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Tables of Contents for Fuchs''s Radiographic Exposure and Quality Control
Chapter/Section Title
Page #
Page Count
Preface to the Sixth Edition
ix
2
Acknowledgments
xi
Part I PRODUCING THE RADIOGRAPHIC IMAGE
5
64
Chapter 1. X-RAYS AND RADIOGRAPHIC VARIABLES
5
15
Generation of X-Rays
5
4
X-Ray Tube
6
3
Interactions in the Anode
9
3
Bremsstrahlung
9
1
Characteristic Radiation
10
2
X-Ray Beam Spectra
12
1
Properties of X-Rays
13
1
The X-Ray Beam
13
1
Attenuation
14
2
Absorption by Homogeneous Object
14
1
Absorption by Body Part
15
1
X-Ray Beam Nomenclature
16
1
The Prime Factors
17
1
Types of Radiographic Variables
17
1
Summary
18
1
Review Questions
19
1
2. RECORDING THE PERMANENT IMAGE
20
9
Beginnings of Photography
20
1
Birth of Radiography
21
1
Modern X-Ray Film
22
2
Latent Image Formation
24
1
Processing the Silver Image
25
1
Resume of Image Production
25
3
Summary
28
1
Review Questions
28
1
3. QUALITIES OF THE RADIOGRAPHIC IMAGE
29
24
Components of the Image
29
5
Visibility
29
1
Recognizability
30
4
Qualities of the Radiograph
34
15
Density Versus Tone Value
34
1
Contrast Versus Gray Scale
35
6
Fog and Other Noise
41
5
Geometrical Integrity
46
2
Resolution
48
1
Summary
49
3
Hierarchy of Image Qualities
49
1
Definitions of Image Qualities
50
1
Discrepancies in Terminology
51
1
Review Questions
52
1
4. INTERACTIONS OF X-RAYS WITHIN THE PATIENT
53
16
Types of Interactions
53
3
Photoelectric Effect
53
1
Compton Effect
53
1
Thompson Effect
54
1
Other Interactions
55
1
Production of Subject Contrast
56
8
Tissue Thickness
58
1
Tissue Density
59
1
Tissue Atomic Number
60
1
X-Ray Beam Energy
60
2
Compton Scatter Radiation
62
1
X-Ray Beam Intensity
63
1
Summary
64
1
Review Questions
64
5
Part II VISIBILITY FACTORS
69
164
5. MILLIAMPERE-SECONDS
69
20
Effect on X-Ray Beam Spectrum
69
1
Reciprocity Law
70
1
Arithmetical Relations
71
1
Relation Between Milliamperage and Time
71
1
Decimal Equivalents of Fractional Exposures
71
1
Tables of mAs Values
71
1
Working With Decimal Timers
72
2
Exercise #1
74
1
Working With Millisecond Timers
74
1
Exercise #2
75
1
Exercise #3
75
1
Working With Fractional Timers
75
2
Exercise #4
76
1
Exercise #5
76
1
Exercise #6
77
1
Exercise #7
77
1
Exercise #8
77
1
Converting Fractional and Decimal Times
77
2
Exercise #9
78
1
Exercise #10
79
1
Finding mA and Time Combinations for a Desired mAs
79
2
Exercise #11
80
1
Exercise #12
80
1
Exercise #13
80
1
Control of Density
81
2
Time-Density Relation
81
1
mA-Density Relation
81
1
mA-Time Relation
82
1
Visible Density Change
83
3
Underexposure and Quantum Mottle
86
1
Effect on Contrast
86
1
Exposure Time and Motion
87
1
Effects on Other Qualities
87
1
Summary
88
1
Review Questions
88
1
6. KILOVOLTAGE-PEAK
89
33
Effect on X-Ray Beam Spectrum
89
2
Control of Contrast
91
8
Penetration and Gray Scale
91
4
Influence on Scatter Fog
95
4
Overexposure by Kilovoltage
99
1
Control of Density
99
6
Sufficient Penetration
103
2
Optimum kVp
105
2
The 15 Per Cent Rule
107
5
Applying the 15 Per Cent Rule
109
1
Exercise #14
110
1
Arithmetical Table
111
1
kVp Versus mAs for Density Control
112
2
Visible Density Change
114
1
Effects on Other Qualities
115
1
Exposure Latitude
115
5
Kilovoltage and Exposure Latitude
115
2
Contrast Versus Exposure Latitude
117
2
Use of Higher Kilovoltages
119
1
Summary
120
1
Review Questions
121
1
7. MACHINE PHASE AND RECTIFICATION
122
7
High-Frequency Generators
123
1
Effect on X-Ray Beam Spectrum
124
1
X-Ray Quantity
124
1
X-Ray Quality
124
1
Effect on Density
124
2
Effect on Contrast
126
1
Effect on Other Qualities
126
1
Rectification and Generators
126
1
Battery-Powered Mobile Units
127
