Medical Imaging

Non-invasive visualization of internal organs, tissue, etc.

Image a 2D signal f(x,y) or 3D f(x,y,z)

Medical imaging using ionising radiations

Medical imaging has come a long way since 1895 when Rntgen first
described a new kind of ray.

That X-rays could be used to display anatomical features on a

photographic plate was of immediate interest to the medical community at
the time.

Today a scan can refer to any one of a number of medical-imaging

techniques used for diagnosis and treatment.

Major Modalities

Projection X-ray (Radiography)

X-ray Computed Tomography (CT)

Nuclear Medicine (SPECT, PET)

Ultrasound

Magnetic Resonance Imaging

Projection X-ray Imaging

Image records transmission of x-rays through object

The integral is a line-integral or a projection through obj

m(x,y,z) x-ray attenuation coefficient, a tissue property, a function of

electron density.

X-Ray tube

The X-rays are produced from electrons that have been accelerated from
in vacuum from the cathode to the anode.

Emission occurs when filament is heated by passing current through it.

When the filament is hot enough, the electrons obtain thermal energy
sufficient to overcome the energy binding the electron to the metal of the
filament.

After accelerated they will be stopped at a short distance. Most of the

electron Energy will produce heat at the anode. Only Some percentage
will be converted to X-ray.

Deceleration of charged particle results in the emission of electromagnetic

field called Bremmstralung radiation.

These rays will have wide, continuous distribution of energies with the

maximum being the total energy the

anode.

electron had when reaching the

The number of X-rays will be small at higher energies and

increased for lower energies.

Principle of an X-ray system with image intensifier. X rays impinging on the

image intensifier are transformed into a distribution of electrons, which produces
an amplified light image on a smaller fluorescent screen after acceleration. The
image is observed by a television camera and a film camera and can be viewed
on a computer screen and stored on a CD-ROM or a PACS.

Summary: X-ray Imaging

Oldest non-invasive imaging of internal structures

Rapid, short exposure time, inexpensive

Unable to distinguish between soft tissues in head, abdomen

Real time X-ray imaging is possible and used during interventional

procedures.

Ionizing radiation: risk of cancer.

Computerized Tomography

Imaging of a cross sectional slice of the body using X-rays.

Invented by Dr. G. N. Housfield in 1971. Received the Nobel prize in

medicine in 1979.

The method is constructing images from large number of

measurements of x-ray transmission through the patient. The resulting

images are tomographic maps of the X-ray linear attenuation
coefficient.

CT imaging

Goal of x-ray CT is to reconstruct an image whose signal intensity at every

point in region imaged is proportional to (x, y, z), where is linear
attenuation coefficient for x-rays.

In practice, is a function of x-ray energy as well as position.

X-ray CT is now a mature (though still rapidly developing) technology and

a vital component of hospital diagnosis.

Principles of x-ray attenuation

In a uniform substance of linear attenuation coefficient , x-ray intensity,

as measured by a detector placed at depth d is

First generation CT

Single X-ray source

Translate rotate
movement

Single detector

CT and corresponding pixels in image

Ultrasound for imaging

Basic principle same as used in radar and sonar and similar to echolocation method of bats.

Emitter sends out pulses of sound. These bounce off objects and returned
echoes provide information about object, in particular location, size and
reflectional properties.

Gases and liquids support only longitudinal waves; solids support

transverse waves as well, but these are rapidly attenuated for non-rigid,
soft solids.

Acoustic waves with frequencies above those which can be detected by

the human ear. In practice, 20 kHz < f < 200 MHz.

An acoustic wave is a propagating disturbance in a medium, caused by

local pressure changes at a transducer.

The molecules of the medium oscillate about their resting (equilibrium)

positions, giving rise to a longitudinal waves.

c 1540 m/s 6.5 s/cm in most body tissues

= c / f = 1.5 mm at 1 MHz.

Most widespread use is in medical imaging

Non-invasive, low risk

Obstetrics, abdominal problems, measurement of blood flow and detection

of constrictions in arteries and veins.

Also used in non-destructive testing in industry: e.g., cracks in structures.

Sonar, underwater imaging (e.g., in submarine echo-location devices).

Reflections occur when the incident wave encounters a boundary between

two materials with different acoustic impedances.

Acoustic impedance Z is the material property which relates pressure

changes p (in excess of atmospheric) to the vibrational velocity u of the
particles in the medium.

At a single plane wave through a substance with density and speed of

sound c, then Z = c.

