Cursul 2 5

Cursul II
Notiuni Curs I
Semnale si sisteme
Reprezentarea imaginii
Caracteristicile si factorii calitativi ai imaginilor
medicale
University Politehnica of Bucharest
Cursul II
Notiuni Curs I
Semnale si sisteme
medicale
What is Medical Imaging?

Using an instrument to see the inside of a human body
Non-invasive
Some with exposure to small amount of radiation (X-ray,
CT and nuclear medicine)
Some w/o ( ultrasound)
The properties imaged vary depend on the imaging
modality
X-ray ( projection or CT): attenuation coefficient to X-ray
Nuclear medicine (PET, SPECT): distribution of
introduced radio source
Ultrasound: sound reflectivity
MRI: hydrogen proton density, spin relaxation
Projection vs. Tomography

Projection:
A single image is created
for a 3D body, which is a
shadow of the body in a
particular direction
(integration through the
body)
Projection vs. Tomography

Tomography
A series of images are generated, one from each slice of a 3D object in a
particular direction (axial coronal sagital)
To form image of each slice, projections along different directions are
first obtained, images are then reconstructed from projections (backprojection, Radon transform)
Anatomical vs. Functional Imaging
Some modalities are very good at depicting anatomical structure (bone, different tissue types,
boundary between different organs)
X-ray, X-ray CT
MRI
Some modalities do not depict anatomical structures well, but reflect the functional
status (blood flow, oxygenation, etc.)
Ultrasound
PET, functional MRI
Boundaries between the two classes are blurring as the imaging resolution continues to improve
Common Imaging Modalities
Projection radiography (X-ray)

Computed Tomography (CT scan or CAT Scan)
Nuclear Medicine (SPECT, PET)
Ultrasound imaging
MRI
Optical imaging
Spectrul electromagnetic
The electromagnetic spectrum comparing the size of objects that can be studied with various
techniques.
Waves Used by Different Modalities
Lesson II
Notiuni Curs I
Semnale si sisteme
medicale
10
Semnale si sisteme
The object being imaged is an input signal
Typically a 3D signal
The imaging system is a transformation of the input signal to an
output signal
The data measured is an output signal
A 2D signal (an image, e.g. an X-ray) or a series of 2D signals
(e.g. measured projections from a CT scan), or 4D data (a series of 3D
volume in time)
Image reconstruction
An inverse process: from the measured output signal -> desired
images of the object (a series of 2D slices)
INPUT SIGNAL -> SYSTEM or PROCESS -> OUTPUT SIGNAL
Example: Projection X-Ray

Input signal: (x; y) is the linear attenuation coefficient
for x-rays of a body component along a line
Imaging Process: integration over x variable:
Output signal: g(y)
Exemple de semnale
Transformarile semnalelor
Sisteme liniare -Proprietati
Sisteme liniare invariante la translatie SLIT
Sisteme liniare invariante la translatie - SLI
Transformata Fourier: cazul 1D
Frecventa spatiala

Astfel, transformata Fourier a unei imagini este o reprezentare in
domeniul frecventei.
Multe prelucrari de imagine presupun eliminarea din imagine a
componentelor de o anumita frecventa, de exemplu cele de nivel
coborat sau cele de nivel inalt.
Aceste operatii sunt usor de realizat pe transformata Fourier a imaginii.
O prelucrare de imagine bazata pe transformata Fourier are loc in trei
pasi:
Se calculeaza transformata Fourier a imaginii

Se proceseaza reprezentarea in domeniul Fourier
Se calculeaza transformata Fourier inversa, obtinandu-se imaginea
prelucrata
Fourier: Exemple
Fourier: Exemple
Proprietatea de convolutie si raspunsul in

domeniul frecventa
Fourier - Aplicatii
A more complicated 2-D Fourier spectrum is obtained when a chest

radiograph is transformed to the spatial frequency domain as illustrated in the
next figure. The transformed data show a broad range of spatial frequencies,
with significant vertical and horizontal features, as might be expected from
the horizontal ribs and vertical vertebral column displayed in the radiograph.
A chest radiograph is illustrated in (a) with its 2-D Fourier spectrum in (b). The spatial
frequency data show a broad range of values with significant vertical and horizontal
features associated with the vertebral column and ribs, respectively.
Fourier - Aplicatii
A potential use of the FT and its inverse is the removal
of unwanted or corrupt data from a digital image and
this process is illustrated in the final figure below.
An extreme example of a corrupt image may be
generated by adding together the two images.
The Fourier spectrum in panel (b) portrays the
frequency characteristics of the summed image.
The undesirable features attributable to the sinusoidal
pattern may be removed by editing of the data in the
frequency domain as in panel (c), before the inverse FT
is performed to recover an image largely free of
artifact, as in panel (d).
Fourier Aplicatii: eliminare zgomot
The use of the FT and its inverse

