I assume that everyone has had at some point the experience where less was more. Especially when dealing with computer based image postproduction. Software makes handy wonderful, or better: powerful, filters. Experienced artists know that only a pinch of something or homeopathy is a key to better results.
The same holds true in X-ray production. A maximum of energy does not provide better images. Let’s look closer at this point.
What is the influence of energy to X-ray images ?
Higher energies in X-rays mean shorter wavelengths and a higher resolution. Therefore it might seem reasonable to increase the energy in our X-ray tubes always to the maximum to produce incredible images based on a maximum resolution.
With four images below I show the influence of increased energy levels on X-ray images of a single rose. The applied energy levels are 40kV, 60kV, 90kV and 109kV. The steps of postproduction were the same in every image. Slight differences are owed to best contrast in each exposure.
Surprisingly to the novice we get an increasing loss of contrast (or less available contrast) in each image with higher energies. This effect of loosing contrast can easily be seen in this series of four X-rays and is highest at 109kV.
The explanation for less available contrast with higher energies is the following physical effect: the more photons have shorter wavelengths the more photons run unaffected through the object down onto the sensor. With all photons running through without any hindrance the sensor would show a homogenous gray value.
Every structure looses contrast when turning to higher energies. The optimum for a structure is found by experience and varies significantly.
In the medical field the applied energy strongly depends on the purpose of the examination and the structural demands to be diagnosed.
The above demonstrated meaningless low contrast for our single rose at 109kV doesn’t hold true at all in radiology. Radiologists use frequently 125kV for a chest film to get reproducibly valuable contrast in most patients.
You always need some time to find out the best exposure values for a photo. Same idea holds in X-Ray imaging.
Today I did an x-ray series with my biggest Nautilus shell on a conventional radiography sensor, not a film. Starting from the lowest possible value 40kV an increment of 10 kV up to 70 kV can be seen in the images:
Black regions in the image a transparent, white are opaque. The center of the Nautilus has a loss of structure.
With 50 kV the structure in the center of the Nautilus is better depicted wheras the edge gets more transparent:
Same effect for the center and the edge can be seen with 60 kV:
With 70 kV it’s an exaggeration for the edge and best depiction for the center:
Higher kV means more transparency for denser structures but a loss of structure in transparent areas.
At fixed energy, X-Ray imaging behaves like a shadow related to visible light. When photographing, there is not chance to look through an opaque object. With higher energies, x-rays go through opaque objects and can be collected on a sensor.
Composing the images obtained at different energies is an X-Ray HDR image:
The representation of an X-Ray with white on black is a reminiscence of the film era. Radiologists just looked at the negatives ! Inverting black and white shows the positive image, like a print. Here I show the same image as positive, but rotated and flipped horizontally. Look how ethereal it appears now:
Are you already high-brow ? You don’t want physics, because you didn’t like it at school ? Then take a look at a well understandable FAQ-sheet for x-rays of flowers given by Harold Davis. The doctor advices you to stop reading here !
Those who like some more background may read the following paragraphs.
Our eyes are sensitive to visible light. The wavelengths of visible light range from 400nm to 750 nm. Digital sensors for photography are modified in their sensitivity to gain a pleasing image for human eyes. E.g. we like green tones. A digital sensor for photography can be modified in its sensitivity within the range of visible light and over a wider range of wavelengths than visible light. The energy of visible light ranges between 1.6 eV (750nm) and 3.2 eV (400nm). Typical spatial resolutions of photographic sensors in the consumer section are between 4µm and 8µm.
A digital x-ray sensor works with spatial resolutions between approximately 70µm and 140µm. Using a medical x-ray machine the available energy levels of x-rays depend on the purpose of a human examination. Energy levels of mammography systems vary between approximately 20 keV and 45 keV, depending on manufacturer. Energy levels of conventional x-rays for bones or chest vary between approximately 80 keV and 125 keV. The corresponding wavelengths are under these conditions 0.06nm (20 keV) down to 0.01 nm (125keV).
As you may know, visible light and x-rays are part of the electromagnetic spectrum. Visible light and x-ray differ in their energy. Higher energy of a radiation means higher frequency and shorter wavelengths. Our eyes don’t see other light than visible light. X-rays are a special light then, not to be seen with our eyes – but with a digital sensor.
A substantial property of x-rays is their ability to run through objects with mainly no interaction. The x-ray sensor „sees“ only a small percentage of less radiation coming from the x-ray source when an object is placed near the sensor.
The left hand image appears normal to your eyes when thinking of an x-ray. Before the digital era, radiologists were using films, an analog medium to produce an x-ray. As x-rays run through an object with mainly no interaction, the dark parts of the left image were fully exposed to radiation. A dark part in an x-ray image therefore was called transparent by radiologists. The parts with lighter grey or white in it were called „opaque“ or „dense“ or „attenuated“ areas. The brighter parts result from the attenuation of radiation by an object. As a matter of convenience, digital x-ray images are shown like the left image. You see already details of the inner structure of our flower, a Bird of Paradise.
The right hand image is an inverted grey scale image. Black turns into white, 50% grey stays unaffected and white turns into black. A 75% grey turns into a 25% white. In every photo editor that’s just a simple and easy action to do. The inverted image is more pleasant to the perceptive habits of our eyes. To our experience, the inverted image is preferable for fusion imaging.