Overview of Digital Imaging and Radiation Protection Issues: Robert M. Gagne Micab/Decs/Ost RMG@CDRH - Fda.gov

OVERVIEW OF
DIGITAL IMAGING
AND RADIATION
PROTECTION
ISSUES
Robert M. Gagne
MICAB/DECS/OST
rmg@cdrh.fda.gov
[From: Handbook of Medical Imaging, Volume I.,
Chapter 4, J. Beutel et al, eds, SPIE Press 2000]
TERPSSC 2001
Robert M. Gagne
What is the purpose of this

presentation?
Here are a couple reasons:
interest in digital imaging!
some concerns related to radiation
safety and effectiveness
potential for exposure increase
(and/or reduction??)
Forces a re-visit of some actions

in the far radiological health past
imaging system inefficiency
Review of options (regulatory or

otherwise) for dealing with actual
and/or perceived concerns
TERPSSC 2001
Robert M. Gagne
What kind of equipment?

Digital radiography (DR)
not digital fluoroscopy using CCD
cameras
not film digitizers
Three different types of DR

systems
flat panel imaging arrays
computed radiography systems
CCD based - optically coupled
systems
What are the concerns?

No equivalence to "speed" or self
limitation as in screen/film systems
Inefficient" systems possible?
TERPSSC 2001
Robert M. Gagne
Flat Panel Imaging Arrays

(indirect conversion)
[From: Medical Imaging, 2000]
Image Formation
TERPSSC 2001
Robert M. Gagne

(direct conversion)
Image Formation
TERPSSC 2001
Robert M. Gagne
Number of Pixel Elements (3000 x 2500)

Pixel Element Size ( 0.14 mm x 0.14 mm )

TERPSSC 2001
Robert M. Gagne
Computed Radiography
Image Formation
Chapter 5, M. Yaffee, eds, SPIE Press 2000]
Pixel Elements
(2160 x 1800)
TERPSSC 2001
Pixel Elements ( 0.2

mm x 0.2 mm )
Robert M. Gagne
CCD based - lens coupled DR system

[From: P. Sund et al, Proc. SPIE 3977: 437; 2000]
CCD based - fiber optic coupled DR system

Pixel Elements
(3000 x 2500)
TERPSSC 2001
Pixel Element ( 0.14

mm x 0.14 mm )
Robert M. Gagne
What are radiation

protection and safety issues?
Unique characteristics of
screen/film imaging systems
self limitation of patient
exposure
concept of "speed" defined and
understood
New considerations for digital

radiography
no self limitation as in
screen/film systems
no consensus on speed
"inefficient" systems possible?
TERPSSC 2001
Robert M. Gagne
Film/Screen Self Limitation
Imaging task with large dynamic

range
Be careful not to under or over
expose film
Self limitation of patient
exposure
TERPSSC 2001
Robert M. Gagne
Film/Screen Speed
Difference
in speed
of about 2
Film/screen speed
speed = 100/E where E is exposure in
mR to produce an optical density of
1.0
position on exposure axis dependent
on speed
higher speed number translates to
lower patient exposure
TERPSSC 2001
Robert M. Gagne
DR Speed
4500
4000
3500
Pixel Value
3000
Gain 1
Gain 2
2500
Gain 3
2000
1500
1000
500
0
0
20
40
60
80
100
120
Relative Exposure
DR operating point
equivalence to film/screen speed set
at installation?
no self limitation except at extreme
ends of the gray-scale transfer curve
patient exposure increase / decrease /
equivalence compared to film/screen?
TERPSSC 2001
Robert M. Gagne
Imaging System Inefficiency

Chest radiography - screening program
(60s-70s) for cardiopulmonary disease
need for rapid, economical imaging system
Photofluorographic (PFG) imaging

system
mobile vans
TERPSSC 2001
Robert M. Gagne
Public Health Concerns

Low detection rate for tuberculosis,
heart disease, and other respiratory
diseases
High patient radiation exposure vs
conventional screen/film radiography
BRH develops standard technique for
estimating patient exposure
TERPSSC 2001
Robert M. Gagne
Digital Radiography
(CCD based - lens coupled)
Visible
light
Digital
Radiography
System
X-rays
Lens
CCD
Camera
(image)
- Not all but focus on those with

Phosphor
(object)
large object and small image

- Less than 1 % of light photons
make it to film!!
Careful system design to overcome

inefficiencies
TERPSSC 2001
Robert M. Gagne
Level of Public Health

Concern
Installation base is small (even

smaller for CCD based - lens
coupled systems)
computed radiography not included
Basic questions: Is there evidence

of higher patient radiation exposure
with these imaging systems
screen/film radiography?
TERPSSC 2001
Robert M. Gagne
Options
Tracking exposure levels
NEXT 2001
chest radiography
diagnostic reference levels (ICRP,
AAPM, many others)
practical tools for managing radiation
dose levels to patients
Quality assurance programs

Performance evaluation of
Computed radiography system,
Med. Phys. 28(3), March 2001
Diagnostic x-ray Performance

Standard
performance requirements on levels
of imaging performance such as
detective quantum efficiency (DQE)
dose display at operators console
TERPSSC 2001
Robert M. Gagne
Dose Display
Previous slide describes several viable
options
TEPRSSC
radiation standards and
safety committee
Diagnostic x-ray Performance

Standard
dose display at operators console for all
radiographic equipment
Practical considerations yet to be

explored or evaluated
cost
effectiveness
alternatives?
dose descriptor and definition?
tie to diagnostic reference levels
effective resource allocation
TERPSSC 2001
Robert M. Gagne
Summary
Different types of DR
flat panel imaging arrays
computed radiography systems
CCD based - optically coupled systems
Radiation safety and effectiveness

issues
no equivalence to "speed" as in
screen/film systems
"inefficient" systems
present revisits the past
potential for exposure reduction and/or
increase??
Options for dealing with perceived

and/or actual concerns
one suggested regulatory approach
TERPSSC 2001
Robert M. Gagne

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OVERVIEW OF

What is the purpose of this

Forces a re-visit of some actions

Review of options (regulatory or

What kind of equipment?

Three different types of DR

What are the concerns?

Flat Panel Imaging Arrays

[From: Medical Imaging, 2000]

Flat Panel Imaging Arrays

[From: Medical Imaging, 2000]

Flat Panel Imaging Arrays

Number of Pixel Elements (3000 x 2500)

Pixel Element Size ( 0.14 mm x 0.14 mm )

Pixel Elements ( 0.2

CCD based - lens coupled DR system

CCD based - fiber optic coupled DR system

Pixel Element ( 0.14

What are radiation

New considerations for digital

Film/Screen Self Limitation

Imaging task with large dynamic

Imaging System Inefficiency

Photofluorographic (PFG) imaging

Public Health Concerns

- Not all but focus on those with

large object and small image

Careful system design to overcome

Level of Public Health

[From: Medical Imaging, 2000]

Installation base is small (even

Basic questions: Is there evidence

Quality assurance programs

Diagnostic x-ray Performance

Diagnostic x-ray Performance

Practical considerations yet to be

Radiation safety and effectiveness

Options for dealing with perceived

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