Personal Introduction

My name is Sharon Moore. I have been a Radiologic Technologist for 35 years. I finished my preliminary career training in 1973. Upon completing that part of my education, I became a registered board certified radiologic technologist. In the next phase of my education, I completed a four year college program and received my Bachelor of Science degree in Radiologic Sciences. I have been involved in many facets of the Radiology profession through the course of 35 years and seen many changes to the health care industry.
My career has given me the opportunity to be involved in the role as a technologist with general radiology exams, emergency room procedures, operating room procedures, radiation therapy treatments and simulation, nuclear medicine studies, quality assurance, education and hospital administration. As my career progressed, I wore many hats including but not limited to: a technical coordinator in a very large hospital in Manhattan, a VP in a small community hospital, a clinical instructor, professor and clincial coordinator within hospital and college base educational programs in New Jersey. Now, I have joined forces with Barry Weinstein, President of Capital Medical Equipment, Inc. located in New Jersey. Many of you know Barry. I myself, have known him approximately 20 years. I met Barry through his father, Harvey. We remained in close contact through the years and now it brings us together in the buy/sell imaging equipment arena.

When looking back on my teaching, the areas that I most enjoyed were in radiation physics and equipment operations. I taught all aspects of radiation physics for radiography, ultrasound, nuclear medicine and radiation therapy. In addition, I taught about equipment operations and how physics are related. Based on my extensive experience in this field, I have developed a very strong understanding between physics and equipment.

I must point out that my knowledge is not name brand specific, but is applicable to all manufacturers. I am pleased to say that I will be posting blogs on a variety of topics to help educate our community. You can access this information anytime on our company's web site http://www.capmedonline.com/. Since I have a passion for teaching, I believe a forum setting would be a ideal place to educate and discuss equipment. So I have taken it upon myself to set up a blog for the purpose of educating. By reading the blog and presenting feedback, I hope the process will aid all of us with buying/selling our products.

My first topic which has many components for discussion, will be divided into a series of blogs on Digital Fluoroscopy. Part I has been posted and there will be a continuation of this until the topic has been completed. I will then continue to select a variety of topics that will help to educate our community.

Some of these topics you may be familiar with and some you may not. I encourage any readers to submit responses/comments if you wish. My goal is to help our community to be better prepared to handle basic equipment knowledge while serving the medical profession on day to day and long term projects. I hope that you find this educational and fun.

I look forward to hearing your feedback. Let's enjoy this ride together!

Digital Fluoroscopy- Part I

In this writing, I will try and give you an overview about Digital Fluorscopy. This is the first part of a series of blogs that will discuss many aspects of Digital Fluoroscopy and how it functions.

Introduction on Digital Fluoroscopy

The advantages of Digital Fluoroscopy (DF) over conventional fluoroscopy are the speed of image acquisition and post processing to enhance image contrast.

A matrix is described as how many pixels are used to create your image. Imagine that a pixel is a bucket of water, and now you need to fill a barrel which will represent your final image. Instead of looking at a digital image in volume such as a barrel of water, you are looking at an image that has a width and length to it. So, in creating an image, we will have so many pixels across for the width and so many pixels down for the length. The higher the number of pixels utilized in a matrix, the greater the amount of image storage information. Pixel arrangements have greatly increased through the years creating a more enhanced image. A very good example of this is our televisions in our homes. A standard tube like TV was designed to have a 525.5 (width) X 525.5 (length) lines of information to create our TV image we watch. Now today, we purchase high definition TV systems whose matrix arrangement is 1018 or higher, which would mean a 1018 X 1018 arrangement. Twice as much information stored in the same space yields much higher and better image quality. This premise is carried into the digital world when we look at pixel arrangements.

A 1024 x 1024 image matrix is sometimes called a 1000 line system.

In DF, the spatial resolution (how much information is stored within the space given) is determined by both the image matrix and by the size of the image intensifier.

•Spatial resolution is limited by the pixel size.
•DF Pixel size:
Pixel size = image intensifier size / matrix

Digital fluoroscopy is much the same as conventional fluoroscopy, where digital units have a computer added to it and usually two monitors instead of one monitor as with conventional fluoroscopy.
A DF examination is very similar to a conventional fluoroscopic study.
The console contains special function keys as well as alphanumeric keys, which are found for most equipment in the left module (side of key board), which allows patient data entry and information transfer ability to the computer.

The right portion of the console contains additional special function keys for data acquisition and image display.
It also contains computer interactive video controls and a pad for the cursor and region of interest (ROI) manipulation, where you can zoom in and magnify on specific anatomy.
Some systems may have joysticks or a mouse versus a pad.
Two monitors are used.
The left monitor is used to edit patient and examination data and to annotate final images.
The right monitor displays subtracted images (which are images, that look like our negatives from a role of film) by dulling background anatomy that is irrelevant and highlighting the relevant anatomy of interest.

High Voltage Generators
The fluoroscopic tube that lies beneath the table is a standard radiographic tube.
The tube current is measured in hundreds of mA (milliamperes or 1/1000 of an ampere) instead of less than 5 mA, as in a standard image-intensifier fluorscopy tube.

If the tube were energized continuously, it would fail because of thermal overloading and the patient dose would be exceedingly high.
Images from DF are obtained by pulsating the x-ray beam in a pattern known as pulse-progressive fluoroscopy.
During DF, the x-ray tube operates in the radiographic mode.
Image acquisition frame rates are 1 per second to 10 per second which are the most common ranges.
Because it requires 33 ms (millisecond or 1/1000 of a second) to produce one video frame, x-ray exposures longer than that can result in unnecessary patient dose.
The catch to this though is longer exposures reduce the noise levels (snow on image) and improve image quality.
X-ray generators must be capable of switching on and off very quickly.
The time that is required for the x-ray tube to be switched on and reach the selected level of kVp (kilovoltage peaks or 1000 volts) and mA is called the interrogation time.
The time required for the x-ray tube to be switched off is the extinction time.
DF systems have to incorporate three-phase or high-frequency generators with interrogation and extinction times of less than 1 ms.

END- PART I

In Part II of Digital Fluoroscopy we will continue this topic and examine the role of a CCD camera and how it is part of digital systems.

Disclainer: Capital Medical Equipment, Inc. and Sharon Moore will not be held liable for written materials within this blog or any future blogs. This blog was created as an educational tool and for no other purpose. It will be prohibitted by law to copy, reprint or publish this material without written permission of the author or Capital Medical Equipment, Inc."