The most recent advances in medical imaging involve converting the x-ray information directly or indirectly into digital information. Two advantages of digital images are storage and the ability to manipulate the information on the image.

Just as with an digital information the digital medical image can be stored on any type of computer device. These images can also be sent electronically too other health care providers. One does need to ship a film if a specialist far away from the patient needs to be part of a diagnostic team.

Manipulation of the image can be a process as simple as changing the contrast in order to see some aspect more clear. It can also be used to remove uninteresting aspects of the image or the watch change over time. For example, digital subtraction angiography is a rather fancy name for removing the unwanted information. An image of a region of the body is taken before and after a procedure such as injecting a compound which highlights certain organs. The tow images are subtracted bit-for-bit. The result is an image which shows only the parts of the body in which the physician is interested.

Digital images can be created in five basic ways.

1. Directly from a digital process such as computed tomography.
2. Digitizing fluoroscopic images
3. Using a solid state x-ray detection system instead of film (computed radiography)
4. Using an array of solid state detectors (direct radiography)
5. Scanning film.

Processes 3-5 involve applications of contemporary physics in the effort to convert the information in the x-ray beam to digital.

A common detector consists of an array of charge coupled devices (CCD). These solid state devices involve the photoelectric effect and electron-hole production. The system is frequently set up as a chip that is divided into a large number of bins (pixels). The bins create a 2-dimensional array. Incoming x-ray photons eject electrons. Thus, charge builds up depending on number of photons which strike each bin. A computer-type device reads the charge on each bin (pixel). This charge is then directly related to the number of photons and thus the brightness of the image at that pixel.

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