Classes of Medical Imaging Modalities Medical Imaging

Anatomical or structural

The ability to discriminate different constituents of the body

Water, bone, soft tissue, etc.

X-ray imaging, computed tomography (CT), ultrasound, and Magnetic Resonance Imaging (MRI) The ability to discriminate different levels of metabolism caused by specific biochemical activity

Functional or metabolic

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Biochemical activity:

Describes the functional behavior of tissue or organs May be caused by internal or external simulation

Functional Magnetic Residents Imaging (fMRI), Single Photon Emission Computed Tomography (SPECT), Positron Emission Tomography (PET)
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Image Processing Medical Imaging

Medical Imaging Examples

X-Ray Imaging

Anatomical cases

X-ray imaging for fracture identification, mammography tumor identification Ultrasound examinations of fetuses fMRI methods for measuring blood flow or oxygenation level in brain tissue

Functional cases

Changes in blood flow/oxygen level reflect numeral activity caused by stimulation

An incident electron, with energy higher than the binding energy of a particular shell level, is used to eject an electron

Example: sound or light simulation

Total energy preservation results in the release of a x-ray photon

PET imaging utilizing flurodeoxyglucose (FDG) administration shows blood flow and glucose metabolism in tissue

X-ray photons are focused in a monochromatic beam Scattering is a major problem in projection radiography

Utilized to detect if tissue is affected by a tumor or epilepsy

Photons arrived at the same detector location through different paths Anti-scatter grids and collimators are used to reduce indirect arrivals at the sensor
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X-Ray Absorption

X-Ray Example

For a radiation beam passing through a medium with linear attenuation coefficient N0=Nine-t

Chest x-ray of a male

Nin and N0 are the total number of photons entering and leaving the medium of thickness t In more general cases, the attenuation coefficient and source are spatially varying

Normal result

Yields integral expression along x-ray path

Example: attenuation coefficients for bone and fat

Photon energy dependent

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Image Processing Medical Imaging

X-Ray Computed Tomography (I)

X-Ray Computed Tomography (II)

Conventional x-ray radiography projects a 3-D object onto a 2-D detector plane

For x-ray radiation parallel to the xdirection

3-D information is diagnostically important

Bone fracture treatment may require 3-D imaging Heart and brain diagnoses require 3-D imaging

Sensor readings along the y direction give information on the ydirection projection of the selected slice Gives x-direction projection information

Consider a 3-D object as a stack of 2-D slices Assume the x-ray radiation is parallel to the x-direction

Rotate the source and detector for alignment along the y-direction

The recorded radiation is given by

( x , t ; z ) dx I out ( x; y , z ) = I in e

First generation CT scanners rotated parallel beam sources and detector

Obtain projections at multiple angles Stack multiple slices to form volume

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(x,y,z) is the attenuation coefficient and Iin and Iout are the source and detected radiation

Multiple angle scans are performed for each slice (z value)

Image Processing Medical Imaging

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X-Ray Computed Tomography (III)

CT Example

First-generation CT scanner geometry

Source: parallel beam Detector: linear array Scanning: translation and rotation of source/detector pair Source: fan beam Detector: linear array Scanning: translation and rotation of source/detector pair Source: fan beam (covers entire object without translation) Detector: arc of detectors Scanning: Entire projection obtained from single source location

CT slice

Second-generation CT scanner geometry

Cardiac cavity of a cadaver

Third-generation CT scanner geometry

Pathological image

Additional views obtained by source/detector rotation

Image corresponding to the actual CT slice

Rotate only no translation required

Fourth-generation CT scanner geometry

Source: fan beam (covers entire object without translation) Detector: ring of detectors Scanning: source rotation
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Image Processing Medical Imaging

Magnetic Resonance Imaging (MRI)

MRI Example

Nuclear Magnetic Residents (NMR) independently explained by Felix Bloch and Edward Purcell in 1946

1952 Nobel Prize Obtains physical and chemical properties based images of an object 2003 Nobel Prize

Paul Lauterbur and Peter Mansfield used the NMR principal in MRI imaging

Like CT, MRI is tomographic imaging that produces three-dimensional images Unlike CT, MRI is not based on the transmission of external radiation through the object MRI uses nuclear magnetic resonance property of selected matter in the object

MRI methods allow image capture based on multiple parameters that represent various physical and chemical properties

Human brain a cross-section example

Parameters: T1 weighted, T2 weighted, and Spin-Density T1 weighted, T2 weighted, and Spin-Density of hydrogen protons

Functional MRI (fMRI) reports physiological behavior over time

Images anatomical structures as well as biochemical properties

Biochemical properties are based on physiological function, such as blood flow and oxygenation

