SCREEN FILM RADIOGRAPHY

Moderetor: Presenter:
Dr.Sunil Kumar(M.D.) Dhiraj Gupta JR-2
INTRODUCTION
• Radiography is a procedure in diagnostic radiology in which X-Rays are
used to produce a shadow picture of a patient. This will enble us to
visualise the internal structure.
• In Radiography Technique, the radiation from the x-ray tube is
transmitted through the patient’s body, then reaches to the film.
• After processing the film,the Radiograph is obtained.A radiograph is
negative Image.
• The production of good radiological image require number of
accessories such as -
 Grid
Cassette
Intensifying screen
X-ray Film
RADIOGRAPHY
GRIDS
Grid Design and Principle
GRID RATIO
• The ablity of grid to discriminate against scattered radiation is
measured by grid ratio which is defined as the ratio of the height(h) to
the width of the spacer(b) between the lead strips.

Grid Ratio = h/b

as the grid ratio increases, the grid removes more scattered radiations.

The typical grid ratio ranges from 4:1 to 16:1.

TYPES OF GRID
• Grids may be classified as –
1. Parallel grid
2. Crossed grid
3. Focused grid
4. Moving grid (Potter-Bucky).
Cassettes
• Cassettes are rigid, light-tight devices that hold x-ray film in contact with the
intensifying screen
Cassettes
• Configuration varies
Cassettes - Cross Section
• An important function of the cassette is to hold the
screen in contact the film in an air tight seal.
• Loss of contact between the screen and film will
result in increased light spread away from the
screen and thereby decrease detail.
RADIOGRAPHIC FILM

• Xray films are the most important material used to “decode” the
information carried by the attenuated Xray beam, when they are
made to pass through the tissue.
• X-ray film consisting of a radiation-sensitive, emulsion coated on
both sides of a transparent sheet of plastic, called the base.
• The film is sandwiched between the radiographic intensifying
screens in a protective cassette.
• The intensifying screens change the Xrays into visible light. The
visible light exposes the radiographic film.
Film Identification
• Should be permanently identified with medical record information.
• Date of exposure
• Full name of patient
• Institution exposure made
• Referring physician
• Patient identification number
Radiographic Film
• Diagnostic radiographic film is manufactured by coating both sides of a base
material with an emulsion containing photosensitive crystals.
• Several other materials are also used to improve the performance and
permanence of the film:
• Base
• Adhesive
• Emulsion with crystals
• Supercoat
 History
• The first x-rays were recorded on glass plates.
• These were coated with emulsion on one side only.
• The exposure dose was quite high.
• During WWI, nitrocellulose based film was found to be a more feasible
choice for recording x-rays.
• The flaw with nitrocellulose based film was its easy flammability.
• In 1924, cellulose acetate replaced the nitrocellulose based film.
• In 1960, the first medical radiographic film using a polyester base was
introduced.
1.FILM BASE
• Provides a surface and support for the emulsion.
• Most film bases are composed of polyester.
- Dimethyl terepthalate(DMT) and ethylene glycol
are brought together under low pressure and high
temperature.
- Can withstand higher temperatures and is more
fireproof.
• 150 to 250 µm thick.
Quality of Film Base
• Flexible yet tough
• Permit easy handling in the darkroom.
• Make good contact with cassette pressure pads.
• Stable
• Does not change its dimension during the heating and
immersion in chemicals required for processing.
• Rigid
• To be placed onto viewbox.
• Uniformly lucent
• Permits transmission of light without adding artifacts to
the diagnostic image.
• In1933, blue tint was added to the x-ray film in an effort to
produce a film that was “easier” to look at
2.Adhesive
• Designed to glue the emulsion to the base and prevent bubbles or
other distortion when the film is bent during processing or handling,
or when it is wet and heated during development.
3.EMULSION
• The emulsion is the heart of the film.

• The x-rays or light from the intensifying screens interact

with the emulsion and transfer information to the film.

• Most important ingredients of a emulsion are gelatin

and silver halide.

