6 Slides Per Page - Digital Radiography Solutions

6 Slides Per Page - Digital Radiography Solutions

11/24/2013
Mastering Digital
Radiography: CR and DR
Exposures, Techniques
and Doses
The following slides show a hand phantom exposed
from 50 to 100 kV to demonstrate the minute
differences visualized on an image using higher kV
and lower mAs with both CR and DR.
Dennis Bowman RT(R)
Clinical Instructor/Staff Radiographer
Community Hospital of the Monterey Peninsula (CHOMP)
Cabrillo College
Speaker/Consultant – Digital Radiography Solutions (dRs
(dRs))
CR
50 kV
CR
60 kV
CR
70 kV
CR
80 kV
1
11/24/2013
CR
90 kV
CR
100 kV
DR
50 kV
DR
60 kV
DR
70 kV
DR
80 kV
2
11/24/2013
DR 100 kV DR 90 kV Barry Burns –
Barry Burns –the CR guru
These are the “new” digital Optimum kVs
These are the “new” digital Optimum kVs
as developed by Barry Burns DIGITAL OPTIMUM kV
Body Part - Adult
� Barry Burns ­
Barry Burns ­ MS, RT(R), DABR MS, RT(R), DABR –– Retired adjunct Professor of Radiologic Science, University of North Carolina School of Medicine in Chapel Hill, North Carolina, stipulated that when using CR everyone can increase
can increase 1515-20 kV from film/screen techniques (except Konica which is 5­­10 kV).
techniques (except Konica which is 5
Chest (Bucky/Grid)
Chest (Non-Grid)
Abdomen
Extremities (Non-Grid)
Extremities (Grid)
Extremities (Bucky)
AP Spines
C-Spine Lateral
T-Spine Lateral
L-Spine Lateral
Ribs
Skull
BE (Air Con)
Abdomen (Iodine)
Pediatric:
Infant Extremities
Pediatric Chest (Screen)
Universal CR Technique Chart using 100% More mAs
UNIVERSAL CR TECHNIQUE CHART 100% More mAs
Part
View
kV
mAs
kV
mAs
Abd omen
AP (Grid)
85
10-15
85
20-25
85
Ankle
Ankle
AP
Obl
70
70
Small
1.8
1.6
70
70
Medium
2
1.8
70
70
Ankle
Lat
70
1.5
70
1.6
70
2
Chest -Adult
AP (tt - 72")
85
2 - 2.5
85
3.2 - 4
90
5 - 6.4
90 12.5 - 15
Lat (tt - 72")
90
4.5 - 5.5
90
7.5 - 9
PA (72")
80
2
80
2.8
80
Chest - Baby
30-40
2.5
2.2
3.2
L at (72")
80
5
80
6.3
80
8
Chest - Newborn
AP (40")
70
1.6
72
1.8
74
2
Chest - Newborn
C-Spine
L at (40")
AP (Bucky - 72" )
74
85
3.2
12.5
76
85
3.6
15
78
85
4
18 - 20
C-Spine
AP (Bucky - 40" )
85
5
85
6.4
85
16
85
18 - 20
85
C-Spine
Odon toid (40")
85
6
85
8
85
10
C-Spine
Lat (B ucky - 72")
85
12.5 - 15
85
15 - 20
85
20 - 25
C-Spine
Swimmers (40" )
90
40 - 60
95
50 - 60
100 50 - 75
85
8 - 10
25
C-Spine
Trauma Obl. ( tt )
77
10
77
15
77
20
C-Spine
AP (tt - 40")
77
5
77
6
77
7-8
C-Spine
Elbow
Lat (tt - 72")
AP
77
70
16
2.2
77
70
20
2.5
77
70
24
2.8
Elbow
Obl
70
2.5
70
3
70
3.2
70
2.2
Elbow
Lat
Femur - Distal
Lateral ( tt )
77
3
Fin ger
All Views
63
0.8
63
Foot
AP
70
1.8
70
70
Foot
Obl
73
2
70
2.5
70
3.2
Foot
Forearm
Lat
AP
73
70
2.5
2.5
70
70
3.2
3
70
70
3.5
3.5
Forearm
Lat
70
2.5
70
3
70
3.5
H and
PA
66
1.25
66
1.6
66
2
H and
H and
Obl
Lat
66
70
1.5
2
66
70
2
2.5
66
70
2.5
3
77
Size of the Patient –
Size of the Patient – The techniques are of a small, medium and large male
are of a small, medium and large male
Large
Chest -Adult
Odon toid (72")
50-60
70-80
kV mAs
Chest - Baby
C-Spine
kV
110-130
80-90 (105)
80-85
65-75
75-90
85-95
85-95
85-100
85-100
85-100
80-90
80-90
110-120
76-80
2.5
70
4
77
5
1
63
1.25
2.2
70
2.8
Small = 120­160 lbs.
