X-ray artifacts
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X-ray artifacts can present in a variety of ways including abnormal shadows noted on a radiograph or degraded image quality, and have been produced by artificial means from hardware failure, operator error and software (post-processing) artifacts.
There are common and distinct artifacts for film, computed (CR) and digital radiography (DR).
Common causes
- improper handling of the films
- errors while processing the films
- patient movement while taking the image
Common artifacts (all forms of radiography)
- motion artifact
- due to patient movement resulting in a distorted image
- image compositing (or twin/double exposure)
- superimposition of two structures from different locations due to double exposure of same film/plate
- grid cut-off
- radiopaque objects on/external to the patient (e.g. jewellery (e.g. necklaces, piercings), clothing (e.g. buttons), hair (e.g. ponytail, hair braids etc.)
- debris in the housing
- debris in the housing caused by the collimator tube can cause small trapezoidal regions, indicative of lead shavings
Film radiography artifacts
- finger marks
- improper handling with hands
- clear film
- malfunction of the machine or placing the film in the fixer before developer solution
- static electricity
- black “lightning” marks resulting from films forcibly unwrapped or excessive flexing of the film
- crescent-shaped black lines
- due to fingernail pressure on the film
- crescent-shaped white lines
- due to cracked intensifying screen
- black film
- complete exposure to light.
- clear spots
- air bubbles sticking to film during processing
- fixer splashed on film prior to developing
- dirt on the intensifying screen
Computed/digital radiography artifacts
- detector image lag or ghosting
- latent image from previous exposure present on current exposure
- incorrect detector orientation i.e. upside-down cassette
- spoke like radiopaque lines (case 6)
- backscatter
- electronics are visible on the exposed image
- increased radiation exposure required for portable DR (digital radiography) examinations
- stitching artifacts
- occur when two separate DR/CR (digital/computed radiography) images are merged into a single image (see case 3)
- over exposure
- dead pixel artifact
- signal dropout 4
- large areas of signal loss, due to detector drop
- speckled radiopaque spots 4
- due to detector drop
- detector calibration limitation 4
- faint radiopaque striping (often vertical) in the background of an image, yet not evident on the anatomy
- this artifact should be carefully examined, if it does not interfere with the anatomy, it is not a detector failure/grid cut off, rather a limitation of the detector calibration
. - often seen as lower exposure
- failure of detector offset correction 4
- similar to ghosting, however, the digital detector not being calibrated when promoted is the cause
- electronic shutter failure 4
- the digital image often will have obscurely shaped, tight collimation that defies logic
- often a computer error often fixed with recollimation post exam (this should be explored before
reexaminationre-examination)
- values of interest misread 4
- image appears washed out and underexposed
- this is often due to a largely collimated area of smaller anatomy i.e. a patella protection
- tighter digital collimation in conjunction with reprocessing will correctly assign the correct values of interest
- mid grey clipping 4
- loss of contrast in areas of different pixel density yet not change in density can be seen i.e. the metal on a knee replacement
- due to poor contrast enhancement
- grid-line suppression failure 4
- faint grid lines present on an image, with no grid cut off
-<li>this artifact should be carefully examined, if it does not interfere with the anatomy, it is not a detector failure/grid cut off, rather a limitation of the detector calibration. </li>- +<li>this artifact should be carefully examined, if it does not interfere with the anatomy, it is not a detector failure/grid cut off, rather a limitation of the detector calibration</li>
-<li>often a computer error often fixed with recollimation post exam (this should be explored before reexamination)</li>- +<li>often a computer error often fixed with recollimation post exam (this should be explored before re-examination)</li>
References changed:
- 1. Terri L. Fauber. Radiographic Imaging and Exposure. (2012) ISBN: 9780323083225 - <a href="http://books.google.com/books?vid=ISBN9780323083225">Google Books</a>
- 2. Walz-Flannigan A, Magnuson D, Erickson D, Schueler B. Artifacts in Digital Radiography. AJR Am J Roentgenol. 2012;198(1):156-61. <a href="https://doi.org/10.2214/AJR.11.7237">doi:10.2214/AJR.11.7237</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/22194492">Pubmed</a>
- 3. Shetty C, Barthur A, Kambadakone A, Narayanan N, Kv R. Computed Radiography Image Artifacts Revisited. AJR Am J Roentgenol. 2011;196(1):W37-47. <a href="https://doi.org/10.2214/AJR.10.5563">doi:10.2214/AJR.10.5563</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/21178029">Pubmed</a>
- 4. Walz-Flannigan A, Brossoit K, Magnuson D, Schueler B. Pictorial Review of Digital Radiography Artifacts. Radiographics. 2018;38(3):833-46. <a href="https://doi.org/10.1148/rg.2018170038">doi:10.1148/rg.2018170038</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/29676963">Pubmed</a>
- 1. Radiographic Imaging and Exposure, 4e. Mosby. ISBN:0323083226. <a href="http://books.google.com/books?vid=ISBN0323083226">Read it at Google Books</a> - <a href="http://www.amazon.com/gp/product/0323083226">Find it at Amazon</a><span class="auto"></span>
- 2. Walz-Flannigan A, Magnuson D, Erickson D et-al. Artifacts in digital radiography. AJR Am J Roentgenol. 2012;198 (1): 156-61. <a href="http://dx.doi.org/10.2214/AJR.11.7237">doi:10.2214/AJR.11.7237</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/22194492">Pubmed citation</a><span class="auto"></span>
- 3. Shetty CM, Barthur A, Kambadakone A et-al. Computed radiography image artifacts revisited. AJR Am J Roentgenol. 2011;196 (1): W37-47. <a href="http://dx.doi.org/10.2214/AJR.10.5563">doi:10.2214/AJR.10.5563</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/21178029">Pubmed citation</a><span class="auto"></span>
- 4. Walz-Flannigan Alisa I., Kimberly J. Brossoit, Dayne J. Magnuson and Beth A. Schueler. "Pictorial Review of Digital Radiography Artifacts". RadioGraphics 38, no. 3 (2018): 833-846. <a href="http://dx.doi.org/10.1148/rg.2018170038" target="_blank">. doi:10.1148/rg.2018170038</a>.
Tags changed:
- xray
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