Digital Radiography

E. Herbert
 Objectives
At the completion of this chapter, the student should be able to do the following:

1. Identify five digital radiographic modes in addition to computed

radiography.

2. Define the difference between direct digital radiography and indirect

digital radiography.

3. Describe the capture, coupling, and collection stages of each type

of digital radiographic imaging system.

4. Discuss the use of silicon, selenium, cesium iodide, and gadolinium

oxysulfide in digital radiography.

Screen-film radiography had many limitations, which were eliminated with
the introduction of digital radiography (DR).
From film-screen to CR and now to DR, radiography has evolved to become
faster and more efficient. But how does DR really work, and why is it the
future? Let’s find out!"
 Build on Prior Knowledge (Link to CR)
CR Recap:

• Used cassette-based imaging plates (IP) with photostimulable phosphor (PSP).

• Requires a CR reader to process images.

• Transitioned from film-screen to semi-digital systems.

DR (The Next Step)

• DR is cassetteless — it eliminates the need for cassettes and readers.

• Uses flat-panel detectors (FPDs) or direct capture systems for instant image
acquisition.

• Faster, more efficient, and commonly used in modern radiology departments.

 Define Digital
Radiography (DR)
• "Digital Radiography (DR) is an advanced imaging technology that directly captures X-ray images
using flat-panel detectors and instantly transfers them to a computer for viewing, eliminating the
need for cassettes and external readers."
 ✅ Key Features:

• ✔ Uses Flat Panel Detectors (FPDs)

✔ Images appear instantly on a monitor
✔ Higher image quality with lower radiation dose
✔ Faster workflow = improved patient care
 Various DR imaging systems
DR is best described by 3 elements:
• capture
• coupling
• and collection
Capture element - that in which the x-ray is
captured. In computed radiography (CR), the capture
element is the photostimulable phosphor. In the other
DR modes, the capture element may be sodium iodide
(NaI), cesium iodide (CsI), gadolinium oxysulfide
(GdOS), or amorphous selenium (a-Se).
 Various DR imaging systems
Coupling element - that which transfers the
x-ray–generated signal to the collection element.
The coupling element may be a lens or fiberoptic
assembly, a contact layer, or a-Se.
 Various DR imaging systems
Collection element
• May be a photodiode, a
charge-coupled device (CCD), or a thin-film
transistor (TFT).
• The photodiode and the CCD are light-sensitive
devices that collect light photons.
• The TFT is a charge sensitive device that collects
electrons.
 Types of DR systems:
• 1⃣ Indirect DR – Uses a scintillator + photodiode to convert X-rays to
light, then to an electrical signal.

• 2⃣ Direct DR – Uses amorphous selenium (a-Se) to convert X-rays

directly into an electrical signal, skipping the light conversion step.
 CHARGE-COUPLED DEVICE
• Developed in the 1970s
• Highly light sensitive
• Device for military use

• Like digital cameras the CCD has 3 principle advantages

Sensitivity, Dynamic range & 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.
This sensitivity is important for low patient radiation
dose in digital imaging.
• 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
• Note CCD radiation response is linear, but the screen-film image receptor has a curved response.

• Although the screen-film image receptor has 3 decades of radiation response—optical density (OD) from 0 to 3—only
approximately 30 shades of gray are perceivable by the human eye.

• With the use of a CCD image contrast is unrelated to image receptor x-ray exposure. Furthermore, each of the 4
decades of radiation response—0 to 10,000—can be visualized by image postprocessing.

• Also, it should be noted that at very low x-ray exposure, the response of a CCD system is greater than that of screen
film. This should result in lower patient dose during DR.

• A CCD is very small, making it highly adaptable to DR in its various forms.

• The CCD itself measures approximately 1 to 2 cm, but the pixel size is an exceptional 100 × 100 μm
(microns/micrometers)!
CESIUM IODIDE/
CHARGE-COUPLED DEVICE
• One successful approach to DR is shown in Figure A.

• This use of tiled CCDs receiving light from a scintillator

allows the use of an area x-ray beam, so that, in contrast

A
to SPR (scanned projection radiography), exposure time is

short.

• The image receptor shown in Figure B is of this type.

• The scintillation light from a CsI phosphor is efficiently

transmitted through fiberoptic bundles to the CCD array.

