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Lindsey Shriner

Notebook 6

DR Processing

Processing a typical digital image begins after the exposure has occurred.
The technologist will select the correct anatomy and x-ray at the console and this will set the
correct histogram for processing.
Histogram- graphic representation of all of the digitally recorded signals of a digital x-ray
The correct anatomy should be selected prior to processing, otherwise the image will not
process the correct density and contrast.
A knee radiograph will look very different from a chest exam.
They eliminate unnecessary information outside the collimated field which will degrade the
Histograms show the distribution of pixel values for any given exposure. The graphic
representation appears as a pattern of peaks and valleys that varies for each body part.
Low energy gives a wider histogram and high energy gives a narrower histogram.
Lindsey Shriner

Once the patients anatomy has been established the information is rescaled and the look
up table (LUT) is applied.
Signal-to-noise ratio- the ratio of the amount of total signal versus the amount of noise
present in any digital image.
The Nyquist Theorum- when sampling a signal, the sampling frequency must be greater than
twice the frequency of the input signal so that the reconstruction of the original image will be
as close to the original signal as possible.
For digital imaging, at least twice the pixels needed to form the image must be sampled. If
to few are sampled there will be a lack of resolution. Oversampling does not result in
additional useful information though.
This theory is applied to all systems.
Aliasing- when spatial frequency is greater than the Nyquist frequency and the sampling
occurs less than twice per cycle, information is lost and a fluctuating signal is produced.
When the signal is reproduced, frequencies above the Nyquist frequency cause aliasing.
Also known as folder or biasing and causes mirroring of the signal at a quarter of the
frequency. This can look like the moire effect
If the frequency is exactly at the Nyquist frequency, often a zero amplitude signal will result,
this is known as critical frequency.
Automatic rescaling- images are produced with uniform density and contrast, regardless of
the amount of exposure.
Occurs in an effort to display the pixels for the area of interest.
Problems with rescaling occur when too little exposure is used, which results in quantum
mottle. Or when too much exposure is used, resulting in loss of contrast and loss of distinct
edges because of increased scatter production.
This is not a substitute for appropriate technical factors.
Look-up table (LUT)- a histogram of the luminance values derived during image acquisition.
A reference to evaluate the raw information and correct the luminance values.
There is a LUT for every anatomic part.
Exposure indicator- shows the amount of exposure the IR received, not the patient.
Contrast manipulation- involves converting the digital input data to an image with appropriate
brightness and contrast using contrast enhancement parameters.
Controlled by using a parameter that changes the steepness of the exposure gradient.
Lindsey Shriner

Using a different parameter the brightness can be varied at the toe and shoulder of the
curve to remove the extremely low values and the extremely high values.
The parameters should be used only to enhance the image, and should not take the
place of using proper techniques.
Spatial frequency resolution- detail or sharpness of the image.
Sharpness is controlled by various factors such as focal spot size, screen and film speed,
and OID.
Technologists can choose the structure to be enhanced, control the degree of
enhancement for each density to reduce image graininess and adjust how much edge
enhancement is applied.
Image manipulation can result in loss of information so most facilities do not want
technologist using it.
Spatial frequency filtering- After the signal is obtained for each pixel, the signals are averaged
to shorten processing time and storage. The more pixels involved the smoother the image
Edge enhancement- occurs when fewer pixels in the neighborhood are included in the
signal average. The smaller the neighborhood the greater the enhancement.
High-pass filtering- when the frequencies of areas of interest are known, those frequencies
can be amplified and other frequencies
Increases contrast and edge
Masking- suppressing frequencies.
Smoothing- also known as low-pass
filtering. Occurs by averaging each pixels
frequency with surrounding pixel values to
remove high-frequency noise.
Good for viewing small structures.
Modulation transfer function- ability of a system to record available spatial frequencies.
Image manipulation- most common image processing parameters are those for brightness
and contrast.
Window level- controls how bright or dark the screen image is.
Window width- controls the ratio of black and white, or contrast.
Lindsey Shriner

Background removal or shuttering- used to blacken out the white collimation borders,
effectively eliminating veil glare.
Should never be used to mask poor collimation.
Veil glare- excess light causes ever sensitization of a chemical within the eye called
rhodopsin and results in temporary white light blindness.
Image orientation- the way anatomy is oriented on the imaging plate. The reader has to be
informed of the location of the patients head versus the feet.
Image stitching- when the anatomy or the are of interest is too large to fit on one cassette,
multiple images can be stitched together using specialized software programs. Computer
programs are able to join the images almost seamlessly.
Image annotation- allows selection of preset terms and/or manual text input and can be
particularly useful when such additional information is necessary.
Input annotation of the patients left or right side should never be used as a substitute for
technologists anatomy markers, it may not transfer to PACS.
Magnification- two basic types of magnification techniques come standard with digital
systems. One functions as a magnifying glass and a small segment of anatomy on the main
image shows a magnified version of the underlying anatomy. The other is a zoom technique
that allows magnification of the entire image.
Detective quantum efficiency- measurement of how efficiently a system converts an x-ray
input signal into a useful output image.
Image receptor response- the amount of signal picked up from the exposure and how it forms
the image.