1973, British Journal of Radiology, 46, 885-888 OCTOBER 1973 Cineradiography By G. M. Ardran, M.D., F.R.C.P., F.F.R. Nuffield Institute for Medical Research, University of Oxford ABSTRACT was covered with a piece of black paper, upon which The history of cineradiography from the discovery of the limb of an animal, say a frog, could be photo- X rays in 1895 until 1972 is briefly reviewed. Maclntyre reported in 1897 on his method of attempting cineradio- graphed. As yet, the movement must be slow and graphy both by photography of the fluorescent screen and consequently carried out by an artificial or slow by the direct method whereby the X-ray image was recorded directly onto film. The methods were not of great value anaesthesia. In the present stage of our knowledge until the speed of films, fluorescent screens and optical the former gives the more satisfactory result. Some systems had improved together with increased outputs from months ago Dr. Maclntyre showed, by means of the X-ray tubes and improvements in focal spot size were attained. mercury interrupter, that he could obtain instan- The contribution of early French workers and other taneous photographs of the bones of his finger by a British workers is discussed. Cineradiography was really single flash of the tube, due to one vibration of the shown to be of value following the work of Janker in Ger- many in the 1930s. contact breaker. At a meeting of the Glasgow The developments and applications made by Barclay in Philosophical Society recently, he was able to pass Oxford and subsequent work at the Nuffield Institute for films forty feet in length through the cinematograph: Medical Research is briefly described. The advent of electron optical image intensifiers in 1953 made the method the movements of the leg of a frog could clearly be practical and fairly universal. The intensifiers enabled an seen when demonstrated on a magic lantern screen improvement in the quality of work and considerable re- by means of the cinematograph." Five pictures of a duction in patient X-ray exposure. The introduction of stereoscopic cineradiography and cineradiography with frog's knee illustrated part of the action of flexion of sound recordings is reported together with the advent of this joint. high-speed cine up to 400 frames per second. The study of the mechanism of swallowing, the investigation of the It is clear that Maclntyre appreciated the two urinary tract, speech difficulties, and angiocardiography are basic methods of recording movements using X some of the principle uses today. The introduction of time lapse cinefluorography for examination of the large bowel rays and paved the way for the future development at one frame per minute for up to two hours is reported. The of rapid serial radiography and cineradiography. The competition from recordings on video tape are discussed two methods were firstly the indirect, which photo- briefly. graphs the fluorescent image or secondly the direct, Cinematography and radiography were both born whereby the X-ray image was recorded directly at approximately the same time. The Lumiere on to the film or via intensifying screens in contact cinematograph was given a press showing at the with the film. Empire Theatre in London on February 7, 1896. Following the pioneer work of Maclntyre, he and Paul, a London instrument maker, demonstrated his other workers pursued both methods. Because of the "Theatregraph" on February 28, 1896 at the Royal slow speed of the systems much of the early work Institution. The first "Vitascop" developed by really consisted of rapid serial radiography either Edison arrived in London on April 30, 1896. X rays with full-sized films or by photofluorography. Copies were discovered in 1895 and it is remarkable that of the full-sized serial films might be made on to Maclntyre of Glasgow is reported in Volume I of the cine film so that they could be projected in motion. Archives of Skiagraphy in April 1897 in the follow- From these early beginnings until the present day all ing way:— manner of full-sized rapid serial equipment has been "Doctor Maclntyre has for some time been ex- produced, improvements being made and superior perimenting on the best method of obtaining rapid results obtained as X-ray tube outputs were in- exposures with a view to recording the movements creased and finer focal spots became available and as of organs within the body. Two methods have been the speed of films and intensifying screens were adopted, one in which the shadow of the object, as increased. Except for certain experimental purposes seen upon the potassium platino-cyanide fluorescent these were not usually transferred to cine film for screen, was photographed by means of the ordinary projection since in most instances this produced a camera. This, however, was found to be too slow jerky movement, the films having been exposed at for the purpose. The other method was to allow the rates of about 2-12 per second (Ardran, McLaren sensitive film to pass underneath the aperture in a and Sutcliffe, 1950). A tremendous amount of work case of thick lead covering the cinematograph. This was done on this type of serial equipment in the early opening corresponded to the size of the picture, and years of this century in many counties