Computed

Tomography
A summarized PPT for review purposes.
 COMPUTED
TOMOGRAPHY
- is the process of creating a cross-sectional tomographic plane
(slice) of any part of the body which is then reconstructed by
a computer.
- produces cross-sectional images of “slices” of anatomy like
the slices in a loaf of bread.
- from the Greek word “tomos” meaning slice or section, and
“graphe” meaning drawing
COMPUTED TOMOGRAPHY HAS BEEN PREVIOUSLY IDENTIFIED
AS:
• COMPUTED AXIAL TOMOGRAPHY
• COMPUTERIZED TRANSAXIAL TOMOGRAPHY
• COMPUTERIZED RECONSTRUCTION TOMOGRAPHY
• DIGITAL AXIAL TOMOGRAPHY
ORIENTATIONS:
1. CORONAL
2. SAGITTAL
3. TRANSVERSE
4. AXIAL
GODFREY HOUNSFIELD – clinical demonstration of CT (1970)
ALLAN M. CORMACK – developed the mathematics used to reconstruct CT
image.
ATKINSON MORLEY’S HOSPITAL, ENGLAND – first scale CT unit used to
examine
the skull and disease of the brain
called
“Head Scanning”

MAYO CLINIC AND MASSACHUSSETS GENERAL HOSPITAL

- The first CT unit in the US

DR. ROBERT LEDLEY – developed the first scanner capable of visualizing

any section
of the body.
 CT SCANNER DESIGN
FIRST GENERATION
- A demonstration project
-Characteristic: translate/rotate (Bushong ) or rotate/translate (Reveldez)
- X-ray Beam Shape: pencil beam
-Detector: single detector
-Imaging Time: 5-minute imaging time

SECOND GENERATION
Characteristic: translate/rotate (Bushong ) or rotate/translate (Reveldez)
X-ray Beam Shape: narrow fan beam
Detector: multiple detector (5-30)
Imaging Time: 30 seconds
Advantage: speed
Rationale: consist of multiple detectors
Disadvantages:
o Increased scattered radiation
o Increased radiation intensity toward the edges of the beam
Compensation: used of bow-tie filter
Bow-tie Filter: equalize the radiation intensity that reaches the detector array
THIRD GENERATION
Characteristic: rotate/rotate
X-ray Beam Shape: wide fan beam
Detector: curvilinear detector array (30)
Imaging Time: <1 second
Advantages:
o Better x-ray beam collimation
o Decreased scattered radiation
o Good image reconstruction
Disadvantage: ring artifacts
Compensation: software connected image reconstruction algorithm

FOURTH GENERATION
Characteristic: rotate/stationary
X-ray Beam Shape: wide fan beam
Detector: fixed circular detector array (4000) with detector ring
Imaging Time: <1 second
Advantage: no ring artifacts
Disadvantage:
o Increased patient dose
o High cost
 FIFTH GENERATION (early 1980’s)
Electron beam CT
Ultrafast CT scanner
X-ray tube rotation is mechanical
No moving parts
Electron Gun: produces a focused electron beam that generates a rotating x-ray fan
beam after being steered along tungsten target rings

SIXTH GENERATION (early 1990’s)

-Helical/Spiral CT
-Volumetric scanners
-Introduced by Will Kalender and Kazuhiro Katada
-Uses slip ring technology
-Excels in 3D multiplanar reformation
-Slip Ring: electromechanical device that conduct electricity and electric
signals through rings and brushes across a rotating surface onto a fixed
surface

SEVENTH GENERATION
- 64-Slice CT
-Multiple detector array
IMAGING SYSTEM DESIGN
MAJOR COMPONENTS
1.) Gantry
2.) Operating Console
3.) Computer

GANTRY
- Largest component
Subsystems: x-ray tube, detector array, high voltage generator,
patient couch and mechanical support

