Nugzar Liparteliani

INTRODUCTIO
N Computed Tomography is a well accepted imaging
modality for evaluation of the entire body.
 Computed Tomography(CT) Scan Machines Uses X-
rays, a powerful form of Electromagnetic Radiation.
 The images are obtained directly in the axial plane of
varying tissue thickness with the help of a
computer.
 Some pathology can be seen in saggital or coronal
plane by reconstruction of the images by
computer.
 CT has undergone several evolutions and nowadays
multi- detectors CT scanners have been evolved
which have better application in clinical field.
COMPARISION OF CT WITH
CONVIENTIONAL RADIOGRAPHY
Conventional radiography suffers
from the collapsing of 3D
structures onto a 2D image.
 2D imaging was used – X-rays
 there was super imposition of structures.
 less clarity of images

CT gives accurate diagnostic

information about the
distribution of structures inside
the body.
 Computed : use of computer
 Tomography:
Greek word tomos means "slice", graphy means
"write".
 Computed Tomography is the process of
generating a two-dimensional image of a slice or
section through a 3-dimensional object (a
tomogram)
 Computed tomography (or computerized axial
tomography) is an examination that uses X-ray and
computer to obtain a cross-sectional image of the
human body.
 The first commercially CT scanner was invented by
Sir Godfrey Hounsfield in Hayes, United Kingdom,
at EMI Central Research Laboratories using X-rays

 The first EMI-Scanner was installed in Atkinson

Morley Hospital in Wimbledon, England

 The first patient brain-scan was done on 1 October

1971.
 Emi scanner is limited to scanning only brain.
 Hounsfield and Cormack got the 1979
Nobel Prizefor their contributions to CT.
 Allan McLeod Cormack 'stheoretical
calculations on x-ray was used by Hounsfield.
 Gantry (scanner system)
 Patient's table
 Computer(operation control)
 Scanner system:
1. X ray tube
2. Detector system
3. Collimators
4. Filters
 X-ray tube: generates x-ray beams
 Detector: detects the x-rays passing through

the patient's body.

 Collimator: narrows the beams of x-rays

 Filters: these are used to filter some rays

from entering the patient's body that may

be harmful.
COMPARISION OF CT WITH CONVIENTIONAL
A conventional X-ray
RADIOGRAPHY . image is basically a shadow.
Shadows give you an incomplete picture of an object's
shape.

This is the basic idea of computer aided tomography. In a CT scan

machine, the X-ray beam moves all around the patient, scanning from
hundreds of different angles
Comparison of CT with Conventional
Radiography
Radiographic procedure is qualitative and not
quantitative
ADVANTAGE OF COMPUTED
TOMOGRAPHY OVER CONVIENTIONAL
RADIOGRAPHY.
 To overcome superimposition of structures.
 To improve contrast of the image.
 To measure small differences in tissue contrast.
TOMOGRAPH
Y
Imaging of Layer/Slice.
Principle
Images of structures lying above and below the
plane are blurred out due to motion unsharpness
while the structures lying in plane of interest appear
sharp in in the image.
Tomography
PRINCIPLE OF
COMPUTED
TOMOGRAPHY
 The internal structure of the object can be
reconstructed from multiple projections of
the object.
 Mathematically principle of CT was first developed
in 1917 by Radon.
 Proved that image of unknown object could be
produced if one had several number of
projections throughout the object.
 VARIOUS PARAMETERS OF
CT
SLICE
 MATRIX
 PIXEL
 VOXEL
 CT NUMBER
 WINDOWING
 WINDOW WIDTH
 WINDOW LEVEL
 PITCH
SLICE/CU
Tfor production of CT image is called Slice.
 The cross section portion of body which is scanned

 The slice has width and therefore volume.

 The width is determined by width of the x rays beam.
Cross Sectional Slices
Think like looking into the loaf of bread by cutting
into the thin slices and then viewing the slice
individually.
MATRI
X number.
 The CT image is represented as the Matrix of the

 A two dimensional array of numbers arranged in

rows and columns is called Matrix.
 Each number represent
the value of the image at
that location.
PIXE
Lpixel.
 Each square in a matrix is called a

 Also known as picture element.