to remove unwarranted
information from an image.
(a) An image obtained by adding
the sine wave and chest
radiography images together with
its equivalent Fourier spectrum in
(b). The unwanted interference
caused by the sinusoidal
brightness pattern can be
removed by editing the spatial
frequency information as shown
by the blackened areas in (c).
The inverse FT then recovers the
original chest image largely
undistorted as shown in (d).
Further refinement of the editing
process would ideally allow
complete restoration of the image
quality.
Fourier Aplicatii: filtrare in domeniul

frecventa
Lesson III
Notiuni Curs I
Semnale si sisteme
medicale
30
semnal bidimensional in spatiul continuu= definit ca o
functie de 2 variabile in spatiu continuu: f(x,y)
f(x,y) = interpretata ca o functie de luminanta variabila in
spatiul bidimensional (x,y)-> r(x,y)
=> d.p.d.v. al notatiei f(x,y) = functie definita in domeniu
spatial
Teoretic -> modelul imaginii intr-un spatiu continuu
nelimitat-> un plan bidimensional, dar abordarea folosita in
practica -> dimensiunea imaginii este intotdeauna limitata
la un spatiu finit (dreptunghi)
31
Reprezentari diferite ale unui semnal

bidimensional
Grayscale image
Surface representation
profiles along indicated horizontal, vertical, and diagonal lines
32
Informatia de culoare in reprezentarea

unei imagini
Imagistica Medicala -> rezultatul majoritatii tehnicilor de
obtinere ale imaginilor medicale -> imagini cu nivele de gri
Culoarea = subliniaza contrastul in imagini cu nivele de gri
(afisarea in Matlab a unei radiografii cu functia imagesc) explicatia
O imagine color = reprezentata printr-o functie vector:
f ( x, y ) = [ fR ( x, y ), fG ( x, y ), fB ( x, y )]T
33
Image Representation: Digitization &

Sampling
Images must be digitized
Analog continuous space continuous-value -> 2D
image => discretization of 2 kinds:
Spatial sampling
Amplitude quantizing
analog function = matrix of

numbers
34
Spatial sampling
ideal spatial sampling =
the analogue image
a 2-D sampling signal s(x,y) (formed
of an infinite number of periodically repeated Dirac impulses)
s ( x, y ) =
( x kx, y iy )
i = k =
The sampled image =

analogue image (to be sampled image)
function:
the sampling
f s ( x, y ) = f ( x, y ) s ( x, y )
f (kx, iy ) ( x kx, y iy)

i = k =
35
Spatial sampling
only those discrete values of the analogue image are
needed that correspond to the nodes of the sampling grid:
f = f (kx, iy )
The information carried
by the intermediate image
values is lost
so that the image matrix
= the complete image
content
36
Sampling
Sampling = choosing which
points you want to have
represent a given image;
analog image -> sampling = a
mapping from a continuum
of points in space to a
discrete set
digital image -> sampling = a
mapping from one discrete
set of points to another
(smaller) set
37
Spatial sampling = Example
a pixel is a point
It is NOT a box, disc or teeny wee light
It has no dimension
It occupies no area
It can have a coordinate
More than a point, it is a SAMPLE
38
Spatial sampling = Example

(Thomas Funkhouser course slides)
http://www.cs.brown.edu/exploratories/freeS
oftware/repository/edu/brown/cs/exploratori
es/applets/sampling/introduction_to_samplin
g_guide.html
University Politehnica
of Bucharest
39
40
Sampling and Reconstruction

