 )on( d!'&ance &ran'm!''!on of !ma(e !nforma&!on Econom!c advan&a(e 8 a& )ea'& !n &he )on( run* CR#DR E 4I<M# CREE+ FILM these can not be modified once processed

If copied lose quality DR/CR print from file no loss of quality

/no fau)&0 TECH+IFUE
F/S4 RT %)st #hoose te#h"!#al -a#tors (%As ' 03p) to opt!%all, 3!s)al!5e a"ato%!# &eta!l CR4 the sele#t!o" o- pro#ess!"$ al$or!th%s a"& a"ato%!#al re$!o"s #o"trols ho* the a#6)!re& late"t !%a$e !s prese"te& -or &!spla, +OW T+E IMAGE /OO7S CAN 8E A/TERED 89 T+E COMP(TER 1 EVEN W+EN :8AD; TEC+NIQ(ES ARE SET

DR In!&!a) e>-en'e h!(h

ver, )ow do'e &o -& : !ma(e .ua)!&, of 133' u'!n( a A33' &echn!.ue Therfore L &he do'e needed &o maCe &he !ma(e &ora(e #Arch!v!n( 4I<M# CREE+ f!)m'M =u)C, de&er!ora&e' over &!me

re.u!re' )ar(e '&ora(e G e>-en'e env!ronmen&a) concern' CR G DR "333 !ma(e' '&ored on CD8R 7uCe=o> CD '&ora(e no de&er!ora&!on of !ma(e' ea', acce'' Tran'm!''!on of Ima(e'

PACS 8 P!c&ure Arch!v!n( G Commun!ca&!on' ,'&em DICOM 8 D!(!&a) Ima(e' G Commun!ca&!on !n Med!c!ne TE/ERADIOGRAP+9 8Remo&e Tran'm!''!on of Ima(e'
;enef!&' of Com-u&er 5we=68 =a'ed E!ew!n( ,'&em'

Hardco-, '&ud!e' are no )on(er m!'-)aced or )o'&8 e)!m!na&e' f!)m' Mu)&!-)e -h,'!c!an' ma, acce'' 'ame -a&!en& f!)m' Pa&!en&' do no& have &o wa!& !n Rad!o)o(, for f!)m' once '&ud, !' com-)e&ed

/4!)m8)e''0 com-onen&' CR or DR CD ROM or s!%!lar o)tp)t E%a!l #apa.!l!t, D!$!t!5!"$ #apa.!l!t, or ser3!#e H!'&o(ram Ana),'!' A h!'&o(ram !' a -)o& of (ra, 'ca)e va)ue

v'. &he fre.uenc, of occurrence 5N -!>e)'6 of &he (ra, va)ue !n &he !ma(e +ISTOGRAM : a =ar (ra-h de-!c&!n( &he den'!&, d!'&r!=u&!on 5!n numer!ca) va)ue'6 of &he !ma(!n( -)a&e

A/GORIT+M : a 'e& of ma&hema&!ca) va)ue' u'ed &o 'o)ve a -ro=)em or f!nd an avera(e ;a'!c' of D!(!&a) Ima(e' d!(!&a) !ma(e' are a 5ma&r!>6 of -!>e) 5-!c&ure e)emen&6 va)ue'

The a)(or!&hm a&&em-&' &o d!'&!n(u!'h amon( &he -ar&' of &he h!'&o(ram wh!ch re-re'en& &he ran(e of den'!&!e' from =one &o 'of& &!''ue

H!'&o(ram' 'e& for '-ec!f!c e>am' 5=od, -ar&'6 'hou)d -roduce d!(!&a) !ma(e' &ha& are

con'!'&an& 5re(ard)e'' of CE- or mA' u'ed Correc& A)(or!&hm 5=od, -ar&6 mu'& =e 'e)ec&ed -r!or &o -roce''!n( !ma(!n( -)a&e Me&hod' &o D!(!&!ze an Ima(e 1. 4!)m D!(!&!zer 8 Te)erad!o(ra-h,

','&em 5PAC , DICOM6 ?. E!deo Camera 5v!d!con or -)um=!con6 9. Com-u&ed Rad!o(ra-h, A. D!rec& Rad!o(ra-h, 4I<M DIGITIOER Ana)o( v' D!(!&a)
Ana)o( 8 one va)ue =)end' !n&o ano&her 5)!Ce a &hermome&er6 D!(!&a) 8 d!'&!nc& 'e-ara&!on