 VOXE
L
Each individual element or number in the image
matrix represents a three dimensional volume
element in object called VOXEL.
CT
NUMBER
 The numbers in the image matrix is called CT
NUMBER.
 Each pixel has a number which represents the x-ray
attenuation in the corresponding voxel of the
object.
HOUNSFIELD
UNITS(HU)
 Related to different composition and nature of Tissue.
 The CT NUMBER is also known as
Hounsfield units(HU).
 Represent the density of tissue.
 Different Tissue have different CT number Range in
HU.
TISSUE AND CT NUMBER
APPROXIMA
Air TE - 1000
Fat -100
Pure water 0
CSF 15
White matter 45
Gray matter 40
Blood 20
Bone/calcification +1000
TISSUE AND CT NUMBER
APPROXIMATE
WINDOWING is a system where the CT no. range of
interest is spread cover the full grey scale available
on the display system
WINDOW WIDTH –Means total range of CT no.
values selected for gray scale
interpretation. It corresponds to contrast
of the image.
WINDOW LEVEL– represents the CT no. selected
for the centre of the range of the no. displayed on
the
image. It corresponds to brightness of image .
WINDOWING
WINDOWING
Pitc
hcalled Pitch.
 The relationship between patient and tube motion is

 It is defined as table movement during each

revolution of x-ray tube divided by
collimation width.
 For example: For a 5mm section, if patient moves
10mm during the time it takes for the x-ray tube
to rotate through 360˚, the pitch is 2.
 Increasing pitch reduces the scan time and
patient dose.
STEPS OF CT IMAGE
FORMATION
Phase of CT
scanning
1.Scanning the patient or data
Acquisition
a)X-ray Generator
b)X-ray Tube
c)X-ray Filtration System
d)Detector System

2.Reconstruction
a)Simple back projection
b)Iterative method
c)Analytical method

3.Display
DATA
ACQUISTION
The scanning process begins with data
acquisition
 Data Acquisition refers to a method by
which the patient is systematically
scanned by the X ray tube and
detectors to collect enough
information for image reconstruction
Majorcomponents of Data Acquisition
System(DAS)
a)X-ray Generators
Generators are located on rotating scan frames
within the CT gantry to accommodate slip Ring.
Power: 50 to 80kw
Frequency: 5 to
50kHz KVp: 80-120
mA:80-500
b) X-ray Tube
 Rotating anode x-ray tube with unique cooling.
 Small focal spot size (0.6mm) to improve spatial resolution.
 Anode heating capacity:1MHU to 7MHU
 Cooling rate:1MHU per minute.

c)X-ray Beam Filtration System

 CT employs monochromatic beam but radiation from
CT X-ray tube is polychromatic. so, X-ray beam is shaped
by compensation filter.
a) Pre patient Collimators: Reduces the patient dose.
b) Post patient Collimators: Reduces the scattered radiation
detectors .
Overall Functions
of Collimators.
 To decrease
scatter radiation
 To reduce patient
dose
 To improve image
quality
 Collimator width
determines the
slice thickness
d)Detectors
The detectors gather information by measuring the x-
ray transmission through the patient.
 Two types:
Scintillation crystal detector
(Cadmium tungstate+ Si Photodiode)
Can be used in third and fourth generation scanners
Xenon gas ionisation chamber
Can be used in third generation scanners only
2)Reconstructio
nReproduction of an image from raw data is called
Reconstruction.
A)Simple back projection
The image is created by reflecting the attenuation
profiles back in same direction they were
obtained.
2)Reconstructio
n
B)Iterative method
 It start with assumption that all point in matrix have
same value and it was compared with measured
value and make correction until Values come with
in acceptable range.
 It contain three correction factor
1. SIMULTANEOUS RECONSTRUCTION
2. RAY BY RAY CORRECTION
3. POINT BY POINT CORRECTION
C)Analytical Method

Today commonly used .

