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Radiographic
Receptors
Online Textbook
Table of Contents
CHAPTER CONTENTS
INTRODUCTION AND OVERVIEW
SCREEN FUNCTIONS
X-Ray Absorption
Light Production
Exposure Reduction
RECEPTOR SENSITIVITY
Materials
Spectral Characteristics
Thickness
Photon Energy (KV)
IMAGE BLUR
Thickness
Screen-Film Contact
Crossover
Halation
IMAGE NOISE
ARTIFACTS
X-Ray Absorption
The first function performed by the intensifying screen is to absorb the x-ray beam
(energy) emerging from the patient's body. The ideal intensifying screen would absorb all
x-ray energy that enters it; real intensifying screens are generally not thick enough to
absorb all of the photons. As we discuss later, increasing the thickness of an intensifying
screen to increase its absorption capabilities degrades image quality.
In most cases, a significant portion of x-ray energy is not absorbed by the screen material
and penetrates the receptor. This is wasted radiation since it does not contribute to image
formation and film exposure. The absorption efficiency is the percentage of incident
radiation absorbed by the screen material. An ideal screen would have a 100% absorption
efficiency; actual screens generally have absorption efficiencies less than 100%.
Absorption efficiency is primarily determined by three factors: (1) screen material, (2)
screen thickness, and (3) the photon energy spectrum.
Light Production
The second function performed by the intensifying screen is to convert a portion of the
absorbed x-ray energy into light. This is the fluorescent process. Fluorescence is the
property of a material that enables it to absorb radiation energy in one portion of the
photon-energy spectrum and emit some of the energy in the form of lower energy photons.
Materials that glow, or emit visible light, when exposed to high-photon energy ultraviolet
light have this property. The figure below illustrates what happens to the x-ray energy that
Speed
Sensitivity (mR)
1200
0.1
800
0.16
400
0.32
200
0.64
100
1.28
50
2.56
25
5.0
12
10.0
Most receptors are given a nominal speed rating by the manufacturer. The actual speed
varies, especially with the x-ray spectrum (KV) and film processing conditions.
The sensitivity (speed) of an intensifying screen-film receptor depends on the type of
screen and film used in addition to the conditions under which they are used and the film is
processed.
We now consider characteristics of the screen that contribute to its sensitivity.
Materials
Several compounds are used to make intensifying screens. The two major characteristics
the material must have are (1) high x-ray absorption and (2) fluorescence. Because of their
fluorescence, intensifying screen materials are often referred to as phosphors.
Soon after the discovery of x-rays, calcium tungstate became the principal material in
intensifying screens and continued to be until the 1970s. At that time, a variety of new
phosphor materials were developed; many contain one of the rare earth chemical elements.
Phosphor compounds now used as intensifying screen materials include:
barium lead sulfate
barium strontium sulfate
barium fluorochloride
yttrium oxysulfide
lanthanum oxybromide
lanthanum oxysulfide
gadolinium oxysulfide.
Each compound contains one element that is the primary x-ray absorber.
You will recall that the probability of x-ray absorption is higher when the photon energy
is just slightly higher than the K energy of the absorbing material. The K-edge energy is, in
turn, determined by the atomic number of the material.
Calcium tungstate, the most common screen material for many years, uses tungsten as
the absorbing element. The K edge of tungsten is at 69.4 keV. For most x-ray
examinations, a major portion of the x-ray beam spectrum falls below this energy. For this
reason, screens containing tungsten are limited with respect to x-ray absorption. Today,
most intensifying screens contain either barium, lanthanum, gadolinium, or yttrium as the
absorbing element. The K edge of these elements is below a major portion of the typical xray beam spectrum. This increases the chance of x-ray interaction and absorption.
Spectral Characteristics
The other elements in the compound contribute to the fluorescent properties of the
material. Each compound produces light of a color (wavelength) that is specific to the
particular material. The light from intensifying screens is produced in either the ultraviolet,
blue or green portion of the light spectrum, and intensifying screens are sometimes
classified as either blue or green emitters. The significance of this is that a screen must be
used with a film that has adequate sensitivity to the color of light the screen emits. Some
radiographic films are sensitive only to blue light; others (orthochromatic) are also
sensitive to green light. If screen and film spectral characteristics are not properly matched,
receptor sensitivity is severely reduced.
Thickness
The selection of a screen is generally a compromise between exposure and image quality,
as illustrated below. Thin screens absorb a relatively small fraction of the x-ray photons;
thicker screens absorb a greater fraction and thus require less x-radiation to produce the
same film exposure. Unfortunately, increasing screen thickness also increases image blur.
The spectrum of photon energies within an x-ray beam is most directly affected and
controlled by the KV; therefore, the sensitivity and speed of a specific intensifying screen
is not constant but changes with the KV selected for a specific procedure.
Significant exposure errors can occur if technical factors (KV and MAS) are not adjusted
to compensate for the variation in screen sensitivity. This often occurs when the same
technique charts are used with screens composed of different materials. Also, the KV
response characteristics of automatic exposure control (AEC) sensors should be matched to
those of the intensifying screens.
IMAGE BLUR
The most significant effect of intensifying screens on image quality is that they produce
blur. The reason for this was illustrated above. Let us consider the imaging of a very small
object, such as a calcification. The x-ray photons passing through the object are absorbed
and produce light along the vertical path extending through the intensifying screen. Before
exiting the screen, the light spreads out of the absorption path, as illustrated. The light
image of the object that appears on the surface of the intensifying screen is therefore
blurred; the degree of blurring by this process is related to the thickness and light
transparency of the intensifying screen.
The major issue in selecting intensifying screens for a particular clinical application is
arriving at an appropriate compromise between patient exposure and image quality or,
more specifically, between receptor sensitivity (speed) and image blurring (visibility of
detail). Screens that produce maximum visibility of detail generally have a low absorption
efficiency (sensitivity) and require a relatively high exposure. On the other hand, screens
with a high sensitivity (speed) cannot produce images with high visibility of detail because
of the increased blurring.
Intensifying screens are usually identified by brand names, which do not always indicate
specific characteristics. Most screens, however, are of five generic types:
1. mammographic
2. detail
3. par speed
4. medium speed
5. high speed.
The figure below shows how these general screen types fit into the relationship between
image blur and required exposure.
Screen-Film Contact
If the film and intensifying screen surfaces do not make good contact, the light will
spread, as shown below, and will produce image blurring. This is an abnormal condition
that occurs when a cassette or film changer is defective and does not apply sufficient
pressure over the entire film area. Inadequate film-screen contact usually produces blurring
in only a portion of the image area.
ARTIFACTS
Intensifying screens can be significant sources of image artifacts. Artifacts can be
produced by scratches, stains, and foreign objects, such as hair, dust, and cigarette ashes,
on the screen surface.
Intensifying screens should be cleaned periodically according to the manufacturer's
instructions.