If imaging is performed with film alone (no intensifying screens), what is true about exposure and patient dose?

• A. The same exposure is required as with screens
• B. Exposure is reduced, lowering patient dose
• C. Imaging time is shortened
• D. More X-ray exposure is required, resulting in higher patient dose

Answer: (D)

Intensifying screens multiply the effect of the X-ray beam by converting X-ray energy into light, which then exposes the film more efficiently. When you use film alone without screens, the film is far less sensitive because there’s no light amplification, so to achieve the same image density you must increase the X-ray exposure substantially. That higher exposure directly raises the dose delivered to the patient. Imaging time isn’t shortened by removing screens; in fact, you typically need more exposure, not less, to get a satisfactory image.