all right part two of cr uh just a couple of things on artifacts and errors and kind of terms that you should know um one of the main ones would be the ghosting error or the ghost image that you might find in cr and that is an error with the erasing and as we know from our previous video that the cr plate is erased using a bright white light well here you can see we call it a double image um so this is actually i think a horse or something not a patient x-ray but you can kind of see the shadow over here of this lead marker also this area over here looks less dense so what happened was they took an exposure on this cr plate processed it it didn't erase fully but the machine the processing machine put it back into the outer casing and it was used as an exposure again well we're getting the new exposure but we still have a faint sort of shadow or a ghost image of the original and usually you can see the person's marker so if this happens to you're unfortunately gonna have to repeat it um and if you do a big exposure um you have a big patient you have to use a higher technical factors i would recommend erasing twice um to prevent this from happening but so ghost error or ghost image is a cr error that you'll see and it's an issue with the erasing process which is a bright white light roller malfunction error um so you can see this clear line something happened within the rollers and if you remember with the cr plate it takes that imaging plate through a set of rollers inside that cr processor and if there's a malfunction when it's scanning it can be under the beam for a longer amount of time where it's not supposed to be and so this whole section ended up being a lot brighter than up here so this artifact was right through the area of anatomy so that would most likely have to be repeated here's another one this is a complete malfunction there's a bright line here and then this is completely not exposed there's a white line here going through that i think had dirt on the rollers possibly so it happens and then this one you'll probably see um more than the roller issue but it's called a moire pattern it happens with an error with the cr grids and it's called a wave like pattern so it almost has it clearly has grid lines going through your picture right you can see it looks like um sort of bad lines coming through here they have kind of a wavy appearance so if you see the term wave like artifact or wave like grid error it's going to be this one it's the more a pattern um it's actually an error with how the laser is scanning the cr and it's parallel to the grid lines here so cr grid error you're going to get a more effect which is a weave like appearance okay some general about artifacts um the cassettes and imaging plates should be cleaned uh believe it or not it's a technologist's responsibility whether you've seen it done or not they easily collect dust so you really want to make sure that if you are somewhere that's using the sierra plates that they're getting cleaned and i know for us we're transitioning basically to all digital so they're just not used as much or as often so if you have to take one out or the scoliosis cassette that we have a cr so that will need to be kind of checked for dust and cleaned watch for any um scratches and if you see it something on your image itself you're seeing like a bright white line through the anatomy it's most likely a scratch that's on the cr imaging plate itself part of the protective coating might have gotten scratched off so you're getting a scratch on the plate so it should be cleaned with a solution that's assigned by the vendor whatever they specified that you're going to clean it with and um they should be wiped down after every patient you know your basic infection control stuff and check your hinges if there's a hinge issue if you're putting it in the cr reader and you're getting an alert it's not taking the plate out it's most likely an issue with the hinges those little locks on the outside protective area and you know with your infection controls try just like you do with your dr cassettes put a bag over it if and then you're gonna use your cleaning wipes don't use cleaning solution do not pour cleaning solution down into your cassette pretty please there are some advantages and some disadvantages of everything right but some advantages of cr over film um was you no longer needed a dark room we no longer needed like the processing chemicals and all of that we now have packs it increased our speed there's lower patient dose because we can use lower techniques and then you know cr and now with dr um there's fewer repeats due to under over exposure because of all of the computer applications that are provided there's pros processing capabilities we can you know change things around we'll talk about that in a second and then disadvantages one of the things that it could be possibly leading to and with digital itself is something we call dose creep um so dose creep is actually a pattern of radiation exposures that are being increased by clinicians over time just to make sure that they have a quality image so watching your exposure index numbers knowing the ranges for your exposure index numbers for each set of equipment is important where should where's my target should i be between 100 and 300 am i using a direct digital do i have a grid on things like that is just really important to be aware of