Medical images

Image Processing Courses

PUCP, 2009
Rachid Harba

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Medical images

Objective
 Visualize the inside of the human body

Anatomic Images

Functional Images

Brief history of medical instruments

1781 Laennec Stethoscope

1895 Roentgen X ray

1971 Hounstfield Scanner

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Outline
1. Tomodensitometry
2. Scanner
3. MRI
4. Nuclear medicine
5. Echography
1. Tomodensitometry

X-ray
 Roentgen (1895)

Electromagnetic radiations

Photons with short wave length:

= 109 1012 m, or
= 3 1017 6 1019 Hz

 Unity: Roentgen

X-ray that in 1 cm3 of air leads to a
ionisation of 3 109 coulomb
 REM [Roentgen Equivalent
Man]

Maximal Dose : 50 rem a year

1 rem = 10 mSv
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Tomodensitometry
4. X-RAY
1. Electron flux (tungstne)

2. Acceleration (tension
anode/cathode10 kV)

3. Shock

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Tomodensitometry

X-ray properties
 Straight line propagation
 Go through a lot of material:

Depends on the thickness x and on the atomic number

Berr-Lambert law
I = Io exp( x )
 Dangerous to man
 Can be seen on a photographic film

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Tomodensitometry

Lungs
Foot

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Tomodensitometry

Performance increase
 Contrast liquids
 Iodine : UIV (kidney), hysterography
(uterus), arthrography (shoulder, knee,
ankle, wrist...), angiography and
angiocardiography (veins), urography
 Barite : cholecystography (digestive
system)

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Tomodensitometry

Fast: few seconds

Painless
+
Not expensive

Large dissemination

Spatial resolution 100 microns (0.1 mm)

Ionisation: 30 to 200 mREMs per exam
-
Possible allergie to contrast agent

Impossible to transport

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2. Scanner

Inventor: Hounsfield, 1971 (Nobel price)

Principe
 Rotation of a X-ray source arround a Region
Of Intereest (ROI)
 3D computed reconstruction (inverse Radon
transform using FFT)

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Scanner 2

1
y

Reconstruction principle
 Hypothesis: P(t) is the sum of 4 x 0

f(x,y) along parallel lines

5
 P(t) is the Radon transform of f(x,y)
6

 The Fourier transform (FT) of P(t) is equal to the 2D FT

of f(x,y) along radial lines
 If P(t) is known for every (t,), then the FT of f(x,y) is
known too
 F(x,y) is recovered using a 2D inverse FFT (filtered
retroprojection) 11
Scanner

Benefits
 Real 3D objetcts
 High quality transversal cuts

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Scanner

Limitations
 Rotation arround the patient
Only static organs

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Scanner for the heart

 Syncronization
with ECG
 Dynamic Spatial Reconstructor (Mayo Clinic,
USA)

t t t t t
0 0 0 0 0

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Scanner

3D

Fast: about 20 min
+
Painless

High resolution 1 mm

Ionisation: 2500 to 44000 mrems per examen

Possible allergy to contrast liquids
-

Non transportable

Expensive

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3. MRI

Magnetic Resonance Imaging

Inventor: Lauterbur, 1973

Brievly
 Atomic resonance (hydrogen) under magnetic
waves
 Powerfull constant magnets (0,1 3 Tesla) in
the tunnel
 Faraday cage to reduce electromagnetic
pollutions

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 MRI Principle
1. 70% of human body is composed of water that
includes Hydrogen
2. Hydrogen atoms are like small magnets
3. Their direction is radom under a null external
magnetic field
4. Then, a strong external magnetic field is applied
and they all ligned up
5. When the constant magnatic fiel is stopped,
hydrogen atoms precess and emit magnetic waves
6. These waves are detected, analyzed and the final
image is formed

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MRI

Exemples

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MRI

Benefits
 Non invasive, painless, no radiation

Medical use of MRI

A powerfull general purpose aparatus

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MRI

Limitations
 The patient must not move during the exam ( 20 minutes)
 Psychological effects when the patient is positionned in the
tunnel
 No metalic objects in the room
 No pacemakers, metal teeth, prothesis,...

