(CA) Contrast agents are used to change the imaging characteristics, resulting in additional information about anatomy, morphology or physiology of the human body. Radiocontrast agents (also called photon-based imaging agents) are used to improve the visibility of internal body structures in x-ray and CT procedures. Contrast agents are also used to increase the contrast between different tissues in MRI (magnetic resonance imaging) and ultrasound imaging. The ideal imaging agent provides enhanced contrast with little biological interaction.
First investigations with radiopaque materials are done shortly after the discovery of x-rays. These positive contrast agents attenuate x-rays more than body soft tissues due to their high atomic weight. Iodine and barium have been identified as suitable materials with high radiodensity and are used until today in x-ray and CT contrast agents. Iodine-based contrast agents are water-soluble and the solutions are used nearly anywhere in the body. Iodinated contrast materials are most administered intravenous, but can also be introduced intraarterial, intrathecal, oral, rectal, intravesical, or installed in body cavities. Barium sulfate is only used for opacification of the gastrointestinal tract. Negative contrast agents attenuate x-rays less than body soft tissues, for example gas.

Iodinated contrast media are differentiated in;

Intravascular iodinated contrast agents are required for a large number of x-ray and CT studies to enhance vessels and organs dependent on the blood supply. Injectable contrast agents are diluted in the bloodstream and rapidly distributed throughout the extracellular fluid. The main route of excretion is through the kidneys, related to the poor binding of the agent to serum albumin. The liver (gall bladder) and small intestine provide alternate routes of elimination particularly in patients with severe renal impairment. The use of special biliary contrast agents is suitable for gallbladder CT and cholecystograms because they are concentrated by the liver to be detectable in the hepatic bile.
The introduction of fast multi-detector row CT technology, has led to the development of optimized contrast injection techniques. The amount of contrast enhancement depends on the contrast agent characteristics, such as iodine concentration, osmolality, viscosity, and the injection protocol, such as iodine flux and iodine dose. Adverse reactions are rare and have decreased with the introduction of nonionic contrast agents.
See also Contrast Enhanced Computed Tomography, Abdomen CT, Contrast Media Injector, Single-Head CT Power Injector, Multi-Head Contrast Media Injector, Syringeless CT Power Injector, CT Power Injector.

An arthrography is a radiographic examination of a joint (such as the knee, shoulder, hip, elbow or wrist) that requires an injection of a contrast medium into the joint space.
For an opaque x-ray arthrography a water-soluble iodinated contrast agent is injected and a series of fluoroscopic controlled images is produced. Magnetic resonance arthrography combines the arthrogram with MRI. A small quantity of gadolinium contrast agent is added to the injection into the joint space. The traditional radiographic images are followed by an MRI of the extremities. A non-invasive possibility is an indirect MR arthrography, which doesn't require the injection into the joint. The dye is given prior to the imaging procedure.
The contrast fluid produces a bright signal and allows evaluation of small defects of the joint capsule, assessment of articular surface and labral cartilage, and in case of an indirect arthrogram also of the surrounding soft tissue. If a gaseous medium is used, this exam is called pneumoarthrography and a combination with liquid contrast is used in double-contrast arthrography.
MR arthrography is often used to evaluate hip and acetabular labrum, shoulder rotator cuff and glenoid labrum (see Shoulder MRI), and less often in wrist and knee MRI studies. Also combinations of CT and nuclear medical techniques with arthrography are available.

Breast imaging methods include mammography (mammogram), ultrasound, breast MRI, positron emission tomography, xeromammography, diaphanography and thermography.
Mammography is widely used as a screening method and diagnostic tool for breast cancer detection or evaluation of breast disease. Digital mammography takes multiple thin digital image 'slices' through the breast, which provides higher potential to see a small mass within dense tissue. The mammography quality standards act guarantees a high image quality.
Breast ultrasound (also called ultrasonography) should only be used as an additional imaging modality to evaluate specific breast abnormalities, especially to differentiate cystic from solid masses. Ultrasound is also used to guide needle breast biopsies.
Magnetic resonance imaging (MRI) is useful for breast MRI screening in cases of high cancer risk. In addition, multifocal breast cancer can be missed by standard practice mammography and can be early detected with breast MRI.

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.

Imaging refers to the visual representation of an object. Today, diagnostic imaging uses radiology and other techniques, mostly noninvasive, to create pictures of the human body. Diagnostic radiography studies the anatomy and physiology to diagnose an array of medical conditions. The history of medical diagnostic imaging is in many ways the history of radiology. Many imaging techniques also have scientific and industrial applications. Diagnostic imaging in its widest sense is part of biological science and may include medical photography, microscopy and techniques which are not primarily designed to produce images (e.g., electroencephalography and magnetoencephalography).
Brief overview about important developments:
Imaging used for medical purposes, began after the discovery of x-rays by Konrad Roentgen 1896. The first fifty years of radiological imaging, pictures have been created by focusing x-rays on the examined body part and direct depiction onto a single piece of film inside a special cassette.
In the 1950s, first nuclear medicine studies showed the up-take of very low-level radioactive chemicals in organs, using special gamma cameras. This diagnostic imaging technology allows information of biologic processes in vivo. Today, single photon emission computed tomography (SPECT) and positron emission tomography (PET) play an important role in both clinical research and diagnosis of biochemical and physiologic processes.
In the 1960s, the principals of sonar were applied to diagnostic imaging. Ultrasound has been imported into practically every area of medicine as an important diagnostic tool, and there are great opportunities for its further development. Looking into the future, the grand challenges include targeted contrast imaging, real-time 3D or 4D ultrasound, and molecular imaging. The earliest use of ultrasound contrast agents (USCA) was in 1968.
The introduction of computed tomography (CT/CAT) in the 1970s revolutionized medical imaging with cross sectional images of the human body and high contrast between different types of soft tissues. These developments were made possible by analog to digital converters and computers. First, spiral CT (also called helical), then multislice CT (or multi-detector row CT) technology expanded the clinical applications dramatically.
The first magnetic resonance imaging (MRI) devices were tested on clinical patients in 1980. With technological improvements including higher field strength, more open MRI magnets, faster gradient systems, and novel data-acquisition techniques, MRI is a real-time interactive imaging modality that provides both detailed structural and functional information of the body.

Today, imaging in medicine has been developed to a stage that was inconceivable a century ago, with growing modalities:
x-ray projection imaging, including conventional radiography and digital radiography;
All these types of scans are an integral part of modern healthcare. Usually, a radiologist interprets the images. Most clinical studies are acquired by a radiographer or radiologic technologist. In filmless, digital radiology departments all images are acquired and stored on computers. Because of the rapid development of digital imaging modalities, the increasing need for an efficient management leads to the widening of radiology information systems (RIS) and archival of images in digital form in a picture archiving and communication system (PACS). In telemedicine, medical images of MRI scans, x-ray examinations, CT scans and ultrasound pictures are transmitted in real time.

See also Interventional Radiology, Image Quality and CT Scanner.