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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. Gagn
e

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. Gagn
e

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. Gagn
e

Flat Panel Imaging Arrays


(indirect conversion)

[From: Medical Imaging, 2000]

Image Formation
[From: Handbook of Medical Imaging, Volume I.,
Chapter 4, J. Beutel et al, eds, SPIE Press 2000]

TERPSSC
2001

Robert M. Gagn
e

Flat Panel Imaging Arrays


(direct conversion)

[From: Medical Imaging, 2000]

Image Formation
[From: Handbook of Medical Imaging, Volume I.,
Chapter 4, J. Beutel et al, eds, SPIE Press 2000]

TERPSSC
2001

Robert M. Gagn
e

Flat Panel Imaging Arrays

Number of Pixel Elements (3000 x 2500)


[From: Handbook of Medical Imaging, Volume I.,
Chapter 4, J. Beutel et al, eds, SPIE Press 2000]

Pixel Element Size ( 0.14 mm x 0.14


mm )
[From: Handbook of Medical Imaging, Volume I.,
Chapter 4, J. Beutel et al, eds, SPIE Press 2000]

TERPSSC
2001

Robert M. Gagn
e

Computed Radiography

Image Formation
[From: Handbook of Medical Imaging, Volume I.,
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. Gagn
e

CCD based - lens coupled DR system


[From: P. Sund et al, Proc. SPIE 3977: 437; 2000]

CCD based - fiber optic coupled DR system


[From: Handbook of Medical Imaging, Volume I.,
Chapter 4, J. Beutel et al, eds, SPIE Press 2000]

Pixel Elements
(3000 x 2500)

TERPSSC
2001

Pixel Element ( 0.14


mm x 0.14 mm )

Robert M. Gagn
e

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. Gagn
e

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. Gagn
e

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. Gagn
e

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. Gagn
e

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. Gagn
e

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. Gagn
e

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. Gagn
e

Level of Public Health


Concern

[From: Medical Imaging, 2000]

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. Gagn
e

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. Gagn
e

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. Gagn
e

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. Gagn
e

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