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I would argue that most of the differences noted in these images are primarily due to the absence vs. presence of a Grid/Bucky (and to gross overexposure on the CXR?), rather than being due to any advantage of DR over CR, unless the former is a newer unit with improved detail, etc., compared to the latter. I would also note that CR might be less likely to have mattress/other artififacts--or foreign objects--present. Finally--although this is a minor point--I believe the correct spelling for the word used in the discussion of the CR CXR to indicate "non-moving" should be stationary, not stationery (the latter representing, for example, the paper upon which we might write letters).

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joint

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what are the basic projection for skull

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I would recommend everyone who works with CR to perform a little investigation with their exposure indices.

We had a quiet day and were struggling with a processor fault that was very unusual (consistent complete "white out" of C-spine regardless of exposure). In an attempt to try and reproduce the fault, a colleague purchased a leg of lamb and performed a series of exposures to mimic a horizontal beam C-spine projection. Our exposure index table states that a spine should have an "s" number bewteen 200 and 600. The lamb was exposed with a given kV and mAs with tight collimation, moderate collimation and poor collimation. We didn't reproduce the error but did find some interesting results.

60kV 4mAs: Tight = s3467, Moderate = s692, Poor = s186
66kv 8mAs: Tight = s1175, Moderate = s257, Poor = s68
70kv 12mAs: Tight = s661, Moderate = s126, Poor = s55
75kV 25mAs: Tight = s263, Moderate = s12, Poor = s25
80kV 51.2mAs: Tight = s112, Moderate = s15, Poor = s11
85kV 80mAs: Tight = s58, Moderate = s8, Poor = s5

With tight collimation and using 180cm like a standard cross table lateral C-Spine technique, we found that approximately 70kV for 12mAs up to 75kV 25mAs gave an exposure index that roughly approximated the upper and lower S number boundaries. 70kV for 12mAs was diagnostic with a small amount of mottle starting to appear outside of critical anatomy. 75kV for 25mAs produced a very nice image whose appearance indicated that a much lower exposure could have been used.

The interesting part of this investigation was jsut how dramaticly the collimation affected the exposure index. and exposure of 60kV for 4 mAs gave s3467 with tight collimation (indicating very underexposed), s692 with moderate collimation (indicating slightly underexposed) and s186 with poor collimation (over exposed).

I would be very interested to see if anyone else has similar findings.

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Check out Guest Blog at Carestream- http://blog.carestreamhealth.com/2012/04/27/forty-years-of-radiology-experience/

Get some energy back into the Discussions and comment.

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When I was a student, the above textbook, by James Morgan, was one of our main texts. I found it to be an easy-to-read, and quite useful, reference source. And I liked the title very much, and still (after more than 40 years in radiography) find it to be an apt descriptor of the way I view my profession. Later, the text was updated by John Cullinan & his daughter, and I have a copy of that version, but unfortunately, somewhere along the way, I lost my original edition. I wish I still had it.

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Hello, i'm a new first year at the University of Newcastle studying diagnostic radiography. I've been hearing a lot of doom and gloom from third years about how it's getting extremely hard to find PDY positions, and they mentioned something about this being due to the introduction of NPDP meaning there's less PDY positions for them.
By the time I graduate, the end of 2014/start of 2015, the NPDP will become compulsory and will replace the PDY. Apparently because of this, by the time I graduate, will it mean it is a lot easier to secure a NPDP position vs. the current graduate who is trying to secure a PDY?
All I want to know is how hard will it be for me to become AIR accredited/how hard will it be for me to secure that NPDP year when I graduate.
Do uni marks/which uni you graduated from matter? I'm aiming for a distinction average to better my chances for NPDP, but will a graduate from say, University of Sydney/QUT be taken into more consideration than a Newcastle Uni student?

Thanks in advance

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It is a given that the inherent latitude of the Digital systems enable us to visualise a far wider range of densities than Film/Screen technology.

However, the use of Compensating Filters also reduces Dose to the Patient by absorbing the excess radiation before it reaches the less dense regions of the subject. In so doing scatter is reduced resulting also in a reduction in "noise" and, therefore, improved image quality.

From the Film/Screen days Optimum kV was also employed to modify the Latitude of the "Radiation Image", before it impinged upon the receptor, enabling the sensitometric response of the receptor to depict the range of structural densities of the subject in the processed image.

With Intensifying Screens of calcium tungstate, then later the Rare Earths such as terbium activated gadolinium oxysulfide, the kV response was pretty much linnear through out the medical diagnostic X-Ray spectrum from 40 to 150kV. I believe this is no longer the case and that there is a peak sensitivity of the phosphors used in digital systems at around 60 to 80kV, requiring more exposure outside this range to achieve the same Exposure Index, (or equivalent).

This seems to be of proprietary value to the various manufacturers so not that easy to confirm.

It does raise the point that an exposure chart management policy recommending raising chart kVs across the board may be misplaced and counter to ALARA.

Regards

Gary Allbutt

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