Chapter 32 Film Artifacts

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Chapter 32 Film Artifacts
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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.

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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

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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.

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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.

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Common exposure artifacts

• 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

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Dentures

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

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Dentures

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

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Poor Gowning Ear Rings

• There we see an ear ring on a base posterior view.

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Poor Gowning Ear Ring

• A single ear ring on a lateral cervical spine
  view.

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Poor Gowning Pins in Hair

• Bobby pins can ruin cervical or skull radiographs.

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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 patients hair was in a bun. She put her hair
  down and the mass disappeared.

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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

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Hair Extensions
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Poor Gowning Necklace

• When someone measures the patient and positions
  the view, how can you not see a necklace?

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Poor Gowning Bra

• The complete study of a brassiere.
• P-A Lateral Views

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Patient with arms across chest

• Make sure the arms are to the patients sides and
  out of the view on A-P or P-A views.

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Rings and Watch

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

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Patient with arm to side

• Make sure the arms are properly positioned for
  lateral views.

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Metallic artifacts on Lumbar View

• Intern took film with patient in shorts.
• Shorts had metal eyelets for the drawstrings.
• Something in pocket.

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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.

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Fingers in the spine

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

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Cassette Artifact Dirty Screens

• Dirty or damaged screens will cause white spots
  on the image.

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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.

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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.

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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.

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Common Processing Artifacts

• 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

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Film Guide Scratches

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

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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

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Other Processing Artifacts

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

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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.

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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.

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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.

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Kissing Artifacts

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

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Kissing Artifacts

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

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Kissing Artifacts

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

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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.

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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.

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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!!!!

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Common Handling Storage Artifacts

• 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.

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Common Handling Storage Artifacts

• Appearance
• Crown, tree or smudge static
• Yellow-brown stain

• Cause
• Humidity or temperature too low
• Thiosulfate left on film due to improper washing

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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.

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Film Handling Artifacts

• The door to the darkroom was opened before the
  film was completely in the processor.

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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.

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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.

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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.

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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.

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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.

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End of Lecture