SIEMENS

SRM UNIVERSITY

Bio-Medical Instrumentation
SUPERVISED BY: GUIDANCE OF: Mr. Subrata Patnaik Aggarwal UNDER THE Mr. Rishabh Mr. Asim Khan

SUBMITTED BY:
RUDRA RAKSHIT SINGH SRM UNIVERSITY ELECTRONICS AND COMMUNICATION ENGINEERING

Roll no.- 10408929

ACKNOWLEDGEMENT

I take this opportunity to express my profound sense of gratitude and appreciation to all those who helped me throughout the duration of the project. First and foremost, I would like to express my thanks to Mr.Subrata Patnaik, SIEMENS HEALTHCARE DEPARTMENT , for providing guidance and expert supervision for this project and giving crucial feedback that influenced the development of this project, which were critical in the deployment of the project, without which I would have not been able to complete the project. I would also like to give my special thanks to Mr. Rishabh Agarwal, Mr. Mohammed Asim Khan and all other employees of Healthcare Department, SIEMENS Ltd. (India) for his encouragement, support, help , guidance and providing necessary details. I am truly thankful to the entire SIEMENS organisation for their support and timely help whenever required.

RUDRA RAKSHIT SINGH ELECTRONICS AND COMMUNICATION ENGINEERING SRM UNIVERSITY.

ABSTRACT
The well planned, properly executed industrial training helps a lot in inducing good work culture. It provides a linkage between the students and industry in order to develop awareness of industrial approach to problem solving based on broad understanding of processes and operations in an industrial organization. The project is based on the various products of SIEMENS which are dedicated towards diagnosing and to analyze its utilization by generating different types of critical and specific reports as per the needs of the management. The system being diversified in nature demanded a 5 weeks period for understanding the principles, concepts, operations of the various instruments and familiarizing with the platform of their development for the completion of the project. The training undertaken in such an indigenous company gave me an opportunity to gain practical experience increasing my horizon of knowledge. I have tried to share some of my knowledge by way of this project report.

COMPANY PROFILE
PRINCIPLES OF SIEMENS:

We strengthen our CUSTOMERS - to keep them competitive Our success depends on the success of our customers. We provide our customers with our comprehensive experience and solutions so they can achieve their objectives fast and effectively.

We empower our PEOPLE - to achieve world-class performance

Our employees are the key to our success. We work together as a global network of knowledge and learning. Our corporate culture is defined by diversity, by open dialogue and mutual respect, and by clear goals and decisive leadership.

We push INNOVATION - to shape the future

Innovation is our lifeblood, around the globe and around the clock. We turn our people's imagination and best practices into successful technologies and products. Creativity and experience keep us at the cutting edge.

We embrace corporate RESPONSIBILITY - to advance society

Our ideas, technologies and activities help create a better world. We are committed to universal values, good corporate citizenship and a healthy environment. Integrity guides our conduct toward our employees, business partners and shareholders.

We enhance company VALUE - to open up new opportunities

We generate profitable growth to ensure sustainable success. We leverage our balanced business portfolio, our business excellence and synergies across all segments and regions. This makes us a premium investment for our shareholders. Siemens (Berlin and Munich) is a global powerhouse in electrical engineering and electronics. The company has 434,000 employees working to develop and manufacture products, design and install complex systems and projects, and tailor a wide range of services for individual requirements. Siemens provides innovative technologies and comprehensive know-how to benefit customers in 190 countries. Founded more than 150 years ago, the company is active in the areas of Information and Communications, Automation and Control, Power, Transportation, Medical, and Lighting.

SIEMENS WORLDWIDE:
Werner Von Siemens in Berlin, Germany incepted siemens on 1st October 1647. Initially there were three units in different areas of operation: SRWSiemens Reiniger werke (Medical Engineering), SSW-Siemens Schukert Werke (energy) and SH_Siemens Halske (Communication). They finally merged into Siemens AG (Aktiengesellschaft) in the 1970s. Ever since its evolution Siemens had been at the forefront of developing leading edge .It has a strong global presence having sales and service facilities in more than 190 countries and with 339 production facilities outside Germany with worldwide manpower strength of about four lakhs. To continue with its pioneering research and to stay ahead in the field of electrical and electronic technology, Siemens put strong emphasis on research and development with over 4500 employees engaged in this key activity of approximately 8% of the turnover. On an average Siemens spends DM 35 million a day on R&D and has its R&D centers in Europe and USA apart from Germany.