$".@ e>ac&

A+A<OG TO DIGITA< IMAGE

Conver'!on of conven&!ona) ana)o( f!)m' &o d!(!&a) forma& for PAC' and &e)erad!o)o(, a--)!ca&!on' w!&h s#a""!"$ laser &!$!t!5ers

CO+TRA T G DE+ ITY

Mo'& d!(!&a) ','&em' are ca-a=)e of 13?A 'hade' of (ra, 8 =u& &he human e,e can 'ee on), a=ou& 93 'hade' of (ra, The O-&!ca) Den'!&, and Con&ra'& can =e adPu'&ed af&er &he e>-o'ure =, &he Rad!o(ra-her.

Th!' !' PO T 8 PROCE I+G ;a'!c' of D!(!&a) Ima(e' P!>e) va)ue' can =e an, =!& de-&h 5va)ue' from 3 &o 13?96 Ima(e con&ra'& can =e man!-u)a&ed &o '&re&ched or con&rac&ed &o a)&er &he d!'-)a,ed con&ra'&.

T,-!ca)), u'e /w!ndow w!d&h0 and /w!ndow )eve)0 &o a)&er d!'-)a,ed con&ra'& Then &he COMPUTER correc&' an, e>-o'ure error' Therefore a)mo'& A+Y &echn!.ue can =e u'ed on &he -a&!en& :

The com-u&er w!)) f!> !& DO E IMP<ICATIO+ MORE EHP OURE TO PATIE+T TECH+IFUE E TA;<I HED HIGHER BEP I <E MA <E PATIE+T DO E Do'e Im-)!ca&!on'
Ima(e' near), a)wa,' )ooC =e&&er a& h!(her e>-o'ure'.

Hu(e d,nam!c ran(e mean' near), !m-o''!=)e &o overe>-o'e.

PO T PROCE

I+G

TECH+IFUE CO+I DERATIO+

BEP De-endan&
+ow COMPUTER con&ro)' CO+TRA T H!(her CE- &o '&!mu)a&e e)ec&ron &ra-' DEEE<OPER

4IHER %A H DRY %ATER 8 O<EE+T 'cra&ch Cr!m-!n( #cre'en& marC EMERGI+G PRO;<EM
/;ETTER0 :+OT +ECE ARI<Y 4A TER

/<EAR+I+G CUREE0 4OR TECH+O<OGI T G PHY ICIA+ TUDE+T APP<ICATIO+ G /I UE 0 /PIT4A<< O4 CR0

PO ITIO+I+G G PROPER CO<<IMATIO+ ARE CRITICA< TO GOOD IMAGI+G OUTCOME

7u'& )!Ce Pho&o&!m!n(, !& can ma(n!f, ,our m!'&aCe'

CO<<IMATIO+ CRITICA< A THE COMPUTER READ THE DE+ ITY EA<UE O4 EACH PIHE< : IT I AEERAGED I+TO THE TOTA<

C<O E CO<<IMATIO+ I ;ETTER CO+TRA T ;AD CO<<IMATIO+ I MORE GRAY A+D <E DETAI< D!(!&a) !ma(!n( !' no& &he end a)), cure a)) for !ma(!n( -ro=)em'. I& !' '&!)) &echno)o(!'& de-enden&.

To Produce Fua)!&, Ima(e' 4or Conven&!ona) ProPec&!on or CR Rad!o(ra-h,M

The 'ame ru)e', &heor!e', and )aw' '&!)) a--), and can no& =e over)ooCed 44D#O4D
5 ID# OD6 Inver'e .uare <aw ;eam A)!(nmen& Tu=e8Par&84!)m A)!(nmen& Co))!ma&!on Gr!d' E>-o'ure 4ac&or'M BEP, Ma

Pa&!en& Po'!&!on!n(

+E% IMAGE &owe) &ha& wa' u'ed &o he)- !n -o'!&!on!n( a ch!)d CR !' MORE 'en'!&!ve &o ARTI4ACT

CR !ma(e : +E% IMAGE

<!ne cau'ed from d!r& co))ec&ed !n a CR Reader
Dou=)e e>-o'ure Ch!)d

* H!(h re'o)u&!on w!&h d!(!&a) !ma(!n(