41
Example: Adjusting Brightness

42
Digitization
the representation of an object, image, sound, document or
a signal (usually an analog signal) by a discrete set of its points or samples
The result:
digital representation or digital image, for the object,
digital form for the signal
To obtain numbers tractable by computers, the sample values obtained by
sampling are consequently digitized by an analogue to- digital (A/D)
converter.
The finite code: only limited-precision numbers => the measured values
rounded to the nearest of the available levels ( 256, 4096, or 65,536 levels
corresponding to 8-, 12-, or 16-bit fixed point)
43
Digitization
As any natural image has limited dimensions, the result of
digitization is a finite set of numbers representing the sample
values picture elements, pixels*, that may be arranged into a
matrix.
Contemporary systems use matrices of sizes approximately
in the range between 0.3 and (rather rarely) 16 Mpixels (Mpx),
corresponding to square matrices of 512 512 to 4096 4096;
however, many systems use the rectangular (nonsquare) format.
This image size, together with the bit depth, determines the memory
requirements (unless data compression is used): e.g., a 5-Mpx 16-bit
gray-scale image requires 10 Mbytes of memory space, and a color
image three times as much.University Politehnica of Bucharest
44
Cursul IV
Cuprins
Caracteristicile si factorii calitativi in imaginile
medicale:
calitatea imaginii,
contrastul imaginii,
Sensibilitate la contrast,
Functia de transfer a modulatiei
Contrastul local
Factorul incetosare - blur si vizibilitatea detaliului,
zgomot, artefact, distorsiune,
compromisuri,
Caracteristicile tesutului
Characteristics and quality factors in

medical images
the internal structures and functions of the human body are not generally
visible
images = created through which the medical professional -> into the body
to diagnose abnormal conditions & guide therapeutic procedures
The medical image is a window to the body
No image window reveals everything
Different medical imaging methods reveal different characteristics of the
human body
the range of image quality and structure visibility -> depending on
characteristics of the imaging equipment, skill of the operator, and
compromises with factors such as patient radiation exposure and imaging
time.
47

medical images
The figure is an overview
of the medical imaging
process.
The five major

components are:
the patient,
the imaging system,
the system operator,
the image itself, and
the observer.
Components Associated with the Medical Imaging Process
48

medical images
The objective = make an object within the patient's body visible to the observer.
The visibility: depends on the characteristics of the imaging system and the
manner in which it is operated.
Most medical imaging systems have a number of variables that must be

selected by the operator
They can be changeable system components, such as intensifying screens in

radiography, transducers in sonography, or coils in magnetic resonance imaging
(MRI).
most variables are adjustable physical quantities associated with the imaging
process: kilovoltage (radiography), gain (sonography), and echo time (TE) (MRI)
The values selected -> determine the quality of the image and the visibility of
49
specific body features.
IMAGE QUALITY
Medical Imaging is the Process of Converting Tissue Characteristics into a

Visual Image
The task of every imaging system is to translate a specific tissue characteristic into image
shades of gray or color.
If contrast is adequate, the object will be visible.
The degree of contrast in the image depends on characteristics of both the object and the
imaging system.
50
IMAGE QUALITY
The quality of a medical image: the imaging method, the
characteristics of the equipment, and the imaging variables selected
by the operator
Image quality = a composite of at least five factors: contrast, blur,
noise, artifacts, and distortion.
The human body contains many structures and objects that are
simultaneously imaged by most imaging methods.
We often consider a single object in relation to its immediate
background
The visibility of an object is determined by this relationship rather
than by the overall characteristics of the total image.
51
Image Contrast
Contrast means difference.
In an image, contrast can be in the form of different shades of gray,

light intensities, or colors.
Contrast is the most fundamental characteristic of an image.
An object within the body will be visible in an image only if it has
sufficient physical contrast relative to surrounding tissue.
52
Image Contrast
The physical contrast of an object must represent a difference in
one or more tissue characteristics.
For example, in radiography, objects can be imaged relative to their
surrounding tissue if there is an adequate difference in either
density or atomic number and if the object is sufficiently thick.
When a value is assigned to contrast, it refers to the difference
between two specific points or areas in an image.
In most cases we are interested in the contrast between a specific
structure or object in the image and the area around it or its
background.
The degree of physical object contrast required for an object to be
visible in an image depends on the imaging method and the
characteristics of the imaging system.
Image Contrast
The primary characteristic of an
imaging system that establishes the
relationship between image contrast
and object contrast is its contrast
sensitivity.
Consider the situation shown below.
The circular objects are the same size
but are filled with different
concentrations of iodine contrast
medium.
That is, they have different levels of
object contrast. When the imaging
system has a relatively low contrast
sensitivity, only objects with a high
Increasing Contrast Sensitivity Increases Image
concentration of iodine (ie, high
Contrast and the Visibility of Objects in the Body
object contrast) will be visible in the
image.
If the imaging system has a high
contrast sensitivity, the lower-contrast
55
objects will also be visible.
Contrast Sensitivity
contrast sensitivity = a characteristic of the imaging method and the
variables of the particular imaging system
It relates to the system's ability to translate physical object contrast
into image contrast.
It is difficult to compare the contrast sensitivity of various imaging
methods because many are based on different tissue characteristics.
certain methods do have higher contrast sensitivity than others.
Exemplu
(CT) generally has a higher contrast sensitivity than conventional
radiography
This is demonstrated by the ability of CT to image soft tissue objects
(masses) that cannot be imaged with radiography.
56
Contrast Sensitivity
Consider the image:
Here is a series of objects with
different degrees of physical
contrast. They could be vessels
filled with different concentrations
of contrast medium. The highest
concentration (and contrast) is at
the bottom. Now imagine a
curtain coming down from the top
and covering some of the objects
so that they are no longer visible.
Contrast sensitivity is the
characteristic of the imaging
system that raises and lowers the
curtain. Increasing sensitivity
raises the curtain and allows us to
see more objects in the body. A
Effect of Contrast Sensitivity on Object Visibility
system with low contrast
sensitivity allows us to visualize
only objects with relatively high
University Politehnica of Bucharest inherent physical contrast.
57
Functia de transfer a modulatiei - MTF
Cursul V
Blur and Visibility of Detail

Structures and objects: vary in physical contrast and in size
Objects: from large organs and bones to small structural features
(small calcifications).
Each imaging method has a limit as to the smallest object that can
be imaged and thus on visibility of detail.
Visibility of detail is limited: all imaging methods introduce blurring
into the process
The primary effect of image blur is to reduce the contrast and
visibility of small objects or detail.
63
Blur and Visibility of Detail

Consider the image below, which
represents the various objects in the
body in terms of both physical
contrast and size.
As we said, the boundary between
visible and invisible objects is
determined by the contrast
sensitivity of the imaging system.
We now extend the idea of our
curtain to include the effect of blur. It
has little effect on the visibility of
large objects but it reduces the
contrast and visibility of small
objects.
When blur is present, and it always
is, our curtain of invisibility covers
small
objects and image detail.
Effect of Blur on Visibility of Image
Detail
64
Noise
Another characteristic of all medical

images is image noise.
Image noise, sometimes referred to as

image mottle, gives an image a
textured or grainy appearance.
The source and amount of image noise

depend on the imaging method.
65
Noise
In the image below we find our
familiar array of body objects
arranged according to physical
contrast and size.
We now add a third factor, noise,
which will affect the boundary
between visible and invisible
objects.
The general effect of increasing
image noise is to lower the curtain
and reduce object visibility.
Effect of Noise on Object Visibility
In most medical imaging situations

the effect of noise is most
significant on the low-contrast
objects that are already close to
the visibility threshold.
67
Cursul 6
Artifacts, Distortion
most imaging methods can create image features that do not
represent a body structure or object
an artifact does not significantly affect object visibility and diagnostic
accuracy.
But artifacts can obscure a part of an image or may be interpreted as
an anatomical feature.
Distortion: A medical image should not only make internal body
objects visible, but should give an accurate impression of their size,
shape, and relative positions.
70
Artifacts
Artifacts: image features that do not correspond to a real object, and are not due
to noise
artefactul de miscare: blurring or streaks due to patient motion
artefactul in forma de stea star artifact: in CT, due to presence of metallic
material in a patient
artefactul dat de cresterea in intensitate a fascicolului: broad dark bands or
streaks, due to significant beam attenuation caused by certain materials
artefactul in forma de inel: because detectors are out of calibration
Artifacts, Distortion
Rezolutie sistemului: abilitatea de a separa doua puncte.