� Small = 120­
� Medium = 160­
Medium = 160­200 lbs.
� Large = 200­
Large = 200­240 lbs.
� Females would be approximately 10 lbs. lighter.
2.8
3
11/24/2013
Page 2
Universal CR Technique Chart using 100% More mAs
using 100% More mAs
UNIVERSAL CR TECHNIQUE CHART
Part
View
Small
kV
mAs
100% More mAs
Medium
kV
If you have never seen these kind of techniques before…
mAs
Large
kV
mAs
77
4- 6
Hip
AP ( tt )
77
3
77
4
Hip
Humerus
Knee
Knee
X-Table Lat (Grid)
AP
AP (Bucky)
Obl (Bucky)
90
70
81
81
30 - 50
3
3.5
3.2
90
70
85
85
60 - 80
4
3.5
3.2
90 100 - 120
70
5
85
4
85
3.5
Knee
Knee
Knee
L-Spine
Lat (Bucky)
Sunrise ( tt )
Non-Bucky
AP
81
70
70
90
3.2
4
2.5
8 - 12
85
70
70
90
3.2
5
3.6
16 - 20
85
70
70
90
L-Spine
Mandible
Pelvis
Ribs
X-Table Lat (Grid)
Obl (40")
AP (Grid)
Upper (72")
95
77
85
80
80 - 100
6
10
8 - 12
95
77
85
80
125 - 160
8
20
14 - 20
Ribs
Ribs
Shoulder
Shoulder
Lower (40")
Obl (72")
AP
Mercedes
85
80
77
77
10 - 15
10 - 20
3
12
85
80
77
77
20 - 25
20 - 30
4- 6
16 - 20
85
80
77
77
30 - 40
30 - 40
7- 8
25 - 30
Shoulder
Sinus
Sinus
Sinus
Axillary
Caldwell
Waters
Lateral
70
85
85
85
4
8
10
4
77
85
85
85
5- 6
10
12
5
77
85
85
85
7- 8
12
14
6
3.5
6
4.5
25 - 30
� They will be hard to believe and scary. 95 200 - 320
77
10
85
30
80 25 - 30
Skull
Skull
Tib-Fib
Tib-Fib
AP
Lat (Grid)
AP
Lat
85
85
77
77
12
5
3
2.5
85
85
77
77
15
6
3.5 - 4
3.2
85
85
77
77
18
7
4.5
4
Toe
T-Spine
T-Spine
Wrist
All Views
AP
Lat (2 sec)
PA
63
90
90
66
1.25
7.5 - 10
15 - 25
1.5
63
90
90
66
1.25 - 1.5
16 - 20
35 - 40
1.8
63
90
90
66
1.5 - 2
30
60 - 70
2
Wrist
Wrist
Obl
Lat
66
70
1.8
2
66
70
2
2.2
66
70
2.2
2.5
Zygomatic Arch
SMV v iew (tt - 30")
70
10
70
12
70
14
Exposure Index numbers
� Dose Exposure, Exposure Index/Indicator numbers. (S, LgM, EI, EI_s, ReX
(S, LgM, EI, EI_s, ReX, EXI, DEI) are how you tell if , EXI, DEI) are how you tell if your technique was correct.
