COMPUTED TOMOGRAPHY [CT SCANS]

SUPPORT MATERIAL:
BOOK – The 1001 Inventions that changed the world
WRITTEN BY -TREVOR BAYLIS and JACK CHALLONER
PUBLISED BY- www.hachetteindia.com

HISTORY:
Counrad Rontgen (1845 – 1923) was the first person to take x- ray
photograph of a person. He was a Nobel prize winner in 1901. Those x-
rays were of 2 dimensional. But those x-rays failed to image the body’s soft
tissue while it is kept perpendicular.

SUPPORT MATERIAL:
YOUTUBE VIDEO – HISTORY OF CT – MAYO CLINIC
PUBLISHED – 16TH April 2020

TRANSCRIPT: -
Hello, my name is Dr.Cynthia McCullough and I’m a diagnostic imaging
physicist at Mayo Clinic in Rochester Minnesota since 1991.I have
specialized in x-ray computed tomography commonly referred to as CT and
I continued to be fascinated by the rich history of this powerful inventions I
was also asked to give a brief introduction to the technology of x-ray
computed tomography before there was CT there was an exam called
pneumo and sefa log Rafi in which the patient was strapped into a chair
and air was injected into the spinal column the patient was turned upside
down and side to side so that the air would bubble up into the ventricles of
the brain x-rays were taken at all these different positions to try to detect a
loss of symmetry in the ventricles of the brain perhaps indicating the
presence of a mast this exam has been described as a form of torture
which caused the patient a great deal of pain and typically cause vomiting
throughout the exam as well as severe headaches afterwards it is not an
exam that you or I would want to have but before CT this was the only way
to detect large cerebral masses CT began with the pioneering work of two
talented individuals one a physicist and the other an engineer Alan Cormac
was a naturalized American physicist who was born in south Africa where
he studied physics at the Universities of Cape Town he furthered his
studies at Cambridge and then became a professor at Tufts Universities he
mainly worked on particle physics but his side interest was on x- ray
technology and so here and there as time allowed he worked on the idea of
how one could reproduce the inside of an object by measuring attenuation
line integrals through the object he completed some of this work and it was
published in the Journal of Applied Physics in 1963 and 1964 but the
papers generate little interest when Hounsfield showed the first patient
images in 1971 acquired with the head CT scanner that he had built
cornets work becomes a significant interest Dr. Carmack was an honorary
member of the inventions of CT is perhaps is mostly associated with
Godfrey house field because he is the one who built an actual devise on
which humans could be scanned and started his career in the Royal Air
Force in Britain as a radio operator but we’re so talented that he was
quickly promoted to instructor and eventually they asked him to go and
study to be an engineer he led design teams at the EMI Central Research
Lab outside London and become interest and pattern recognition he
thought back to his early days of radar and how with the knowledge of the
signal bouncing back at you one could identify an object he began his work
on the CT project in 1967 and the first patient was scanned using a
prototype devise on October 1st of 1971 at the Atkinson morning Hospital
in Winbledon England my fascination with the history of CT is fueled in part
by the role that Mayo Clinic where I work has had in the development of CT
the first commercial system serial number one was installed at the Mayo
Clinic in Rochester Minnesota and on June 18th 1973 Mayo performed its
first patient exam one of the compelling aspects of this story to me is how
closely Godfrey house code worked with radiologist James Ambrose to
translate the technology that he had built into a clinical tool for diagnosis of
diseases or injury he was later knighted by the Queen of England and was
properly referred to as sir Godfrey Hounsfield for their independent efforts
which were done half of the world apart Cormark and Hounsfield were
jointly awarded the 1979 Nobel Prize in Physiology and medicine this is the
first brochure for the EMI mark 1 scanner was installed. During the mid -
1980s considered CT to be amateur and rather under uninteresting
technology and it was predicted that magnetic resonance imaging was
going to replace CT and perform all future cross sectional imaging hares
close up of the patient online Minh process the plaid pants date the photo
interestingly in 1975 CT mammography was already being explored after
sometime the doses for the CT have changed along the evolution I will
explain some of these changes in order to compare the doses from the
early days to those achieved currently Ed McCullough and colleague Tom
Paine surveyed many of the CT scanner that were available in the early
years of CT and reported the maximum surface dose while these values
are hard to read it demonstrates that they made measurements over many
different scanner type and scan parameters these doses are in rats so ‘I ve
converted the values into Milla gray as it is a common used today, these
values are the peak dose from one scan and in some cases the doses
reached up to 200 Mel gray there were many different scan options and
this led to considerable variabilities in the doses delivered from a single
scan . the data provided are from the historical records at Mayo Clinic and
use just south state detectors CT scanner the data show how the doses
have been reduces over the years for an abdominal CT exam the current
average values for the volume CT doses index is more in the range of 12
mil gray in 2019 importantly as these doses were decreasingly the image
thickness was also decreasing so the image was getting down, these
techniques have to do with system hardware such as beam filtration and
beam shaping which remove photon that will not contribute significantly to
the image formation but do contribute dose to the patients beam collimation
particularly for the multi-site CT scanner continues to be an important part
of the technology in order to preserve dose efficiency education and
software tools have also become available to set up the scan aquatint in a
way that is appropriate for a specific patient and a specific diagnostic task
this has helped the community to titrate the doses to the lowest level which
still preserve the diagnostic information and allow the radiologists to
accurately perform a diagnostic interpretation CT detectors have also
improved dramatically with photon counting energy resolving quantum
detectors on the horizon the detector electronics for example have become
more stable and have much lower electronics noise levels recently dose
reduction efforts have focused primarily on how to create higher quality
images or images with lower noise level image demising and iterative
reconstruction techniques are now in widespread use and the CT imaging
field is poised to move into the era of machine learning and convolutional
neutral networks which are going to take the doses down to a level that our
predecessors not even imagined CT had certainly come a long way it can
image the entire body from head to toe in a matter of seconds , Anatomy is
revealed in remarkable details and the dose is used to acquire the day are
in some cause such as for low – dose chest CT scanning approaching
those from convectional x-rays exams I hope that you’ve enjoyed the
journey through the CT of much of which still remains to be written ,thank
you.

EXPLANATION:
Before CT there was an exam called pneumo and sefa log Rafi in
which the patient was strapped into a chain and air was injected into the
spinal column. The patient turned upside down and side to side so that the
air would bubble up into the ventricles of the brain. X – rays were taken at
different position to try to detects a loss of symmetry in the ventricles.

IN THE BEGINNING OF CT: -

The evolution took place from 1919-2004
1968 - Godfrey Hounsfired devised the CAT Scan.
1971 - A prototype scanner was installed at Atkinson Morley’s
Hospital.
1975 - The large scanners that could image the entire body
we’re being marked.
1960 – Allen Cormark had independently began work with the
mathematical technique necessary to reconstruct the image.
DEVELOPMENT OF CT SCANS: -
1975 - Godfrey Housefired and James Ambrone found EMI1010
body CT scanner.
1979 - It has very interesting geometry. This was also called a new
taking geometry.
1983 – Along with OMNI QUAD – I and PICKER 600 &1200, so
many CT scans were discovered. The CT scans with different
geometry had developed an easy way to view the whole body