Two popular method used in that method

are:-

1. 2-D FOURIER ANALYSIS

2.FILTERED BACK PROJECTION

2-D FOURIER ANALYSIS
In it any function of time or space can be represented by
the sum of various frequencies and amplitude of sine and
cosine waves.
For example the actual projected image of original object
is more rounded than those shown which would be
slowly simplify and corrected by Fourier
transformation.
2-D FOURIER
ANALYSIS
FILTERED BACK PROJECTION
Same as back projection except that the image is
filtered, or Modified to exactly counterbalance the
effect of sudden density Changes , which cause
blurring(star like pattern) in simple back projection.
3)Displa
y It is a digital image.
 The reconstructed image is displayed on the monitor.

 It consists of 2D representation of 3D object in the

form of pixels.
 CT pixel size is determined by dividing the FOV
by matrix Size which is generally 512*512.

 PIXEL SIZE= FOV (mm)/ MATRIX SIZE

Generations of CT
Scan
First Generation
Narrow pencil beam
 Single detector
 Detector used is made up of
NaI.
Translate –Rotate movements of
Tube- detector combination
 Scan time-5mins.
Designed only for evaluation
of brain.
First generation CT
Scanner
•Head kept enclosed in a
water bath
•Paired detectors
•A reference detector
Second Generation CT
Scanner
Second
Generation
 Narrow fan beam
 Linear detector array(5 to30)
 Translate-Rotate movements of Tube-Detector
combination
 Fewer linear movements are needed as there are
more detectors to gather the data.
 Between linear movements, the gantry rotated
30o
 Scan time~30secs(advantage over first
generation)
 Third
Generation
•Rotate(tube)Rotate(detectors)
Motion.
•Pulsed wide fan beam.
•Arc of detectors(600-900)
•Detectors are perfectly aligned
with the X-Ray tube
•Both Xenon and
scintillation crystal
detectors can be used
•Scan time< 5secs
•Disadvantage: Ring Artifacts
due to electronic drift
between many detectors.
Fourth
Generation
Fourth
Generation
 Complete circular array of about 1200 to 4800
stationary detectors
 Single x-ray tube rotates with in the circular array
of detectors
 Wide fan beam to cover the entire patient
 Scan time of newer scanners is about ½ s or, <2s.
 Designed to address ring artifacts by
keeping detector assembly stationary.
 Disadvantage: High cost.
Fifth
Generation
 stationary/stationary
 Developed specifically for cardiac tomographic imaging
 No conventional x-ray tube; large arc of tungsten
encircles patient and lies directly opposite to the
detector ring
 Electron beam steered around the patient to strike the
annular tungsten target
 Capable of 50-msec scan times; can produce fast-
frame- rate CT movies of the beating heart
 Electron gun
 Large Arcs of tungsten
targets
 Detector ring
 17 slices per second
CT SCAN IN RADIOLOGY
DEPARTMENT.(16 SLICES)
Patient Positioning and Data
Acquisition
TECHNICAL
SPECIFICATION
(Hitachi ECLOS 16)
 CT scanner mode: Multislice
 Slices per rotation: 16
 Other rotation speed options: 1.0, 1.5, 2.0, 3.0 seconds
 Minimum rotation speed: 0.8 seconds
 Gantry diameter: 70 cm
 Maximum beam width (cm): 2 cm
 Table weight limit: 495 lbs
 Table movement range vertically/longitudinally: 42 to 100
cm vertical, 186 cm horizontal
 X-ray generator kV range: 100, 120, 130 kVp
 Maximum scan range: 175 cm
 X-ray tube heat capacity: 5.0 MHU
 Power requirements: 3-phase, 200 Amp max.
SPIRAL/HELICAL
CT
 Spiral/Helical scanning uses third generation or fourth
generation slip ring design.
 Spiral computed tomography (or helical computed
tomography) is a computed tomography(CT) technology
in which the source and detector travel along a helical
path relative to the object. Typical implementations
involve moving the patient couch through the bore of the
scanner whilst the gantry rotates. Spiral CT can achieve
improved image resolution for a given radiation dose,
compared to individual slice acquisition. Most modern
