IMAGE PROCESSING TECHNOLOGY II

COMPILED NOTES
TOPIC 1: DIGITAL IMAGE ACQUISITION AND DISPLAY
Define the following terms
Picture elements: These are the elements which make up the image i.e matrix and pixels.

The matrix: is a pattern of cells laid out in rows and columns that cover the entire area of the image.
A digital image matrix is made up of individual picture elements, each designated by its column and
row number. In this simplified representation of a digital image as it is stored in the computer, the
background density is assigned a numerical value of 0, the soft tissues of the thigh are given a value
of 11, and the bone of the femur a value of 555.

Voxels: This is image data acquired from three-dimensional volumes of tissue within the patient
(from “volume-elements”). In radiographic images each pixel in the image represents a voxel within
the patient. Each voxel from a CT scan is in the shape of a cube representing a small portion of the
three-dimensional “slice” that is being sampled.

Objectives
 Types of radiography
 Film screen radiography, digital radiography
 Computed and direct digital radiography
 Process of imaging in direct digital radiography
 Advantages of direct digital radiography
 Advancement in direct digital radiography
 Discuss spatial resolution, contrast resolution, and noise related to computed
radiography.
 Identify opportunities for patient radiation dose reduction with computed radiography.

Limitation of film screen radiography

1. No Manipulation – Cant be manipulated i.e. magnification, cropping, windowing, etc
are not possible
2. Storage – Image quality deteriorates over time
3. - Requires large space and more management for
4. storage
5. Transmission – loss of quality during transmission.
6. - Loss of quality during duplication

DIGITAL RADIOGRAPHY
 When digital detectors are used to capture information then its called digital
radiography
 Films and Screens are replaced by digital detectors.
 Image reception, display and storage are done separately.
Advantages of digital radiography
 Manipulation – can be magnified, compressed, cropped, contrast enhanced.
 Storage – stored in digital files requiring much less space
no reduction in quality on long time storage
 Duplicate –Can Be made into multiple copies without loss of quality
 Transfer-Can be easily send anywhere through PACS
 Acquiring images with CR or DR, involves using a detector that can respond in a
linear manner.
 The exposure latitude is very wide because a single detector can be sensitive to a
wide range of exposures
ADVANTAGES OF A GOOD DR SYSTEM
 Have a high detector quantum efficiency (DQE) detector with 2–3 or higher line
pair/mm spatial resolution and a higher signal-to-noise ratio
 Produce digital images of high quality
 Deliver a low dosage to patients
 Produce the digital image within seconds after X-ray exposure
 Comply with industrial standards
 Have an open architecture for connectivity
 Be easy to operate
 Be compact in size
 Offer competitive cost saving

TYPES OF DIGITAL RADIOGRAPHY

I. Direct digital radiography system
II. Computed radiography system
Computerized Radiography system

Terms used in CR
• IP = imaging plate
• PD = photodiode
• PMT = photomultiplier tube
• PSL = photostimulable luminescence
• PSP = photostimulable phosphor
• SP = storage phosphor
• SPS = storage phosphor screen

Receptor
 CR contains photo illuminable Phosphor plates acting as detecting and storage layer
in place of conventional films.
 Coating of europium activated barium fluorohalide is used in these phosphor plates.
  Photostimulable Luminescence: these are materials emit some light promptly in the
way that a scintillator does following x-ray exposure. However, they also emit light
some time later when exposed to a different light source this property is called
 photostimulable luminescence (PSL). These materails are such as barium fluorohalide
with europium (BaFBr:Eu or BaFI:Eu).
 It is an activator and is responsible for the storage property of the PSL
 The SPS appears white because the small PSP particles (3–10 µm) scatter light
excessively property called turbid.
 Imaging plate: Imaging Plate The PSP screen is housed in a rugged cassette that
appears similar to a screen-film cassette. In this form as an image receptor, the PSP
screen-film cassette is called an imaging plate (IP).
 Optically stimulated luminescence (OSL): they are used to detect and measure the
blue light emitted when metastable electrons to return to the ground state with the
emission of a shorter wavelength light in the blue region of the visible spectrum.
Through this process, the latent image is made visible.