SIEMENS IN INDIA:

Siemens ltd is a leading electrical and electronics engineering company in India. Established in 1922, it was incorporated as a company in 1957 and in 1962 was converted into a public limited company with 51 % of its equity held by Siemens AG and the remaining 49 % held by Indian shareholders. It operates in the energy, industry, healthcare, transportation, information, communications and components business segments. It also operates joint ventures in the fields of communication and information technology. In addition Siemens group in India has presence in the field of power design, renovation and modernization of existing power plant, lighting, and household goods. The Siemens group in India has a widespread marketing and distribution network in addition to multiple manufacturing processes in India. It also has a well-organized up-market value addition in engineering, software, system integration, erection, commissioning and customer services. Siemens long association with India begins in the year 1867 when Werner Von Siemens personally supervised the laying of the first transcontinental telegraphic line between Calcutta and London. Siemens has played an active role in the technological progress experienced in the last three decades. In the 60s the nations expanding investments in power generation called for a range of high quality electrical and auxiliary equipments. Siemens grew out of response to this need. First in a small way assembling switchboards at workshop in Bombay and Calcutta. With products as varied as Switchgears, Motors, Drives and Automation, Power systems automation, Railway signaling systems, Medical engineering and telecommunication equipments. Siemens extensive network in India includes 10 manufacturing units, 12 sales offices, 30 representatives, 350 dealers, and system houses. Being

closely related to Siemens AG, Germany gives Siemens India access to the worlds latest developments in every field. Siemens technology has been made available to the reputed Indian organizations in the form of collaboration agreements with BHEL, BEL, HMT, ECIL and Mafatlal industries to name a few. Besides associates and subsidiary companies have been formed like:

DIFFERENT SEGMENTS OF

SIEMENS

Inc. IN INDIA:

Siemens Business Communication Systems Limited (SBCSL). Siemens Information Systems Limited (SISL). Siemens Communication Software Limited (SCSL). Siemens Public Communication Network Limited (SPCNL). Siemens Metering Limited (SML). Information Communication Mobile (ICM). Information Communication Networks (ICN). Siemens with its global experience and expertise in the above sectors has helped to keep India in the frontline of International Technology. Siemens true international presence is well established by the diversified markets that serve by manufacturing products ranging from switchgears to mobiles, from providing power to providing the most ultra-modern medical machines and equipments. Its major segments of work in India are:

POWER GENERATION:

Towns world over are not known for their buildings and houses but because of their infrastructure, and power is backbone for any nations development. Siemens have been supplying the technological know-how, equipments and expertise to the power industry, both public and private sectors, since 1954. it plays an important role in generating over 30,000 MW of power close to half of the total installed capacity in the country today. Siemens is associated with major power projects in the country- 500MW turbojets and 200 MW Combined Cycles Power Plant. For Tata Electric Company at Trombay, the gas based Combined Cycle Power Plant for Maharashtra State Electricity Board (MSEB) at Uran and 655 MW Combined Cycle Power Plant for Gujrat Torrent Energy Co-operation in Gujarat and 3 X 500MW Jayamkondam Lignite Power corporation in Tamil Nadu.

SWITCHGEARS:

The increased operating requirement demanded by todays industries has led to a considerable change in the technology for modern distribution and control gear. For example, they must be: able to communicate with electronic systems and meet stringet regulations for personal safety, in addition to coping with increased switching duties and inrush currents. The Siemens range of distribution and control equipment has not only been continually upgraded and recognized to fulfill these requirements of the 21st century but it is manufactured and tested to such high standards that it requires very little maintenance, thus providing a long and reliable operation.

MOTORS DRIVES AND UPS SYSTEMS:

MOTORS: Siemens motors are high quality machines, which are designed to combine to very vital requirements of modern industry-optimum efficiency and high reliability. They have economical energy consumption and are resilient enough to withstand wide voltage and energy fluctuations. The user friendly ranges of motors are available in several ratings of horsepower and speed and in different constructions that enable the right power to be selected, both technically and economically. Customs built equipments have always been a tradition with Siemens. Sugar centrifuge motors for the cane crushing process, motors for AC variable speed drives for the machine industry, material handling, steel and mining industry are some of the special purpose motors.

DRIVES: Variable speed drives are well established in all the sectors of the industry. Siemens offers the complete range of AC/DC drives for a variety of industrial applications. Siemens drives guarantee stable operation in the manufacturing process, holding the process parameters within extremely tight limits. They ensure optimum product quality and maximum production.