MRI imaging can create any direction cross-sectional images and multi-dimensional imaging sequences without making any physical changes to the instrument MRI has fast signal acquisition (fraction of the second) MRI has high spatial resolution (millimeter to hundreds of a millimeter)

Temporal and spatial resolution relaxed to increase signal-to-noise ratio

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MRI Principles (I)

MRI Principles (II)

Objective: map the spatial location and associate properties of specific nuclei or protons in an object Nuclei with odd atomic number possess angular moment

A hydrogen atom has one proton in its nucleus

Odd atomic number results in nuclear spin Gyromagnetic ratio is 42.58MHz/T

Angular moment referred to as spin Spinning of the charge protons creates and magnetic field The charged protons thus an possess angular moment and magnetic moment Magnet representation Symbolic representation

External magnetic fields of 0.5-1.5T yield sufficient magnetic moment for imaging the human body Water molecules contained hydrogen protons the hydrogen proton is an excellent choice for NMR based imaging in the human body

A significant percentage of the human body is water

Example shown of charge proton with angular moment (J) and magnetic moment ():

Other protons that exhibit the NMR phenomenon are available in the body (C, F, and P)

Note: =J where is a gyromagnetic ratio

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MRI Principles (III)

MRI Principles (IV)

No external magnetic field case:

External magnetic field case:

The direction of the magnetic moment is random

Nuclei align along or against the magnetic field

Zero net longitudinal and transverse vectors

External magnetic field case:

Nuclear paramagnetic polarization with specific orientations Interaction between the magnetic moment of the nuclei and external magnetic field cause the spinning nuclei to precess

Nuclei aligned along the field have lower energy level Nuclei aligned against the field have higher energy level More nuclei align along the field than aligned against it

Wobbles like a spinning top subject to a gravitational field

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Results in a net magnetization vector in the direction of the external magnetic field The procession is still random net zero vector in the transverse direction
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MRI Principles (V)

MRI Principles (VI)

Using classical mechanics:

RF energy received by a nuclei at 0 causes a change in state

The torque generated by the interaction of the magnetic moment of a proton and the external magnetic field is equal to the rate of change of angular momentum

Results in NMR The excited nuclei returns to equilibrium through a relaxation process
Emits energy at the same precession frequency: 0

During NMR

Result given by the equation of motion for isolated spin:

dJ = H 0 = H 0k , dt = J; dJ = H 0 k , d

Nuclei can receive energy to move from a lower-energy state to a higher-energy state
Nuclei oriented along the external magnetic field can flip and oriented against the magnetic field Resulting net longitudinal vector is no longer in the direction of the external magnetic field

90-degree pulse

where H0 is the strength of the external magnetic field and k is the unit vector in the z-direction

Equation solution yields:

0 = H 0 Larmor equation precession frequency depends on gyromagnetic ratio and external magnetic field intensity
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RF energy pulse at the Larmor frequency required to shift the net longitudinal vector by 90 All of the nuclei precess in phase

Longitudinal vector rotates in the x-y plane

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MRI Principles (VII)

MRI Principles (VIII)

180-degree pulse

RF energy pulse at the Larmor frequency required to shift the net longitudinal vector by 180 All of the nuclei precess in phase

Energy emitted during the relaxation process induces an electrical signal in the RF coil at the Larmor frequency

Basic MRI imaging signal:

Longitudinal vector rotates in the x-y plane

RF Energy provided by a RF electromagnetic coil oscillating at the Lamor frequency

When RF pulses turned off, excited nuclei go through a relaxation phase

The free induction decay of the signal in the RF coil

Consider the external magnetic field and the RF pulls causing nuclear excitation

Change of the net magnet visitation vector:

M x i + M y j ( M z M z0 ) k dM =M H dt T2 T1

Net longitudinal magnetization vector returns to equilibrium state (in line with the field) Net transverse magnetization goes to zero as nuclei dephase
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T1 longitudinal (spin-lattice) relaxation time

Return to equilibrium net nine physicians vector in the z-direction Loss of coherence (dephasing) leading to net zero vector in the x-y plane
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T2 transverse (spend-spin) relaxation time

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MRI Principles (IX)

MRI Principles (X)

Transverse relaxation process Magnetization relaxation after the RF pulse

The voltage induced in the RF coil is given by (t )

V (t ) = t =

t object

H r (r ) M (r, t )dr

Transverse Longitudinal

Result is spatially dependent

Free Induction Decay (FID)

Goal: identify a magnetic resonance response of spinning nuclei are at a specific spatial location Superimpose gradient magnetic field on static external magnetic field

