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Having reviewed the exposure factor considerations we now need to
look at the differences with CR.
mA - It is no longer true that mAs controls image density,
in FS where the same medium is used for detection and display the 2
are intimately linked. However in CR where detection and
display are separate processes they are not linked. For a
given CR image receptor mAS still determines the number of quanta
that are absorbed and , therefore noise, the image processing
controls the output signal and hence image density in CR.
kV - Kv still controls contrast BUT a linear response of
CR (Exposure v density) means that matching the subject contrast to
the Kv and film screen combination is much less important. The prime
influence on contrast in CR comes from the
"lookup tables" Kv along with tube filtration still controls the
incident x-ray spectrum and therefore, subject contrast and scatter,
image processing can partially compensate for loss of subject
contrast.

This difference between Film Screen imaging and Computed
radiography and the transition from FS to CR imaging is something
radiographers find difficult and when they produce a light or
dark image are tempted to repeat the image using more or less
exposure respectively in order to correct the image - this is the
INCORRECT way to approach the problem, the method should be to
check the Exposure index to see if enough exposure has been received
by the imaging plate to permit image manipulation then check and
adjust the image using the image processing functions of the system.
Scatter
As with FS systems scatter plays an important role - in fact
scatter and its control is more important in CR than in FS
radiography

CR Systems and Scatter
Here we compare the absorption spectra of FS screens (green
line) and CR image screens, (pink line) note the absorption
peak (K edge) of CR screens to the considerably lower due to
the primary absorber Barium of CR compared with Gadolinium of FS
screens, hence the greater sensitivity to scattered radiation
energies.

Now look at the primary and secondary or scatter spectra for a
typicaly 80 Kv exposure, the scattered x-rays have lower energies
than the primary beam, the storage phosphor CR absorbtion peak falls
in the middle of the scattered engies range indicating that it will
absorb a fair amount of these energies - compare this with the Lanex
regular screen phosphor.
CR storage phosphor screens absorb more x-ray scatter than most
conventional FS combinations under the same exposure conditions.
This may explain observations that image quality of some images
where there is a lot of scatter eg (Mediatinum in non grid chest
images and the abdomen of large patients) is lower with CR
than conventional FS radiography.

Summary of Comparison of CR and FS phosphorus

Lookup table,
table allowing a display system to map pixel values into colours or
grey scale values with a convenient range of brightness and
contrast. Thus, a narrow range of input pixel intensities may be
mapped onto the available range of output intensities. Rather than
using the pixel values directly, the value is instead used as an
address into a lookup table where the content of the table at that
address defines the output grey-scale value .
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