1. PA Projection.
2. Lateral View.
3. PA - Parietoacanthial ( Waters Method ).
General Image Quality Guidelines and Radiation Protection considerations:
• Images should have a visually sharp reproduction of all structures, such as outer and inner
lamina of the Cranial Vault (Cranial Cavity), the various sinuses and sutures where visible,
vascular channels, Petrous part of the temporal bone and the pituitary fossa.
• Important image details should be visualized.
• Whenever possible, use an Occipito-frontal (PA) rather than a fronto-occipital (AP) since
this vastly reduces the dose to the eyes.
• Exposure Factors: 70 – 85 kVp.
20 mAs.
• Cassette (IR) Size: 24 x 30 cm, (10 x 12 inches).
• Cassette Orientation: Portrait ( Lengthwise ).
• FFD / SID: 100cm, (40 in).
• Always using Bucky (Grid).
• Projections of the skull may be taken with the Patient sitting, standing or Laying
depending on the patient's condition.
Positioning:
• Rest patients nose and forehead against table/ Bucky.
• Flex neck to align OML perpendicular to IR.
Centering Point: Exit at the level of the Nasion.
Central Ray: Perpendicular to the IR / Bucky, Parallel to the radiographic baseline
(Orbitomeatal Line).
Collimation: Outer skin margins of the skull.
Evaluation Criteria
 No rotation is evidenced by The
lateral borders of the orbits to the
lateral borders of the skull are
equidistant on both sides.
 Area Covered Collimation:
 Shutter A: Open to include the
lateral skin margins of the skull.
 Shutter B: Open to include the
entire skull superiorly, and the
maxilla inferiorly.
 Exposure:
 Assess for adequate penetration of
the thickest part of the skull, the
frontal bone.
 Bony trabecular patterns and
cortical outlines are sharply
defined.
 Soft tissues are visualized.
Positioning:
Erect
• Patient standing or sitting facing the upright Bucky.
• Place the side of interest of the head closest to the Bucky.
• Oblique the body slightly to assist with positioning and patient comfort
• Adjust head into a true lateral position.
• Align midsagittal plane parallel to IR
• Align interpupillary line perpendicular to IR
• Position the Zygomatic Bone to the center of Bucky.
Supine
• Can be performed supine with patient in
a lateral recumbent position on the X-ray table.
Centering Point: Zygomatic Bone in the
center of Bucky.
Central Ray: Perpendicular to the IR / Bucky.
Collimation: Closely collimate to Facial Bones.
Evaluation Criteria
 No tilt is evidenced by There
is superimposition of the
superior orbital plates and both
lateral margins of Mandible.
 Area Covered Collimation:
Shutter A: Open to include the
skin margins of the top of skull
superiorly, and the end of
Mandible inferiorly.
Shutter B: Open to include the
Facial Bones.
Exposure:
• Assess for adequate
penetration of the thickest part
of the skull.
• Bony trabecular patterns and
cortical outlines are sharply
defined.
• Soft tissues are visualized.
Positioning:
• The patient should be seated, facing the upright Bucky, and it can be performed in Prone
Position.
• The median sagittal plane should be perpendicular to the cassette.
• The patients mentum of the chin should be touching the upright Bucky and sufficiently
raised to bring the Mentomeatal Line is Approximately Perpendicular to IR, and the
Orbitomeatal baseline or radiographic baseline 55° to IR.
• Make the Acanthion in the center of Bucky.
Centering Point: CR exits at Acanthion.
Central Ray: Perpendicular to the IR / Bucky.
Collimation: Collimate closely to outer
margins of the skull.
Evaluation Criteria
 No rotation is evidenced by
The lateral borders of the orbits
to the lateral borders of the skull
are equidistant on both sides.
 Clearing the maxillary sinuses
of the Petrous ridge.
 Area Covered Collimation:
Shutter A: Open to include the
lateral skin margins of the skull.
Shutter B: Open to include the
top of skull superiorly, and the
Occipital bone superimposed
with Cervical Spine inferiorly.
Exposure:
• Assess for adequate
penetration of the thickest part
of the skull.
• Bony trabecular patterns and
cortical outlines are sharply
defined.
• Soft tissues are visualized.
1.
2.
PA - ( Waters Method ).
PA - Anterior Oblique for Optic Foramen,
(Rhese Method).
General Image Quality Guidelines and Radiation Protection considerations:
• Images should have a visually sharp reproduction of all structures, such as outer and
inner lamina of the Cranial Vault (Cranial Cavity), the trabecular structure of the cranium,
the various sinuses and sutures where visible, vascular channels, Petrous part of the
temporal bone and the pituitary fossa.
• Important image details should be visualized.
• Whenever possible, use an Occipito-frontal (PA) rather than a fronto-occipital (AP)
since this vastly reduces the dose to the eyes.
• Exposure Factors: 65 – 80 kVp.
16 - 20 mAs.
• Cassette (IR) Size: 18 x 24 cm, (8 x 10 inches).
• Cassette Orientation: Landscape ( Crosswise ).
• FFD / SID: 100cm, (40 in).
• Always using Bucky (Grid).
• Projections of the skull may be taken with the Patient sitting, standing or Laying
depending on the patient's condition.
Positioning:
• The patient should be seated, facing the upright Bucky, and it can be performed in Prone
Position.
• The median sagittal plane should be perpendicular to the cassette.
• The patients mentum of the chin should be touching the upright Bucky and sufficiently
raised to bring the Mentomeatal Line is Approximately Perpendicular to IR, and the
Orbitomeatal baseline or radiographic baseline 35° to IR.
• Make the Midpoint of the Orbits in the center of Bucky.
Centering Point: CR exits at Midline
of the Level of the Mid-Orbital Region.