A protective layer >very thin, tough, clear plastic that protects the phosphor layer
Phosphor layer: This is a layer of photostimulable phosphor that “traps” electrons during
exposure
A reflective layer. > sends light in a forward direction when released in the cassette reader.
Conductive layer>absorbs and reduces static electricity
A color layer. Newer plates, located between the active layer and the support, that absorbs
the stimulating light but reflects emitted light.
A support layer >This is a semi rigid material that gives the imaging sheet some strength.
A backing layer >This is a soft polymer that protects the back of the cassette
Process image formation
• Expose: The first of a sequence of events that results in an x-ray–induced image
forming signal.
• Stimulate: Stimulation of the latent image results from the interaction of an infrared
laser beam with the photostimulable phosphor (PSP).
• Read: The light signal emitted after stimulation is detected and measured.
• Erase: Before reuse, any residual metastable electrons are moved to the ground
state by an intense light.

 On exposure to X ray energy is absorbed and stored temporarily by crystals in the

plate
 Readout process – plate is scanned with high energy laser beam and energy stored in
crystals is set free in form of light photons.
 Light thus emitted is collected and converted into digital images.
 X-rays strike the photostimulable phosphor > light is given off + energy(electrons) >
conductive layer (phosphor center) > .
  Energy is deposited within the phosphor particles creates the latent image
 The phosphor plate is then fed through the CR reader
 Focused laser light > beam shaping optics > laser mirror > surface of the plate >
energize trapped electrons>emit visible blue light > PMT(amplifier) > electrical signal
> ADV > digital image

Erasing the image:

 Erased to prevent a buildup of background signal
 CR has erasure mode
 Automatically erase the plate by flooding it with light to remove any electrons still
trapped after the initial plate reading.
Mechanical features:
• CR cassette is inserted into the CR reader, the IP is removed and is fitted to a precision drive
mechanism.

• This drive mechanism moves the IP constantly yet slowly (“slow scan”) along the long
axis of the IP.
• While the IP is being transported in the slow scan direction, a deflection device such
as a rotating polygon (shown in Figure 15-13) or an oscillating mirror deflects the
laser beam back and forth across the IP. This is the fast scan mode.
Optical features: These are Components of the optical subsystem include the laser, beam-shaping
optics, light-collecting optics, optical filters, and a photodetector.

Role of CR computer
The computer of the CR reader is in control of the slow scan and the fast scan. This control
works off the computer clock in gigahertz (GHz).
Image buffer is usually a hard disc. This is the place where a completed image can be stored
temporarily until it is transferred to a workstation for interpretation or to an archival
computer.
Imaging characteristics of a CR:
• Image Receptor Response Function: this the response of the image receptor to the
exposure factors.
• Computed radiography imaging is characterized by extremely wide latitude.
• Four decades of radiation exposure results in 10,000 gray levels, each of which can
be evaluated visually by post processing.
Sources of noise in CR
Mechanical defects:
• Slow scan driver
• Fast scan driver
Optical defects
• Laser intensity control
• Scatter of stimulating beam
• Light quanta emitted by screen
• Light quanta collected.
Computed defects
• Electronic noise
• Inadequate sampling
• Inadequate quantization
Advantages of CR
 Imaging plate can be reused after exposure to white light
 It can be easily integrated into existing conventional
 Personnel and time saving
Disadvantages
 Imaging plates are expensive and can easily get damaged by manual handling.
Direct digital radiography
Objectives:
• Identify five digital radiographic modes in addition to computed radiography.
• Define the difference between direct digital radiography and indirect digital
radiography.
• Describe the capture, coupling, and collection stages of each type of digital
radiographic imaging system.