X-RAY TUBE
 Special requirements:
o Power capacity: must be high
 >120 kVp
 400 mA
o High speed rotors: for heat dissipation
o Anode heat capacity: 7 MHU (Spiral CT)
o Heat storage capacity: 8 MHU
o Anode cooling rates: 1MHU/min
o Focal spot size: small
 DETECTORY ARRAY
o The entire collection of detectors
o Group of detectors
o The image receptor in CT
o Detector: absorbs radiation and converts it to electrical
signal
o Optimal Characteristics:
o High detector efficiency
 The ability of the detector to capture transmitted photons

o Types:
Gas-filled detector – previously used
Scintillation & solid-state detectors – recently used
o Gas detector:
Basis: ionization of gas
Three types:
 Ionization chamber
 Proportional counter
 Geiger-Muller counter
Characteristics:
 Excellent stability
 Large dynamic range
 Low quantum efficiency
Scintillation detector:
o Characteristic: high x-ray detection efficiency (90%)
 Reduces patient dose
 Allows faster imaging time
 Improves image quality
o Crystals used: Sodium iodide
o Replaced by:
 Bismuth germinate (BGO)
THREE IMPORTANT FACTORS CONTRIBUTING TO
 Cesium iodide (CsI)
DETECTOR EFFICIENCY
o Current crystal of choice:
1.) GEOMETRIC EFFICIENCY
 Cadmium tungstate (CdWO4)
 The area of the detectors sensitive to radiation as a fraction of
 Special ceramics
the total exposed area
 The amount of space occupied by the detector collimator
plates relative to the surface area of the detector

2.) QUANTUM EFFICIENCY

 The fraction of incident x-rays on the detector that are
absorbed and contribute to the measured signal

3.) CONVERSION EFFICIENCY

 The ability to accurately convert absorbed x-ray signal to
electrical signal
OVERALL/DOSE EFFICIENCY
-product of geometric, quantum and
conversion efficiency

CAPTURE EFFICIENCY
Refers to the ability with which the detector obtains photons
that have passed through the patient

ABSORPTION EFFICIENCY
Refers to the number of photons absorbed by the detector
Depends on: physical properties of the detector face
o Thickness
o Material
HIGH VOLTAGE GENERATOR
o High frequency power
o High voltage step-up transformer
o Power: 50 kW
o Accommodates higher x-ray tube rotor speeds
o Accommodates instantaneous power surges characteristic of
pulsed system
 COLLIMATION
Restricts the volume of tissue irradiated
 Purpose:
o Reduces patient dose
o Improved image contrast
PATIENT COUCH Types: post patient & prepatient collimator
o Supports the patient comfortably Prepatient Collimator
o Construction: low-Z material (Carbon fiber) o Limits the area of the patient that intercepts the useful beam
o Rationale: it does not interfere with x-ray beam transmission o Mounted on the x-ray tube housing or adjacent to it
& patient imaging o Purpose: to decrease patient dose
o Features: should be o Determines:
o Smoothly and accurately motor driven  Dose profile
 Rationale: precise positioning is possible  Patient dose
o Capable of automatic indexing Predetector/Post Patient Collimator
 Rationale: operator does not have to enter the room between o Restricts the x-ray beam viewed by the detector array
each scan o Purpose:
 To decrease scattered radiation
 To improved contrast
o Determines:
 Slice thickness
 Sensitivity profile
OPERATING CONSOLE
Contains meters and controls
For selection of proper imaging technique factors
For proper mechanical movement of the gantry and patient couch
For the use of computer commands
 Allow image reconstruction and transfer
 2-3 operating consoles
o 2 for CT radiologic technologists
 1st: To operate imaging system
 2nd: to post-process images for filming and filing
o 1 for physician
 To view the images
 To manipulate contrast, size & general visual appearance
 Accepts the reconstructed image from operator’s console
 Displays reconstructed image for viewing and diagnosis
 Two monitors:
o 1st: provided for operator
 To annotate patient data on the image (e.g. hospital
identification, name, patient number, age, gender)
 To provide identification for each image (e.g. number, technique, couch
position)
o 2nd: allows the operator to view the resulting image before transferring
it to hard copy or physician’s viewing console
COMPUTER
 Unique subsystem of the CT imaging system
 Microprocessor & primary memory: heart of the computer
o Determine reconstruction time
 Array processors:
o Mostly used in CT instead of microprocessors
o Rationale:
 Does many calculations
 Faster than microprocessors (<1 sec reconstruction time)

Computer memories: ROM & RAM

- Random access memory: temporary memory that stores
information while software is used
-Read only memory: for storage data only and cannot be
overwritten