The Exposure Index ­ EI (what we will call it from � The Exposure Index ­
now on) number is best if the centering and collimation are very good.
EI ranges and corrupted numbers
� The concept of Agfa’s CR 1.7
The concept of Agfa’s CR 1.7­­2.3 LgM range, Fuji’s CR 400­
CR 400­100 S range, GE’s (DR) .2
100 S range, GE’s (DR) .2­­.6 range and Siemens‘ DR 200­
Siemens‘ DR 200­900 range.
� Even with the range you should always be shooting for the “best” number in that range (which means the lowest dose).
These EI numbers are easily corrupted (but
but only
� These EI numbers are easily corrupted (
up to 100% in most cases).
� Lead shields or surgically implanted metal can definitely skew the EI #.
� Collimated fields using less than 33% of the IR.
Centering, collimation and corrupting Exposure Index numbers Agfa CR Perfectly centered and collimated to 14x14
117 kV @ 5 mAs –
117 kV @ 5 mAs – LgM is 2.04 or S# is 240
4
11/24/2013
Perfectly centered ­
Perfectly centered ­ now 17x14 now 17x14 ­­ 117 kV @ 5 mAs LgM is 2.11 or S# is 196 23.3% change
Centered 2” high –
Centered 2” high – 117 kV @ 5 mAs
LgM is 2.24 or S# is 153 66.7% change
GE built in detector (DEI range .42 ­1.27)
GE built in detector (DEI range .42 ­
8”x8” DEI .60 0.0% change
Centered 1” high –
Centered 1” high –117 kV @ 5 mAs
LgM is 2.21 or S# is 163 56.7% change
Shoulder phantom with 3 sheets of Polyethylene to make it the thickness of a large adult male.
These experiments will show the difference in EXI and DEI numbers when the collimation is left more and more open.
GE built in detector 9”x9” DEI .66 10.0% change
5
11/24/2013
GE built in detector 10”x10” DEI .71 18.3% change
GE built in detector 11”x11” DEI .80 11”x11” DEI .80 33.3% change
33.3% change
GE built in detector 12”x12” DEI .89 48.3 % change
GE built in detector 13”x13” DEI .96 60.0 % change
To summarize those 2 examples
� The technique always stayed the same. It was just the centering or collimation changes that corrupted the EI number.
� Even though the exposure index number (LgM, S and DEI) has been corrupted up to 60%, the image is still perfectly diagnostic/passable in any facility.
If your EI number is above 100% over what is � If your EI
considered perfect it is not a corruption problem. This means you over
This means you over exposed.
exposed.
What does mAs do in the digital world?
� Not what it did in the film world, that’s for sure!!
� To a large extent, mAs does not really control brightness (density) any more.
� Brightness is almost completely controlled by processing algorithms.
� You just need enough mAs or your image will have quantum noise or mottle.
6
11/24/2013
Critiquing digital images Critiquing digital images (continued)
� The EI numbers are the number 1 way to critique your image.
� Some DR control panels do not have an EI number.
You definitely need to use the magnification � You definitely need
mode to check for noise and burn.
� You should always be able to Level and Window � It is impossible to prove you used the correct technique if all you are using is what the finished image looks like as your gauge.
� Witness the awesome power of Automatic Rescaling
and make your image look well penetrated and contrasty.
contrasty.
Fuji 85 kV @ 4 mAs ­
Fuji 85 kV @ 4 mAs ­ S# 357
85 kV @ 8 mAs ­
85 kV @ 8 mAs ­ S# 171
85 kV @ 32 mAs ­
85 kV @ 32 mAs ­ S# 38
85 kV @ 200 mAs ­
85 kV @ 200 mAs ­ S# 6
7
11/24/2013
85 kV @ 400 mAs ­ S# 3
Carestream Portable Detector
85 kV @ 2 mAs
EI 1385
85 kV @ 4 mAs
EI 1682
85 kV @ 8 mAs
EI 1966
85 kV @ 16 mAs
EI 2257
85 kV @ 32 mAs
EI 2517
8
11/24/2013
85 kV @ 45 mAs
EI 2405
What are the differences between CR and DR?