• It is about 3-5 µm thick.

a.Gelatin

• The gelatin is clear so it transmits the light to the

silver halide crystals.
• It is porous so the processing chemicals can easily
penetrate to the silver halide crystals.
• The primary function of the gelatin is to provide a
support medium for the silver halide crystals by
holding them in place.
b.Silver Halide

• Composition:
• 90-99% Silver Bromide.
• 1-10% Silver Iodide - it increases sensitivity.
• Silver Iodo-Bromide crystals are precipitated and
emulsified in Gelatin.
• Precipitation reaction involves:

AgNO3 + KBr  AgBr + KNO3

Crystal Lattice

•Crystal is formed by Ag+ Br-

and I-
•Crystal size will vary from 1.0
to 1.5 microns in diameter.
•Each cubic centimeter of
Emulsion contains 6.3 x 109
crystals.
•1 grain averages 1 - 10
million silver ions.
Crystal defects

Point Defect: A Point defect

consists of a Silver Ion that has
moved out of its normal position in
crystal lattice (Interstitial Ions)
defect is called as frankel defect.

Dislocation Defect:
A dislocation is a line imperfection
in the crystal.
Chemical sensitization

• Produced by adding
allylthiourea, to the emulsion ,
which reacts with silver halide
to form silver sulfide.

• Silver Sulphide is usually

located on surface of the
crystals and is referred as
“sensitivity speck”.
4.Supercoat
• Layer of hard protective gelatin designed to prevent the soft emulsion
from being abused physically or chemically.
Reflections
• Crossover effect: blurring of the image caused by
light from one screen crossing into the light from
another screen.
• Halation: an effect on a radiographic image caused
when light that is reflected from the air interfaces
on the back of the base material.
• Antihalation coating: a substance applied to the
back of a single-emulsion film designed to
absorb light coming from the emulsion and
preventing backscatter, (removed by the
processing chemicals to permit light to be
transmitted through the film for viewing).
Types Of Film
• Direct Exposure/ nonscreen films

• Intensifying screen films

• Special Application Films likes:-

• Mammography
• Fluoroscopic spot filming
Direct Exposure/ Nonscreen films

• When extremely fine detail is critical to the

diagnostic quality of the image (extremely high
radiation exposure).
• Dental
• Reconstructive surgery of the hands
• Single emulsion, extremely fine grain silver halide
crystals, much greater silver content.
• Thicker emulsion layer to achieve sufficient
sensitivity- requires manual processing.
 INTENSIFYING SCREEN
• These screens are fitted in x-ray cassettes and interact with x-rays to
convert most of their radiant energy (>95%) in to visible light
thereby, exposing the x-ray film finally with light (and not the x-
rays). The amount of light emitted by the intensifying screen is
proportional to the amount of x-radiation passing through it.
• Generally the x-ray films are more sensitive to light rays than the x-
rays and therefore the use of intensifying screens allow reduction in
the exposure factors without affecting the general quality of
radiograph.
The intensifying screen typically has following
components-

1. Base: Provides a strong, smooth, but flexible support for the
fluorescent layer. This is constructed usually from paper,
cardboard or polyester with total thickness not exceeding
approximately 0.18 mm.
Ideal properties of an intensifying screen include:
Chemically inert, moisture resistant, no discolouring with age
2. Substratum: It is the bonding layer between the base & the
phosphor layer. It may be reflective, absorptive or transparent in
nature.
3. Phosphor:- The x-ray photon will strike the phosphor crystal in the
screen.
• The excited phosphor will emit a specific wavelength of light that
exposed the film.
• The efficiency of the screen is based on:
• Thickness of phosphor layer
• The type of phosphor
• The size of the phosphor crystal
• Increased efficiency, decreased spatial resolution (thicker layer, larger
crystal size).
• The rare earth screens may have any of the following types of phosphor
material-
• Terbium activated gadolinium oxysulphide

• Terbium activated lanthanum oxysulphide

• Terbium activated yttrium oxysulphide

• Thulium activated lanthanum oxybromide

Screens
• The thicker the
phosphor layer the less
detail of the image
• Note the spreading of
the light in the thicker
screen layers
• X-ray absorption efficiency and their light conversion ratio of rare
earth screens are far superior to calcium tungustate type films.
For example rare earth screen film combination has 12 times
faster speed than par speed tungustate screen film combination
and exposure is reduced by 15-50%.

