#5 Grid Cut-Off in the Digital World 03 /01 /2013
After years of wondering about it,
sometimes noticing it and finally researching it, I’ve come to the conclusion
that grid cut-off isn’t mentioned anymore because no one even knows it’s happening. With film it was totally obvious because grid
lines covered 50-100% of the image. That
is not the case at all with digital images.
This is because the post processing has grid suppression software built
in that does just that – it suppresses the grid lines so they don’t appear in
the image.
This is a little good and a lot bad. Good because the image doesn’t have annoying
grid lines in it which could superimpose anatomy or pathology. Bad because the radiographer does not know that
there is grid cut-off occurring, with all the ill effects that grid cut-off
creates. These include: decreased contrast, increased brightness,
increased Exposure Index (EI) number, more technique (mAs) needed and possible
decreased sharpness of detail.
Whenever you are using a grid and the
image has any problem with contrast, brightness, detail or EI number, it is
almost a given that you have grid cut-off.
It is happening all the time
and almost no one knows it. In fact,
most of the grids that come with both CR and DR equipment are incorrect for use
with chest x-rays.
There are many different styles of grids,
but the 2 most common are with the grid lines running parallel with the floor
(called a horizontal grid) and 90 degrees to the floor (called a “decubitus” or
“short axis” grid). When using the grid
for any AP chest work where the central ray (CR) is being angled caudally into
the patient and grid, the grid needs
to be short axis so that the grid lines are still parallel with the CR.
I did some experiments recently with the
grids that came with both our GE and Siemens
DR equipment and both of them were horizontal
grids. This isn’t written anywhere on
them, but I proved it by taking chest phantom shots with a 10 degree caudal
tube angle and the grid both lengthwise and crosswise. With the GE grid it needed to be put in
behind the patient with the handle to the side which is very difficult and the
Siemens grid needed to be put in portrait and not landscape. With our CR grids we had to purchase separate
grids that were short axis so that we could continue to put the grid behind the
patient crosswise.
When you get grid cut-off, it means you
have used more mAs than needed to get a proper EI number. From my research I’ve concluded it’s around
30%.
I was thinking I could have you go to the
Presentation Download on my home page and look at the slides that discuss grid
cut-off, but I do not have time to cover it in my 2 hour lecture. It is only in my 6 and 8 hour presentations. Sorry about that. Hopefully one day I will have it on my site
in the Current Research section.
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