though 885 VOL. 46, No. 550 G. M. Ardran clinically useful equipment only really became largely due to his use of 35 mm film instead of 16 available in the 1950s. Rapid serial equipment will mm. Since one needed the fastest film emulsion not be further considered and the following will obtainable this was inevitably very grainy. This refer to the production of X-ray films designed to be meant that for otherwise similar speed systems the projected as cine films to demonstrate movement. grain on the 16 mm film was four or five times as Maclntyre continued with his work and is re- large, relative to the image, as with 35 mm film, and ported to have shown cinematograph films in 1914 this caused considerable deterioration of image taken by both methods. He is stated to have said quality. One of the reasons for the relatively poor that when photographing the screen image the best quality of the Russell Reynolds equipment was the results were obtained with a barium platino cyanide adherence to 16 mm film and his results were not as screen which had been moistened (MacLean, 1927). good as Jankers. He appreciated this point and Jarre (1933) in his excellent review of this subject about 1950, again with Messrs. Watsons produced states that: "It seems certain that Bleyer (1896), a 35 mm cineradiographic equipment though this Battelli and Garbasso (1896) and McKay (1896) almost immediately became obsolete with the pro- contemporaries of Maclntyre's, had rontgen cine- duction of image intensifiers in 1953. Although matography in mind, when they devised means to Russell Reynolds made many films, which he dem- photograph the fluoroscopic image". For some years onstrated, I can find no evidence that he published most of the more useful clinical or physiological any results scientifically or clinically valuable which study of movements was carried out by the rapid he discovered by his method (Reynolds, 1935). serial method employing full-sized films, cineradio- Barclay, when he came to the Nuffield Institute graphy not yet being good enough to be really for Medical Research, University of Oxford, in 1936, valuable. inherited a Russell Reynolds Watson 16 mm equip- Lomon and Comandon (1911 and 1924) in France ment but found it too low powered for serious work developed a "Radio cinematographic" and had, at in man and modified it for some animal experimen- their disposal, lenses of/I-55 aperture and in 1911 tal studies (Barclay, Franklin and Prichard, 1940). were able to demonstrate movements of the heart, He, with Seddon (1947), produced a useful film on thorax, intestines and some joints. It is not possible the movements of joints in man which was used for to say whether their results were superior to those of teaching purposes for many years. At the time of Maclntyre at this time. Barclay's death in 1949 this equipment had been Russell Reynolds had commenced his experi- retired as being of little practical use. ments in 1921 and reported these in 1927. He des- Shortly afterwards the Nuffield Institute found a cribed his technique and equipment and succeeded need for some cineradiographic equipment and an in taking films of some joints and the chest with inexpensive 35 mm equipment was developed (Ard- exposure rates of up to 16 frames per second. The ran and Tuckey, 1952) based on the use of an old results were regarded as promising but it was 35 mm cinematograph projector used as a camera. appreciated by all that until the speed of the system This produced films at 25 frames per second which could be improved serious work was not possible. were comparable with those produced by Janker Russell Reynolds was a great champion of this and when, in 1952, the equipment was fitted with a technique in Great Britain and by the middle 1930s specially designed Wray/0-75 lens, produced films in conjunction with Messrs. Watsons, produced a equal in quality to those produced anywhere else. complete 16 mm cineradiographic equipment. This Valuable results were obtained with this equipment. had relatively limited use since the speed of the A camera was designed and made for the Nuffield system was still low (Reynolds, 1934). Institute by Messrs. Vinten incorporating the Wray F. Melville (1927) also produced films of joints /0-75 lens modifying their HS300 frames per sec- and the chest at 16 frames per second. He was very ond camera to operate at 100 frames per second with conscious of the radiation exposures used. a 90° shutter as was the case with the cinematograph In 1931 Janker in Germany started to report his projector. The quality of films at 25 frames per work in this field. He succeeded in obtaining 100 second with a 15x12 fluorescent screen was similar images per second by the indirect method working to those with the simpler equipment. Both these with small laboratory animals such as cats and at equipments in 1952 employed pulsed X-rays using slower rates with human material. In subsequent the first General Radiological constant potential years he also obtained simultaneous sound record- electronic generator. This was satisfactory at up to ings and developed stereo cineradiography. Apart 75 frames per second: when used at 100 frames per from other improvements Janker's success was second, for animal experimental work, continuous