� For all CR (except Agfa) you can use at least 50
times too much mAs and have a perfectly
diagnostic/passable image.
� For most DR you can use about 10 times too
much mAs.
How can there be a
Universal CR/DR technique chart?
Merrill’s Atlas of Radiographic
Positioning and Procedures
� As we all well know, this would have been
� In mid 2013 Bruce Long, First Author of
impossible in the film/screen processor days.
� All modern generators (25 years or newer) are
high frequency and all tubes are the same on the
inside.
� All CR/DR manufacturers set their systems up to
have the perfect EI# appear when 1 mR hits the
Image Receptor.
Is the EI range given by the
vendor perfect for your facility?
Merrill’s, hired me to create the first ever
digital technique charts for the Merrill’s Atlas.
� In it’s 50+ year history they have always had
film/screen techniques.
� In the 14th edition which will be released in
2015, there will be almost 250 digital
techniques included (half CR and half DR).
� Each technique will also have the ESE Dose.
This hip had an LgM of 1.81.
The mag view shows that there is acceptable mottle.
� My colleague Ramiro and I discovered that we
could use half the mAs and still have a perfectly
diagnostic image.
� Our rads loved the idea of cutting the radiation
dose in half (though images had acceptable
mottle)
mottle) because we’re an Image Gently facility.
9
11/24/2013
This lateral C­
C­Spine also had an LgM of 1.81.
The mottle shown is also acceptable.
Universal CR Technique Chart
Least mAs
UNIVERSAL CR TECHNIQUE CHART
Part
Universal CR Technique Chart
Least mAs (Page 2)
UNIVERSAL CR TECHNIQUE CHART
Part
View
Small
kV
kV
mAs
Large
kV
mAs
Hip
AP ( tt )
77
1.6
77
2
77
2 - 3.2
Hip
X-Table Lat (Grid)
90
16 - 25
90
30 - 40
90
50 - 60
Humerus
AP ( tt )
65
1.25
65
2
65
2.5
Knee
AP (Bucky)
81
1.8
85
1.8
85
2
Knee
Obl (Bucky)
81
1.6
85
1.6
85
1.8
Knee
Lat (Bucky)
81
1.6
85
1.6
85
1.8
Knee
Sunrise ( tt )
70
2
70
2.5
70
3.2
Knee
Non-Bucky
70
1.8
70
2
70
2.2
L-Spine
AP
90
4.0 - 6.3
90
8.0 -10
L-Spine
X-Table Lat (Grid)
95
40 - 50
95
60 - 80
Mandible
Obl (tt - 40" )
70
3
70
4
70
Pelvis
AP (Grid)
85
5
85
10
85
90
12.5 - 16
95
100 - 160
16
5
Ribs
Upper (72" )
85
4.0 - 6.3
85
7.0 -10
85
12.5 - 16
Ribs
Lower (40" )
80
5.0 - 8
80
10 - 12.5
80
16 - 20
Obl (72")
80
Ribs
5.0 - 10
80
10.0 - 16
Shoulder
AP
70
1.6
70
2.0 - 3.2
70
3.6 - 4
Shoulder
Mercedes
77
6.3
77
8.0 - 10
77
12.5 - 16
Shoulder
