1. Chapter 15 Radiographic Intensifying Screens And Cassettes
There are three key parts of the Image Receptor for Conventional Radiography:
Film to record the image
Intensifying Screens to expose the film
Cassette to protect the screens and film

2. Radiographic Intensifying Screens
Less than 1% of the incident x-rays interact with the film to contribute to the latent image.
The intensifying screens converts the remnant radiation to light than produces the latent image. They act as an amplifier of the remnant radiation.

3. Radiographic Intensifying Screens
About 30% of the x-rays striking the screens interact with the screens producing a large number of visible light photons.
The use of intensifying screens results in considerable lower radiation dose to the patient but has the disadvantage of causing a slight blurring of the image.

4. Radiographic Intensifying Screens
Most conventional radiographic cassettes have a pair of screens that sandwich the film. This design used double emulsion film.

5. Screen Construction Four Distinct Layers Protective Coating Phosphor
Reflective layer
Base

6. Protective Coating Coating is transparent to light.
Resistant to abrasion and damage from handling.
Resistant to static electricity
Provide a surface for cleaning while protecting the phosphors.

7. Phosphors The active layer of the screen is the phosphors.
The phosphors emit light when stimulated by x-rays.
Prior to 1970 the most common phosphor was a crystalline form of Calcium Tungstate.

8. Phosphors Modern screens use rare earth elements such as: Gadolinium
Lanthanum
Yttrium

9. Properties of Phosphors used in Intensifying Screens
High atomic number so x-ray absorption will be high. Quantum Detective Efficiency
Emit a large amount of light per x-ray absorption. Conversion Efficiency
Light must be of proper wavelength to match the sensitivity of the film Spectral Matching

10. Properties of Phosphors used in Intensifying Screens
Phosphor Afterglow should be minimal.
Phosphor should not be affected by heat humidity or other environmental conditions

11. Influences of the Action of Intensifying Screens
Thickness of the phosphor Layer
Concentration of the crystals
Size of the crystals.

12. Reflective Layer
The light from the phosphors is emitted isotropically.
Without a reflective layer, only half of the light would interact with the film.
The reflective layer redirects the light to the film.

13. Reflective Layer
Some screens have special dyes that absorb the light photons coming at a large angles.
These photons would increase the image blur.
Only the photons perpendicular to the film are emitted. The dye increases spatial resolution but reduce speed.

14. Base The base is the layer farthest from the film.
It is usually made of polyester. The bas should be:
Rugged and moister resistant
Can not be damaged by radiation or discoloration
Chemically inert, flexible and free of impurities.

15. Luminescence The x-ray photon is absorbed by the target atom.
The outer shell electron is raised to an excited state.
It returns to a ground state with emission of a light photon.

16. Luminescence
Any material that gives of light in response to a stimulus is a luminescent material.
Two types of luminescent material.
Fluorescent: gives off light only during stimulus. Good for screens
Phosphorescence: continues to give off light after stimulus. Bad for screens called Lag or Afterglow.

17. Properties of Screens
Phosphor composition: Rare earth screens are very efficient in conversion of x-ray to light.

18. Properties of Screens
Phosphor thickness: The thicker the phosphor layer, the higher the number of x-rays converted to light.
High speed screens have thick layer. Detail screens have a thin layer.
Reflective layer will increase speed and blur

19. Properties of Screens
Dye: Light controlling dyes are added to control the light spread to improve spatial resolution.
Crystal size: Larger crystal produce more light per interaction. Detail screens have small crystals.

20. Properties of Screens
Concentration of crystals: The higher the concentration of crystals, the higher the speed.

21. Image Noise Rare earth screens have increased speed for two reasons:
Detective Quantum Efficiency or the ability to absorb the photons ( High Z)
Conversion Efficiency: Amount of light emitted per x-ray.

22. Image Noise
Conversion Efficiency: High conversion efficiency results in increases image noise.
Noise appears as a speckled background.
It occurs with fast screens and use of high kVp.
The factors that make rare earth screens have greater speed also contribute to increased noise.
Increased conversion efficiency results in lower exposure. Less x-rays results in an increased quantum mottle.

23. Spatial Resolution
Image detail is the result of spatial resolution and contrast resolution.
Generally the conditions that increase speed reduce spatial resolution.

24. Spatial Resolution
When screens phosphor reacts with x-rays a larger area of the film is exposed than what would be exposed by radiation alone.
This results in reduced spatial resolution and more blur.