• The result is high x-ray capture efficiency and good spatial

B
resolution—up to 5 lp/mm.
• The assembly of multiple CCDs for the purpose of viewing an area x-ray beam presents the
challenge to create a seamless image at the edge of each CCD.

• This is accomplished by interpolation of pixel values at each tile interface.

 CESIUM
IODIDE/AMORPHOUS
SILICON

• CsI capture the x-ray, as in Figure 1, as well as transmission of 1

the resulting scintillation light to a collection element.

• The collection element is silicon sandwiched as a TFT. Silicon is a

semiconductor that usually is grown as a crystal.

• When identified as amorphous silicon (a-silicon), the silicon is not

crystalline but is a fluid that can be painted onto a supporting
surface. 2
• Cesium iodide has a high photoelectric capture, because the atomic

number of cesium is 55 and that of iodine is 53.

• Therefore, x- ray interaction with CsI is high, resulting in low patient radiation doses.

• The DR image receptor is fabricated into individual pixels, as shown in Figure 2.

• Each pixel has a light-sensitive face of a-Si with a capacitor and a TFT embedded.
• Figure 1 is a micrograph of an a-Si array that
shows contacts for the switch control address drivers
and the data lines. An exploded view of a single pixel
shows that a large portion of the face of the pixel is
covered by electronic components and wires.
They are not sensitive to the light emitted by the CsI phosphor.
• The geometry of each individual pixel is very important,
as illustrated in Figure 2. Because a portion 1
of the pixel face is occupied by conductors, capacitors,
and the TFT.
It is not totally sensitive to the incident image-forming x-ray beam.
• The percentage of the pixel face that is sensitive to x-rays is the
fill factor. The fill factor is approximately 80%

2
• Therefore, 20% of the x-ray beam does not contribute to the image.

• This represents one of the dilemmas for DR.

• As pixel size is reduced, spatial resolution improves but at the expense of the
patient radiation dose.

• With smaller pixels, the fill factor is reduced, and x-ray intensity must be
increased to maintain adequate signal strength.

• Cesium iodide has been used for years as the capture element of an image-
intensifier tube.

• Similarly, GdOS (gadolinium oxysufide) has been widely used as the capture
element of most rare earth radiographic intensifying screens.
• In Screen film radiography - As GdOS screen-film speed was increased, spatial
resolution was reduced because of light dispersion in the GdOS.

Such is not the case with DR.

• Increasing thickness of GdOS in a DR image receptor increases the speed of the

system with no compromise in spatial resolution.
 AMORPHOUS
SELENIUM
• The final DR modality is identified by some as
direct DR because no scintillation phosphor is
involved.
• The image-forming x-ray beam interacts directly
with amorphous selenium (a-Se), producing a
charged pair as shown in Figure 1. 1

• The a-Se is both the capture element and the

coupling element.
• The a-Se is approximately 200 μm thick and is
sandwiched between charged electrodes.
• The entire image receptor would appear as that
shown in Figure 2 for CsI/a-Si and described as an
active matrix array (AMA) of TFTs.

2
• X-rays incident on the a-Se create electron hole pairs through direct
ionization of selenium.
• The created charge is collected by a storage capacitor and remains
there until the signal is read by the switching action of the TFT.
 SUMMARY
• Currently, four methods are used to produce a digital projection
radiograph.

• 1. CR uses a photostimulablenphosphor to generate a latent image.

• The visible image results when the PSL is scanned with a laser beam.

• 2. Cesium iodide (CsI) scintillation phosphor can be used as the capture

element for image-forming x-rays.

• This signal is channeled to a CCD through fiberoptic channels.

• 3. Gadolinium oxysulfide or CsI is used to capture x-rays.

• The light from these scintillators is conducted to an AMA of TFTs, whose sensitive
element is a-Si.

• 4. Finally, amorphous selenium is used as a capture element for x-rays in an alternate

DR method.
 Homework:
• 1. What is the difference between digital radiography and conventional radiography?

• 2. What is the difference between digital and analog in film?

• 3. What is the comparison of computed radiography and digital radiography?

• 4. What are the similarities between film-based and digital radiography (DR & CR)?

• 5. What is the main advantage of digital radiography (DR & CR) compared to film-based
radiography?

• 6. What is one of the major advantages of digital radiography (DR & CR) over the analog
FS radiography?

• 7. What is the greatest advantage of digital imaging (DR & CR) systems?

• 8. Which are disadvantages of using digital radiography?

THANK YOU