OCTOBER 1973 Cineradiography radiation was employed (Ardran, 1960a; 1960b). motors to drive the camera so that the framing speed The situation was completely changed in 1953 could be synchronized to the mains impulses; for when the first electron optical image intensifiers speeds less than 25 frames per second with 50 cycle became available and these, in conjunction with 35 mains, speeds could be chosen to record the image mm and tandem optics, so improved the quality and produced by the same number of mains impulses for reduced the radiation exposures that cineradio- each frame. Following this, many manufacturers graphy finally became a relatively simple and more produced cine pulse units to give individual identical or less routine procedure. It rapidly became appa- pulses per frame giving short exposures and no rent that quantum mottle was a problem with image radiation when the shutter was closed. intensifier cineradiography as well as with conven- In 1956 Ardran and Wyatt described a portable tional radiography (Ardran and Crooks, 1954). image intensifier cineradiographic camera: this The tandem optics and the high speed films avail- used a synchronous motor and a gear box so that able at this time meant that there was no need for films could be exposed at 25 or 50 frames per faster optical systems, faster film or camera shutters second with continuous or pulsed radiation or at with an aperture greater than 180 deg.: for the best one, two or four frames per second with pulsed work when radiation exposure was not a critical radiation if the X-ray generator could give individual problem the optics needed to be stopped down. Some exposures at this rate. The camera could be used workers reduced the speed of the system and thereby with self rectified portable equipment at 50 frames obtained better results by using lower aperture per second, each impulse exposing a single frame. single lens optics. Others used fine grain film: they At 25 frames per second, two impulses exposed each did not always appreciate that their superior results frame. The Field Emission Corporation's "Fexi- were not due to the fineness of the film grain but tron" cold cathode generators are pulsed at 1,000 merely to the slower speed of the film reducing cycles per second and it is thus possible if the output quantum mottle (Astley, 1955). is sufficient to pulse cine films at up to this rate, The original 5 in. diameter intensifiers were though the maximum brightness build up time of improved to give larger fields, e.g. 9 in. or 10 in. and 2 ms of most intensifiers would result in inefficiency. the 12 in. Cinelix. These extended the use when a Advances have been made in the use of cine- large field was necessary but otherwise did not radiography since it became possible to record necessarily improve the quality. Some workers simultaneously ECGs, pressures, flow, sound or photographed the television monitor image: this other physiological parameters. This might be done could result in films taken with a lower radiation by recording each cine frame on the physiological exposure but because of the image of the television recorder but has also been done by recording the raster were not so good for detailed work as films data simultaneously on the unexposed portion of taken directly from the output phosphor. Stereo- each cine frame. scopic cineradiography and cineradiography with Cine techniques have also been improved partic- sound recordings were again adapted to the new ularly for experimental work by the use of direct method. Some workers, usually using 16 mm equip- enlargement with fine focal spots. Two or three ment, increased the framing speed up to 400 frames times enlargement may be obtained with the 0*3 mm per second; for most work in man this did not prove focal spot and up to perhaps 20 times, using a focal to be of great value. spot of about 10/Lt such as can be obtained from the At first image intensifier cinefluorography was Harwell El 2 micro focus generator. Of course the carried out with a continuous radiation exposure, output from these fine focal spots is relatively low the camera shutter closing for about half the framing and this may limit the size of the object radio- cycle and covering the film while it was moved. This graphed and may result in a return to continuous meant that the radiation exposure was 30-50 per rather than pulsed exposures. cent more than was necessary. When the equipment The basic technical problem of a slow speed was used with fully rectified four-valve equipment system with high radiation dose was solved by the or with half-wave rectified equipment, the film introduction of the image intensifier, and from then showed variable exposures due to the framing speed technical advance became of much less importance. not being synchronous with the mains impulses. The important problem now was to decide for what Attempts were made to overcome this by the use purpose cineradiography might be usefully em- of very large condensers in the high tension circuit ployed. Sooner or later every moving part of the to give more constant potential current. This prob- body was investigated and slowly it was used to lem was better overcome by the use of synchronous elucidate various physiological and clinical problems. 