Chapter 8 digital imaging

Chapter 8: Digital Imaging

Learning Objectives

  • Key Terms in Digital Imaging: Define the essential terminology related to digital imaging technologies and processes.

  • Equipment for Digital Imaging: List all necessary equipment required for executing digital imaging procedures effectively.

  • Computed Radiography (CR) System: Explain the workings and components of the CR digital imaging system.

  • Digital Radiography (DR) System: Explain the practical operation and features of the DR digital imaging system.

  • Comparison of CR and DR: Compare and contrast the CR and DR systems, highlighting their differences and similarities.

  • Exposure Technique Charts: Recognize the significance of utilizing exposure technique charts in digital imaging to ensure safe and accurate imaging.

  • Image Processing: Describe the processes involved in the processing and postprocessing stages of a digital image.

  • Picture Archival and Communication System (PACS): Explain the function of PACS in image storage and management.

  • DICOM and DICOM Grayscale: Define DICOM and the associated grayscale standard utilized in medical imaging contexts.

Digital Imaging Overview

  • Image Generation:

    • Images are produced, processed, viewed, and stored using computer technology.

    • Computer networks facilitate remote image viewing outside medical facilities.

  • Types of Digital Imaging:

    • Computed Radiography (CR)

    • Digital Radiography (DR)

Computed Radiography (CR)

  • Image Acquisition: Images are obtained using CR cassettes that contain photostimulable phosphor plates.

  • CR Systems: Include a dedicated CR reader essential for processing the images.

Digital Radiography (DR)

  • Cassette-less System:

    • DR is termed as “cassette-less” because it incorporates a flat-panel detector integrated within the x-ray table or an upright wall unit.

    • Images are ready for immediate viewing, typically within seconds.

  • Flat-panel Detectors:

    • Indirect Conversion: X-rays are converted to light before being transformed into an electric signal.

    • Direct Conversion: X-rays are transformed directly into an electric charge without the intermediate light step.

Indirect Conversion Detectors
  • Scintillator (Cesium Iodide): Converts X-rays into visible light.

  • Thin Flat Panel Technology: Includes photodiodes (e.g., amorphous silicon) that convert light into an electrical signal.

  • Thin Film Transistor (TFT): Acts like a switch to relay electrical signals from the detector to the image processor using an analog-to-digital converter.

  • Charged Coupled Device (CCD): Converts light photons into an electrical signal based on the photoelectric effect.

  • Complementary Metal Oxide Semiconductor (CMOS): Converts light into a digital signal using photosensitive pixels integrated with on-chip circuitry.

Direct Conversion Detectors
  • Non-scintillation Technology: Employs semiconductors (e.g., amorphous selenium) to convert X-ray photons directly into electric charges with the aid of TFT.

Matrix and Pixel

  • Pixel (Picture Element): The smallest unit in a digital image that forms the foundation of digital imaging.

  • Matrix: A configuration of pixels that collectively forms an image.

  • Matrix Size: Refers to the total count of pixels in a defined matrix, influencing overall image resolution.

Spatial Resolution

  • Definition: The capability of an imaging system to differentiate between closely located objects within an image.

  • Pixel Characteristics:

    • Pixel Size: Impacts image resolution directly.

    • Pixel Pitch: The distance between adjacent pixels; smaller distances yield better resolution.

  • Detector Elements (DEL): A matrix of pixels in the detector that collect electrical charges.

    • DEL Size: Influences the spatial resolution of the image.

    • Fill Factor: Percentage of a pixel area that is responsive to the image signal (whether light photons or electric charge).

    • Matrix Size and Sampling Frequency are additional factors affecting resolution.

Image Signal (Exposure-related)

  • Distinction Capability: The ability of the digital system to recognize different intensity levels within an image.

  • Dynamic Range: Reflects the detector’s capability to respond sensitively to various radiation levels.

  • Signal-to-Noise Ratio (SNR):

    • Measures the system's efficiency in translating X-ray input into a quality radiographic image.

    • Signal: Useful information.

    • Noise: Non-useful information amidst the signal.

  • Quantum Noise (Quantum Mottle): Occurs when there are insufficient photons reaching the detectors to produce a high-quality image.

  • Contrast-to-Noise Ratio (CNR): Assesses image quality based on contrast rather than raw signal data.

Contrast Resolution (Equipment Related)

  • Definition: The capacity to identify variations in intensity in an image.

  • Bit Depth: The number of bits assigned per pixel, determining the range of grayscale representation.

  • Modulation Transfer Function (MTF): Measures the contrast at a particular spatial frequency in an image.

  • Detective Quantum Efficiency (DQE): Quantifies the overall signal and noise performance of an imaging system.

Digital Processor Functions

  • Window Level: Controls the overall image density, affecting the lightness or darkness of an image.

  • Window Width: Manipulates the contrast displayed in the image.

  • Brightness: Overall luminescence levels in an image are adjusted during processing.

  • Shuttering: Techniques used to blacken non-image areas (like collimation borders) in an image.

  • Image Stitching: Combining multiple images to create a single cohesive image.

  • Image Annotation: Enables text to be added directly onto an image for clarity and documentation.

  • Edge Enhancement: A processing method to sharpen image edges, resulting in increased contrast.

Image Processing and Display

  • Raw Data Processing:

    • Analog-to-Digital Converter (ADC): Converts analog information into digital values for processing.

    • Quantization: The process of deriving a pixelated digital image by sampling a continuous tone image resulting in a matrix filled with grayscale values.

  • Corrections Applied:

    • Rescaling: Applied when the X-ray exposure is inadequate or excessive to produce a quality image.

    • Flat Fielding: A technique to correct uniformity issues in shading across images.

    • Dead Pixel Correction: Software methods to fill in missing data using surrounding pixel information.

    • Smoothing: Averaging the frequency of each pixel with adjacent pixels to reduce noise.

Data for Display
  • Look-Up Table (LUT): Utilized to apply desired contrast to displayed images.

  • Values of Interest (VOI): Establishes the range of histogram data that should be shown in the final image display.

Exposure Technique Charts

  • The introduction of digital imaging allows manipulation of image contrast and density, but it does not replace the necessity for traditional technique charts.

  • Technique Chart Utilization:

    • To choose the correct mA, kVp, and exposure time to minimize patient exposure.

    • Practice ALARA (As Low As Reasonably Achievable) principles.

    • Ethical consideration: It is unacceptable to set exposure levels high intentionally to avoid image repeats.

Exposure Indicators

  • Denote the quantity of exposure absorbed by the phosphors utilized in particular digital imaging systems.

  • Histogram: A graphical representation that maintains a record of exposure values captured by the imaging receptor.

Postprocessing

  • Health Level-7: Represents a communication standard for all medical information systems utilized within a hospital or clinic setup.

  • DICOM: The standard that ensures all medical imaging devices speak a common language.

    • DICOM Grayscale: Defines the response of a display system in such a way that the observer's perception of image contrast remains consistent across different pixel values throughout the image.

  • EMR (Electronic Medical Records): Represents the digital record of medical and clinical data within individual doctor offices.

  • EHR (Electronic Health Records): A system that aggregates data across multiple providers.

  • RIS (Radiology Information System): Manages radiological data.

  • HIS (Hospital Information System): Manages broader hospital data.

Picture Archival and Communication System (PACS)

  • PACS Role: Utilized for managing and storing images effectively.

  • PACS Network Components: