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Computed Tomography

Basic Principles
Tomography is term derived from the Greek word
tomos , meaning to write a slice or section
Conventional Tomography was developed to reduce
super-imposition effect of simple radio graph; in this
arrangement , x-ray tube and photographic film are
moved in synchronization so that one plane of the
patient is focused while all other planes are blurred
Mathematical principles of Computed Tomography
were first developed in 1917 by Radon
It was proved that an image of an unknown object could
be produced :
if one had an infinite number of projections through the

Basic Principles
Conventional X-ray image reduces the 3D patient anatomy
to a 2D projection image
It is generated by projection from the x-ray source through
the object onto the film
Density at a given point on an image represents :

x-ray attenuation properties along a line within the patient

Line starts from x-ray focal spot and the point on the
detector corresponding to the point on the image
If there are regions of small and large variations in density
along same beam path ,small variation cannot be detected.
Example : in chest radiograph where dense bony structures
make it difficult to derive information about the less dense
information about the lungs fields.

Basic Principles

Basic Principles
With a conventional radiograph, information with respect
to the dimension parallel to the x-ray beam is lost
Limitation can be overcome, to some degree, by acquiring
images through several direction .
For objects that can be identified in these images, provide
location information
This may not be practical because of the higher exposure
received by the patient
In CT anatomical information is digitally reconstructed
from x-ray transmission data
These data obtained by scanning an area from many
directions in the same plane to visualise information in that
The ideas involved were originally developed for imaging

Basic Principles
With a conventional radiograph, information with respect to
the dimension parallel to the x-ray beam is lost
Limitation can be overcome, to some degree, by acquiring
images through several direction .
For objects that can be identified in these images, provide
location information
This may not be practical because of the higher exposure
received by the patient
In CT, pictures displayed are not photographs but are
digitally reconstructed from a large no. of absorption profiles
Profiles are taken at regular intervals around a slice, with each
profile being made up from a parallel set of absorption values
through the object

Tomographic Images

Basic Principles
In CT , x-rays from a collimated source are passed through a
slice of the object or patient from a variety of directions
For directions along which the path length through-tissue are
longer, fewer x-rays are transmitted as compared to directions
where there is less attenuating the x-ray beam
Also, structures in the patient such as bone , may attenuate
X-rays more than a similar volume of less dense soft tissue
In principle CT involves determination of attenuation
characteristics for each small volume of tissue in patient slice
This constitute transmitted radiation intensity recorded from
various irradiation directions
It is these calculated tissue attenuation characteristics that
actually compose the CT image.

Basic Principles
For monochromatic X-ray beam , the tissue attenuation
characteristics can be described by :

Basic Principles
Let a slice of heterogeneous tissue is irradiated
the slice is divided into volume elements or voxels with
each voxel having its own attenuation constant
Sum of the voxels attenuation coefficients for each x-ray
beam direction can be determined from experimentally
measured beam intensities for given voxel width.
However , each individual voxel attenuation coefficient
remains unknown.
CT uses knowledge of attenuation coefficient sums
derived from X-ray intensity measurement made at all the
various irradiation directions
And calculate attenuation coefficients of each individual
voxel to form the CT image.

Tomographic Images
The tomographic image is a picture of a slab of the
patients anatomy
The 2D CT image corresponds to a 3D section of the
CT slice thickness is very thin (1 to 10 mm) and is
approximately uniform
The 2D array of pixels in the CT image corresponds to an
equal number of 3D voxels (volume elements) in the
Each pixel on CT image displays average x-ray attenuation
properties of the tissue in the corresponding voxel

Tomographic Images

Tomographic acquisition
Single transmission measurement through the
patient made by a single detector at a given
moment in time is called a ray
A series of rays that pass through the patient at the
same orientation is called a projection or view
Two projection geometries have been used in CT
Parallel beam geometry with all rays in a projection
parallel to one another
Fan beam geometry, in which the rays at a given
projection angle diverge

Tomographic acquisition
Purpose of CT scanner hardware is :
to pass beam through the patient at different positions
acquire a large number of transmission measurements
Single CT image may involve approximately 800 rays
taken at 1,000 different projection angles
Before the acquisition of the next slice, the table that the
patient lies on is moved slightly in the cranial-caudal
direction (the z-axis of the scanner)

