Stitch Imaging X-Ray vs Full Spine (Explainer)

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How do I achieve a full spine x-ray?

You can achieve this type of image in one of two ways:

1. Stitching together sectional x-rays or
2. Obtaining a single image using a full-size digital radiography (DR) panel.

Each option typically produces the same result: an x-ray image of the full spine.

Full spine x-ray image in stitching mode

In stitching mode, we overlay three images and “stitch” them together to create a final full spinal image. The image produced by a full spinal DR panel will be identical to the examples presented below.

How to stitch x-ray images

This YouTube video describes how to stitch x-ray images using the DRGEM RadMax version 3 software. Read out our DRGEM product range.

The first step would be to take your patient x-ray, apply cropping and editing and then use the software to stitch the images.

Stitched x-ray images pros and cons

Pros

• Individual control on your factors for each region of interest, ensuring you following ALARA principles at all times.
• Easier to stitch images of a taller person, thus not being limited to the height of the individual due to panel size restrictions.
• Easier to stitch images of a shorter person where you can potentially get away with a combined cervical and thoracic shot, followed by a lumbar shot.
• Cheaper to work with a standard size DR panel instead of full spine panel.
• Standard size DR panel will work with all wall and table buckys.

Cons

• Additional steps required to stitch the images (during or after the x-ray is taken).
• Minor overlay of 1-2 cm required between your x-ray images during x-rays to allow room for stitching.

Full spine x-ray image pros and cons

Pros

• Full size DR panel that allows up to 86cm of image to be taken.
• Abillity to utilise a grid on your standard size DR panel.
• To obtain a full-spine set requires an ability to have a longer room for an increase in focal distance between your tube and wall bucky.
• Single image acquisition.
• No editing of images for stitching.

Cons

• Will require a custom bucky to fit in to.
• More expensive.
• Will require Nolan filters as you are using the densest part of patient body to complete the exposure.
• Longer training required on the use of Nolan filters.
• Shadows cast over your images due to the use of Nolan filters.
• Lumbar spine region with hips will increase collimation area to thoracic and cervical region, thus increase in dose to patient.
• Larger room required for the x-ray system to gain the distance for a full spine.

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