CT IMAGE QUALITY

DR. RAHEEL IQBAL

 CT IMAGE QUALITY

The image quality is mainly determined by 3 factors:

 Resolution
 Noise
 Contrast
 SIGNIFICANCE OF IMAGE QUALITY

 Image quality relates to how well the image

represents the object scanned.
 Image quality is significant for providing an accurate
diagnosis.
 RESOLUTION

 Resolution is the measure of how far two objects

must be apart before they can be seen as separate
details in the image.
 For two objects to be seen as separate the detectors
must be able to identify a gap between them.
 Resolution is measured in line pairs per centimeter
(lp/cm) i.e. the number of line pairs that can be
imaged as separate structures within one centimeter.
 TYPES OF RESOLUTIONS

There are two types of resolution in CT scanning:

 Transaxial resolution (7 lp/cm)

 Axially across the patient

 Z-sensitivity (0.5 - 10 mm)

 Along the length of the patient in the z-direction
 Factors Affecting Transaxial Resolution

 Focal Spot
 Detector Size
 Detector Design Properties
 Number of projections
 Reconstruction filter
 Pixel Size
 FOCAL SPOT

 Size
 Smaller focal spots give higher resolution.
 There are usually two available focal spot sizes on CT scanners, for
example:
 Fine = 0.7 mm
 Broad = 1.2 mm

 Properties
 Flying focal spot: the position of the focal spot is rapidly altered in the
transaxial plane and/or the Z-axis. Each focal spot position increases
the number of projections sampled and improves spatial resolution.
For example, if the position of the focal spot moves in the X-Y plane,
then the in-plane resolution increases.
 Focus-detector distance (FDD)
 Focus-isocentre distance (FID)
 PIXEL SIZE

 Higher the pixel size, the lower spatial resolution.

 The pixel size (d) is measured by the equation: d =

FOV/n
where:
FOV = field of view (mm)
n = image matrix size

 To improve spatial resolution we can:

 Reduce the field of view (smaller FOV = smaller pixel size)
 Increase the matrix size (larger n = small pixel size).
 Other Factors

 Detector size = Smaller detectors give higher resolution but

more detectors within an area also means more partitions (dead
space) and a reduced overall detection efficiency.
 Number of projections = Larger number of projections gives
finer resolution (up to a point).
 Reconstruction filter = Higher resolution or "sharp" kernels
(e.g. bone reconstruction) have better spatial resolution than soft
kernels (e.g. soft tissue reconstruction).However, higher
resolution kernels do not average high spatial frequency signals
and therefore produce more noise.
 Factors Affecting Z-Sensitivity

 Detector slice thickness

 Overlapping samples
 Focal spot
 Factors Affecting Z-Sensitivity

 Detector slice thickness = The wider (in the z-axis)

the detector row, the lower the resolution
 Overlapping samples = Acquiring the data using
overlapping slices can improve Z-sensitivity. This is
achieved by using a low spiral pitch e.g. pitch <1.
 Focal spot = A fine focal spot improves the z-
sensitivity
 NOISE

 There is random variation in the number of photons forming each part

of the image that can obscure the signal received from the subject,
called noise.

 There are three sources of noise:

1. Quantum noise
2. Electronic noise
3. Noise introduced by the reconstruction process e.g. backprojection.
 Quantum Noise

 Quantum noise occurs when there are an insufficient number of

photons detected.
 In CT, the number of x-ray photons detected per pixel is also
often referred to as signal-to-noise ratio (SNR).
 Quantum Noise is the dominant source of noise in an image.
Photon registration by the detectors is a stochastic process. The
number of photons detected will vary randomly about a mean
value and that variation is the noise. The noise in the final image
is given by:
Noise (standard deviation) ∝ 1/√(no. of photons)
 Factors Affecting Noise

 From the equation we can say that increasing the number of

photons reduces the amount of noise and, therefore, anything
that increases the number of photons will reduce the noise.

 Increased number of photons can be achieved by:

1. Increasing tube current (mA)
2. Increasing the rotation time (s)
3. Increasing the slice thickness (mm)
4. Increasing the tube kilovoltage (kV).
 CONTRAST

 Contrast is the difference in the image signal intensity between two

areas of interest e.g. a lesion and background tissue.
 A high contrast image has a greater difference between the grey
shades displayed but a smaller range of shades of grey.
 A low contrast image has a smaller difference (i.e. it's more difficult to
make out different areas) but a larger range of greys.
 Image contrast is altered by windowing on the
viewing monitor. Images are presented at a
certain width and centre of Hounsfield units
displayed. The larger the width, the larger the range
of shades displayed and, therefore, the smaller the
difference in contrast between each shade. The
window is adjusted for the Hounsfieid unit of the
tissues that need to be assessed.
 Factors Affecting Contrast

 Noise: a higher noise will obscure any contrast between objects.

 Tube current: a higher tube current reduces the noise in the image, so
will improve contrast.
 Inherent tissue properties: the difference in the linear attenuation
coefficient of adjacent imaged objects will determine the contrast
between those objects
 Beam kilovoltage: a higher beam energy will generally reduce the
contrast between objects.
 Use of contrast media : increases contrast between objects e.g. blood
vessels and surrounding tissue.
 SUMMARY

 Resolution
 Transaxial resolution
 Scanner factors
 Focal spot size
 Flying focal spot
 Focus detector distance
 Focus isocentre distance
 Detector size

 Scan parameters
 Number of projections
 Reconstruction filter
 Pixel size (d, mm) given by d = FOV/n (FOV=field of view, n=image matrix size)

 Not affected by:

 Tube current
 Tube kilovoltage
 SUMMARY

 Z-Sensitivity
 Equals effective slice thickness
 Affected by:
 Detector slice thickness
 Overlapping samples

 Noise
 Quantum noise = Dominant source of noise
 Noise ∝ 1 / √no. of photons
 Increasing number of photons achieved by:
 Doubling tube current (mA)
 Doubling rotation time (s)
 Doubling slice thickness (mm)
 Others:
 Electronic noise in detection system
 Noise introduced by reconstruction.
 SUMMARY

 Contrast
Affected by:
 Noise.
 Tube current.
 Inherent tissue properties.
 Beam kilovoltage.
 Use of contrast media.
THANK YOU