Tomographic acquisition
Purpose of CT scanner hardware is :
to pass beam through the patient at different positions
acquire a large number of transmission measurements
Single CT image may involve approximately 800 rays
taken at 1,000 different projection angles
Before the acquisition of the next slice, the table that the
patient lies on is moved slightly in the cranial-caudal (
Head -tail) direction (the z-axis of the scanner)

1st generation: rotate/translate, pencil beam

1st generation: rotate/translate, pencil beam

Collimated X-ray beam passes through the body and its
attenuation is detected by two sensors
X-ray tube alongwith detector moves on a gantry and in
straight line to sample data 180 times
At the end of the travel, a 1tilt is made and a new linear
scan begins
Assembly travels 180 around patients position. The
arrangement is known as Traverse and Index
This procedure results in 32400 independent
measurements of attenuation
This is sufficient for system computer to produce an

1st generation: rotate/translate, pencil beam

This is a fairly slow procedure and requires a
typical scan time of 5 minutes
It is essential for the patient to keep still during
the entire scan period
For this reason earlier scanners were limited to
brain studies
Picture quality and hence diagnostic utility is
exceptionally good.

Tomographic reconstruction
Each ray acquired in CT is a transmission
measurement through the patient along a line
The unattenuated intensity of the x-ray beam is
also measured during the scan by a reference

I t I0e

ln( I 0 / I t ) t

Tomographic Reconstruction
There are numerous reconstruction algorithms
Filtered backprojection reconstruction is most
widely used in clinical CT scanners
Builds up the CT image by essentially reversing
the acquistion steps
The value for each ray is smeared along this
same path in the image of the patient
Data from a large number of rays are back projected onto the image matrix
areas of high attenuation tend to reinforce one
another, as do areas of low attenuation, building
up the image

2nd generation: rotate/translate, narrow fan beam

Improved version of traverse-index arrangement consists of
a fan beam of x-rays and a bank of detectors (incorporated
linear array of 30 detectors)
Effectively takes several profiles with each traverse and
permits greater index angle
Using 10 fan beam , it is possible to take 10 profiles, 1
intervals with each traverse and then index through10
before taking next set of profile
180 profiles can be taken in 18 traverses
More data acquired to improve image quality
Shortest scan time was 18 seconds/slice
Narrow fan beam allows more scattered radiation to be

3rd generation: rotate/rotate, wide fan beam

3rd generation: rotate/rotate, wide fan beam

X-ray source and detectors mounted on a common frame
and rotate around the patient usually through 360
System gives a wide fan beam , typically 30 ~50
Frame travels quite fast , so that complete rotation takes
only few seconds
Detector number increased substantially (> 800 detectors)
Angle of fan beam increased to cover entire patient
Eliminated need for translational motion
Newer systems have scan times of second
Disadvantage : inefficient for smaller object ; cant be
calibrate during scanning

Ring artifacts
The rotate/rotate geometry of 3rd generation scanners
leads to a situation in which each detector is responsible
for the data corresponding to a ring in the image
Drift in the signal levels of the detectors over time affects
the t values that are back-projected to produce the CT
image, causing ring artifacts

4th generation: rotate/stationary

Designed to overcome the problem of ring artifacts
X-ray source rotates within a full circle of stationary
detectors arranged around patient
Stationary ring of about 4,800 detectors
Individual detectors lined up practically without gaps , so
radiation which has penetrated the patient optimally used
System permits calibration during scanning thus
eliminates problem of detector drift
Cost is very high

3rd vs. 4th generation

5th generation: EBCT(stationary/stationary)

Developed specifically for cardiac tomographic imaging
An electron beam sweeps back and forth through a
magnetic field
Beam strikes the annular tungsten target underneath the
patient and generates x-rays and x-ray detectors are
mounted on a semicircular array above the patient
X-ray tube and x-ray detectors are heavy (~250Kg) it
takes one second or more to take all snap shots
In EBCT beam can be moved back and forth through a
magnetic field quickly, it is capable of 50-ms scan time
Combined with ECG triggering it can produce fast-framerate CT movies of the beating heart
Cardiac images obtained with a conventional CT may be
blurred due to motion artifact

