Bucky View in Radiography
Definition and Technical Purpose
The Bucky view refers to radiographic imaging performed using a Bucky grid (also called Potter-Bucky grid), which is an anti-scatter device positioned between the patient and the image receptor to improve image contrast by reducing scattered radiation. 1, 2
The Bucky grid consists of thin lead strips separated by radiolucent material that selectively absorbs scattered X-rays while allowing primary radiation to pass through to the detector. 1, 2
Clinical Applications and Benefits
In Mammography
For mammographic imaging, the Bucky grid significantly improves contrast improvement factor (CIF), particularly for thicker breast tissue (≥4 cm compressed thickness), making it essential for adequate visualization of subtle findings in women over 40 with dense breasts or larger breast volumes. 1, 2
Specific Performance Characteristics:
Cellular grids outperform linear grids in mammography, with cellular grids demonstrating 5-10% higher contrast improvement factors at standard mammographic energies (25-30 kVp). 1, 2
The contrast improvement factor increases with breast thickness, providing the greatest benefit for compressed breast thickness of 6-8 cm compared to 2-4 cm. 1
Grid performance is optimized at 25-30 kVp for standard mammographic technique, with tungsten-septa air-interspaced cellular grids (4:1 grid ratio) providing superior performance over high-transmission cellular grids. 2
Important Technical Considerations:
The Bucky factor (radiation dose increase required when using a grid) increases with breast thickness but decreases with higher kVp settings. 1
Cassette tunnels introduce additional scatter and should never be used with non-grid or magnification techniques. 1
For magnification mammography (spot compression views), the grid should be removed because magnification technique uses air-gap geometry to reduce scatter, and adding a grid would unnecessarily increase radiation dose without improving image quality. 3, 4
In Chest Radiography
For chest radiography in patients with COPD or other respiratory conditions, the Bucky grid is essential for adequate visualization of lung parenchyma and mediastinal structures, particularly in larger patients where scatter radiation would otherwise degrade image contrast. 5
Additive copper filtration combined with Bucky grid technique can improve image quality in digital chest radiography by optimizing the signal-difference-to-noise ratio while maintaining appropriate soft tissue to bone contrast. 5
Critical Clinical Pitfalls
When NOT to Use Bucky Grid:
Never use the Bucky grid for magnification mammography (spot compression with magnification views), as the air-gap technique inherently reduces scatter without requiring grid-based scatter reduction. 3, 4, 1
Magnification mammography with microfocal spot technique (2X magnification) provides superior detection of microcalcifications with significantly reduced radiation exposure (entrance dose of 1.35 mGy for average breast) compared to contact mammography with grid. 4
Radiation Dose Considerations:
The Bucky factor represents the increase in radiation exposure required when using a grid compared to non-grid technique. 1, 2
For 6 cm breast thickness at 28 kVp, the Bucky factor varies by grid type, with cellular grids generally requiring less dose increase than linear grids for equivalent contrast improvement. 2
The benefit-risk ratio strongly favors using appropriate Bucky grid technique for standard diagnostic mammography, as the improved cancer detection capability far outweighs the minimal additional radiation risk. 3
Modern Digital Imaging Context
In contemporary practice, digital breast tomosynthesis (DBT) has largely replaced traditional spot compression views for diagnostic workup, as DBT provides equivalent or superior diagnostic accuracy while potentially reducing overall radiation exposure. 6
However, the Bucky grid remains essential for standard 2D mammographic projections (craniocaudal and mediolateral oblique views) that accompany DBT examinations. 6