• Discuss the use of silicon, selenium, cesium iodide, and gadolinium oxysulfide in
digital radiography.

Advantages of DDR
I. No cassettes reading or film development required.
II. Signal from X ray receptor is directly send to computer for image reconstruction
III. Minimal work is required by technician
IV. The image acquisition device is either built into the table and/or wall stand or
enclosed in a portable device.
V. images recorded on an electronically readable device.
VI. Has flat panel detectors or charge couple devices which are connected to
computers with wires
VII. Image is available within seconds of image capture

Disadvantages of DDR
But needs new installation in X ray room
X-ray photons are absorbed by the coating material

and immediately converted into an electrical signal

DDR are in two types:

 Direct conversion type: Photoconductors like amorphous selenium directly convert X-

rays into electrical charges.

 Photoconductors used – amorphous selenium, lead iodide. most commonly selenium is

used

 Selenium drum or flat panel detector can be used

 Flat panel detector -Available in size 43 ×43 cm,41×41 cm and 43×35 cm

 Image can be generated within 10 seconds

 CCDs act as miniature cameras that convert light produced by x-ray interaction with
photostimulable phosphors into an electrical charge.

 Indirect conversion types: A scintillator converts x-rays into visible light.

 The light is then detected by an area-CCD or thin-film light is then converted into an
electric charge by photodetectors such as amorphous silicon photodiode arrays or
charge-coupled devices (CCDs)
 involves two steps.

-X ray to visible light by scintillator

- Visible light to charges by photo detectors similar to CR
DDR read out process
 Charges are generated by Direct and indirect conversion process
 Sensed by electric readout mechanism present in thin film transistor array
 Analog to digital conversion performed and images produced
Charge coupled device
• They are light sensing elements of digital imaging
• They posses the following advantages in imaging characteristics: sensitivity, dynamic
range, and size.
• The CCD is a silicon-based semiconductor.
• Sensitivity is the ability of the CCD to detect and respond to very low levels of visible
light.
• Dynamic range is the ability of the CCD to respond to a wide range of light intensity,
from very dim to very bright.
• The dynamic range relative to that of a 400- speed screen-film radiographic image
receptor
• A tiled charge-coupled device (CCD) designed for digital radiography (DR) imaging.
 • They are in several types: Cesium iodide/ charge-coupled device, cesium
iodide/amorphous silicon, amorphous selenium (Direct digital radiography).

Thin film transistors

 Used in both direct and indirect conversion
 Structure – Deposited in multiple layer on glass substrate. lowest layer has readout
electronics. Higher layer has charge collectors. X ray element and light sensitive

element are deposited on top layer. Encased in protective layer for insulation
connected to computers through wire for image reconstruction

Structure in thin film transistors

Direct converter
 Top
 X ray element
 Charge collector array
 Readout electronics

Indirect converter
 Top
 X ray element
 Light sensitive element
 Charge collector array
 Readout electronics
Types of scintillators
 Unstructured scintillator: visible light emitted can spread to adjacent structure

 Structured scintillator: Consists of caesium iodide crystals on detectors which are

parallel needles channel most signal directly to photo iodide layer.
Advantages of direct conversion method
 The advantage of the direct image capture method is that it eliminates the
intermediate step of light photon conversion.

Differences
 The indirect capture method uses either amorphous silicon phosphor or scintillator
panels while the direct capture method uses the amorphous selenium panel.

Image processing
 Raw data is processed by computers and converted into image
 Processing includes removing technical artefacts and optimising contrast.
 Removing unwanted signals called noise
 Windowing and reversing of contrast is done for better view
Advantages of DDR
 Quick image development, within 10 sec
 Very less work done by technician so less manpower is required
 Less radiation dose than film screen or conventional radiography.
Advances in DR system
 Wireless DR system – Data is transferred to computer without wire. Useful in
difficult regions like axilla and TM joint
 Mobile DR system- useful for bedridden patients.
  Automatic image stitching – image reconstruction after multiple sequential
exposure. Useful for imaging large anatomical regions like whole spine in a single
film.
 Computer aided diagnosis- suspicious looking areas are marked by computer for
review by radiologist.