Central Ray: Perpendicular to the IR /
Bucky.
Collimation: Collimate closely to
margins of the Orbits.
Evaluation Criteria
 The Petrous ridges should
appear in the lower third of the
maxillary sinuses.
 There should be no rotation,
This can be checked by
ensuring
that the distance from the
lateral orbital wall to the outer
skull margins is equidistant on
both sides.
Positioning:
• The patient should be seated, facing the upright Bucky, and it can be performed in Prone
Position.
• Patient's head rests in 3 point landing (Chin, Cheek and Nose).
• Patient is rotated 37° from true PA.
• Center to Orbit down, Forehead should not touch table
Centering Point: Direct perpendicular
entering approximately (1 in) Superior
and (1 in) Posterior to elevated top of Ear
attachment exiting Orbit closest to IR.
Central Ray: Perpendicular to the IR /
Bucky.
Collimation: Collimate closely to Orbits.
Evaluation Criteria
 Optic Foramen should be
projected in Lower, Outer
Quadrant of Orbit examined.
1.
2.
3.
4.
Orthopantogram (OPG) for Mandible.
Lateral Mandible.
AP Axial (Townes).
Axiolateral Oblique, (Laws) Bilateral with open
and closed mouth .
General Image Quality Guidelines and Radiation Protection considerations:
• Images should have a visually sharp reproduction of all structures, such as outer and
inner lamina of the Cranial Vault (Cranial Cavity), the trabecular structure of the cranium,
the various sinuses and sutures where visible, vascular channels, Petrous part of the
temporal bone and the pituitary fossa.
• Important image details should be visualized.
• Whenever possible, use an Occipito-frontal (PA) rather than a fronto-occipital (AP)
since this vastly reduces the dose to the eyes.
• Exposure Factors: 65 – 80 kVp.
16 - 20 mAs.
• Cassette (IR) Size: 18 x 24 cm, (8 x 10 inches) or 24 x 30cm (10 x 12 in).
• Cassette Orientation: Landscape (Crosswise) or Portrait (Lengthwise).
• FFD / SID: 100cm, (40 in).
• Always using Bucky (Grid).
• Projections of the skull may be taken with the Patient sitting, standing or Laying
depending on the patient's condition.
Positioning:
• Patient is in an erect position, either standing or sitting or Supine.
• Position the patient so that their back and posterior skull are touching the Bucky.
• Bring the patients chin down until the radiographic baseline Orbitomeatal line (OML) is
perpendicular the Bucky.
Centering Point: Directed to 6 cm superior to the Nasion.
Central Ray: CR 35° Caudal.
Collimation: Margins of the Cassette.
Positioning:
• Patient prone with head in true lateral, then rotate face toward table 15° with side of
interest closest to film.
• Interpupillary line is perpendicular to table.
• Need bilateral with open and closed mouth.
Centering Point: Enter 1.5 in superior to Upside EAM.
Central Ray: CR 15° Caudal.
Collimation: Margins of the Cassette.
1.
2.
3.
Axiolateral Oblique, (Laws Method).
Axiolateral Oblique, (Stenvers Method).
Axiolateral Oblique, (Arcelin Method).
General Image Quality Guidelines and Radiation Protection considerations:
• Images should have a visually sharp reproduction of all structures, such as outer and
inner lamina of the Cranial Vault (Cranial Cavity), the trabecular structure of the cranium,
the various sinuses and sutures where visible, vascular channels, Petrous part of the
temporal bone and the pituitary fossa.
• Important image details should be visualized.
• Whenever possible, use an Occipito-frontal (PA) rather than a fronto-occipital (AP)
since this vastly reduces the dose to the eyes.
• Exposure Factors: 65 – 80 kVp.
16 - 20 mAs.
• Cassette (IR) Size: 18 x 24 cm, (8 x 10 inches) or 24 x 30cm (10 x 12 in).
• Cassette Orientation: Landscape (Crosswise) or Portrait (Lengthwise).
• FFD / SID: 100cm, (40 in).
• Always using Bucky (Grid).
• Projections of the skull may be taken with the Patient sitting, standing or Laying
depending on the patient's condition.
Positioning:
• Patient prone with head in true lateral, then rotate face toward table 15° with side of
interest closest to film.
• Interpupillary line is perpendicular to table.
• Need bilateral with open and closed mouth.
Centering Point: Enter (2 in) superior and (2 in) posterior to Upside EAM.
Central Ray: CR 15° Caudal.
Collimation: Margins of the Cassette.
Positioning:
• Position Patient Seated, Erect or Prone.
• Have Patient rest Head on Forehead, Nose, and Zygoma.
• Rotate Face Toward Table 45°.
Centering Point: Enter (4 in) posterior and (1/2 in) inferior to Upside EAM.
Central Ray: CR 12° Cephalic.
Collimation: Margins of the Cassette.
Positioning:
• Position Patient Seated, Erect or Supine.
• Rotate Midsagittal Plane 45° Away from side being examined.
Centering Point: Enter (3/4 in) superior and (1 in) anterior to EAM.
Central Ray: CR 10° Caudal.
Collimation: Margins of the Cassette.
1. Lateral View
• Exposure Factors: 70 kVp , 16 mAs.
• Cassette (IR) Size: 18 x 24 cm
• Cassette Orientation: Landscape
• FFD / SID: 100cm, (40 in).
• Always using Bucky (Grid).
Positioning:
• Position Patient Seated, Erect or
Supine.
• Interpupillary Line is
Perpendicular to IR.
• Midsagittal Plane Parallel to IR.
Centering Point: Enter (3/4 in)
superior and (3/4 in) anterior to
EAM.
Central Ray: Perpendicular to
the IR / Bucky.
Collimation: Margins of the
Cassette.