1
Summary
127
1
Review Questions
128
1
8. BEAM FILTRATION
129
7
Protective Filtration
129
2
Effects on Image Qualities
129
2
Compensating Filtration
131
2
X-Ray Beam Quality and HVL
133
2
Summary
135
1
Review Questions
135
1
9. FIELD SIZE LIMITATION
136
11
Collimation Devices
136
2
Positive Beam Limitation
137
1
Overcollimation
138
1
Scatter Radiation
138
1
Effect on Contrast
139
1
Effect on Density
140
3
Effects on Other Qualities
143
1
Calculating Field Size Coverage
143
2
Exercise #15
145
1
Summary
145
1
Review Questions
146
1
10. PATIENT STATUS AND CONTRAST AGENTS
147
17
Physique
147
2
Body Habitus
147
2
Body Tissues
149
1
Evaluation of the Patient
150
2
Influence of Age
151
1
Anthropological Factors
151
1
Soft Tissue-Bone Relation
152
1
Body Thickness
152
3
Method for Measuring Thickness of Part
152
1
Thickness Ranges
153
2
Exercise #16
155
1
Molecular Composition
155
2
Magnitude of Absorption Variables
156
1
Use of Contrast Agents
157
3
Influence of Respiration
160
1
Effects on Other Qualities
161
1
Summary
162
1
Review Questions
162
2
11. PATHOLOGY AND CASTS
164
9
Additive Diseases
164
2
Destructive Diseases
166
2
Trauma
168
1
Post-Mortem Radiography
168
1
Soft-Tissue Technique
168
1
Casts and Splints
169
3
Summary
172
1
Review Questions
172
1
12. SCATTERED RADIATION AND IMAGE FOG
173
8
Desirable Gray Scale Versus Fog
173
2
Secondary Versus Scatter Radiation
175
1
Causes of Scatter Fog
175
1
Effects on Density and Contrast
176
2
Fog Versus Blur
178
1
Scatter and Radiation Exposure
179
1
Summary
179
1
Review Questions
180
1
13. GRIDS
181
15
Grid Ratio
182
1
Effect on Contrast
183
2
Examples of Fog Control Using Grids
183
1
Indications for Grid Use
184
1
Grid Ratios and Density Compensation
185
4
Exercise #17
188
1
Effects on Other Qualities
189
1
Grid Cut-Off
189
4
Grid Radius
190
2
Alignment of the Beam and Grid
192
1
Special Grids
193
1
Summary
194
1
Review Questions
195
1
14. INTENSIFYING SCREENS
196
24
Historical
196
2
First Use of Intensifying Screens
197
1
Screen and Cassette Construction
198
2
The Intensifying Screen
198
1
The Cassette
199
1
Efficiency of the Phosphor Layer
200
7
Thickness of the Phosphor Layer
201
1
Phosphor Density
201
1
Atomic Number of Phosphor Elements
201
1
Crystal Size
202
1
Chemical Compound Used for Phosphor Molecule
202
1
Addition of Dyes to Phosphor Layer
203
1
The Reflective Layer
203
1
KVP Dependence and K-Edge Effect
203
3
Summary
206
1
Efficiency of Rare Earth Screens
207
2
Spectral Matching
209
1
Screen Speeds and Density
209
4
Density Factors
210
3
Exercise #18
213
1
Effect on Contrast
213
1
Effect on Sharpness of Recorded Detail
214
2
Screen-Film Contact
214
1
Thickness of Protective Coat
214
1
Screen Speed
214
2
Screen Crossover
216
1
Effects on Other Qualities
216
1
Screen Lag
217
1
Special Screens
217
1
Care of Screens
218
1
Summary
218
1
Review Questions
219
1
15. IMAGE RECEPTOR SYSTEMS
220
13
Film-Screen Combinations
220
3
Film Composition
221
2
Latent Image Formation
223
2
Film Speed
225
1
Image Receptor Speed
226
1
Film Contrast and Latitude
227
1
Geometric Factors
228
1
Film Holders
229
1
Summary
230
1
Review Questions
230
3
Part III GEOMETRICAL FACTORS
233
62
16. FOCAL SPOT SIZE
233
7
Effect on Sharpness of Recorded Detail
233
3
Penumbra
234
2
When Focal Spot is Larger than Object
236
1
Effect of Magnification
236
2
Effects on Other Qualities
238
1
Summary
239
1
Review Questions
239
1
17. THE ANODE BEVEL
240
9
Line-Focus Principle
240
1
Anode Heel Effect
241
2
What "Heel" Effect Is
241
2
Distribution of X-Ray Intensity Over Film Area
243
3
Intensity-Film Area Relation
243
3
Summary
246
2
Review Questions
248
1
18. SOURCE-IMAGE RECEPTOR DISTANCE
249
15