Axillary
70
2
70
2.5
70
3.2
Sinus
C aldwell
85
4
85
5
85
6.3
Sinus
Waters
85
5
85
6.3
85
7
Sinus
Lateral
85
2
85
2.5
85
3.2
Skull
AP
85
6.3
85
8
85
9
Skull
Lat (Grid)
85
2.5
85
3.2
85
3.6
Tib-Fib
80
16 - 20
AP
70
1.6
70
1.8 - 2
70
2.2
Tib-Fib
Lat
70
1.4
70
1.6
70
2
Toe
All Views
63
1.2
63
1.6
63
2
T-Spine
AP
T-Spine
Small
kV
mAs
LEAST mAs
Medium
kV
mAs
Large
kV
mAs
Abdomen-(Most mAs)
AP (Grid)
85
10-15
85
20-25
85
30-40
Ankle
Ankle
AP
Obl
66
66
1.25
1.2
66
66
1.4
1.2
66
66
Ankle
Lat
66
1.1
66
1.2
66
1.4
Chest -A dult
Chest -A dult
A P (tt - 72")
Lat (tt - 72")
85
90
1 - 1.2
2.2 - 2.8
85
90
1.6 - 2
3.6 - 4.5
90
90
2.5 - 3.2
6.3 - 8
Chest - Baby
PA (72")
80
1.6
80
2
80
2.5
Chest - Baby
Chest - Newborn
Lat (72")
AP (40")
80
70
3.2
1.2
80
72
4
1.2
80
74
5
1.2
Chest - Newborn
C-Spine
Lat (40")
AP (Bucky - 72")
74
85
2
6.3
76
85
2
7.5
78
85
2
9.0 - 10
1.6
1.5
C-Spine
AP (Bucky - 40")
85
2.5
85
3.2
85
C-Spine
C-Spine
Odontoid (72")
Odontoid (40")
85
85
8
3.2
85
85
9.0 - 10
4
85
85
12.5
5
C-Spine
Lat (Bucky - 72")
85
6.3 - 8
85
8.0 - 10
85
10 - 12.5
C-Spine
C-Spine
Swi mmers (40")
Trauma Obl. ( tt )
90
70
20 - 32
5
95
77
25 - 32
7.5
100
77
25 - 36
10
4 -5
C-Spine
A P (tt - 40")
70
2.5
70
3
70
3.5 - 4
C-Spine
E lbow
Lat (tt - 72")
AP
70
70
8
1.1
70
70
10
1.2
73
70
E lbow
Obl
70
1.1
70
1.4
70
1.6
E lbow
Femur - Di stal
Lat
Lateral ( tt )
70
77
1.1
1.6
70
77
1.2
2
70
77
1.4
2.5
Finger
A ll Views
63
0.6
63
0.8
63
1
Foot
Foot
AP
Obl
70
70
0.9
1
70
70
1.1
1.2
70
70
1.4
1.6
Foot
Lat
70
1.2
70
1.6
70
1.8
Forearm
Forearm
AP
Lat
70
70
1.2
1.2
70
70
1.5
1.5
70
70
1.8
1.8
Hand
Hand
PA
Obl
66
66
0.6
0.75
66
66
0.8
1
66
66
1
1.2
Hand
Lat
70
1
70
1.2
70
1.5
12
1.4
Differences of the Least mAs to
100% More mAs technique charts
LEAST mAs
Medium
mAs
View
90
3.6 - 5
90
8.0 - 10
90
16
Lat (2 sec)
90
8 - 12.5
90
18 - 20
90
32 - 36
Wrist
PA
66
0.8
66
0.9
66
1
Wrist
Obl
66
0.9
66
1
66
1.1
Wrist
Lat
70
1
70
1.1
70
1.2
Zygomatic Arch
SMV view (tt - 30")
70
5
70
6
70
7
How to use these four charts
� Begin with the “Most
“Most mAs”
mAs” because this has
the least chance of noise.
� The Least mAs chart uses the smallest mAs of
all the charts (least dose to patient, most
chance of mottle).
� The 33% More mAs chart uses 33% more
mAs/dose than the Least mAs chart.
� The 66% More mAs chart uses 66% more
mAs/dose than the Least mAs chart.
� The 100% More mAs chart uses 100% (double)
more mAs/dose than the Least mAs chart.
