CRDR MIDTERMS

direct radiography and quality assurance

digital radiography

An advanced method of capturing and storing radiographic images using digital technology, replacing traditional film-based imaging systems.

digital radiography

It provides numerous benefits including faster image acquisition, improved image quality, and easier storage and retrieval of images.

radiography

The process of creating images of the inside of an object or body using radiation

digital imaging

Uses digital sensors and computers to capture, process, and display images.

CR

Uses a phosphor plate to capture the image, which is then read by a scanner and converted to digital format

DR

Uses solid-state detectors (such as flat-panel detectors) to capture the image directly, allowing for real-time image processing.

Early 1970s

The introduction of digital detectors and computer systems for medical imaging.

1980s

Computed Radiography (CR) became popular, which was an intermediate step before fully digital systems.

1990s-2000s

The rise of Digital Radiography (DR) with the advent of flat-panel detectors

direct radiography

Immediate image acquisition; Digital signal is directly converted into an image without the need for an intermediate process.

flat-panel detectors

Direct radiography uses _____________

indirect radiography

Uses a two-step process

phosphor plate or scintillator

In indirect radiography, _____________ is used to convert x-rays to light.

charge-coupled device (CCD) or complementary metal-oxide semiconductor (CMOS)

In indirect radiography, _____________ is used to convert light into digital signals

x-ray source

Similar to conventional radiography, it generates X-rays which pass through the object or body being imaged.

digital detector

Flat-panel detectors or CCD and CMOS detectors are used to capture X-rays and convert them into a digital image.

Amorphous selenium (a-Se)

Commonly used in direct DR systems.

Amorphous silicon (a-Si)

Commonly used in indirect DR systems.

image processing software

After the image is captured, it is processed by specialized software for enhancement, manipulation, and storage.

image processing software

Processing includes features like contrast adjustment, noise reduction, and edge enhancement

display monitor

Digital images are displayed on high-resolution monitors, allowing radiologists to analyze the images; calibrated to ensure accurate image display.

storage system

Images are stored digitally in Picture Archiving and Communication Systems (PACS) or other digital storage solutions.

faster results

No need for film development; images are available within seconds to minutes. (advantage of DR)

improved image quality

Digital images can be enhanced for better clarity and contrast (advantage of DR)

reduced radiation dose

DR systems typically require less radiation to produce a high-quality image, reducing patient exposure. (advantage of DR)

enhanced image manipulation

Images can be adjusted for contrast, brightness, and sharpness after they are taken. (advantage of DR)

easier storage and sharing

Digital images can be stored electronically and easily shared via networks such as PACS. (advantage of DR)

cost-effective

Elimination of film, chemicals, and physical storage needs reduces overall costs. (advantage of DR)

initial cost

High initial setup cost for digital detectors and associated infrastructure. (disadvantage of DR)

technological dependence

Requires ongoing maintenance and technical support for hardware and software. (disadvantage of DR)

resolution

Some digital systems may have lower resolution compared to traditional film, although this is improving. (disadvantage of DR)

potential for over-reliance

Technologists may become too reliant on post-processing, neglecting the importance of proper positioning and technique.

detector type

The choice of detector affects resolution and sensitivity. (key factors affecting dr image quality)

exposure parameters

Proper X-ray exposure is crucial to avoid underexposure, resulting in noise, or overexposure, resulting in loss of detail. (key factors affecting dr image quality)

processing algorithms

The software used to process the image can significantly affect its final quality. (key factors affecting dr image quality)

noise and artifacts

Digital images can be affected by noise (random variation) or artifacts caused by equipment or improper handling. (key factors affecting dr image quality)

medical imaging

Commonly used in areas like orthopedics, dentistry, mammography, and chest radiology. Used for diagnosing bone fractures, lung conditions, infections, and more. (applications of dr)

industrial applications

DR is used for non-destructive testing (NDT) to inspect materials and machinery for defects. (applications of dr)

veterinary medicine

DR is widely used for imaging animals for diagnosis.(applications of dr)

higher resolution detectors

Continued development of detectors with better resolution for more detailed images. (future trends in dr)

integration with AI

AI can be used to automatically detect anomalies, assist with diagnostics, and improve image processing. (future trends in dr)

portable systems

Advances in portable DR systems will enable point-of-care imaging, especially in emergency settings. (future trends in dr)

wireless technology

Wireless DR systems will improve convenience and flexibility, especially in settings like emergency departments and rural clinics. (future trends in dr)

quality assurance

Refers to the systematic processes implemented to ensure the consistent production of high-quality images for diagnostic purposes

quality assurance

Involves evaluating the performance of imaging equipment, maintaining proper exposure settings, and ensuring optimal image quality while minimizing radiation exposure to patients.

accurate diagnoses

Effective QA: High-quality images are essential for accurate diagnosis

patient safety

Effective QA: Proper radiation levels are maintained to reduce unnecessary exposure.

equipment longevity

Effective QA: Regular maintenance ensures that equipment performs optimally, reducing downtime and repair costs.

compliance

Effective QA: Ensures compliance with regulatory standards and protocols.

equipment calibration

Calibration ensures that radiographic equipment is performing according to manufacturer specifications.

consistent performance

Proper calibration is essential for maintaining image quality and ensuring _____________ of both CR and DR systems.