Estimating SID
249
1
Effect on Sharpness of Recorded Detail
249
1
Effect on Magnification
250
3
Effect on Shape Distortion
253
1
Effect on Density
254
8
The Inverse Square Law
255
1
Exercise #19
256
1
Experiment No. 1-SID Density Relation
256
1
The Square Law
256
2
Experiment No. 2-Time-SID Density Relation
258
1
Example No. 1-Time and SID
259
1
Example No. 2-mAs and SID
259
1
Example No. 3-Technique Change Factor and SID
259
1
Exercise #20
260
1
Rules of Thumb for Distance Changes
260
2
Exercise #21
262
1
Effect on Contrast
262
1
Summary
262
1
Review Questions
263
1
19. OBJECT-IMAGE RECEPTOR DISTANCE
264
7
Effect on Sharpness of Recorded Detail
264
1
Effect on Magnification
265
1
Effect on Shape Distortion
265
1
Effect on Contrast
266
3
When Object is Near Film
266
1
When Object is Distant
266
3
Effect on Density
269
1
Air Gap Technique
269
1
Summary
269
1
Review Questions
270
1
20. DISTANCE RATIOS
271
6
Magnification: The SID/SOD Ratio
271
2
Exercise #22
273
1
Sharpness: The SOD/OID Ratio
273
2
The "Geometric Unsharpness" Formula
273
1
Sharpness of Recorded Detail
274
1
Visibility Functions
275
1
Macroradiography (Magnification Technique)
275
1
Summary
276
1
Review Questions
276
1
21. BEAM-PART-FILM-ALIGNMENT
277
8
Off-Centering Versus Angling
277
1
Effect on Shape Distortion
277
5
Shape of the Anatomical Part
278
1
Objects With a Distinct Long Axis
279
2
Objects Without a Distinct Long Axis
281
1
Effect on Density
282
1
Effects on Other Qualities
282
1
Summary
283
1
Review Questions
284
1
22. GEOMETRIC FUNCTIONS OF POSITIONING
285
2
Projection Routines
285
1
Summary
286
1
Review Questions
286
1
23. MOTION
287
8
Effect on Sharpness of Recorded Detail
288
1
Effect on Contrast
289
1
Effect on Density
290
1
Effects on Other Qualities
290
2
Summary
292
1
Review Questions
292
3
Part IV COMPREHENSIVE TECHNIQUE
295
124
24. ANALYZING THE RADIOGRAPHIC IMAGE
295
22
Visibility Functions
295
7
Density
295
4
Contrast and Gray Scale
299
2
Noise
301
1
Geometrical Integrity (Recognizability)
302
3
Sharpness of Recorded Detail
302
2
Magnification
304
1
Shape Distortion
305
1
Resolution
305
6
Density Trace Diagrams
306
1
Modulation Transfer Function
307
1
Geometrical Penumbra
307
1
Absorption Penumbra
308
2
Total Penumbra
310
1
Magnification, Distortion and Noise
310
1
Critiquing and Repeating Radiographs
311
3
Exercise #23
314
1
Summary
314
1
Review Questions
315
2
Exercise #24
316
1
25. SIMPLIFYING AND STANDARDIZING TECHNIQUE
317
10
Radiographic Quality
317
1
Criteria
317
1
Evolving the Exposure System
318
1
Optimum (Fixed) Kilovoltage Technique
318
6
Technique
319
3
Optimum Milliamperage
322
1
Controlling Density with Exposure Time
322
1
Selection of Basic mAs
322
1
Overexposure
323
1
Underexposure
323
1
Variable Kilovoltage Technique
324
1
Summary
325
1
Review Questions
326
1
26. TECHNIQUE BY PROPORTIONAL ANATOMY
327
11
Usefulness of the Proportional Anatomy System
329
2
Proportional Anatomy Groupings
331
1
Technique Derivations by Proportional Anatomy
331
1
Key Derivation References
332
2
Applying the System
334
3
Exercise #25
334
3
Summary
337
1
Review Questions
337
1
27. TECHNIQUE CHARTS
338
12
Developing Charts
339
7
Exercise #26
343
3
Formats for Technique Charts
346
2
Automatic Exposure Technique Charts
348
1
Summary
348
1
Review Questions
348
2
28. AUTOMATIC AND PROGRAMMED EXPOSURE CONTROLS
350
23
Minimum Response Time
351
1
Back-Up Time
352
2
The AEC Density Control
354
4
Limitations of AEC
358
5
Detector Cell Configuration
363
5
AEC Technique Charts
368
1
Trouble-Shooting
368
1
Programmed Exposure Controls
369
1
Summary
370
1
Review Questions
371
2
29. MINIMIZING PATIENT DOSE
373
7
Milliampere-Seconds (mAs)
373
1