This is the proof of how much dose you save
your patient when you increase the kV and
decrease the mAs and/or decrease the EI #.
� If you have a diagnostic image and the EI
numbers show you can use less mAs, go to the
“66% More mAs” chart.
� If again you have a diagnostic image and the EI
numbers show you can use less mAs, go to the
“33% More mAs” chart.
� Finally, if you have a diagnostic image and the
EI numbers show you can still drop the mAs,
go to the “Least mAs” chart.
Radiation Dose Saved
SID kV mAs
Dose
(mR)
40"
40"
40"
40"
40"
221.0
152.8
134.8
120.0
87.0
70
81
85
90
96
20
10
8
6.3
4
Radiation 50% EI
Saved Decrease
(%)
(mAs)
30.90%
39.00%
45.70%
60.60%
5.0
4.0
3.2
2.0
50% EI
Dose
(mR)
Total Dose
Reduction
(%)
76.4
67.4
60.0
43.5
65.43%
69.50%
72.85%
80.32%
10
11/24/2013
How Low Can You Go?
� This is my version of ALARA.
� With the new optimum kVs already in place, it’s
Speaking of How Low We Can Go, we now have
Cesium and Gadolinium based DR detectors.
� CsBr (Cesium Bromide) and CsI (Cesium
figuring out how low can we take the mAs and get
an image with no, or acceptable, mottle.
� I’m hoping that everyone will make it a
competition or goal to see what is the
minimum dose needed for any given view.
� It doesn’t take any skill to overexpose.
Iodide) Needle Phosphor detectors are high
efficiency compared to standard Gadolinium
based detectors . Gadolinium detectors need
33% to 50+% more exposure than Cesium to
produce a similar image.
Here is the
CESIUM DR UNIVERSAL TECHNIQUE CHART.
Page 2 of the
CESIUM DR UNIVERSAL TECHNIQUE CHART.
CESIUM DR UNIVERSAL TECHNIQUE CHART
Part
View
Small
Abdomen
AP (Grid)
Ankle
AP
Ankle
Obl
Ankle
Lat
Chest -Adult
AP (Grid)
Chest -Adult
AP (Non Grid)
Chest (2-9 lb) AP (Non Grid - 45")
Chest (2-9 lb) Lat (Non Grid - 45")
Chest (10-20 lb)PA (Non Grid - 72")
Chest (10-20 lb)Lat (Non Grid - 72")
Chest (21-35 lb)PA (Non Grid - 72")
Chest (21-35 lb)Lat (Non Grid - 72")
C-Spine
AP (Bucky - 72")
C-Spine
AP (Bucky - 40")
C-Spine
Odontoid (72")
C-Spine
Odontoid (40")
C-Spine
Lat (Bucky - 72")
C-Spine
Swimmers (40")
Elbow
AP
Elbow
Obl
Elbow
Lat
Finger
All Views
Foot
AP
Foot
Obl
Foot
Lat
Forearm
AP
Forearm
Lat
Hand
PA
Hand
Obl
Hand
Lat
Medium
Large
kV
mAs
kV
mAs
kV
mAs
85
70
70
70
117
90
71
73
81
85
81
85
85
85
85
85
85
90
66
66
66
60
66
66
66
68
68
63
63
66
4 to 5
1.5
1.3
1
1.6
1
1.0
1.4
1.1
1.4
1.4
1.8
6.0-8.
2
8.0
2.5
4
12.5
1.0
1.2
1.4
0.63
1.0
1.2
1.8
1.2
1.4
0.6
0.8
1
85
70
70
70
117
90
73
75
81
85
81
85
85
85
85
85
85
95
66
66
66
60
66
66
66
68
68
63
63
66
8 to 10
2
1.8
1.25
2
1.6
1.3
1.6
1.2
1.6
1.6
2.0
8.0-11
3
11.0
3.5
6.3
16.0
1.2
1.4
1.6
0.7
1.2
1.4
2.2
1.6
1.8
0.8
1
1.2
85
70
70
70
117
90
75
77
81
85
81
85
85
85
85
85
85
95
66
66
66
60
66
66
66
68
68
63
63
66
16 -20
2.5
2
1.5
3.2
2
1.5
2
1.4
1.8
1.8
2.2
11.0-14
4
14
4.5
8
25
1.4
1.6
1.8
0.8
1.6
1.8
2.8
2.2
2.5
1
1.2
1.6
Here is the
GADOLINIUM DR UNIVERSAL TECHNIQUE CHART.