• 4. Super-coat: This is a transparent external protective layer

which helps in resisting surface abrasion. It is constructed from
cellulose acetate and has anti-static and waterproofing qualities.
 Screens - Resolution
• Resolution (detail) can be measured using a line
resolution phantom.
• Resolution is defined as the smallest number of
line pairs that can be seen
• High detail screen (50 speed) may resolve 16
Line Pair/mm
• Rapid screen (400 speed) may resolve 5 Line
Pair/mm but require 1/8th the radiation
SPECIAL FILM TYPES

• Mammography Film: Single emulsion film currently used in modern

radiography.
• Laser Film: Used with a laser printer for digital radiography, CT and
MRI.
• Subtraction Film: used in angiography to do subtraction
where the bone is removed for better visualization of the
arteries.
• Spot film: Special roll film of 70 to 105 mm width used in
fluoroscopy.
• Can be processed in x-ray film processor.
• Cine film:
• 35 mm black & white film.
• Used in coronary angiography.
• Requires motion picture film processor.
Sizes of radiographic films
• 5X7
• 8X10
• 10x12
• 11x14
• 14x17
IMAGE PROCESSING
• When an X-ray film has been exposed, it must be processed in order
to produce a permanent visible radiographic image.

• The purpose of processing is to transforms the latent image into a

visible image
FILM PROCESSING

Washing
Steps of Processing

• 1. Exposure - Latent image created

• 2. Development - Converts latent image to black metallic silver
• 3. Wash [stop bath] - Removes excess developer
• 4. Fixing and Hardening - Dissolves out unexposed silver halide crystals
• 5. Washing - Removes products of processing
• 6. Dry - Removes water.
Latent Image Formation

• x ray causing ionisation of AgBr ion by the process called as

photoelectric effect The primary interaction with the bromide
crystals is by Compton and photoelectric interactions
• AgBr + X-ray photons = Ag+ + Br-
• Silver bromide Silver ions + Bromine ions
• The latent image is formed by deposits of free (ionized) silver
ions
DEVELOPEMENT
• Development is a process of chemical reduction.
• The reduction is achieved by the developer donating electrons
to silver ions in the exposed silver bromide and iodide grains
converting them to atoms of metallic silver.
Ag+ + electron  Ag
• The mode of action of developer is not fully understood but
the existence of electric charge barriers around the halide
grains is thought to be involved.
Charge Barrier:
•Both exposed and unexposed UNEXPOSED GRAIN
silver bromide grains are
surrounded by a negative
charge barrier of bromide ions
created by the excess of
potassium bromide employed
in the synthesis of silver
bromide during the
manufacture of emulsion.
•The charge barrier protects
the silver bromide from attack
by electrons in the developer
solution.
•Exposed silver bromide EXPOSED GRAIN
grains possess a weakness in
the charge barrier caused by
the presence of neutral silver
atoms, which have collected
at the sensitivity speck.
•This development center
enables electrons from the
developer to penetrate the
grain and reduce all its silver
ions to metallic silver.
Constituents Of The Developer
• This consists of:
1. Developing agents
2. Accelerators
3. Restrainer
4. Preservative
5. Hardener
6. Sequestering agents
1.Developing Agents
• These are the reducing agents.
• Primary function is to supply the electrons that convert the exposed
silver halide grains to silver.
• Principal component is hydroquinone.
• Secondary constituent is phenidone or metol.
• Known as PQ developer.
2.Accelerators/Buffers

• PQ developers need alkaline medium for their action (10 - 11.5 pH).
• Includes Sodium Hydroxide, Sodium Carbonate and Borates.
• The alkali adjusts the hydrogen ions liberated during the
development process.
3.Restrainers/Anti-Foggants
• Decrease the formation of Fog( Fog is the development of the
unexposed silver halide grains that do not contain a latent image ).
• Anti-foggants permit rapid development of exposed grains .
• Potassium bromide, Benzotriazole.
• The development process itself produces potassium bromide as a
byproduct, so the developer replenisher need not include potassium
bromide.
4.Preservatives
• Sodium sulfite
- Forms colorless soluble products (sulfonates) after combining with
colored oxidized products of developing agents.
-Acts as a preservative by preventing oxidation of hydroquinone by
removing dissolved oxygen in the solution and at the interface.
5.Hardeners

• Powerful organic hardeners such as gluteraldehyde prevent the

excessive swelling of gelatin in the emulsion when it absorbs water
during development.
6.Sequestering agents

• Prevent precipitation of insoluble mineral salts, which tend to occur

in hard water areas. Compounds based on EDTA are used for this
purpose.
• Solvent: Carrying medium for dissolving the developer constituents.
- Tap water
Replenishment
• During the process of development the developing agents,
preservatives are consumed and H+, Bromide are increased.
• The purpose is to maintain:
-developing agent conc.
-preservative conc.
-Bromide conc. and
-pH at constant level
 Development Reaction (High Volume)

• Bromide and acid are formed (pH is lowered).