Detective quantum efficiency (DQE)

Its how efficiently a system converts the x-ray input signal into a useful output image
DQE is a measurement of the percentage of x-rays that is absorbed when they hit the
detector. Both indirect and direct DR capture technology has increased DQE over CR.

Potential errors in cassetteles imaging

Electronic noise- Due to signal loss during conversion
LUT
Table that maps the image grayscale values into some visible output intensity on a monitor
or printed film. Its an image processing arogarithm in CR & DR

DR versus radiation dose

 Wide dynamic range of the digital detectors and the capabilities of post-processing
allow obtaining more information from the radiographic images and avoiding
retakes.
 With use of phosphor plates in the image formation process, it has been possible to
lower the dose to the patient.
 Substantially lower the radiation dose to the patient while maintaining or even
increasing the image quality.

Digital imaging exposure indicators

In digital radiography (DR), exposure indicators are parameters that provide feedback on the
radiation exposure received by the imaging detector (e.g., a digital X-ray sensor or flat-panel
detector). These indicators help ensure that the appropriate radiation dose was used for a
particular imaging study. Monitoring exposure indicators is critical for optimizing image
quality, minimizing patient radiation dose, and promoting safety in radiological imaging.
Here are the key exposure indicators in digital radiography.
1. Exposure Index (EI):
 The exposure index provides a numerical value that indicates the radiation
exposure received by the detector.
 EI helps radiologists and technologists assess whether the exposure is
appropriate for obtaining a diagnostic image.
 Different manufacturers may have their own specific algorithms to calculate
the exposure index.
2. Deviation Index (DI):
 The deviation index compares the actual exposure received by the detector to a
reference exposure.
 It helps evaluate the exposure deviation from the optimal level, aiding in dose
optimization and ensuring consistent image quality.
3. Signal-to-Noise Ratio (SNR):
 SNR is a measurement of the quality of the image, indicating the ratio of the
signal (useful image information) to the noise (unwanted variations) in the
image.
 A higher SNR indicates a clearer, higher quality image.
4. Contrast-to-Noise Ratio (CNR):
 CNR measures the contrast in the image relative to the noise present in the
image.
 A higher CNR indicates better contrast and image quality.
5. Detector Saturation Indicator:
 This indicator alerts the technologist when the detector has received a very
high radiation exposure, potentially leading to pixel saturation and loss of
image information.
 Avoiding saturation is crucial to maintain image quality and accurate
diagnosis.
6. Exposure Time (ms or seconds):
 The duration for which the X-ray beam is applied to the patient is an essential
exposure indicator.
 Exposure time affects the radiation dose and image quality; longer exposure
times may result in motion artifacts.
7. Air Kerma at the Detector:
  Air kerma (measured in milligray, mGy) represents the radiation energy
absorbed by the detector.
 It helps evaluate the radiation dose to the detector and its potential impact on
image quality.
8. Dose-Area Product (DAP):
 DAP represents the radiation dose delivered to the patient during the X-ray
procedure, considering both exposure intensity and the area exposed.
 It helps estimate the overall dose to the patient.

IMAGE ARCHIVAL AND SHARING

Image display
Digital imaging needs a machine for image acquisition, equipment for image processing, and devices
for image display and storage. Digital images can be displayed as soft copies in the form of electronic
images on display screens, while still offering the option of hard-copy printouts that can be viewed
on illuminators.

Computed radiography (CR) is an interesting example of how newly-developed image receptor

technology can be combined with conventional x-ray machines to create a new form of image
acquisition that is compatible with computer processing.