Recorded in the coil at Larmor frequency Raw NMR imaging signal

Recall Larmor (precession) frequency is dependent on the net magnetic field

Yields spatially variant Lamor frequency Spatially encoded NMR signal by varying magnetic field

MRI images exploit three parameters of nuclei

Spin density (density of nuclei) Longitudinal relaxation time, T1 Transverse relaxation time, T2 Parameter responses can be combined (weighted)

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3-D Fourier Transform Description of MRI Imaging

MRI Parameters

Directional gradient magnetic fields: Gx, Gy, Gz

Selectively excites a spatial volume with spin nuclei density (x,y,z) Overall gradient atspatiallocation r
G (t ) = Gx (t )i + G y (t ) j + Gz (t )k

FID NMR spin-echo signal from volume location r is

S (t ) = M (r, t )d 3 r

where M (r, t ) = M 0 (r)e and M0 is the magnetization vector at thermal equilibrium Expression can be rewritten as i ( x + y + z ) S ( x , y , z ) = M 0 ( x, y, z )e x y z dxdydz
0

i r G ( t ') dt '

Taking the inverse Fourier transform i ( x + y + z ) ( x, y, z ) = M 0 S ( x , y , z )e x y z d x d y d z

x, y, z: Frequencies corresponding to Gx, Gy, Gz

Relaxation times and spin density for human tissues and fluids Note considerable change in relaxation parameters of tissues/fluids of interest

Example: blood and cerebrospinal fluid (CSF) Image contrast adjusted after reconstruction

Reconstruction of desired values

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Spin density images are T1 weighted by the parameter to improve contrast features the anatomical structures
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MRI Instrumentation (I)

MRI Instrumentation (II)

Three orthogonal coils provide gradient magnetic fields

RF pulses are encoded to selectively excite specific voxels

Simple is case: linear spatially dependent magnetic field General parameters:

Frequency and phase encoding

Proper encoding provides slice views in various orientations

Field strength, linearity, and switching time

Axial, sagittal, coronal

RF coil

Transmits time-varying are pulses

Causes nuclear excitation

Receives signature Free Induction Decay (FID) signal

During nuclear relaxation phase

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MRI Encoding

Transverse Relaxation and Rephasing

Slice selection frequency encoding

Linear gradient applied in the z direction

X direction encoding phase encoding Y direction encoding frequency (read out) encoding Block diagram shows overall spatial encoding

Transverse vector initially phased with 90 pulse During x-direction space in coding transverse vector begins dephasing Rephasing achieved with 180 pulse

Received echo based on rephased transverse vector

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Typical MRI Encoding Sequence Spin Echo Case

MRI Images of a Human Brain

Encoding scheme returns FID from a specified location Varying the time between pulses (cycle repetition time) determines the influence of T1 and T2 on the FID Various encoding schemes can be applied

Echo planar imaging Gradient echo imaging Flow imaging

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Nuclear Medicine Imaging Modalities

Radioactivity Decay

Transmission based imaging (x-ray, CT) provides anatomical information MRI provides some anatomical and some functional information

Radioactivity decay is described by N(t)=N(0)e-t

Detected chemical composition is related to metabolic information

Radionuclide imaging directly involve organ and tissues in the imaging process

N(0) is the number of initial radionuclides and is the radioactivity decay constant The decay half-life is given by Thalf=0.693/

Emission imaging is based on radioactivity decay Unstable nucleus disintegrates into a stable nucleus by releasing nuclear energy and emitting photons

Gamma photons or particles such as positrons and alpha particles are generally released and detected
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Single Photon Emission Computed Tomography (SPECT)

SPECT System & Example

SPECT imaging utilizes gamma rays

Radioisotopes are injected into the body through radiopharmaceutical drugs that metabolize with specific tissues Gamma rays emanating from the tissues are captured by detectors surrounding the body

Source intensity is based on the dose, metabolism, and half-life of the radionuclide Scattering causes loss of source information

Difficult to determine the travel path of the received photon

Recorded radiation form the raw projection data

Lead collimators reduce detection of scatters

Gamma ray attenuation is similar to x-ray attenuation Id=I0e-x

SPECT image of the human brain

Poor resolution and anatomical structure information Result shows radioactivity distribution in tissue representing specific metabolism or blood flow
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x is the distance traveled by the gamma ray and is a medium dependent linear attenuation coefficient
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Positron Emission Tomography (PET)

PET Scanner System

PET is based on the simultaneous detection of two 511 keV photons

Photons are traveling in opposite directions Feature: the ability to trace radioactive material metabolized in tissue