hospitals currently use spiral CT scanners.
SLIP RING
TECHNOLOGY
 In conventional CT scanning there was a paused
between each gantry rotation. But in Helical CT,
Slip Ring technology is used which allows
continuous rotation of gantry without interruption.
 Slip Rings are electrical conducting brushes and
component of gantry transferring the data or,
electrical energy to and from the stationary part
of gantry to rotating part of gantry for
continuous rotation of gantry.
Contd
….
 There are usually three slip rings made up of
conduction materials(i.e. Sliver and Graphite.)
 First Slip Ring provides high voltage power to X-
ray tube.
 Second provide low voltage to control system on
rotating gantry and
 Third Slip Ring transfers digital data from
rotating detectors arrays.
MULTISLICE/MULTIDETECTOR
CT
 Multidetector computed tomography(MDCT) is a form
of computed tomography (CT) technology for diagnostic
imaging.
 In MDCT, a two-dimensional array of detector elements
replaces the linear array of detector elements used in
typical conventional and helical CT scanners. The two-
dimensional detector array permits CT scanners to
acquire multiple slices or sections simultaneously and
greatly increase the speed of CT image acquisition.
 Image reconstruction in MDCT is more complicated
than that in single section CT.
DUAL SOURCE
CT
Dual Source CT (DSCT) is equipped
with two X-ray tubes.
Two corresponding detectors are
oriented in the gantry with an
angular offset of 90 degrees.
ADVANTAGES
1) High temporal resolution(in
response to time domain) for
cardiac imaging without β
blockers which means heart
rate is independent upon
temporal resolution.
2) Less radiation dose even
for obese patient.
3) Faster acquisition time
with shortest breathe
 DUAL ENERGY
CT
 Standard computed tomography (CT)
scanners use normal X-rays to make
cross-sectional ‘slice-like’ pictures or
images of the body.
A dual energy CT scanner is fairly
new technology that uses both the
normal
X-ray and also a second less powerful
X- ray to make the images.
Two pictures are taken of the same
slice at different energies.(i.e.
80/140KV
,100/140KV Or,70/150KV)
This gives dual energy CT additional
advantages over standard CT for a
wide range of tests and procedures.
PORTABLE CT
SCAN
PORTABLE CT
SCAN
 As the world’s first portable, full-body, 32-slice CT (computed
tomography) scanner, BodyTom is a multi-departmental
imaging solution capable of transforming any room in the
hospital into an advanced imaging suite. The system boasts an
impressive 85cm gantry and 60cm field of view, the largest
field of view available in a portable CT scanner.
 The battery-powered BodyTom with an innovative internal drive
system can easily be transported from room to room and is
compatible with PACS, planning systems, surgical and robotic
navigation systems.
 Uniquely designed to accommodate patients of all sizes,
BodyTom provides point-of-care CT imaging wherever high-
quality CT images are needed, including the operating room,
intensive care unit, radiation oncology suites, and the
emergency department.
RADIATION DOSE IN
CT
 Volume Computed Tomography Dose Index (CTDI ) is a vol
standardized parameter to measure Scanner Radiation Output
 CTDIvol provides information about the amount of
radiation used to perform the study.
 CTDIvol is NOT patient dose
 CTDIvol is reported in units of mGy for either a 16-cm
(for head exams) or 32-cm (for body exams) diameter.
 AAPM (American Association of Physicts in Medicine)
introduces a parameter known as the Size Specific Dose
Estimate (SSDE) to allow estimation of patient dose based
on CTDIvol and patient size.
 For the same CTDIvol, a smaller patient will tend to have
a higher patient dose than a larger patient.
EFFECTIVE DOSE
(mSv)
CT
 HEAD------------
GENERAL
RADIOGRAPHY
2  SKULL -------- 0.07
 CHEST ----------  CHEST PA ---- 0.02
8 ABDOMEN --- 1
ABDOMEN --10 PELVIS -------- 0.7
PELVIS -------10