GADOLINIUM DR UNIVERSAL TECHNIQUE CHART
Part
View
Abdomen
AP (Grid)
Ankle
AP
Ankle
Obl
Ankle
Lat
Chest -Adult
AP (Grid)
Chest -Adult
AP (Non Grid)
Chest (2-9 lb) AP (Non Grid - 45")
Chest (2-9 lb) Lat (Non Grid - 45")
Chest (10-20 lb)PA (Non Grid - 72")
Chest (10-20 lb)Lat (Non Grid - 72")
Chest (21-35 lb)PA (Non Grid - 72")
Chest (21-35 lb)Lat (Non Grid - 72")
C-Spine
AP (Bucky - 72")
C-Spine
AP (Bucky - 40")
C-Spine
Odontoid (72")
C-Spine
Odontoid (40")
C-Spine
Lat (Bucky - 72")
C-Spine
Swimmers (40")
Elbow
AP
Elbow
Obl
Elbow
Lat
Finger
All Views
Foot
AP
Foot
Obl
Foot
Lat
Forearm
AP
Forearm
Lat
Hand
PA
Hand
Obl
Hand
Lat
Small
Medium
Large
kV
mAs
kV
mAs
kV
mAs
85
70
70
70
117
90
71
73
81
85
81
85
85
85
85
85
85
90
66
66
66
60
66
66
66
68
68
63
63
66
6 to 8
2
1.6
1.25
2
1.6
1.3
1.8
1.4
1.8
1.8
2.2
8.0 - 10
3
8 to 11
3.5
6.3
16.0
1.4
1.6
1.8
0.8
1.4
1.6
2.2
1.8
2
1
1.2
1.4
85
70
70
70
117
90
73
75
81
85
81
85
85
85
85
85
85
95
66
66
66
60
66
66
66
68
68
63
63
66
10 to 16
2.5
2.2
1.6
2.5
2
1.5
2.0
1.6
2.0
2.0
2.6
11.0 - 14
4
11 to 14
4.5
8
25.0
1.6
1.8
2.0
1
1.6
1.8
2.6
2.4
2.6
1.2
1.5
1.8
85
70
70
70
117
90
75
77
81
85
81
85
85
85
85
85
85
95
66
66
66
60
66
66
66
68
68
63
63
66
20 -32
3.2
2.8
2
4
2.5
1.8
2.5
1.8
2.5
2.3
3
14 - 20
6.3
14 to 18
5.5
10
32
1.8
2
2.2
1.2
1.8
2.2
3.2
3
3.2
1.6
1.8
2.2
CESIUM DR UNIVERSAL TECHNIQUE CHART
Part
View
Small
Hip
AP
Hip
X-Table Lat (Grid)
Humerus
AP (Non Grid)
Knee
AP (Bucky)
Knee
Lat (Bucky)
Knee
Sunrise
Knee
Non-Bucky
L-Spine
AP
L-Spine
X-Table Lat (Grid)
Mandible
Obl (40")
Pelvis
AP (Grid)
Ribs
Upper AP (72")
Ribs
Upper Obl (72" )
Ribs
Lower AP (45")
Shoulder
AP (Bucky)
Shoulder
Mercedes
Shoulder X-T Axillary (N-Grid)
Sinus
Caldwell
Sinus
Waters
Sinus
Lateral
Skull
AP
Skull
Lat (Grid)
Tib-Fib
AP
Tib-Fib
Lat
Toe
All Views
T-Spine
AP
T-Spine
Lat
Wrist
PA
Wrist
Obl
Wrist
Lat
Zygomatic Arch
SMV view
Medium
Large
kV
mAs
kV
mAs
kV
mAs
85
90
66
77
77
70
70
90
95
81
85
81
81
85
77
77
70
85
85
85
85
85
77
77
60
85
90
63
63
67
70