 Central Processing Unit (CPU): performs calculations and

logical operations under control of software instruction
o Heart of the computer
SLIP-RING TECHNOLOGY
Slip ring: electromechanical device that conducts electricity
and electrical signals through rings and brushes
o Allows the gantry to rotate continuously without interruption
o Made MSCT possible
Brushes: transmit power to the gantry components
o Composition: silver graphite alloy
 Used as sliding contact
o Replacement of brushes:
 Every year IMAGE CHARACTERISTICS
 During preventive maintenance IMAGING MATRIX
Layout of cells in rows and columns
Original EMI: 80x80 matrix
o 6000 cells of information
Current system: 512x512 matrix
o 262,144 cells of information
Pixel: a picture element
o Each cell of information
o Two-dimensional
Pixel Size = FOV ÷ matrix size
Voxel: a volume element
o The tissue volume
 CT number/Hounsfield unit: the numeric information
contained in each pixel
 Matrix: rows and columns of pixels displayed on a digital
image
Field of view (FOV): the diameter of image reconstruction
o FOV increased, fixed matrix size CT NUMBER FOR VARIOUS TISSUES
 Result: increase/larger pixel size TISSUES APPROXIMATE CT NUMBER
o Fixed FOV, increase matrix size Dense bone 3000
 Result: decrease/smaller pixel size Bone 1000
Liver 40-60
Muscle 50
White matter 45
Gray matter 40
CT NUMBER/HOUNSFIELD UNIT (HU) Kidney 30
 Used to assess the nature of tissue
Blood 20
 HU: scale of CT number
CSF 15
 Range: -1000 – +3000
Water 0
Fat -100
Lungs -200
Air -1000
IMAGE QUALITY
SPATIAL RESOLUTION
 Ability to image small object that have high subject contrast
 Expressed in: linepairs/millimeter (lp/mm)
 A function of pixel size
 Takenote: SR for a CT image is limited to the size of the pixel
 Image reconstruction and postprocessing tasks: powerful way to affect SR

FACTORS AFFECTING/INFLUENCING SPATIAL RESOLUTION

1.) Pixel size
2.) Slice thickness
3.) Voxel size
4.) Design of prepatient and predetector collimators
5.) Detector size
CTORS EFFECT IN SPATIAL RESOLUTION
Thick slice thickness Poor SR
Thin slice thickness Better SR
Large pixel size Poor SR
Small pixel size Better SR
Large voxel size Poor SR
Small voxel size Better SR
Large detector size Poor SR
Small detector size Better SR
 CONTRAST RESOLUTION
The ability to distinguish one soft tissue from another without
regard for size or shape
Takenote: CR is superior to CT
o Rationale: better x-ray beam collimation
Ability to image low-contrast objects:
o Limited by:
 Size and uniformity of the object
 Noise of the system

CT SCAN ARTIFACTS
ARTIFACTS
 Systematic discrepancy in CT numbers/HU
 Unintended optical density on a radiograph
 More common in CT than in conventional radiographs
 Types:
o Streaking - due to an inconsistency in a single measurement
o Shading – due to a group of channels or views deviating
gradually from the true measurement

o Rings – due to errors in an individual detector calibration

o Distortion – due to helical reconstruction
Four categories:
o Physics-based artifacts
 Caused: physical processes involved in the acquisition of CT
data
o Patient-based artifacts
 Caused: BEAM-HARDENING ARTIFACT
Patient movement Description Increased mean energy of the x-ray beam
Presence of metallic materials when it passes through object
o Scanner-based artifacts, Caused Polychromatic nature of the x-ray beam
 Caused: imperfections in scanner function Effect Cupping artifact
o Helical and multisection artifacts Appearance of dark bands or streak
 Caused: image reconstruction process. (b/n metal or bone)
Pseeudoenhancement of renal cysts
Avoidance
PHYSICS-BASED ARTIFACTS BUILT-IN FEATURES:
 Beam hardening artifact Filtration
o Cupping artifact Calibration correction
o Streak artifact Beam hardening correction software
 Partial volume BY OPERATOR: Patient positioning
 Photon starvation Gantry tilting
 Undersampling Appropriate FOV selection
Appropriate bowtie filter
Most commonly occur Bone and metal
implants
CUPPING
CUPPING ARTIFAC
ARTIFACT
Description Beam is hardened more in the middle
portion of an object than those in the edges
Caused Beam hardening
Effect The middle of the image appear darker than the
periphery
Avoidance Beam hardening correction