Kilovoltage-Peak (kVp)
373
1
Phase and Rectification
374
1
Filtration
374
1
Field Size Limitation
374
1
Patient Status
375
1
Grids and Cassettes
375
1
Image Receptor Combinations
375
1
Distances
375
1
Positioning and Instructions
375
1
Technique Selection
376
1
Technique Charts
376
1
Automatic Exposure Controls
376
1
Fluoroscopy and Mobile Procedures
377
1
Quality Control
377
1
Summary
378
1
Review Questions
378
2
30. QUALITY CONTROL
380
30
Radiation Exposure Monitoring
380
1
Radiographic Unit Monitoring
380
1
Sensitometry and Dark Room Monitoring
380
1
Use of Technique Charts
381
1
Analysis of Repeat Rates
381
1
Continuing Education
381
1
Repeat Analysis
382
5
Determining Repeat Rates
382
1
Departmental Repeat Analysis
383
3
Individual Repeat Analysis
386
1
Implementing a Repeat Analysis Program
387
1
Goals and Results
387
1
Radiographic Equipment
388
17
Timer Quality Control
388
1
Guidelines for Accuracy
388
1
Test Procedures
388
1
Milliamperage Quality Control
389
1
Guidelines for Accuracy
389
1
Test Procedures for Linearity
390
1
Test Procedure for Reproducibility
391
1
Test Procedure for mR/mAs Output
391
1
Kilovoltage Quality Control
392
2
Guidelines for Accuracy
394
1
Test Procedure
394
1
Half Value Layer and Filtration
395
1
Guidelines for Accuracy
395
1
Test Procedures
395
1
Collimator Quality Control
396
1
Guidelines for Accuracy
396
1
Test Procedures
396
1
Light Field Alignment Quality Control
397
1
Guidelines for Accuracy
398
1
Test Procedures
398
1
Vertical Beam Alignment Quality Control
399
1
Guidelines for Accuracy
399
1
Test Procedures
399
1
Distance Indicators
399
1
Guidelines for Accuracy
399
1
Test Procedures
399
1
Focal Spot Quality Control
400
1
Test Procedures
401
2
Image Receptor System Quality Control
403
1
Guidelines for Accuracy
404
1
Test Procedures
404
1
Viewing Conditions
405
1
The Illuminator
405
1
Ambient Lighting
405
1
Automatic Exposure Controls
405
1
Tomographic Units
406
1
Fluoroscopy
407
1
Summary
407
1
Review Questions
408
2
31. SOLVING MULTIPLE TECHNIQUE PROBLEMS
410
9
1. Solving for Density
410
1
2. Solving for Patient Skin Dose
411
1
3. Solving for Contrast
411
1
4. Solving for Sharpness of Recorded Detail
411
1
Solutions to Problems in Table XXVII
412
3
Review Questions
415
4
Part V SPECIAL IMAGING METHODS
419
62
32. MOBILE RADIOGRAPHY
419
6
Mobile Generators
419
1
mAs Selection
420
1
kVp and Line Voltage Compensation
420
1
Geometrical Factors
420
3
Distance Considerations
421
1
Alignment and Positioning Considerations
422
1
Other Considerations
423
1
Manual Versus Automated Technique
423
1
Summary
424
1
Review Questions
424
1
33. FLUOROSCOPIC IMAGING
425
18
William S. Heathman
Imaging Intensifiers
426
1
Beam Splitter
426
1
Fluoroscopy Technique
427
2
Automatic Brightness Control Versus Automatic Gain Control
427
1
Fluoro Tower Release
428
1
Milliamperage
428
1
Kilovoltage
428
1
Exposure Time
428
1
Spotfilming Technique
429
2
Milliamperage
430
1
Kilovoltage
430
1
AEC and Back-Up Timer
430
1
Image Qualities
431
3
Brightness
431
1
Contrast
432
1
Noise
432
1
Lag
432
1
Resolution
433
1
Vignetting
433
1
Magnification
433
1
Image Recording Devices
434
4
Spot Film Cassette Changer
434
1
Spot Film Cameras
434
2
Video Recording
436
1
Cinefluorography
437
1
Mobile C-Arm Fluoroscopy
438
3
Minimizing Patient Exposure
441
1
Summary
441
1
Review Questions
442
1
34. SPECIAL IMAGING TECHNIQUES
443
15
Q. Carroll
E. Seeram
Parallactic Imaging Methods
443
1
Foreign Body Localization
443
1
Tomography
444
7
The Focal Plane
447
1
Movement Patterns
447
2
Applications
449
1
Technique
450
1
Focal Depth, Intervals and Scout Films
450
1
Xeroradiography
451
1
Laser Imaging Systems
452
3
What is a Laser?