Marimea FWHM este egala cu minimul distantei pe care ar trebui sa o aiba cele
doua puncte pentru a percepute separat ca 2 puncte
Meniul Rezolutie Resolution Tool
Acuratetea
Acuratetea cantitativa
Acuratetea diagnosticului
Sensibilitate
Specificitate
Tabelul de contingen "2x2":

Boala vizat
Total
Prezent Absent
Rezultatul Pozitiv
testului
screening Negativ
a+b
c+d
Total
a+c
b+d
a+b+c+d
Sensibilitatea =
a
100
a+c
Boala vizat
Total
Rezultatul
testului
screening
Total
Specificit atea =
d
100
b+d
Prezent
Absent
Pozitiv
a+b
Negativ
c+d
a+c
b+d
a+b+c+d
Compromises
why we do not adjust each imaging procedure to yield maximum
visibility?
the variables that affect image quality also affect factors such as
radiation exposure to the patient and imaging time.
In general, an imaging procedure should be set up to produce
adequate image quality and visibility without excessive patient
exposure or imaging time.
In many situations, if a variable is changed to improve one

characteristic of image quality, such as noise, it often adversely
affects another characteristic, such as blur and visibility of detail.
84
TISSUE CHARACTERISTICS AND IMAGE

VIEWS
A combination of two factors makes each imaging method unique.
These are the tissue characteristics that are visible in the image and
the viewing perspective.
The specific tissue characteristics vary among the various modalities
and methods.
A radiologist search for signs of a pathologic condition or injury in
the body.
Signs can be observed only if the condition produces a physical
change in the associated tissue.
Many pathologic conditions produce a change in a physical
characteristic that can be imaged by one method but not another.
85
Examples
In projection imaging (radiography and fluoroscopy), images are
formed by projecting an x-ray beam through the patient's body
and casting shadows onto an appropriate receptor that converts
the invisible x-ray image into a visible light image.
The primary advantage: is that a large volume of the patient's
body can be viewed with one image.
A disadvantage is that structures and objects are often
superimposed so that the image of one might interfere with the
visibility of another.
86
Examples
Tomographic imaging, sonography, single photon emission
tomography (SPECT), positron emission tomography (PET), and
MRI produces images of selected planes or slices of tissue in the
patient's body.
The general advantage of a tomographic image is the increased
visibility of objects within the imaged plane.
One factor that contributes to this is the absence of overlying
objects.
The major disadvantage is that only a small slice of a patient's
body can be visualized with one image.

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Cursul II

What is Medical Imaging?

Projection vs. Tomography

Projection vs. Tomography

Anatomical vs. Functional Imaging

Common Imaging Modalities

Projection radiography (X-ray)

Waves Used by Different Modalities

Example: Projection X-Ray

Output signal: g(y)

Sisteme liniare -Proprietati

Sisteme liniare invariante la translatie SLIT

Sisteme liniare invariante la translatie - SLI

Transformata Fourier: cazul 1D

Transformata Fourier: cazul 2D

Transformata Fourier: cazul 2D

Se calculeaza transformata Fourier a imaginii

Proprietatea de convolutie si raspunsul in

A more complicated 2-D Fourier spectrum is obtained when a chest

Fourier Aplicatii: eliminare zgomot

The use of the FT and its inverse

Fourier Aplicatii: filtrare in domeniul

Reprezentari diferite ale unui semnal

profiles along indicated horizontal, vertical, and diagonal lines

University Politehnica of Bucharest

Informatia de culoare in reprezentarea

Image Representation: Digitization &

analog function = matrix of

University Politehnica of Bucharest

The sampled image =

f (kx, iy ) ( x kx, y iy)

University Politehnica of Bucharest

Spatial sampling = Example

University Politehnica of Bucharest

Spatial sampling = Example

(Thomas Funkhouser course slides)

University Politehnica of Bucharest

Sampling and Reconstruction

University Politehnica of Bucharest

Example: Adjusting Brightness

University Politehnica of Bucharest

Characteristics and quality factors in

Characteristics and quality factors in

The five major

Components Associated with the Medical Imaging Process

University Politehnica of Bucharest

Characteristics and quality factors in

Most medical imaging systems have a number of variables that must be

They can be changeable system components, such as intensifying screens in

Medical Imaging is the Process of Converting Tissue Characteristics into a

In an image, contrast can be in the form of different shades of gray,

University Politehnica of Bucharest

Functia de transfer a modulatiei - MTF

Functia de transfer a modulatiei - MTF

Functia de transfer a modulatiei - MTF

Functia de transfer a modulatiei - MTF

Blur and Visibility of Detail

Blur and Visibility of Detail

Another characteristic of all medical

Image noise, sometimes referred to as

The source and amount of image noise

University Politehnica of Bucharest

Effect of Noise on Object Visibility