These drives are energy conserving, adaptable to all voltage levels used worldwide, and can be simply integrated into automation environment via the communication bus systems.

UPS: to supply critical loads with power that is available even during shutdowns, Siemens had introduced microprocessor based transistorized UPS (uninterrupted power supply) systems that are highly reliable and service friendly. The range extends from 0.5 KVA to 500 KVA.

TRANSPORTATION SYSTEMS:
Efficient transportation is an essential part of supportive infrastructure. Siemens continues to maintain their leading position in the safety systems for the railways. Siemens has provided electric railway signaling equipment that has increased speed and safety of travel. In the Centralized Route Relay Interlocking System, the operator sets a safe train route, visually indicated on a control panel, which eliminates all conflicting moves. This has resulted in increased utilization of existing networks whether these systems have been introduced. Siemens Automatic Warning Systems (AWS) already in operation on the central end western railways ensures safety through immediate halting of the train that crosses a red signal. In keeping with the modernization program of the Indian railways, Siemens has already diversified their activities.

INFORMATION AND COMMUNICATION:

Telecommunication has become intimately inter-women into modern society and with the increasing number of Internet telephone service providers and rapid rise of call centers all the more importance is attached to it. Siemens is a global and leading provider of information and communication solutions for the Enterprise and Carrier markets. This includes a complete of convergent solutions combining voice, data, video and mobility. With the liberalization of policies by the government, the telecommunication scenario has undergone a sea of change the areas that were inaccessible became accessible and Siemens is now acknowledged key player in Indian Telecom Infrastructure development. It has also set up subsidiary/associate companies, namely:

Siemens Public Communication Networks Limited (SPCNL). Information And Communication Mobile Devices (ICM MP). Siemens Business Communication Systems Limited (SBCSL).

SIEMENS HEALTH CARE

Medical engineering is constantly enhancing the effectiveness of the diagnostic and therapeutic modalities now available to the medical profession. The rapid advances in electronics have resulted in phenomenal benefits accruing to modern medicine. Non-invasive, imaging, faster and accurate diagnosis and paper free documentation of patient data are just a few of the benefits.

Siemens has supplied, installed and continues to maintain wide range of diagnostic equipment in the most of the leading hospitals and medical centers in India. Other installations in the intensive care units (ICUs) include patient monitoring systems, Servo-ventilator and Defibrillators.

PRODUCTS AND SERVICES BY SIEMENS HEALTHCARE

Siemens Healthcare produces a variety of products and services. There are basically three divisions of the products and services:

1) Imaging and IT
The imaging and IT Division provides imaging systems for early diagnosis and intervention, as well as for more effective prevention. These systems are networked with high performance healthcare IT to optimize processes. 1.1) AX- Angio, Fluoro, Radiographic Systems The innovative AXIOM systems excel in image quality, easy handling, high user and patient comfort. 1.2) CT Computed Tomography The configurations of the SOMATOM CT Scanners and clinical

applications help in radiology. 1.3) HS Health Services IT The information technology(IT) solutions and services help achieve better clinical outcomes and operational efficiencies. 1.4) IKM Image and Knowledge Management SYNGO, Siemens unique software for the diagnostic and therapeutic cycles help in management. 1.5) MI Molecular Imaging Siemens help to discover the minutest details with MI solutions in clinical and pre-clinical imaging, cyclotrons and biomarker development and distribution. 1.6) MR Magnetic Resonance MR can show details which cannot be shown with other imaging techniques. 1.7) USD Ultrasound Siemens offers technologically advanced ultrasound equipments and clinical workflow solutions. 1.8) RS Refurbished Systems Refurbished Systems offers Proven Excellence refurbished medical equipment of the modalities AX, CT, MI, MR and US.

2)

Workflow and Solutions

Workflow and Solutions provides complete solutions for fields such as cardiology, oncology and neurology. The division offers solutions for womens health, urology, surgery and audiology. It also provides turnkey solutions and consulting. In addition Workflow and Solutions is responsible for the Sectors service business, for supervising the sales regions and for managing customer relations. 2.1) CS- Customer Service The technical service division provides all of the benefits of an efficient and locally present service staff spanning the globe. 2.2) SP - Special Systems Proven outcomes in Surgery, Urology, Womens Health, and Accessories. 2.3) OCS Oncology Care Systems It aids a lot in oncology and makes a difference in the lives of cancer patients. 2.4) GS Global Solutions

Driving performance by integrated clinical solutions based on outstanding partnerships with the customers.

