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Computed Radiography
(CR) Computed radiography is an imaging technique that uses similar equipment to conventional radiography except that films are replaced by imaging plates. An imaging plate contains photostimulable storage phosphors, which store the radiation level received at each point in local electron energies. The imaging plate is placed under the patient in the same way as conventional film cassettes. After x-ray exposure, the imaging plate is run through a special scanner to read out the image. The digital image can then be processed to optimize contrast, brightness, and zoom. Computed Radiography can be seen as halfway between film-based conventional technology and current direct digital radiography.
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Imaging Plate
An imaging plate is used in computed radiography (CR) instead of a conventional film cassette.
The imaging plate is coated with photostimulable phosphors. The phosphor layer is doped with special substances to alter the crystalline structure and physical properties. After radiation, the enhanced phosphor material absorbs and stores x-ray energy in gaps of the crystal structure, building a latent image.
Usually, the storage phosphors are stimulated with a low-energy laser to release visible light at each point of x-ray absorption. To read-out the image, the plate is inserted into a computed radiography scanner. The scanning laser beam causes the electrons to relax to lower energy levels, emitting light that is captured by a photo-multiplier tube and converted into an electrical signal. The electronic signal is then converted to digital data and can be displayed on laser-printed films, workstations, transmitted to remote systems, and stored digitally.
The CR units automatically erase the image plate after the complete scan. Phosphor imaging plates, like film, are stored in cassette format and can be re-used very often if they are handled carefully. Existing conventional x-ray equipment, from generators to x-ray tubes and examination systems, can be used with imaging plates.
Conventional Radiography
Conventional (also called analog, plain-film or projectional) radiography is a fundamental diagnostic imaging tool in the detection and diagnosis of diseases. X-rays reveal differences in tissue structures using attenuation or absorption of x-ray photons by materials with high density (like calcium-rich bones).
Basically, a projection or conventional radiograph shows differences between bones, air and sometimes fat, which makes it particularly useful to asses bone conditions and chest pathologies. Low natural contrast between adjacent structures of similar radiographic density requires the use of contrast media to enhance the contrast.
In conventional radiography, the patient is placed between an x-ray tube and a film or detector, sensitive for x-rays. The choice of film and intensifying screen (which indirectly exposes the film) influence the contrast resolution and spatial resolution. Chemicals are needed to process the film and are often the source of errors and retakes. The result is a fixed image that is difficult to manipulate after radiation exposure. The images may be also visualized on fluoroscopic screens, movies or computer monitors.
X-rays emerge as a diverging conical beam from the focal spot of the x-ray tube. For this reason, the radiographic projection produces a variable degree of distortion. This effect decreases with increased source to object distance relative to the object to film distance, and by using a collimator, which let through parallel x-rays only.
Conventional radiography has the disadvantage of a lower contrast resolution. Compared with computed tomography (CT) and magnetic resonance imaging (MRI), it has the advantage of a higher spatial resolution, is inexpensive, easy to use, and widely available. Conventional radiography can give high quality results if the technique selected is proper and adequate. X-ray systems and radioactive isotopes such as Iridium-192 and Cobalt-60 for generating penetrating radiation, are also used in non-destructive testing.

See also Computed Radiography and Digital Radiography.
Digital Mammography
The digital mammography is an electronic imaging procedure of the breast. The number of breast imaging facilities equipped with digital mammography (also called computed radiography mammogram (CRM), CR mammogram) is growing due to a number of advantages.
Digital images can be stored directly in a picture archiving and communication system (PACS) and allows the printing, enhancement, magnification, or brightness and contrast manipulation for further evaluation. The sensitivity of digital mammography compared to film mammography is better in women with dense breasts, a population at higher risk for breast cancer, due to these post processing possibilities.
'The American College of Radiology's (ACR) Imaging Network found that digital mammography detected up to 28 percent more cancers than film-screen mammography in women age 50 and younger, premenopausal and perimenopausal women, and women with dense breasts, as reported in October 2005 in the New England Journal of Medicine.'

Advantages of digital mammography:
Faster image acquisition;
shorter examination time;
improved contrast between dense and non-dense breast tissue;
under or over x-ray exposure can be corrected without repeated mammograms;
post processing of breast images for more accurate detection of breast cancer;
Easy storage and transmission over phone lines or a network.

Existing mammography equipment can be converted to 'digital' operation, which allows cost savings compared to integrated digital mammography systems.

See also Breast MRI.
Digital Radiography
(DR) Digital radiography uses a special electronic x-ray detector, which converts the radiographic image into a digital picture for review on a computer monitor. The digital image is then stored and can be post processed by changing the magnification, orientation, brightness, and contrast. Digital radiography (also called direct radiography) is a progressive development of computed radiography (CR).
These advantages can lead to fewer 'recalls' (repeated x-ray images) including a lower radiation dose than analog or conventional radiography. DR and CR systems use no chemicals to process the x-ray images and the hazardous materials and waste associated with film development are eliminated.

Advantages of digital radiography compared with conventional radiography:
saves time and costs due to more effective imaging process and workflow;
improved diagnostic quality images also in cases of x-ray under exposition or over exposition;
lower repeat rate;
films and developing chemicals are omitted;
reduction of hazardous chemical waste.
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