25. Spatial Resolution
Direct exposure can resolve 50 lp/mm with a very small focal spot.
High speed screens can resolve 7 lp/mm.
Detail screens can resolve 15 lp/mm
The unaided eye can resolve 10 lp/mm.

26. Spatial Resolution
High speed screens have thick layers of crystal and /or large crystals.
High detail screens have a thin layer of small crystals.

27. Screen film Combinations
Screens in pairs and double emulsion film is the standard of the industry. Less than 1% of the image is produced by the x-ray photons.
Each screen contributes relatively evenly in the production of the image.

28. Cassettes The cassette is a rigid holder for the film and screens.
It will contain some form of compression to push the film in close contact with the screens.
The front of the cassette is made of a radiolucent material with low absorption characteristics.

29. Cassettes
The back of the cassette may contain some form of metal that can absorb x-rays that are not absorbed by the screens.
Sometime with cassettes that do not adequately absorb the rays, back scatter will result from scatter radiation from the cassette holder or near by wall.

30. Spectrum Matching
For the screen to work at maximum efficiency, the light absorption characteristics of the film must be matched to the light emitted from the screens.
This is called spectrum matching.

31. Spectrum Matching Calcium Tungstate emits a broad blue spectrum.
Rare earth emits a green spectrum.
The film, screens and safelight must match.

32. Asymmetric Screens
Screens in the cassette can be of two types or speeds. Some people use two different speeds in cassette for full spine radiography.
When types of screens are different, they are referred to as Asymmetric screens. One side may be high contrast and the other side wide latitude. The combined image is superior.

33. Care of Screens and Cassettes
High quality radiography requires that the screens be clean and free of artifacts.
Avoid touching the screens with your hands.
Clean the screens with screen cleaner.
Do not slide the film in or out when loading the cassette.

34. Care of Screens and Cassettes
Keeping the dark room clean will help reduce dirt or dust getting into the cassette.
Don’t stack the cassette on top of each other as the weight can damage the cassette.
Load the film completely in the cassette.

35. Care of Screens and Cassettes
Clean the screens at least quarterly. California requires monthly.
Use only specially formulated screen cleaner with anti static properties.
Never use alcohol to clean screens.
Make sure they are dry before reloading with film.

36. Examples of Screen Problems
The hinge of the cassette has failed, resulting in a light leak.

37. Cassette & Screen Problems
Card inside cassette

38. Cassette Artifacts This cassette popped partly open.
With cassette artifacts, think about how the cassette opens.
If the cassette pops open do not use the film.

39. Cassette Artifacts
Dirty screens will appear as white spots on the film.
This film also has some static electricity artifacts.

40. Cassette Artifact Dirty Screens
Dirty or damaged screens will cause white spots on the image.

41. Dirty or Damaged Screens
Dirty or damaged screen will cause white spots on the image.

42. Dirty & Damaged Screens
The white spots on this film are the result of damaged or worn out screens.
Never use alcohol or detergents to clean screens.

43. Poor Screen Contact
Poor screen contact will cause an an area of the image to appear cloudy and blurry. Common reasons for poor contact include:
Worn contact felt
Loose, bent or broken hinges
Loose bent or broken latches
Warped screen

44. Poor Screen Contact Common reasons for poor contact include:
Warped cassette front or frame.
Sprung or cracked cassette frame.
Foreign matter in the cassette.
Screen contact is tested using a wire mesh test tool.
The wire mesh is placed on top of the cassette.

45. Poor Screen Contact A radiograph is taken and the film processed.
The image is viewed from 2 to 3 meters from the view box.
Poor contact will appear as a cloudy and blurry area on the film.

46. Poor Screen Contact
Test the cassette when they are purchased and then twice yearly.

47. 23.4 Screen Contact Testing
Procedure:
Clean screens and let them dry. Use screen cleaner design for the screen used.
With a felt tip pen, write an identification number on the screen next to the I.D. and on the back of the cassette.
Load cassettes.

48. Screen Contact Testing
Procedure:
Set SID to 40” Table Top
Place cassette on table.
Place wire mesh tool on cassette.
Set collimation to film size.
Make exposure and process film.

49. Screen Contact Testing
Procedure:
Hang film on view box.
Step back 72” from view box and view film.
Areas of increased density or loss of resolution indicates poor contact or stained screens.

50. Poor Screen Contact
There is a loss of detail in the thoracic and lumbar spine due to poor screen contact.
This was a new cassette.

51. Poor Screen Contact
Note the blurry image in the spine but sharp image of the ribs.
The screens were not in proper contact in the middle of the cassette due to a bow in the cassette back.

52. End of Lecture