Direct-capture digital radiography (DR) requires total replacement of the image acquisition system.
For all digital systems, image processing is performed by computers.

Image storage and archiving

Images produced by all of the different modalities within a medical imaging department can be
stored on magnetic tapes and discs or on optical discs, enabling a system to be developed that can
retrieve them, display them for viewing on television-type monitors, transmit them to remote
locations and provide archival storage. Such a system is called a picture archiving and
communications system or PACS.

The images can be quickly accessed for printing or to be sent through a local area network (LAN) to
various workstations within the hospital, to doctors’ offices or to a radiologist’s home. the data is to
be transferred to remote locations, then a wide area network (WAN) may be used.

It is essential that the control computer interface with both the hospital information system (HIS)
and the radiology information system (RIS). For the HIS, the RIS, all of the image acquisition systems,
control computer, and workstations to successfully send image data and patient information to one
another, they must share a common high-level computer language. Further, it is essential that
different brands of computerized medical equipment be compatible so that images and data can be
sent between different hospitals and clinics.
DICOM (Digital Imaging and Communication in Medicine)

The DICOM standard does not specify the architecture or even the terminology used between
different types of imaging equipment, but it does standardize the transmission behaviour of all the
devices within a PAC system.

PAC systems distribute copies of the same data files across several computers hard drives which are
independent of each other so this cannot happen. This distribution is referred to as a Redundant
Array of Independent Disks or a RAID system.

RAID systems protect archives of medical images from accidental loss.

Workstations and Display Stations

A workstation: is defined as a fully-equipped computer terminal that cannot only access images, but
can be used to manipulate image quality and permanently save changes made to the image in the
PAC system. Patient information attached to each image can also be added or deleted. The control
console of a CT or MRI machine can be classified as a workstation.

A display station: is defined as a computer terminal that is limited to the display of stored images—
there is no ability to permanently manipulate or change the image, nor generally to print out hard
copies.

DIGITAL IMAGE PROCESSING

Objectives
• Distinguish between spatial resolution and contrast resolution.
• Identify the use and units of spatial frequency.
• Interpret a modulation transfer function curve.
• Discuss how postprocessing allows the visualization of a wide dynamic range.
• Describe the features of a contrast-detail curve.
• Discuss the characteristics of digital imaging that should result in lower patient
radiation doses.

Pre processing:
• Preprocessing: is the computerized operations which must be executed on “raw”
digital images to prepare them for display.
• All corrections that are made to the “raw” digital image data due to physical flaws in
image acquisition that are inherent to the x-ray beam, the elements and circuitry of the
particular image receptor system, or the physical elements and circuitry of the
processor.
• Preprocessing may also be termed acquisition processing.

1. Uniformity:
 These flaws are found not only in the electronics and optics of the receptor system
and processor, but also in the x-ray beam itself.
• In direct-capture DR systems, the detector elements constituting individual pixels can
suffer from various electronic faults which are not found in the reading process for
CR plates.
• These flaws introduce noise into the image or cause a loss of pixels. Additional
software is configured to compensate for these electronic problems.
• Image analysis includes partitioned pattern recognition or segmentation, exposure
field recognition, construction of the initial histogram, and histogram analysis. Each
of these steps must be correctly executed for the following procedures to result in a
proper image.
 By correct exposure field recognition, the proper type of look-up table (LUT) must be
matched with the correctly-interpreted histogram for images that contain background
densities, or a prosthesis or a large bolus of barium that might be confused with
collimated areas.
2. Anode heal effect: It results in less x-ray intensity reaching the anode-end of the
image receptor plate than the cathode end of the plate. “Flat-panel” detectors used in
DR are particularly sensitive to the heel effect, none uniformity of the field of
radiation may combine with none uniformities in the receptor system to cause
significant degradation of the “raw” digital image.

