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Fluoroscopy

&
Digital Fluoroscopy

Fluoroscopy system

Fluoroscopy
A type of radiographic study
Provides a dynamic imaging source
Allows the observer to visualize motility
of organs
Films provide a static image
Contrast media is generally used in
conjunction with fluoroscopy
Static images are obtained on a spot film

History Of Fluoroscopy
Invented in 1896 by Thomas Edison
Original phosphor was zinc-cadmium sulfide
The screen was placed above the patient, the
image was observed by viewing the screen
Dark adaptation was necessary to view images
This type of fluoroscopy was adapted to mirror
optics but only one person could view at a time
In the 1950s, image intensification was developed
In the 1990s, digital fluoroscopy was developed
and is widely used today

Conventional Fluoroscopy

Two types of Fluoroscopy


are:
under-couch tube design
over-couch tube design
Over-couch tube design offers a greater
distance between tube and both patient and
intensifier.
This improves image quality by reducing geometric
unsharpness and reduces radiation skin dose to the
patient.

Under-couch tube design provides direct


fluoroscopy screen and there for allows
operator to be close to the patient.

Illumination During
Fluoroscopy
Fluoroscopy is generally visualized in
dimly lit rooms
Capable of limited brightness levels
Image-intensified fluoroscopy is much
brighter than conventional fluoroscopy
Illumination levels are measured in
lamberts
II levels are about the same brightness
as viewing radiographic films

FLUOROSCOPIC DATA AQUSITION-IMAGE


INTENSIFIED SYSTEM

1.
2.
3.
4.
5.

X-RAY TUBE
PATIENT
IMAGE INTENSIFIER
OUTPUT PHOSPHOR
CAMERA (Viewing
system)
6. MONITOR

Image Intensifier Tube

Receives remnant radiation


Converts it to light
Increases the light intensity
Similar to x-ray tube
Contains a vacuum
Mounted in a metal container to protect
it

Viewing Systems
Image produced at output phosphor
is much smaller, brighter image
Could be viewed directly off output
phosphor
Mirror optics

Finally updated to a television


monitor
Closed circuit monitor system

Television Camera
Plumbicon and vidicon are most often used
Plumbicon - Best for imaging moving organs, i.e.,
heart
Vidicon - Best for imaging stationary organs

A typical vidicon is contained in a glass


envelope with a vacuum
Internal components:
Electron gun
Cathode
Electrostatic grids
Target assembly
Anode

Television Camera Tube


Steering coils
Focussing optical lens Photoconductive layer

Deviation coil
Alignement coil

Input plate

Accelarator grids
Control grid

Electron beam

Iris
Video Signal

Signal electrode

Electron gun
Field grid

Electrode

Television Camera Tube Working


Light image from II is converted to
electric signal
Varying light intensity is received at
target assembly
Electrons are emitted - number
depends on light intensity received
by the target assembly
The electron gun supplies electrons
to fill any deficiency

Television Camera Tube Working


This causes a current to flow
Causes a varying voltage across the
tube
This is the video signal
The video signal pulses are
reassembled into a visible image by
the image monitor

TV camera and video signal


This scanning electron beam moves across the surface
of the TV camera tube in a series of lines.
This is achieved by a series of external coils, which are
placed on the outside of the camera tube. In a typical
television system, the image is formed from a set of
625 lines. On the first pass the set of odd numbered
lines are scanned followed by the even numbers. This
type of image is called interlaced.
The purpose of interlacing is to prevent flickering of
the television image on the monitor, by increasing the
apparent frequency of frames (50 half frames/second).
In Europe, 25 frames are updated every second.

Different types of scanning


1

11

13
3
15

12
2

5
17
7
19

4
16
6
18
8
20

INTERLACED
SCANNING

14

9
21

625 lines in 40 ms
i.e. : 25 frames/s

10
1
3
5
7
9
11
13
15
17

2
4
6
8
10
12
14
16
18

PROGRESSIVE
SCANNING

Image or TV Monitor
The final component in the II system
Converts the varying voltage from
the Vidicon into a visible image
Elements of the TV Monitor
Cathode ray tube
Electron gun
Focusing coils
Control grids

Television Monitor Tube

Image Monitor (Continued)


Electron gun emits electron toward a
fluorescent screen, (TV screen) of the
monitor
Electrons emitted are in
synchronicity with the signal being
emitted by vidicon

Coupling Of The Television


Camera with Image Intensifier
Two methods:
Fiber optics
Cassette loaded spot films are
necessary

Lens coupling
Cine
Spot film camera

Recording The Fluoroscopic


Image
Dynamic Systems
Cine film systems
Videotape recording

Static Systems
Cassettes
Spot film camera
Video recorders
Digital fluoroscopy

Cine Film Systems

Uses a 16 - 35mm movie camera


Image quality is better with 35mm
Patient dose is higher with 35mm
Patient dose is higher with cine than
regular fluoro - requires higher mA
Cine camera is driven by an
electronic synchronous motor

Videotape Recording
Can record image from TV monitor
Uses VHS in. or U-matic in
recorder
Does not exhibit high resolution
Can provide instant playback of
examination
Does not provide additional dose to
patient

Cassettes
High image quality
High patient dose
Delay of two seconds is required
before cassette can be exposed
Multiple images can be exposed on
one cassette
Provides a familiar format, therefore,
most popular

Spot Film Cameras


Also called millimeter and photospot cameras
Similar to movie cameras, but only expose
one frame
Image comes directly from output phosphor
This requires less heat loading, lower mA,
shorter interruption of exam
Used with a beam splitting mirror
Available in 70 and 105mm
70 mm can expose up to 12 frames/sec

Video Recorders
Uses a magnetic disk
Usually records single frames
Has a playback mode

Viewing System Over all


Output screen image can be transferred to
different optical displaying systems:

conventional TV

cinema

Generating a full frame of 525 lines (in USA)


625 lines and 25 full frames/s up to 1000 lines (in
Europe)
interlaced mode is used to prevent flickering
35 mm film format: from 25 to 150 images/s

photography

rolled film of 105 mm: max 6 images/s


film of 100 mm x 100 mm

Digital (Computerized)
Fluoroscopy
Developed in late 70s
Images are taken directly from output
phosphor
A video camera and digital image
processor are used to obtain images
The image is converted from analog to
digital
A dynamic recording can be made
Image can be manipulated in many ways
Less radiation is used

Digital Fluoroscopy Chain of


Events

CCD SYSTEM ADVANTAGE


OVER CAMERA SYSTEM

LOW LEVEL OF ELECTRONIC NOISE


HIGH SPATIAL RESOLUTION
NO LAG OR BLOOMING
NO MAINTENANCE
UNLIMITED LIFE
UNAFFECTED BY MAGNETIC FIELD
LINEAR RESPONSE
LOWER DOSE

Mobile Fluoroscopy
Can provide both static and dynamic
images
Usually connected to a video disk
Can do everything that a fixed unit
can
Generally used in critical care areas
and surgery

Mobile Fluoroscopy

Questions..

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