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Thursday, 21 November 2024
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Computed Radiography
(CR) Computed radiography is an imaging technique that uses similar equipment to conventional radiography except that films are replaced by imaging plates. An imaging plate contains photostimulable storage phosphors, which store the radiation level received at each point in local electron energies. The imaging plate is placed under the patient in the same way as conventional film cassettes. After x-ray exposure, the imaging plate is run through a special scanner to read out the image. The digital image can then be processed to optimize contrast, brightness, and zoom. Computed Radiography can be seen as halfway between film-based conventional technology and current direct digital radiography.
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Diagnostic Imaging
Imaging refers to the visual representation of an object. Today, diagnostic imaging uses radiology and other techniques, mostly noninvasive, to create pictures of the human body. Diagnostic radiography studies the anatomy and physiology to diagnose an array of medical conditions. The history of medical diagnostic imaging is in many ways the history of radiology. Many imaging techniques also have scientific and industrial applications. Diagnostic imaging in its widest sense is part of biological science and may include medical photography, microscopy and techniques which are not primarily designed to produce images (e.g., electroencephalography and magnetoencephalography).
Brief overview about important developments:
Imaging used for medical purposes, began after the discovery of x-rays by Konrad Roentgen 1896. The first fifty years of radiological imaging, pictures have been created by focusing x-rays on the examined body part and direct depiction onto a single piece of film inside a special cassette.
In the 1950s, first nuclear medicine studies showed the up-take of very low-level radioactive chemicals in organs, using special gamma cameras. This diagnostic imaging technology allows information of biologic processes in vivo. Today, single photon emission computed tomography (SPECT) and positron emission tomography (PET) play an important role in both clinical research and diagnosis of biochemical and physiologic processes.
In the 1960s, the principals of sonar were applied to diagnostic imaging. Ultrasound has been imported into practically every area of medicine as an important diagnostic tool, and there are great opportunities for its further development. Looking into the future, the grand challenges include targeted contrast imaging, real-time 3D or 4D ultrasound, and molecular imaging. The earliest use of ultrasound contrast agents (USCA) was in 1968.
The introduction of computed tomography (CT/CAT) in the 1970s revolutionized medical imaging with cross sectional images of the human body and high contrast between different types of soft tissues. These developments were made possible by analog to digital converters and computers. First, spiral CT (also called helical), then multislice CT (or multi-detector row CT) technology expanded the clinical applications dramatically.
The first magnetic resonance imaging (MRI) devices were tested on clinical patients in 1980. With technological improvements including higher field strength, more open MRI magnets, faster gradient systems, and novel data-acquisition techniques, MRI is a real-time interactive imaging modality that provides both detailed structural and functional information of the body.

Today, imaging in medicine has been developed to a stage that was inconceivable a century ago, with growing modalities:
x-ray projection imaging, including conventional radiography and digital radiography;
scintigraphy;
single photon emission computed tomography;
positron emission tomography.

All these types of scans are an integral part of modern healthcare. Usually, a radiologist interprets the images. Most clinical studies are acquired by a radiographer or radiologic technologist. In filmless, digital radiology departments all images are acquired and stored on computers. Because of the rapid development of digital imaging modalities, the increasing need for an efficient management leads to the widening of radiology information systems (RIS) and archival of images in digital form in a picture archiving and communication system (PACS). In telemedicine, medical images of MRI scans, x-ray examinations, CT scans and ultrasound pictures are transmitted in real time.

See also Interventional Radiology, Image Quality and CT Scanner.
Filter Grid
Filter grids are used to reduce scattered noise and increase contrast in x-ray images. Primary radiation passing through an object gets scattered caused by the various density of different materials. Scatter radiation produces noise (radiographic fog) on the film or detector, which degrades the diagnostic quality. Anti-scatter grids act as filters between patient and film (or receiver) to remove scatter radiation. The use of a grid is recommended with body parts thicker than 10 cm and kVp values about 60 kV.
X-ray filter grids are available with focused or parallel strips. These two types are produced with linear or crossed grid configurations. The septa of filter grids consist of high radiation absorbing materials (e.g. lead) separated by permeable parts. During radiation exposure, movement of the grid blurs a projection of the septa.
If the image receptor and x-ray tube (with the focal spot) are in a fixed position relative to one another the grid is automatically aligned. In mobile radiography, the position of the focal spot and the image receptor is variable. Additionally cassettes incorporating anti-scatter grids are also available.
Fluoroscopic System
When invented, a fluoroscopic system consisted of x-ray tube, fluorescent screen and x-ray table. In 1950's, the development of the image intensifier revolutionized fluoroscopes. The basic components are extended by a gantry, image intensifier, camera, film and monitor system. The x-ray tube is usually located under the patient table, in opposition to the image intensifier and film cassette or display unit. The patient table can be rotated to an upright position for certain examinations and can be lowered to horizontal position for other imaging procedures. In some instances, the unit can be operated from outside the room.
Today, the transition from conventional to digital fluoroscopy replaces the image intensifier. A flat-panel detector in combination with sensitive image sensors and digital image processing improves the diagnostic ability of a modern system.
Mammography
Mammography is a diagnostic imaging procedure of the breast to detect and evaluate breast disease. Mammography is widely used as a screening method and plays a key role in early breast cancer detection.
The screening mammography is used to detect breast changes in women who have no signs or symptoms or noticed breast abnormalities. The goal is to detect a breast tumor before any clinical signs are observable.
A diagnostic mammography is used to investigate suspicious breast changes, such as a breast lump, an unusual skin appearance, breast pain, nipple thickening or nipple discharge.
A breast screening or standard mammography requires two mammograms from different angles of each breast including craniocaudal view and mediolateral view. Additional images can be made from other angles or focus on microcalcifications or other suspicious areas.
A mammogram is created by special mammography equipment with long wavelength of the used x-rays. Film-screen mammography is still the most widely used technology, but the state of the art technique is digital mammography. Conventional x-ray equipment was used to produce mammograms until dedicated mammography equipment became available in the late 1960s. Film-screen mammography and xeromammography, introduced in the early 1970s, used lower radiation doses and produced sharper mammograms. The second generation of mammography systems has been introduced in the early 1980s. Chief disadvantages of analog mammography include the labor-intensive handling of the cassettes, relatively slow processing time, the lack of a direct interface to the x-ray system, and no post processing possibilities.
Mammograms of high quality should be done with the lowest radiation dose as possible. Adequate breast compression is important due to shortening of the exposure times, immobilization of the breast, reduction of motion and blurring and prevention of overpenetration by means of equalizing breast thickness.
Further breast imaging procedures include breast ultrasound and breast MRI.
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