When an incident plane wave, with amplitude pi, travelling through a

medium with acoustic impedance Z1 hits a boundary with a second
material of impedance Z2 at normal incidence, there is in general both a
reflected wave pr and a transmitted wave pt:

At a single plane wave through a substance with density and speed of

sound c, then Z = c.

When an incident plane wave, with amplitude pi, travelling through a

medium with acoustic impedance Z1 hits a boundary with a second
material of impedance Z2 at normal incidence, there is in general both a
reflected wave pr and a transmitted wave pt:

Reflecting
Surfaces

Ultrasound
beam

Boundaries giving
rise to echoes

Other orientations
of ultrasound beam

Image Formed

B-scan is simply an A-scan in which the ultrasound beam is moved and

the results are spatially displayed. The ultrasound signal changes the
brightness of a spot on an oscilloscope screen instead of amplitude of the
trace in A-mode.

V
t
PRF generator

Pulse generator

Protection circuit

New
Beam steering
device
Probe

Variable gain
amplifier
(TGC)

TGC generator

V(dB)

New

Demodulator

Compression and
Video Amplifier
Brightness

Co-ordinate
Generator

(x,y)

Display

MRI: Introduction

In 1970s Lauterbur introduced concept of magnetic field gradients, leading

to images based on magnetic resonance.

By 1980s whole body magnets produced in UK, permitting first in vivo

images of human anatomy.

An estimated 20 million scans now performed worldwide annually.

Provides excellent soft-tissue contrast; can be acquired in any imaging

plane; unlike CT, does not involve ionising radiation.

Imaging modality of choice in brain and spinal cord; routinely used in

many other clinical settings.

EM tells us that a current carrying conductor e.g. a piece of wire, produces

a magnetic field encircling it.

When wire formed into a loop, field acts perpendicular to surface area of
loop.

Analogous to this is field produced by negatively charged electrons

orbiting nucleus in an atom, or spinning charge of nucleus itself.

Spinning momentum of nuclear charge ('the spin') produces small

magnetic field referred to as magnetic moment.

Under normal circumstances these moments have no fixed orientation so

no overall magnetic field.

However, when nuclei placed in external magnetic field, for example

patient placed in MRI scanner, they begin to align in given directions.

In case of hydrogen nucleus (single proton with spin quantum number, I =

), two discrete energy levels (2I +1) created;

(i) a higher energy level where magnetic moments oppose the external
magnetic field, & (ii) a lower energy level in which the nuclei aligned with
magnetic field.

Tiny majority of spins in latter energy state thereby creating net

magnetisation in direction of main magnetic field.

Population difference & therefore sensitivity of technique, can be altered

by reducing temperature or increasing field, hence need for strong
magnetic field; for modern clinical scanners, between 0.5 and 3.0 Tesla.

In both cases there is a net magnetisation, M 0, created by the main

magnetic field which is the basis of the imaged signal.

The net magnetisation can be considered in terms of one big spin.

In order to detect this signal a second magnetic field is introduced referred

to as B1. Two things are important about this field: (i) it has to be applied
perpendicular to B0, and (ii) it has to be at the resonant frequency.

Appropriate RF coils are used to transmit B 1, which acts to tip the spins out
of alignment with B0 and towards the direction of the coil (i.e. out of the
longitudinal plane and towards the transverse plane).

If the pulse is applied for long enough the spins are flipped into the
transverse plane and a 90 RF pulse is said to have been applied.
Magnetic Resonance Imaging

The magnetization is excited into an observable state

Magnetization emits energy at a resonant frequency:

Frequency is proportional to magnetic field

We can create a frequency vs. space variation:

Use Fourier analysis to determine spatial location

Magnetic field gradients cause signals from different parts of the body to
have different frequencies.

Signals collected with multiple gradients are processed by computer to

produce an image, typically of a section through the body.

No ionizing radiation expected to not have any long-term or short-term

harmful effects

Many contrast mechanisms: contrast between tissues is determined by

pulse sequences

Can produce sectional as well as projection images.

Slower and more expensive than X-ray

ENDOSCOPY

BIOTELEMETRY
1. It is the measurement of biological parameters over long distance
2. This involves radio frequency signal as a carrier for modulation, referred to
as radio telemetry
DESIGN
1. The telemetry system should be selected to transmit the bioelectric signal
with maximum fidelity and simplicity
2. The system should not affect the living system by any interference.
3. Smaller in size and light in weight
4. The power consumption should be small

5. The system should reject common mode interference rejection

6. A miniature radio telemetry system should be used to reduce noise