NUCLEAR TECHNIQUES IN MEDICINE: COMPUTED TOMOGRAPHY Inman Abdul Rahman Contents of this lecture: 4. Historical development 2. Basic principles 3. Components 4, Generation advancements Objective of this lecture: At the end of this lecture, students: 4. Aware of CT history and importance 2. Know the basic components and basic working principles of CT 3, Versed in the advancement of CT generations History + Mathematical principles of CT were first developed in 1917 by Radon (Austrian Mathematician) + Proved that an image of an unknown object could be produced if one had an infinite number of projections through the object History + Oldendorf (1961) and Cormack (1963) did preliminary work based on Radon’s work. History Godfrey N. Hounsfield + Credited with the invention of computed tomography in 1970- 1971. + Both he and Cormack won the Nobel Prize for Medicine in 1979.History Godfrey N. Hounsfield + Work as a research engineer for a company called EMI (Electro- Musical Instruments LTD.) * Built first Scanner on a lathe bed h took nine days to produce a gle section image. + Honoured with HU Hounsfield Unit History + Early CT scanners were limited to use on the brain. + In 1974, Robert Ledley introduced techniques that led to the development of the first CT scanner that could perform whole- body imaging of patients. Components The CT system consists of: + acomputer work station for operation of the scanner, + image processing computers, + the gantry + and the patient imaging table. Components. Components Gantry + The gantry houses the key components of the scanner. + Many components associated with the production of the x-ray beam and detection and acquisition of the beam must be located within the rotating portion of the gantry.Components Gantry + Heat from the generator, x-ray tube, and other components must be removed efficiently. + The x-ray tube in a CT scanner is designed to produce a fan beam of x-rays that is approximately as wide as the body. Components Gantry + The x-ray tube on a CT scanner is, a much more heavy duty unit than the tubes used for standard x-ray imaging. + Gantry aperture size varies from 54-85 cm in diameter Components Gantry + Onthe opposite side of the patient is the detector array that measures the strength of the x-ray beam at various points laterally across the body. Components Gantry (Detectors) + Detectors, either Xenon gas-filled ionization chambers or solid state crystals. + Solid state crystals absorb nearly 100% of the photons that incident upon them (most common - cadmiun tungstenate) + Xenon gas detectors only 60 - 93%. Components Table + Composed of carbon graphite fiber which is strong yet is low in X-ray density. + The table is supported only on one end and must carry the load without bending or breaking. Components TableComponents Table + Tables are designed to reduce or direct away streak artifacts caused by sharp interfaces between structures of markedly different densities (i.e. table and air) + Allows for easier patient transport. + Table incrementation - accuracy is crucial to obtain fine detail scans. Basic Working Principles + Computed Tomography, CT for short (also referred to as CAT, for Computed Axial Tomography), utilizes X-ray technology and sophisticated computers to create images of cross-section “slices” through the body. Basic Working Principles + CT exams and CAT scanning provide - quick overview of pathologies and enable rapid analysis and treatment plans. + Tomography is a term that refers to the ability to view an anatomic section or slice through the body. Basic Working Principles + This X-ray based system creates projection information of x-ray beams passed through the object from many points across the object and from many angles (projections). Basic Working Principles + Tomography involves taking measurements around the periphery of an object (e.g. process vessel or patient) to determine what is going on inside. Basic Working PrinciplesBasic Working Principles * CT produces cross-sectional images and also has the ability to differentiate tissue densities, which creates an improvement in contrast resolution. *+ Plain film imaging reduces the 3D patient anatomy to a 2D projection image Basic Working Principles *+ Density at a given point on an image represents the x-ray attenuation properties within the patient along a line between the x- tay focal spot and the point on the detector corresponding to the point on the image. Basic Working Principles Basic Working Principles + With a conventional radiograph, formation with respect to the dimension parallel to the x-ray beam is lost. jon can be overcome, to some degree, by acquiring two images at an angle of 90 degrees to one another. Basic Working Principles + For objects that can be identified in both images, the two films provide location information. Basic Working Principles | | iTomographic Images + The tomographic image is a picture of a slab of the patient's anatomy. + The 2D CT image corresponds to a 3D section of the patient. + CT slice thickness is very thin (1 to 40 mm) and is approximately uniform. Tomographic Images + The 2D array of pixels in the CT image corresponds to an equal number of 3D voxels (volume elements) in the patient. + Each pixel on the CT image displays the average x-ray attenuation properties of the tissue in the corresponding voxel. Tomographic Images Tomographic Acquisition + Single transmission measurement