• Developer is consumed.
• Replenisher formulas have a higher pH ,contains no bromide.
• Rate of replenishment - 60ml of the developer is replaced with
replenisher for each 14 x 17 inch film.
Oxidation Reaction (Low Volume)

• pH is raised
• No bromide is produced.
• Replenisher formulas have a lower pH ,contains bromide and high
sulfite conc. to retard oxidation.
• Rate of replenishment — 90ml of the developer is replaced with
replenisher for each14 x 17 inch film processed.
 Factors affecting development

1.Developer Temperature:
• High temperature development:A range of 38-420C is used which
enables 90 seconds or even faster cycle times to be operated.
• Low temperature development: Operated at around 300C and can
still produce very rapid results.
• Medium temperature development:
-Between 33-370C.
2.DEVELOPMENT TIME

• Developer activity- Active developer achieves given image density

more rapidly.
• Type of film emulsion- Thick emulsion film > thinner ones(non screen
type>screen type film)
• Agitation- Proper agitation fasten the development process.
FIXING
• It has 4 major functions:
1.To stop further development -making it acidic.
2.To clear the image -by removing the remaining silver halide from
emulsion.
3.To fix the image-no longer sensitive to light.
4.To complete the process of hardening of the film emulsion .
1.Fixing Agent
• 2 agents:
• Cyanides
-Poisonous.
-Not generally used.
• Thiosulfates - Sodium and Ammonium Salt (more active) –
called Hypo.

AgBr + sod. Thiosulfate


Ag thiosulfate complex + NaBr
(water soluble)
2.Acid:
• Prevents dichoric fog by inhibiting developing agents.
• Provides a suitable environment for the hardening
agents in the fixer.
• Acetic acid is used usually at a pH of 4-4.5.
3.Hardener:
• Reduces drying time and prevents physical damage.
• Aluminium chloride and aluminium sulfate (or
Chromium compounds) are used commonly.
4.Buffer:
• Prevents sulphurization.
• Neutralizes the developer.
• Optimizes hardener activity.
• Sodium acetate is commonly used in conjunction with acetic acid.
5.Preservative:
• Retards decomposition of thiosulphates.
• Sodium sulphate is commonly used.

6.Antisludging agent:
• Boric acid is commonly used and this prevents
sludging of insoluble aluminium compounds in
the hardener.
Rinsing
• After developing the film, film is swollen and soft
• The purpose of rinsing is to remove the any soluble chemical and decrease
the alkalinity of film.
• Timing is about 30 sec in running water

Washing
• Final wash is necessary to prevent browning and to remove residual
chemicals
• Temperature should be maintained between 60-75 F if it exceed more
than 90 than the film is vulnerable for unusual shrinking or swelling.

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Drying
• The last step in film processing is drying the film
• Done by simply hanging the film

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Artifacts - Types
• Processing Artifacts

• Exposure Artifacts

• Handling & Storage Artifacts

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Processing Artifacts
• Chemical fog
• Developer spot
• Fixer spot
• Smudge/finger print
• Reticulation

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Chemical fogging:-

Chemical fogging occurs at the processing stage when old or spent

chemicals are used, chemicals are used in the wrong sequence,
inadequate washing between processing stages or inappropriate
chemicals are used. Because of the wide range of cause, the effects
can be diverse ranging from coloured streaks and blotches through
to the lack of an image or a totally black image. The most common
cause is the use of old or spent chemistry which often results in a
lack of contrast and an undesirable background colour - usually
brown
Developer Spots

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Fixer spot

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Reticulation
Discolored film due to
hypo (fixer) retention.

Chemicals not washed

off – over time the film
turn brown

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Brown film :-

With time the film will go brown if not left in fixer solution or
water bath [final wash] for the required amount of time with
manual processing. Also with exhausted fixer solution with
automatic processing.
Scratch marks

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Exposure Artifacts

• Motion
• Wrong screen-film match
• Double exposure
• Improper grid position

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Motion

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Double exposure
Handling & Storage Artifacts
• Light fog
• Static electricity
• Kink marks
• Scratches
• Dirty cassettes

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Dirt on screen mimicking
a foreign object.

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Scratch marks from
improper handling.

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Pt clothing

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Static electricity

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THANK YOU