452
1
Types of Lasers
453
1
Lasers in Radiology
453
2
Summary
455
1
Review Questions
456
2
35. DIGITAL IMAGING
458
23
Euclid Seeram
The Nature of Images
458
1
The Digital Computer
458
3
Hardware
458
3
Software
461
1
Digital Image Processing Concepts
461
3
Digitizing Images
461
2
Image Processing Operations
463
1
Components of an Image Processing System
464
1
A Digital Radiography System
464
1
Digital Imaging Applications in Radiology
465
8
Digitized Film Radiography
465
1
Digital Projection Radiography Systems
466
1
Digital Fluoroscopy
467
1
Photostimulable Storage Phosphor Digital Radiography
468
1
Digital Image Reconstruction from Projections
469
2
Image Terminology
471
1
Application of Technique
472
1
Three-Dimensional Imaging
473
1
Picture Archiving and Communications Systems (PACS)
474
1
Digital Teleradiology
475
1
Conclusion
476
1
Review Questions
476
5
Part VI PROCESSING THE RADIOGRAPH
481
56
36. PROCESSING STEPS AND CHEMISTRY
481
7
Steps in Processing Procedure
481
1
Developer Constituents
482
3
Reduction and Oxidation
485
1
Fixer Constituents
485
2
Summary
487
1
Review Questions
487
1
37. DEVELOPMENT VARIABLES
488
6
Influence of Development Time
488
1
Influence of Developer Solution Temperature
489
1
Time Compensation for Temperature Changes
490
1
Influence of Developer Solution Concentration
490
1
Fixing Process
491
2
Influence of Fixer Solution Temperature
492
1
Influence of Fixation Time
492
1
Influence of Fixer Concentration
492
1
Types of Image Qualities Affected
493
1
Summary
493
1
Review Questions
493
1
38. AUTOMATIC PROCESSORS
494
17
The Transport System
495
3
Circulation/Filtration System
498
1
The Tempering System
499
1
The Replenishment System
500
3
The Dryer System
503
1
Processor Maintenance
504
1
Common Automatic Processing Artifacts
505
4
Summary
509
1
Review Questions
509
2
39. FILM HANDLING AND DUPLICATION PROCEDURES
511
17
Packing
511
1
Storage
511
2
Heat
511
1
Radiation
512
1
Fumes
512
1
Pressure
512
1
Expiration Date
513
1
Refrigeration
513
1
The Dark Room
513
1
Handling
513
5
Safelight Illumination
515
2
Static Discharges
517
1
Removal of Film from Carton
518
1
Loading and Unloading Film
518
2
Loading the Cassette
519
1
Film Identification
519
1
Daylight Loading Systems
520
2
Components of Daylight Cassette Systems
521
1
Cassetteless Daylight Systems
521
1
Duplication and Subtraction Procedures
522
3
Silver Recovery
525
1
Summary
526
1
Review Questions
526
2
40. SENSITOMETRY AND DARKROOM QUALITY CONTROL
528
9
The H and D Curve
529
3
Processing Control Charts
532
3
Diagnosing Deviations
535
1
Summary
535
1
Review Questions
536
1
Appendix
537
10
I. Blank Technique Charts: Manual & AEC
537
4
II. Answers to Exercises
541
6
Index
547