3) Diagnostics
Siemens Healthcare Diagnostics focus is on the business of diagnostics and those we serve- laboratorians, clinicians and patients. Siemens offers a robust portfolio of performance driven products and services that combine the right balance of science, technology and practicality. Siemens immunoassay, chemistry, hematology, molecular, urinalysis and blood gas testing systems, in conjunction with automation, informatics and consulting solutions, serve the needs of laboratories of any size- today and tomorrow. 3.1) Integrated Diagnosticsa) Integrated diagnostics home 3.2) Assays i. ii. iii. iv. v. vi. Specialty Immunoassay Chemistry Critical care Hematology Hemostasis Immunodiagnostics vii. Integrated viii. Kidney disease ix. Microbiology x. Molecular xi. RIA

3.3) Disciplinea. Automation b. Blood gas c. Chemistry/immunoassay d. Microbiology f. Molecular Diagnostics g. Informatics h. Hematology i. Hemostasis

e. Diabetes & urinalysis solutions 3.4) Disease StatesI. II. Chemistry Immunoassay

j. Services & support

III. Molecular IV. Urinalysis

COMPETITORS OVERVIEW
Siemens Healthcares main competitors are GE Healthcare, Philips, Hitachi, Toshiba, etc. the healthcare industry is an oligopoly industry with only few players who rule the field. But the most important thing in the healthcare industry is to make a loyal customer base and to maintain good customer relations with the previous customers since product rebuy is a very common and important phenomenon in the industry for which a company has to make its after sales services strong and the functioning of the machines should be extremely well.

INTRODUCTION:
X-Rays are penetrating electromagnetic radiation, having a shorter wavelength than light. X rays can be produced by bombarding a target, usually made of tungsten, with high-speed electrons or by accelerating electrons in particle accelerators. Some objects in space, such as black holes and the Sun can also produce powerful X rays . X rays were discovered accidentally in 1895 by the German physicist Wilhelm Conrad Roentgen while he was studying cathode rays in a highvoltage, gaseous-discharge tube. Despite the fact that the tube was encased in a black cardboard box, Roentgen noticed that a barium-platinocyanide screen, inadvertently lying nearby, emitted fluorescent light whenever the tube was in operation. After conducting further experiments, he determined that the fluorescence was caused by invisible radiation of a more penetrating nature than ultraviolet rays . He named the invisible radiation X ray because of its unknown nature. Subsequently, X rays were known also as Roentgen rays in his honor.

NATURE OF X-RAYS:
X rays are electromagnetic radiation ranging in wavelength from about 100 A to 0.01 A (1 A is equivalent to about 10-8 cm/about 4 billionths of an in.). The shorter the wavelength of the X ray, the greater is its energy and its penetrating power. Longer wavelengths, near the ultraviolet-ray band of the electromagnetic spectrum, are known as soft X rays . The shorter wavelengths, closer to and overlapping the gamma-ray range, are called hard X rays . A mixture of many different wavelengths is known as white X rays, as opposed to monochromatic X rays, which represent only a single wavelength. Both light and X rays are produced by transitions of electrons that orbit atoms, light by the transitions of outer electrons and X rays by the

transitions of inner electrons. In the case of bremsstrahlung radiation , X rays are produced by the retardation or deflection of free electrons passing through a strong electrical field. Gamma rays, which are identical to X rays in their effect, are produced by energy transitions within excited nuclei. X rays are produced whenever high-velocity electrons strike a material object. Much of the energy of the electrons is lost in heat; the remainder produces X rays by causing changes in the target's atoms as a result of the impact. The X rays emitted can have no more energy than the kinetic energy of the electrons that produce them . Moreover, the emitted radiation is not monochromatic but is composed of a wide range of wavelengths with a sharp, lower wavelength limit corresponding to the maximum energy of the bombarding electrons. This continuous spectrum is referred to by the German name bremsstrahlung, which means braking, or slowing down, radiation, and is independent of the nature of the target. If the emitted X rays are passed through an X-ray spectrometer, certain distinct lines are found superimposed on the continuous spectrum; these lines, known as the characteristic X rays, represent wavelengths that depend only on the structure of the target atoms. In other words, a fast-moving electron striking the target can do two things: It can excite X rays of any energy up to its own energy; or it can excite X rays of particular energies, dependent on the nature of the target atom.

