Prepared by: Jessa V.

Matanguihan, RRT 7/4/2022

Radiographic Image Quality Reviewer

1. mAs - density
! mAs is the controlling factor of density
! mAs is the quantity of eletrons/amount of radiation
! More radiation will cause more photons reach the detector (image receptor)
! mA - number of photons in the primary beam
! s - number of photons exposing the patient with mA-time relationship
Increased mA or s = increased quantity of radiation
Increased mAs will increase quantity of radiation
Increased quantity of radiation will increase number of photons reaching the
detector
Increased number of photons reaching the detector will increase signal intensity
Increased signal intensity will decrease structural density
Increased mAs = Increased Density 2x

" To maintain same density: use high mA, low s(time) or vice versa (reciprocity law)
" To produce geometric sharpness: use low s (time), high mA (using short time will reduce
patient motion that produce image blur artifact)
" Too high mA will produce focal spot blooming that appears as an image unsharpness; to
compensate, use high kV and low mA
2. kVp - density - contrast
! kVp is the controlling factor of contrast
! Kilovoltage is the speed/force that accelerates electron from the cathode to anode
! Kilovoltage determines the penetrability of photons
Increased kVp decreases patient dose as almost all of the energy will pass through
the body
! Kilovoltage controls x-ray beam energy/quality of x-ray beam
Increased patient thickness will require an increase in kVp for more penetrability
action
Increased kVp will increase the production of scattered radiation
Increased scattered radiation will produce scatter fog (seen as added density on the
image)
Increased density due to scatter radiation fog will decrease image contrast
Increased kVp will reduce patient dose
Increased kVp = Increased scattered radiation = Increased Fog = Increase
density = increased contrast

* to produce high image quality, use low kVp and high mAs, BUT it will increase
patient dose
3. screen speed - density - detail
! Screen speed is the capacity of screen to produce visible light
! Factors affecting screen speed:
# Type/composition of phosphor
" Barium lead sulfate - used for high kVp technique (high kVp technique is used
 Prepared by: Jessa V. Matanguihan, RRT 7/4/2022

to lower patient dose)

High kVp will result into more penetrability action that most radiation will
pass through the patient’s body, therefore it will lower down the patient
radiation dose.
High kVp will result in production of scattered radiation that will add
unwanted density on the image due to scattered radiation fog.
Due to an increase in density by scattered radiation fog with the usage of high
kVp, to compensate, use lower mAs, that will also decrease patient radiation
dose.
" Zinc sulfide - used for low kVp technique (used for high resolution image
quality)
Low kVp will cause a decrease in density, to compensate for the loss, use high
mAs.
High mAs will have increase in number of photons that will reach the image
receptor, that will decrease radiographic noise caused by quantum mottle.
Decreased radiographic noise will result into increased resolution of the
image.
" Rare earth crystal results into high quantum mottle due to its high screen speed
(1,200)
To compensate for high quantum mottle, use high mAs
# Thickness of phosphor layer
Thicker phosphor layer will increase light emission
Increased light emission will increase screen speed
Increased screen speed will increase density, to compensate, use low mAs
Increased screen speed will increase quantum mottle that will decrease
radiographic detail
# Large phosphor crystal size will increase screen speed
# Reflective layer will double the screen speed
2x screen speed will increase quantum mottle, therefore radiographic detail will
decrease
2x screen speed will increase the light emission twice, so the density will also be
doubled. To compensate for increased density, use low mAs
Increased screen speed = Increased quantum mottle = Decreased recorded detail
Increased screen speed = Increased light emission = Increased density
Increased screen speed = use Low mAs = Lower patient dose
Increased screen speed =Decreased image quality due to radiographic noise
4. SID - density - detail - distortion
! SID is the distance from the source to image receptor, also called as FFD (Focal-Film
Distance)
! SID affects blackening of the film (Inverse square law)
If the distance is cut into half, density will increase by 4x
If the distance is doubled, density will decrease by 1/4 of the original intensity
! SID/FFD is also the supplementing/oviating/compensating/adjusting factor of size
magnification under distortion.
 Prepared by: Jessa V. Matanguihan, RRT 7/4/2022

! If there is a change in distortion (magnification), the definition is also affected.

Less distortion, less unsharpness, good definition

Increased SID/FFD will decrease density (Inverse square law)

Increased SID/FFD will decrease magnification
Decreased magnification will decrease distortion
Decreased distortion will decrease unsharpness
Decreased unsharpness will improve recorded detail
Increased SID = Decreased density
Increased density = Decreased distortion = Increased detail

5. OID - density - contrast - detail - distortion

! OID and density is inversely proportional (inverse square law)
! OID is the distance of the object to image receptor, also called OFD (object-film
distance)
! OID is the controlling factor of size distortion (magnification)
Increased OID will increase magnification of the object, therefore distortion will
also increase
Increased distortion will decrease recorded detail
Increased OID will decrease density (inverse square law)
Decreased density will increase contrast
Increased OID = Decreased density = Increased contrast
Increased OID = Increased distortion = Decreased recorded detail

6. CR Angle - density - detail - distortion

! CR (central ray) angle/x-ray tube angle
! Foreshortening and/or elongation is affected by central ray - part under examination -
radiographic film alignment
Increased CR angle will increase foreshortening and/or elongation
Increased foreshortening/elongation will increase distortion
Increased distortion will decrease recorded detail
Increased CR angle will decrease density due to increase in differential part
absorption
Increased CR Angle = Increased distortion = Decreased recorded detail
Increased CR Angle = Decreased density

7. Focal spot size - detail

! Use of large focal spot size will increase blurring due to focal spot blur
Unsharpness is caused by x-rays that originate from different points of focal spot striking
the edge of the objects
Large Focal spot size = Increased Focal Spot Blur = Decreased recorded detail
Small Focal spot size = Decreased Focal Spot Blur = Increased recorded detail
 Prepared by: Jessa V. Matanguihan, RRT 7/4/2022

8. Collimation - density - contrast

! Use of beam restricting device reduces scattered radiation
! Collimator is the best type, useful and accepted type of beam restricting device
Increased collimation means smaller field size
Decreased collimation means larger field size
Increased collimation will decrease/limit scattered radiation
Decreased scattered radiation will decrease fog
Decrased fog will decrease unwanted density on film
Decreased density will increase contrast
Increased collimation = Small Field size = Decrease scattered radiation = Decreased
density = Increased contrast

9. Grid ratio - density - contrast

! Grid ratio = h/d
! High grid ratio have smaller angle of deviation that results into higher scatter radiation
clean-up
! When to use grid?
# Greater than 10 cm patient thickness (results to scatter radiation)
# Higher than 60 kVp

Increased patient thickness and kVp used must use high grid ratio to have higher
scatter radiation clean-up
*scatter radiation produces fog on film (added unwanted density)
High grid ratio will have high scatter radiation clean-up
High scatter radiation clean-up will decrease density
Decreased density will increase contrast
*to compensate for loss of density, use high mAs (increase patient dose)
High grid ratio = Decreased density = Increased contrast
Use of grid = Increased Image Quality = Increase patient dose

FACTORS THAT WILL PRODUCE THE GREATEST & LEAST DENSITY

GREATEST DENSITY LEAST DENSITY
High mAs Low mAs
Short SID Long SID
Short OID Long OID
Low Collimation High Collimation
Low Grid Ratio High Grid Ratio
Fast Screen Speed Slow Screen Speed
Fast Film Speed Slow Film Speed
Low Central Ray angle High Central Ray angle