4 to 5
14
1.6
3.2
2.5
1.6
2.5
4
16
8
8
6
8
6.0
4
8
3
4
5
2
4
2.5
2
1.6
0.63
5
10
0.8
1
1.2
5 to 6
85
90
66
77
77
70
70
90
95
81
85
81
81
85
77
77
70
85
85
85
85
85
77
77
60
85
90
63
63
67
70
8
20
2
4
3.2
2
3
8
28
10
12
12
16
12
7
15
3.5
6
7
3
6
3.2
2.5
2
0.8
8
18
1
1.25
1.5
8
85
90
66
77
77
70
70
90
95
81
85
81
81
8
77
77
70
85
85
85
85
85
77
77
60
85
90
63
63
67
70
12
36
2.5
6.4
5
2.5
3.6
14
40
12
16
18
25
18
12
25
4
8
9
4
8
4
3.2
2.5
1
11 to 12
28
1.25
1.5
1.8
10
Page 2 of the
GADOLINIUM DR UNIVERSAL TECHNIQUE CHART.
GADOLINIUM DR UNIVERSAL TECHNIQUE CHART
Part
View
Hip
AP
Hip
X-Table Lat (Grid)
Humerus
AP (Non Grid)
Knee
AP (Bucky)
Knee
Lat (Bucky)
Knee
Sunrise
Knee
Non-Bucky
L-Spine
AP
L-Spine
X-Table Lat (Grid)
Mandible
Obl (40" )
Pelvis
AP (Grid)
Ribs
Upper AP (72")
Ribs
Upper Obl (72")
Ribs
Lower AP (45")
Shoulder
AP (Bucky)
Shoulder
Mercedes
Shoulder X-T Axillary (N-Grid)
Sinus
Caldwell
Sinus
Waters
Sinus
Lateral
Skull
AP
Skull
Lat (Grid)
Tib-Fib
AP
Tib-Fib
Lat
Toe
All Views
T-Spine
AP
T-Spine
Lat
Wrist
PA
Wrist
Obl
Wrist
Lat
Zygomatic Arch
SMV view
Small
Medium
Large
kV
mAs
kV
mAs
kV
mAs
85
90
66
77
77
70
70
90
95
81
85
81
81
85
77
77
70
85
85
85
85
85
77
77
60
85
90
63
63
67
70
5 to 7
20
2.2
4
3.2
2.4
3.8
7
25
10
2.5
8
12
8.0
6.3
12
4.5
6
7
3
6
3
3.2
2.5
0.8
7
16
1.2
1.4
1.8
eight
85
90
66
77
77
70
70
90
95
81
85
81
81
85
77
77
70
85
85
85
85
85
77
77
60
85
90
63
63
67
70
10 to 12
32
2.8
6.4
5
3
4.5
12
36
12
16
6
25
16
10
20
5.5
8
9
4
8
4
4
3.2
1
11
25
1.5
1.8
2.2
10
85
90
66
77
77
70
70
90
95
81
85
81
81
8
77
77
70
85
85
85
85
85
77
77
60
85
90
63
63
67
70
14 to 16
50
3.2
8
6.4
3.8
5.4
20
60
15
20
25
35
25
14
32
6.3
10
12
5
10
5
5
4
1.2
Sixteen
36
1.8
2.2
2.8
12
11
11/24/2013
Digital
Radiography
Solutions
Maximizing Image Quality, Minimizing Patient Dose
Dennis Bowman
Website: digitalradiographysolutions.com
Email: [email protected]
Phone: 831­601­9860
“like” me on Facebook for a few monthly posts
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