Provides specific information on biochemical and physiological behavior

Method: some radioisotopes decay by admitting positrons

Positron emission is accompanied by a significant amount of kinetic energy

Positrons typically travel 1-3 mm, losing some kinetic energy Annihilation (with a loosely bound electron) occurs Annihilation causes the formation of two Gamma photons with 511 keV

Detector pair is moved in an arc around object Coincidence detection localizes annihilation location

Gamma photons travel in opposite directions Coincidence detection is used to determine the annihilation location Annihilation location is close to the positron emission location

Arrivals are within nanoseconds Scattered photons do not arrive within preset window of time

Reduces scattering problem

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Series of Human Brain PET Images

Ultrasound Imaging

Radiopharmaceutical used: Fluorodeoxyglucose (FDG) FDG images show glucose metabolism and blood flow

Sonar technology was successfully used by the military in World War II Ultrasound waves in medical imaging were first explored in the 1970s and 1980s Current ultrasound uses:

Used to determine heterogeneity and invasiveness of tumors

Diagnostic imaging of anatomical structures, blood flow measurements, and tissue characterization Ultrasound machines are safe, portable, and low-cost

Resolution of PET is better than SPECT Main advantage:

Ultrasound WAV definition: sound waves with frequencies above 20kHz Velocity (c), wavelength (), and frequency () relationship: C=

Ability to tag specific biochemical activity and trace it with time

Frequency remains constant

When a sound wave leaves one medium and enters another (e.g., soft tissue to fat)

Wavelength changes (medium specific velocities, fixed frequency) Directional change governed by laws of diffraction Sound waves follow the principles of reflection, refraction, and superposition Shorter wavelengths provide better resolution and penetrate deeper into tissue Commonly used frequency range: 2-5MHz
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Image resolution is limited by wavelength

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Reflection and Transmission

Refraction and Attenuation

When changing mediums, the acoustic impedance changes

Causes reflection of the incident sound Intensity of the reflected way it is given by
Rij = Z j Zi Zi Z j

The angle of reflection is equal to the angle of incidents The angle of the transmitted wave is given by Snells law

Dependent on the propagation speeds of the two mediums: c1 and c2 c

sin t = sin i
2

Intensity of wave transmitted to the second medium

Attenuation occurs as a wave propagates

c1

Zi + Z j Zi and Zj are the acoustic impedances of the two media

Tij =

2Z j

Attenuation coefficients are characterized in dB/cm and are frequent independent

Application to a multilayer structure yields

R0 = I 0T12T23T34T54T43T32T21

Rearranging using 1+Rij=Tij yields

2 2 2 R0 = I 0 (10 R12 )(1 R23 )(1 R34 ) R45

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Reflection Imaging

Ultrasound System

System parameters

Source and object

s(x,y) acoustic signal intensity (t) acoustic signal pulse R(x,y,z) biological tissue reflectivity (desired parameter) K normalizing constant (t) received pulse Jcr(t) recorded reflected intensity (adaptive time varying gain applied to compensate for attenuation)
ct J cr ( t ) = K R x, y, s ( x, y ) ( t ) 2

Receiver

An ultrasound pulse is typically 2-3 cycles in duration

A crystal element generates pulses and records the reflections Ultrasound images appear noisy with speckles

Recorded intensity signal can be written as a convolution

Acoustic echoes are position dependent

Objects lack a continuous boundary

Imaging extracts R(x,y,z), which characterizes the tissue

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Ultrasound image interpretation is difficult

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Ultrasound Imaging Modes (I)

Ultrasound Imaging Modes (II)

A-Mode:

Record amplitude of returning echoes from tissue boundaries with respect to time

B-Mode:

Perpendicular incident angle Echo time represents acoustic impedance and depth of reflecting boundary

Provides 3-D information

Provides 2-D images representing the change in acoustic impedance of the tissue

M-Mode:

Provides information about signal amplitude variation due to object motion

Fixed position transducer produces a sweep cycle of A-mode recordings Response displayed as a line of intensities representing object the collection

Brightness shows echo strength 2-D information is obtained by pivoting the transducer or using a transducer array

V-shaped image

Example: Display of mitral valve leaflet of a beating heart.

Example: fetal abdomen

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Ultrasound Imaging Modes (III)

Doppler imaging

Effective for imaging blood flow A stationary observer sees a frequency change from a moving source Change in frequency:
f doppler =

Velocity of moving source: Source frequency: f Velocity of sound in the medium: c Incident angle of the moving source with respect to the sound propagation:

2v cos f c

Spatial spanning used to generate 2-D image Doppler shift mapped to intensity/color

Example: Doppler image of kidney

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