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MRI

3D images

No ionisation
+
No contrast liquide

Painless

Good spatial resolution 1 mm

Long exam ( 30 minutes)

No magnetic materials allowed
-

Expensive and non portable

Low dissemination

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4. Nuclear medicine

History:
 1910, radioactiv detectors (Geiger)
 1913, Hevesy photography of a radioactive organ
 1934, Franois and Irne Joliot-Curie create short
life radioactives materials

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Nuclear medicine

Principle of scintigraphy
 Injection of a radio-isotope in the patient
 Emission of rays that can go through material
 Detection of rays using a gamma-camera (Hal Anger)

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Nuclear medicine

Medical intersest
 Functionnal analysis of the human
body
 If a material have necrosis, it is not seen
in nuclaer medicine
 Relatively to their activity, cells will
have an hypofixation, a normal fixation
or an hyperfixation of the radio element

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Nuclear medicine

Applications

Lungs: the radio element is a gas

Heart

kidney

Thyrode

Osteoarticular diseases

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SPECT

Single Photon Emission Computed
Tomography

Principle
 Detector turns arround the patient
 3D reconstruction

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PET

Positon Emission Tomography

Principle :
 Utilisation of an isotope that emits rays
 Beta rays combins with electrons and produce 2
opposite directions gamma rays
 Better analysis of the organ

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Nuclear medicine

Rapide (dpend du radio-isotope, 20 min avec 11C)

Production dimages trs caractristiques de
certains tats pathologiques
+

Rsolution spatiale de 3 6 mm

Rsolution temporelle de plusieurs minutes, mais
synchronisation sur ECG

Radioactif isotopes injection

Long exam (20 min)
-
Possible allergy

Expensive

Low dissemination
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5. Echography

History:
 1883 : Galton (GB) build an ultrasound whistle
 1940 1945 : sonars
 1945 : default detection in materials (Firestone, Sprouze)
 1943 1947 : cerbral tumor detection by Dussik and Leksell
 1953 : use in cardiology (Hertz et Edler)

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Echography

Principe
 Ultrasounds emission using piezo-electric
properties of a material

 The sensor is positionned on the patient skin

 A part of ultrasounds are reflected at each material variation
 The time delay (To) from the emission to the echo is measured
 The distance from the sensor to the material variation is
estimated from the time delay To
 After processing, the echographic image is formed

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Echography

Ultrasounds probes
 Compose of one or multiple cristal transductors for
emission and/or reception
 Frequency between 2,5 to 10 Mhz
 A gel is first applied on the skin
 Examen time between 15 to 30 min

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Echography
 Ultrasons are completly reflected by bone: no possibility to
analyse the human skeleton
 Well adapted for soft organ
 Fast diagnosis

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Echography

Kidney
gallbladder Pancreas

Right Left kidney

Kidney 33
Doppler Echography

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3D Echography

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Dynamic Echography

Dynamic organs

O 1(,,)
2(,,)
P

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Echography

Fast

No irradiation

Painless
+

Costless

Transportable

Spatial resolution 3 mm

Very noisy images (speckle)
-
Difficult to analyse

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Bibliography

Traitement de limage sur micro-ordinateur, Jean Jacques Toumazet,
Sybex

Gomtrie discrte en analyse dimages, Jean-Marc Chassery, Annick
Montanvert, Herms

Analyse dimages : filtrage et segmentation, Jean-Pierre Coquerez, Sylvie
Philipp, Masson

Prcis danalyse dimages, Michel Coster, Jean-Louis Chermant, Presses
du CNRS

Morphologie mathmatique, Michel Schmitt, Juliette Mattioli, Masson

Traitement numrique des images, Mura Kunt, Presses Polytechniques et
Universitaires Romandes

Machine Vision, Ramesh Jain, Rangachar Kasturi, Brian Schunk, Mc
Graw-Hill

Two-dimensionnal imaging, Ronald Bracewell, Prentice Hall

Digital Image Processing, Rafael Gonzalez, Richard Woods, Addison
Wesley Traitements globaux 38