3. Electronic response and gain offsets: Active matrix array in a DR system consists of
hundreds of individual detector elements, and due to unavoidable variations in their
manufacture, some are bound to have slightly less or slightly greater response to the
x-rays or light striking them. In a thin-film transistor (TFT), variable sensitivity of
charge conversion can occur from electric charge becoming trapped within the
semiconductor.

4. Normalization is the initial round of gradation processing designed to give the “raw”
digital image brightness and contrast levels typical of a conventional radiograph.
Within the computer memory, look-up tables have been developed with gradient
curve parameters (GT, GS, GA and GC) customized to each type of anatomy. When
these tables are applied, the position and shape of the acquired image histogram are
aligned with those of a reference histogram to output an “ideal” image.
5. During normalization, equalization or dynamic range compression is used to darken
portions of the image which would usually be too light and to lighten areas that would
normally be too dark. A particular advantage over conventional radiographs is that
this allows soft tissues to be well-demonstrated while maintaining proper density for
bone detail.
 6. Spatial resolution: Spatial resolution (resolution in space) is the ability of an imaging
system to resolve and render on the image a small high-contrast object.
The black on light tan is high contrast. If the dots were shades of gray, they would not
exhibit high contrast but rather low contrast.
Spatial frequency: A line pair is a black line on a light background. One-line pair
consists of the line and an interspace of the same width as the line. Six line-pair
patterns, each line and each interspace representing the size of the dots.
Spatial frequency relates the number of line pairs in a given length, expressed as
centimeters or millimeters. The unit of spatial frequency as used in medical imaging
describes line pair per millimeter (lp/mm). A line pair is a black line on a light
background. One line pair consists of the line and an interspace of the same width as
the line.
7. Modulation Transfer Function (MTF): is the description of the ability of an imaging
system to render objects of different sizes onto an image.
8. Objects with high spatial frequency are more difficult to image than those with low
spatial frequency (Small objects are difficult to image).
9. The ideal imaging system is one that produces an image that appears exactly as the
object. Such a system would have an MTF equal to 1.

10. Contrast resolution is the ability to distinguish many shades of gray from black to white.
Dynamic range is used to describe contrast resolution. The dynamic range of digital imaging
systems is identified by the bit capacity of each pixel.

The Nyquist Theorem: (Sampling theorm) it is the principal to accurately reproduce a pure sine
wave measurements, or sample or rate which might tice its frequency. This through phenomenon
called aliasing wherein the frequency beyond the initial frequency is mirrored and folded in accordion
like fashion and added to the spectrum of lower frequencies. The sampling g frequency should be at
least twice the highest frequency contained in the signal.
It serves as a fundamental bridge between continuos-time signal and discrete time signal in the field
of signal processing. It creates sufficiency for sample rate that permits a discrete sequence of sample
capture all the information from a continuous time signal of finite band width.
Automatic rescaling: is the production of radiographic images regardless of the exposure factors
with uniform density, contrast, size and shape.

Post processing
• These are all manipulation and adjustments of the digital image (whether by default
settings in the processor or by an operator) made after corrections have been made for
data acquisition.
• These are operations are targeted at refinement of the image, and although they may
be performed as part of the default processing of the image, are also somewhat subject
to personal preference.
 • Postprocessing includes detail processing, noise reduction, additional gradation processing for
final display, and adjustments and features applied by the operator to the final image.

1. Detail processing
• These is mainly the frequency and spatial domains:
• Spatial domains is a simple point processing operation which applies a single
mathematical operation equally to each and every pixel in the image (multiplying,
dividing, adding, or subtracting the pixel value by a set amount, or raising it to a
particular power, for example).
• Frequency domains which is pixels to consist of alternating black and white densities.
This pattern can be represented as a mathematical function resulting in a sine-wave, in
which the peaks represent a pitch-black density and the troughs represent blank white.
2. A particular advantage of multiscale frequency processing is its ability to decouple or
separate the enhancement of the contrast of local details (edge enhancement) from the
enhancement of general image contrast. This and other improvements are made
possible by breaking the image down into numerous frequency bands that can each be
subjected to many different processing procedures.

