Chapter 32 Film Artifacts

1. Chapter 32 Film Artifacts

2. Retake Analysis • Required part of a QA program in California. • Evaluation includes • View repeated • Cause of the repeat • Rate of retakes should be less than 5%. • Information can be gathered from the log that the state mandates for patients being exposed to radiation.

3. Chapter 32 Image Artifacts • An artifact is any irregularity on an image that is not caused by the normal shadowing of tissue by the primary beam. • There are three areas where artifacts occur: • Exposure • Processing • Handling

4. Exposure Artifacts • Exposure artifacts are generally associated with how the examination was performed. Example include: • Incorrect screen film match or wrong film • Poor screen contact • Warped cassettes • Dirty screens • Improper use of a grid. • Improper technical factors – most common reason for retakes.

5. Exposure Artifacts • Improper preparation of the patient for the exam or gowning instructions. • Double exposures • Motion blur from improper breathing instructions. • Improper positioning of the patient and equipment.

6. Appearance Unsuspected foreign objects such as jewelry Double exposure Blur Obscured detail Cause Improper patient preparation Reuse of an already exposed cassette Improper patient movement, breathing Poor screen contact Common exposure artifacts

7. Dentures • Older patients may have removable dentures for the upper or lower teeth. • As part of the gowning instructions ask about dentures.

8. Dentures • Partial Dentures are attached to the remaining teeth with metal clips. • Can cause major problems on APOM views.

9. Poor Gowning: Ear Rings • There we see an ear ring on a base posterior view.

10. Poor Gowning: Ear Ring • A single ear ring on a lateral cervical spine view.

11. Poor Gowning: Pins in Hair • Bobby pins can ruin cervical or skull radiographs.

12. More Hair • Here are two A-P cervical spine view. • One the first view a soft tissue mass is seen at the base of the skull. • The patient’s hair was in a bun. She put her hair down and the mass disappeared.

13. More Hair Artifacts • Another example of mouse and dreadlocks. • You will not be able to get the patient to remove the dread locks so have the patient but their hair up for the A-P

14. Hair Extensions

15. Poor Gowning: Necklace • When someone measures the patient and positions the view, how can you not see a necklace?

16. Poor Gowning: Bra • The complete study of a brassiere. • P-A & Lateral Views

17. Patient with arms across chest • Make sure the arms are to the patient’s sides and out of the view on A-P or P-A views.

18. Rings and Watch • The doctor failed to have the patient remove their rings and watch.

19. Patient with arm to side • Make sure the arms are properly positioned for lateral views.

20. Metallic artifacts on Lumbar View • Intern took film with patient in shorts. • Shorts had metal eyelets for the drawstrings. • Something in pocket.

21. Lateral Gonad Shield • It is very important to remove the shield after it is used. • The patient was too large to be done P-A.

22. Fingers in the spine • Keep the hands above the lumbar spine when taking the lateral view.

23. Cassette Artifact Dirty Screens • Dirty or damaged screens will cause white spots on the image.

24. Dirty & Damaged Screens • The white spots on this film are the result of damaged or worn out screens. • Never use alcohol or detergents to clean screens.

25. Poor Screen Contact • Note the blurry image in the spine but sharp image of the ribs. • The screens were not in proper contact in the middle of the cassette due to a bow in the cassette back.

26. Processing artifacts • Processing artifacts are produced during the time the film is in the film processor. • Processing artifacts can be eliminated with a proper processor quality control program and frequent cleaning. • Occasionally the best film processor will jam or malfunction and produce artifacts.

27. Appearance Guide shoe marks Pi lines Sharp increase or decrease in OD Uniform dull gray fog Cause Improper position of guide shoes in turn-around assembly. Dirt or chemical stains on rollers Dirty or warped rollers Improper or bad chemistry Common Processing Artifacts

28. Film Guide Scratches • Guide shoes scratches are parallel and run in the direction of film travel.

29. Other Processing Artifacts • Here we see hesitation marks on top of film. • This film remained in the developer too long. Perhaps from: • Power Failure • Processor jam

30. Other Processing Artifacts • This is what contaminated developer looks like. • Contaminated developer can also appear as a pink film.

31. Processor Chemical Marks • This artifact is called a run back artifact. • Proper cleaning of the cross over rollers can reduce the incidence of this artifact.

32. Processor Water Marks • These spots are the result of water spots on the film. • The upper rollers in the wash tank are supposed to squeegee the film.

33. Chemical Run Down Artifact • If the squeegee rollers in the developer rack do not work, the chemicals run down the film forming the appearance of water running down a window.

34. Kissing Artifacts • If more than one film is feed into the processor at once, only one side of the emulsion will be completely processed.

35. Kissing Artifacts • By running the film through the fixer, the undeveloped emulsion can be fixed and the image will be less degraded.

36. Kissing Artifacts • By running the film through the fixer, the undeveloped emulsion can be fixed and the image will be less degraded.

37. Dirty Developer Rollers • The rollers in the developer tank or cross over are dirty. • This causes the black artifacts on the middle of the film. • Oxidized developer is left on the film.

38. Tractor Marks from Film Jam • Marks that appear as tractor tracks on the upper left portion of the film are referred to as Tractor Marks. • Result of film being feed crocked and jamming the processor.

39. Film Handling Artifacts • A number of artifacts can occur while the film is in storage, in the darkroom or in the x-ray room. • Film is sensitive to heat and humidity. • After exposure it is very sensitive to fog from lighting problems in the darkroom. • Improper handling can cause artifacts. • All handling artifacts are avoidable!!!!

40. Appearance Fog Pressure or kink marks Streaks of increased OD Cause The temperature or humidity too high. Safelight too bright, too close or wrong filter. Light leak or other light in darkroom. Film left in x-ray room during exposure. Rough handling of film. Film not completely in processor when darkroom door opened. Common Handling & Storage Artifacts

41. Appearance Crown, tree or smudge static Yellow-brown stain Cause Humidity or temperature too low Thiosulfate left on film due to improper washing Common Handling & Storage Artifacts

42. Film Handling Artifacts • Crescent shaped artifact is a nail crinkle mark. It is caused by improper film handling. • Black spots are scratches from work surface.

43. Film Handling Artifacts • The door to the darkroom was opened before the film was completely in the processor.

44. Film Handling Artifacts • The top of the film is exposed to light by opening to darkroom door or turning on the lights with the box open.

45. Film Handling Artifacts • Some roller artifacts are seen caused by developer being on the entrance rollers. • Cause: Pulling a film out of the processor feed tray.

46. Static Electricity • Static electricity discharge may appear as a tree or lightning strike. • It may also produce round smudges. • Keep humidity in area at proper level.

47. Film Not Left in Box in Film Bin • The box that the film comes in serves as protection from scratching. • If you take too many sheets out, replace excess film in box not just in the bin.

48. Improperly Washed Film • If the wash tank is not properly filled, fixer is retained on the emulsion. • The retained fixer form silver sulfide and turns the image brown.

49. End of Lecture