x-ray generator calibration

Ensures accurate exposure settings (mA, kVp, exposure time) to achieve optimal image quality.

image receptor calibration

Ensures that CR cassettes and DR detectors are reading images correctly and producing accurate data.

frequency of calibration

Daily, weekly, and quarterly calibrations depending on the equipment and clinical use.

common calibration issues

Inconsistent image brightness, Artifact formation, Reduced image resolution, & Failure to meet regulatory dose standards.

image quality assessment

Assessment of image quality is a crucial part of QA. In both CR and DR systems, various factors influence the final image, including detector performance, exposure parameters, and post-processing.

spatial resolution

Ability to distinguish small objects and fine details.

contrast resolution

Ability to differentiate between different tissue densities.

noise

Random variations in pixel values that can degrade image quality.

artifact presence

Artifacts such as geometric distortions, phantom images, or electrical interference.

phantom imaging

Use of test objects (phantoms) to simulate real-life imaging conditions and test the system's ability to produce accurate images. (qa procedures for image quality)

visual inspection

Inspecting images for artifacts, distortions, or uneven exposure. (qa procedures for image quality)

objective measurements

Using tools like the modulation transfer function (MTF) and signal-to-noise ratio (SNR) to quantify image quality. (qa procedures for image quality)

radiation dose monitoring

Radiation dose optimization is a critical component of QA in radiographic imaging. DR and CR technologies enable dose reduction by allowing better image quality with lower radiation exposure compared to traditional film radiography.

dose area product (dap)

Measures the total radiation dose delivered to the patient.

entrance skin dose (esd)

The dose delivered to the surface of the patient.

exposure settings

Ensuring proper mAs (milliampere-seconds) and kVp (kilovolt peak) settings to minimize unnecessary radiation exposure.

automatic exposure control (aec)

This system automatically adjusts exposure parameters based on the body part being imaged. (maintaining low dose)

optimal technique charts

Pre-established guidelines for optimal exposure settings based on the body part and patient size. (maintaining low dose)

monitoring radiation dose

Routine dose checks and documentation for each procedure to ensure radiation levels remain within safe limits. (maintaining low dose)

system performance testing

Routine testing of the radiographic system ensures that both CR and DR systems are functioning as expected. This involves both hardware and software evaluations to ensure consistent imaging quality.

detector sensitivity tests

Ensures the detectors in CR and DR systems are properly capturing X-ray data.

readout system testing

In CR, the phosphor plate must be read properly, and in DR, the conversion of X-ray photons into a digital signal must be checked.

post-processing software verification

Ensures that the image processing algorithms work correctly and that the software displays accurate images.

regular intervals

Frequency of testing: Routine tests should be performed at ________ (e.g., weekly or monthly) to assess system performance.

image distortion

due to misalignment or malfunctioning of detectors (common system performance issues)

software glitches or failures

may result in improper image processing (common system performance issues)

signal loss or poor image quality

due to aging components (common system performance issues)

maintenance and troubleshooting

Proper maintenance extends the lifespan of CR and DR equipment and ensures the consistent performance of radiographic systems.

preventive and corrective

Maintenance includes both ______________ actions

regular cleaning

Dust and debris can affect detector performance and image quality. Ensure regular cleaning of detectors, cassettes, and other equipment. (preventive maintenance)

detector testing

Periodic testing of detectors for uniformity, sensitivity, and overall performance. (preventive maintenance)

software updates

Ensuring that the software driving image processing and display is up to date. (preventive maintenance)

component replacement

Replacing damaged or malfunctioning parts (e.g., flat-panel detectors or phosphor plates) when performance degrades. (corrective maintenance)

calibration adjustments

Re-calibrating systems if the performance deviates from expected standards. (corrective maintenance)

system diagnosis

Using diagnostic tools to identify and fix system errors or malfunctions. (corrective maintenance)

degraded image quality

________due to aging detectors. (common maintenance issues)

detector failure

Dead pixels or lines in DR panels. (common maintenance issues)

image artifacts

Due to damaged CR cassettes or issues with the laser scanning process. (common maintenance issues)

documentation and reporting

Proper documentation ensures compliance with regulatory standards and provides a reference for tracking system performance and maintenance.

daily logs

Records of daily image quality checks, exposure settings, and any deviations from expected norms.

maintenance records

A log of all performed maintenance, including routine checks, component replacements, and corrective actions.

incident reports

Detailed reports of any malfunctions, errors, or system failures.

radiology managers or medical physicists

QA results must be regularly reviewed by designated personnel such as

regulatory compliance

Ensure adherence to local regulations (e.g., FDA, IEC, or national health authorities).

phosphor plate wear

CR cassettes can degrade with repeated use, affecting image quality. (key maintenance issues in cr)

image lag

Persistent imaging from previous scans can cause "ghosting" or overlapping images. (key maintenance issues in cr)

laser scanner malfunction

In CR systems, the laser used to scan the phosphor plate can deteriorate or malfunction, leading to poor image quality. (key maintenance issues in cr)

detector issues

DR systems rely on detectors like flat panels, which can develop dead pixels, lines, or reduced sensitivity over time. (key maintenance issues in dr)

software errors

Software that controls image processing or communication with the PACS system can malfunction. (key maintenance issues in dr)