STREAK
STREAK DARK
AND DARKBANDBAND
ARTIFACT
ARTIFACTS
Description Appear between two dense objects
Caused Metals (bullets, pacemaker, dental fillings)
Beam hardening
Patient motion
Edge effects
Effect High CT number on the image
Avoidance Beam hardening correction
Most commonly occur Bony regions of the body
Used of contrast media
PARTIAL VOLUME ARTIFACT
Description:
Distortion of signal intensity from an anatomy
Caused: Anatomy that doesn’t lie totally within the
slice thickness
Avoidance:
Thin slice selection
Thin slice incrementation
Most critical region:
Posterior cranial fossa

PHOTON STARVATION ARTIFACT

PHOTON STARVATION ARTIFACTS
Description Potential source of streaking artifacts
Caused High x-ray attenuation
Highly attenuating structures
Effect Insufficient x-ray photons reaching the detector
Very noise projections
Avoidance Increase tube current
Use of adaptive filtration
Automatic tube current modulation
PATIENT-BASED ARTIFACTS
- Metallic materials
-Patient motion
-Incomplete projection

METAL ARTIFACTS
METAL ARTIFACTS
Caused Presence of metal object in the scan field
Effect Incomplete attenuation profile
Severe streaking artifacts
Avoidance Asked patient to remove metallic objects
Use gantry angulation
(for nonremovable items) MOTION ARTIFACTS
ION ARTIFACTS
Increased kVp Caused Patient motion (involuntary & voluntary)
Thin slice thickness Effect Misregistration artifacts
Avoidance By the operator:
Use of positioning aids
Immobilization
Sedation (infant)
Short scan time
Instruct patient to hold breath
By built-in features:
Overscan & underscan modes
Software correction
Cardiac gating
INCOMPLETE
INCOMPLETE PROJECTION
PROJECTION
Description Presence of anatomy lying outside the scan
field produces severe artifacts
Caused Portion of anatomy lies outside the field of view
Effect Incomplete information of the anatomy by the
computer
Generation of streaking and shading artifacts
Avoidance Position patient so that no parts lying
outside the scan field

SCANNER-BASED ARTIFACTS
 Ring artifacts
RING ARTIFACTS
Description Artifacts seen in third generation CT
scanner
Caused Faulty detector
Detector out of calibration
Effect Consistently erroneous reading at each angular
position
Circular artifact
Avoidance Detector calibration
Selecting correct scan FOV
(by using calib
Pitch is also defined as the ratio
of the table speed per rotation
and the total collimation (slice
thickness).
Couch movement (mm/sec) per
360 degree rotation
PITCH = Sample Questions in computing the Pitch
Ratio of a Scanner:
------------------------------------
During a 360-degree x-ray tube
Collimation rotation, the patient couch moves 8
Pitch is expressed as a ratio; 1:1, 1:5 or 2:1 millimeters. Section collimation is 5mm.
and a Pitch Ratio of 1:1 will result in the best What is the Pitch?
image quality. Couch movement per 360 degree
rotation
PITCH = ---------------------------------------
Collimation

8mm
= ----------------
5mm

= 1.6mm
The relationship between the volume of “Tissue Imaged”
and “Pitch” is given as follows:

Tissue Imaged = Collimation x Pitch x Scan Time

QUESTION:
How much tissue will be imaged if collimation is set to 8mm,
with a scan time of 25 seconds, and a pitch of 1.5:1?

Tissue Imaged = 8mm x 25 x 1.5

= 300mm ≈ 30 centimeters
NOTE: 10 millimeters = 1 centimeter
“CT Pixel Size” is determined by dividing the
FOV by the Matrix size.
Example:
Compute the Pixel size for the following
characteristics of a CT scanner used for CT
B. Field of view of 20cm, 512x512 Matrix.
Brain.
200mm
A. Field of View of 20cm, 120x120
= --------- --
Matrix.
512 pixels
Note: 1 centimeter = 10 millimeters
= 0.4mm/pixel
200mm
=-----------
C. Field of view is 36cm, 512x512 Matrix
120 Pixels
360mm
= 1.7mm/Pixel
= --------------
512 Pixels

= 0.7mm/Pixel