6th generation: Spiral

Helical or Spiral CT scanners x-ray tube rotates
continuously, data is acquired while the patient is
moving through the fan beam
Focal spot therefore, traces a helix around the patient
By avoiding the time required to translate the patient
table, the total scan time required to image the patient
can be much shorter
Fast multiple scans are obtained for three-dimensional
imaging and evaluate volume at different locations
Allows the use of less contrast agent and increases
patient throughput
In some instances the entire scan be done within a
single breath-hold of the patient

6th generation: helical

Helical CT has a special advantages that it allows
images to be reconstructed at arbitrary positions and
arbitrary spacing , also resulting overlapping
So if slices of small spacing are required for the clear
proof of lesion (injury) , this technique is very useful
Continuous acquisition of whole sections of the body ,
largely independent of respiration or movement , also
permits the reliable localization of lesion
Disadvantages : slice sensitivity profiles are dependent
on the movement of the patient in Z-direction
Degree of blurring depends on the speed at which
patient is moved and this adversely affect the spatial
This can be minimized by using de-blurring software.
If the table speed per 360 deg. Revolution is same as


generation: multiple detector


When using multiple detector arrays, the

collimator spacing is wider and more of the xrays that are produced by the tube are used in
producing image data
Opening up the collimator in a single array scanner
increases the slice thickness, reducing spatial
resolution in the slice thickness dimension
With multiple detector array scanners, slice thickness
is determined by detector size, not by the collimator

Processing Unit Of CT
For constructing CT image , patient slice is divided up
into numerous three dimensional voxels
Image of the slice is two dimensional picture in which
each picture element ( pixel) value corresponds to
attenuation coefficient of a voxel in object slice
Successive approximation or iterative method is used
to obtain an image of attenuation coefficients from
measured intensity data; Example
More and more iterations, image matrix matches more
and more closely with the object matrix.
Thus image is generated with help of computer
Information received by the computer from the
scanning gantry needs to be processed for
reconstructing of picture

Processing Unit Of CT

Data from gantry contains information on following

parameters :
Positional information - which traverse is being
performed ; how far scanning frame is along its traverse
Absorption information including values of attenuation
coefficient from the detector
Reference information obtained from the reference
detector that monitors the x-ray output
Calibration information obtained , end of each traverse

Positron Emission Tomography (PET)

What is PET?
Positron Emission Tomography (PET) is a non-invasive
test, PET scans accurately image the cellular function of
the human body
In single PET scan physician can examine entire body
PET and CT scans are both standard imaging tools that
physicians use to pinpoint disease states in the body
A PET scan demonstrates the biological function of the
body before anatomical changes take place, while the
CT scan provides information about the body's anatomy
such as size, shape and location
PET scan can distinguish between benign and
malignant disorders (or between alive and dead tissue)
Other imaging technologies merely confirm presence
of a mass

Positron Emission Tomography (PET)

Positron Emission Tomography (PET)
A PET scan allows physicians to measure the body's
abnormal molecular cell activity to detect
Cancer (such as breast cancer, lung cancer, colorectal
cancer, lymphoma, melanoma and other skin cancers),
Brain Disorders (such as Alzheimer's Disease,
Parkinson's Disease, and epilepsy), and
Heart Disease (such as coronary artery disease).
PET scans are simple, painless, and fast, offering
patients and their families life-saving information that
helps physicians detect and diagnose diseases early and
quickly begin treatment.

How PET Works

When disease strikes, the biochemistry of patients
tissues and cells change. In cancer, for example, cells
begin to grow at a much faster rate; PET scan takes a
digital picture of abnormal cellular structure.
The most common form of a PET scan begins with an
injection of a glucose-based radiopharmaceutical (FDG)
This travels through the body, eventually collecting in
the organs and tissues targeted for examination
The patient lies flat on a bed/table that moves
incrementally through the PET scanner
Scanner cameras detect the gamma rays emitted from
the patient, and turns those into electrical signals, which
are processed by a computer to generate the medical

How PET Works

The bed/table moves a few inches again, and the
process is repeated.
This produces the digital images, which are assembled
by the computer into a 3-D image of the patient's body
If an area is cancerous, signals will be stronger there
than in surrounding tissue, since more of (FDG) will be
absorbed in those areas.
PET scans give information about the body's chemistry
that is not available with other imaging techniques.
PET scans reveal metabolic information (as opposed to
anatomical information), providing physician with
extra insight
PET scanning often reveals disease much earlier than
conventional diagnostic procedures (such as CT or
MRI), it can help physicians diagnose disease faster