3. High pass filtering leaves only high-frequency or small details in the image. Low pass
filtering leaves only low-frequency or large structures in the image. Un sharp mask
filtering is a poorly-named process which subtracts a low pass filtered imaged from
the original to enhance the visibility of details when performed in the spatial domain,
the larger the kernel used, the more blurred the low-pass mask.

4. The reduction of random image noise such as quantum mottle is best achieved with
spatial (kernel) processing, whereas the suppression of periodic noise, such as might
be caused by hardware, is best achieved with frequency processing.

5. A final round of gradation processing is designed to give digital images a more

conventional appearance. Perceptual tone scaling is partially based upon psychometric
studies in order to conform the image to the subjective characteristics of the human
eye.

6. Digital processing suites include many combinations of processing procedures in

different sequences which distinguish one manufacturer from another.

7. Dual energy subtraction allows the separation of soft tissue only images from bone
only images, of particular utility in chest imaging.

8. All digital processing operations can be broadly classified as point-processing

operations, local operations, or global operations

Define the following terms

 Contrast manipulation
• Spatial frequency resolution
 • Spatial frequency filtering
• Image manipulation

Special image recording methods

Read and make notes on the following:
Ultrasound image recording

Xeroradiography

Xeroradiography
Xeroradiography was historically used in medical imaging but has been largely replaced by
digital radiography (DR) and computed radiography (CR) systems, which offer faster image
acquisition, improved image quality, and the ability to manipulate and store images digitally.
However, xeroradiography remains a valuable technique in specific applications where high-
resolution imaging is essential.

Components of xeroradiography
1. Preparation of the Patient:
 The patient is positioned appropriately based on the area of interest for
imaging, following standard radiographic positioning techniques.
2. Exposure to X-rays:
 X-rays are directed at the part of the body to be imaged. The X-rays penetrate
the body and interact with the tissues, causing varying degrees of absorption
based on tissue density.
3. Formation of an X-ray Image on a Selenium Plate:
 After exposure to X-rays, a positively charged selenium-coated aluminum
plate is exposed to the X-ray image of the patient's body part.
 X-rays ionize the selenium, creating a latent electrostatic image on the
selenium plate, with areas of higher X-ray exposure corresponding to higher
electrical charge.
4. Transfer of the Latent Image to a Dielectric Developer:
 The charged selenium plate is brought into contact with a fine, dry, negatively
charged, powdered dielectric developer material (e.g., toner).
 The negatively charged toner particles adhere to the positively charged areas
on the selenium plate due to electrostatic attraction, developing the latent
image.
 5. Formation of a Visible Toner Image:
 The toner image on the selenium plate becomes visible and represents the X-
ray image of the patient's anatomy.
 The toner adheres to the charged areas in proportion to the X-ray exposure
received by the selenium plate.
6. Transfer of the Toner Image to a Receptor:
 A receptor, typically a sheet of plastic or paper, is pressed against the selenium
plate, transferring the toner image from the plate to the receptor.
 The transferred toner image now appears on the receptor.
7. Fixing the Image:
 Heat or pressure is applied to the receptor, fixing the toner image in place
permanently.
8. Image Acquisition and Viewing:
 The receptor with the fixed toner image is now ready for image acquisition
and viewing.
 The image can be scanned or digitized to create a digital representation of the
xeroradiographic image for electronic storage and further analysis.

References/ Resources:

1. John Ball and Tony Price; Chesneys’ Radiographic Imaging. Blackwell Science
publishers
2. Terry L. Fauber; Radiographic Imaging and Exposure.
3. Mosby Elsevier publishers. Bushong. S; Radiologic Science for Technologists
4. Quinn B, Carroll R.T. Radiograpy in the digital age, Charles Thomas Publisher Ltd.