through the patient made by a single detector at a given moment in time is called a ray. + Aseries of rays that pass through the patient at the same orientation is called a projection or view. Tomographic Acquisition + Two projection geometries have been used in CT imaging: + Parallel beam geometry with all rays in a projection parallel to one another. + Fan beam geometry, in which the rays at a given projection angle diverge. Tomographic Acquisition an ai petTomographic Acquisition + Purpose of CT scanner hardware is to acquire a large number of transmission measurements through the patient at different positions. + Single CT image may involve approximately 800 rays taken at 4,000 different projection angles. Tomographic Acquisition + Before the acquisition of the next e, the table that the patient lies on is moved slightly in the cranial- caudal direction (the “z-axis” of the scanner). Tomographic Reconstruction + Each ray acquired in CT is a transmission measurement through the patient along a line. Tomographic Reconstruction + The unattenuated intensity of the x-ray beam is also measured during the scan by a reference detector. Tomographic Reconstruction + Mathematical principles of CT were first developed in 1917 by Radon (Austrian Mathematician) + There are numerous reconstruction algorithms + Filtered backprojection reconstruction is most widely used in clinical CT scanners. Tomographic Reconstruction + Builds up the CT image by essentially reversing the acquisition steps. + The value for each ray is smeared along this same path in the image of the patient. + Analogous to Surface PrintingTomographic Reconstruction + As data from a large number of rays are backprojectedonto the image matrix, areas of high attenuation tend to reinforce one another, as do areas of low attenuation, building up the image. Tomographic Reconstruction Tomographic Reconstruction accuistion ackerolection Tomographic Reconstruction Fete f ben | bere pene | [Mey Consideration Why not scan the same all through? Consideration Examination Surface dose Effective dose ChestX-ray 0.015rem 0.002 rem Skull Xray 0.250rem 0.004 rem Abd.X-ray 0.400rem 0.050 rem CTHead rem 0.15 rem CTBody — 3rem 1.2remCT Generations 4* Generation (1970) + Only 2 xray detectors used (two different slices) + Parallel ray geometry + Translated linearly to acqui rays across a 24 cm FOV 160 CT Generations 4" Generation + Rotated slightly between translations to acquire 180 projections at 1-degree intervals + About 4.5 minutes/scan with 4.5 minutes to reconstruct slice + Pencil beam geometry allowed very| efficient scatter reduction, best of all scanner generations 1st Generation AA yb iT Ce - CT Generations 2" Generation (1972) + Incorporated linear array of 30 detectors + More data acquired to improve image quality (600 rays x 540 views) + Shortest scan time was 18 seconds/slice CT Generations 24 Generation + Narrow fan beam allows more scattered radiation to be detected 2"4 Generation Pencil Beam Fan Beam Open Beam Geomety Geometry GeometryCT Generations 3"4 Generation (1976) + Number of detectors increased substantially (to more than 800 detectors) + Angle of fan beam increased to cover entire patient + Eliminated need for translational motion CT Generations 3" Generation + Mechanically joined x-ray tube and detector array rotate together + Newer systems have scan times of ‘second 34 Generation CT Generations 3" Generation + The rotate/rotate geometry of 3°! generation scanners leads to a situation in which each detector is responsible for the data corresponding to a ring in the image CT Generations 3"4 Generation + Driftin the signal levels of the detectors over time affects the jt values that are backprojectedto produce the CT image, causing 9 artifacts 3"4 Generation (Ring Artifact) gaits 103" Generation (Ring Artifact) CT Generations 4! Generation (1978) + Designed to overcome the problem of ring artifacts + Stationary ring of about 4,800 detectors 4 Generation CT Generations 3*4 vs 4! Generation 4. Rotating vs stationary detectors 2. 3" generation fan beam geometry has the x-ray tube as the apex of the fan; 4" generation has the individual detector as the apex 34 vs 4!" Generation ‘curh erarten CT Generations 5! Generation + 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 "CT Generations 5!" Generation + 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 5‘ Generation CT Generations 6” Generation + Helical CT scanners acquire data while the table is moving + By avoiding the time required to translate the patient table, the total scan time required to image the patient can be much shorter CT Generations 6 Generation + Allows the use of less contrast agent and increases patient throughput + Insome instances the entire scan be done within a single breath-hold of the patient 6" Generation CT Generations 7 Generation + When using multiple detector arrays, the collimator spacing is wider and more of the x-rays that are produced by the tube are used producing image data 12CT Generations 7 Generation = Opening up the collimator in a single array scanner increases the slice thickness, reducing spatial resolution in the slice thickness dimension CT Generations 7 Generation ~ With multiple detector array scanners, slice thickness is determined by detector size, not by the collimator 7 Generation CT Generations in the future? CT Generations in the future? CT Generations in the future? 13