887 VOL. 46, No. 550 G. M. Ardran Sometimes when a problem had been elucidated fluorography, as we now know it, will be com- there was no longer any further need for the method. pletely obsolete. The principle clinical problems for which the REFERENCES method is used are angiocardiography, the mechan- ARDRAN, G. M., MCLAREN, J. W., and SUTCLIFFE, J., 1950. Radiographic studies of duodenum and jejunum in man. ism of swallowing, some speech defects and the Journal of the Faculty of Radiologists, 2, 148-164. urinary outflow tract. Angiocardiography is usually ARDRAN, G. M., and TUCKEY, M. S., 1952. The conversion carried out at between 25 and 100 frames per of standard 35mm cine projectors into cine radiographic cameras. British Journal of Radiology, 25, 33-34. second: for the mechanism of swallowing 25 frames ARDRAN, G. M., and CROOKS, H. E., 1954. Some observa- per second is sufficient: the oesophagus can usually tions on the graininess of radiographs. A.E.R.E. Report, March 1954. be examined at four frames per second and the stomach ARDRAN, G. M., and WYATT, D. G., 1956. A portable may only require one of two frames per second. X-ray cinecamera. British Journal of Radiology, 30, 52-54. The urinary outflow tract seldom needs more than ARDRAN, G. M., 1960a. Cineradiography. Research Film 3, 272-277. four frames per second. These slower speeds may be 1960b. Cineradiography. Radiography, 26, 303-308. regarded as rapid serial radiography but the results ASTLEY, R., 1955. Cineradiography with an image amplifier: are recorded on cine film and can be projected at a practical technique. British Journal of Radiology, 28, 221-222. cine speeds or examined frame by frame. Most BARCLAY, A. E., 1935. Direct X-ray cinematography with a cineradiographic films are examined at the speed preliminary note on the nature of the non-propulsive at which they were taken, sometimes faster and movements of the large intestine. British Journal of Radiology, 8, 652-658. sometimes slower, according to the nature of the BARCLAY, A. E., FRANKLIN, K. J., and PRICHARD, M. M. L., problem, but full value is seldom obtained unless 1940. X-ray cinematography in research. British Journal the relative portions are examined frame by frame. of Radiology, 13, 227-234. BARCLAY, A. E., and SEDDON, H. J., 1947. Cineradiography 16 mm film is cheaper and more convenient but it ofJoints (Blackwell Scientific Publications, Oxford). has not produced results as good as may be obtained BATTELLI, A., and GARBASSO, A., 1896. Sopra i raggi del Roentgen. // Nuovo Cimento, 42, 40. with 35 mm because the finer grain film required to BLEYER, J. M., 1896. On the Bleyer photo-fluoroscope. produce the same sized projected image is too slow. Electrical Engineer, New York, 22,10. JANKER, R., 1931. Zur Roentgenkinematographie. Fort- More recently, to examine the large bowel, a 12 in schritte aufdeur Gebiete der Roentgen-Strahlen, 44, 658. "Cinelix" equipment has been used, the film being JARRE, H. A., 1933. Chapter 11 in The Science of Radiology, exposed at one frame per minute for an hour or more. Eds. Otto Glasser, pp.198-209. (Charles C. Thomas, Springfield, Illinois). This introduction of time lapse cinefluorography LOMON, A., and COMANDON, J., 1911. La radiocinemato- (Ritchie, Truelove and Ardran, 1968) has made it graphie par la photographie des ecrans renforcateurs. possible to study usefully the large bowel when other Bulletins et Memoires de la Societe Medicale des Hopitaux de Paris, 3,127. methods over the years have failed (Barclay, 1935). LOMON, A., and COMANDON, J., 1924. Radiographie cine- For some years now the advent of closed-circuit matographique du cceur de l'homrae. Bulletin de V Academie de Medecine (Paris), 91, 711. television has enabled one to record the image on MACINTYRE, J., 1897. X-ray records for the cinematograph. video tape. This may be done with less radiation Archives of Skiagraphy, 1.37 exposure than is required for cinefluorography. It MACKAY, J. S., 1896. The new art of radiography. Elec- trician, 36, 668. suffers from the disadvantage that the quality of the MACLEAN, A. B., 1927. Correspondence in British Journal image is not as good as may be obtained with cine- of Radiology, 23, 216. radiography from the output phosphor of the inten- MELVILLE, F., 1927. X-ray cinematography. British Journal of Radiology, 23, 217-220. sifier and it has proved difficult to view the image, REYNOLDS, R. J., 1927. Some experiments on the produc- frame by frame, or to readily select a particular tion of rapid serial skiagrams from the screen image by frame. If a single television scan is viewed for any means of a cinematograph camera. British Journal of Radiology. 22, 33-44. length of time with the tape stationary, this rapidly 1934. Cineradiography. British Journal of Radiology, 7, results in wear of the tape. However, improvement 415-424. 1935. Cineradiography. British Journal of Radiology, 8, in electronic as distinct from photographic recording 135. are to be expected. RITCHIE, J. A., TRUELOVE, S. C , and ARDRAN, G. M., 1968. Propulsion and retropulsion in the human colon demon- It is quite possible that in 75 years' time cine- strated by time-lapse cinefluorography. Gut, 9, 735-736.
Pages to are hidden for
"cineradiography"Please download to view full document