MECHANISM OF X RAY PRODUCTION :

During his early experiments with X-rays, Roentgen identified as the source of the radiation that area of the glass tube which was hit by the cathode rays, i.e. accelerated free electrons. But he also found that metal brought into the electron beam could function as X-ray source as well. Later it turned out that a smooth piece of heavy metal was a lot more efficient in the production of X-rays than the glass or aluminum originally used by Roentgen. Today X-rays for bombarding a target commonly generates medical diagnostics made from heavy metal, typically tungsten, with fast electrons in a vacuum tube. The free electrons are produced by thermal emission from a very hot tungsten filament and accelerated by the electrical field of a high voltage (40 ... 150 kV) applied between the filament as cathode and the target as anode. When the fast electrons hit the target material and interact with it, most (about 99%) of the energy carried by the electrons is converted into heat. Only the remainder of the energy (~1%) turns into X-ray emission. Two different types of interactions are involved in the production of X-rays leading to two different components in the X-ray beam: bremsstrahlung and characteristic radiation.

The free electrons required to produce radiation are emitted by heating-up the filament. The filament is made from tungsten which allows for extreme temperatures without vaporizing easily. The amount of electrons emitted is a direct function of the filament temperature. The temperature is controlled by the filament current ( 2A ... 4A) . There is, however, a significant delay in temperature response to the controlling current. Therefore, when not radiating, the filament is always kept on a standby temperature just below the point of emitting electrons. And shortly before radiation, the filament temperature is boosted up the value desired. This procedure is called "preparation".

HIGH VOLTAGE When applying high-voltage (40kV ... 150kV), the electrons emitted by the cathode are accelerated towards the anode. They are "charged" with kinetic energy. This energy is released when the electrons interact with the tungsten atoms of the anode. Slamming into the anode about 99% of their kinetic energy is converted into heat, and only 1% is X-rays, or, more properly speaking, bremsstrahlung radiation. The german word "bremsstrahlung" depicts the nature of this kind of radiation: The electrons are stopped "bremsen" to produce radiation "strahlung". The radiation diverges form the point of interaction, the focal spot, as shown.

ROTATING ANODE :
The target area (focal spot), the electrons are slamming into, is heated-up rapidly. When exceeding a temperature of 3400C, the tungsten starts melting, giving off gases which destroy the vacuum and lead to tube failure. To prevent this, the heated-up target area is continuously replaced by a cooled-down area, using a rotating anode. During one rotation, the heat sinks from the surface to deeper parts of the anode preparing the surface for a new onslaught of electrons. Electrically, the anode is an asynchronous motor operated by the Anode Starter device.

THE TUBE HOUSING :

Operating an X-ray tube is rather dangerous:
1. The ionizing X-rays are

emitted all over the place.

2. High voltage, up to 150kV, is

applied. For safe handling, the X-ray tube is placed in a housing lined with lead to absorb the radiation. Because of weight restrictions, the lead shielding cannot be perfect. According to the standards the leakage radiation must not overpass 1mGy/h at maximum operating conditions.For insulation of the high voltage, the tube housing is filled with insulating oil. Additionly, the oil serves as a heat sink.The useful radiation beam leaves the tube housing via the

Bohr's Model of the Atom:

A basic explanation of these processes can be accomplished without using quantum theory. A short reference to Bohr's model of the atom will suffice. According to this model, an atom consists of a heavy nucleus and a number of electrons arranged on well-defined shells around this nucleus. With increasing distance from the nucleus, these shells are designated with the letters K, L, M, N, O, P, Q, etc. All nuclei, except that of regular hydrogen, contain besides the positively charged protons an almost equal number of charge free neutrons. The number of protons in the nucleus corresponds to the element number of the material. In an electrically neutral atom, the number of protons and the number of electrons are equal. The closer the electrons are to the nucleus, the tighter they are bound to the nucleus by its' electric field, or (in other words) the more energy is needed to push them out of their place on the shell

Bremsstrahlung Radiation :
If an incoming free electron gets close to the nucleus of a target atom, the strong electric field of the nucleus will attract the electron, thus changing direction and speed of the electron. The electron looses energy which will be emitted as an X-ray photon. The energy of this photon will depend on the degree of interaction between nucleus and electron, i.e. the passing distance. Several subsequent interactions between one and the same electron and different nuclei are possible. X-rays originating from this process are called bremsstrahlung. Bemsstrahlung is a German word directly describing the process: "Strahlung" means "radiation", and "Bremse" means "brake".

Characteristic Radiation :
If the energy of the incoming electrons exceeds the binding energy of the electrons on a certain shell of the target atoms, an additional process can happen: In a collision, the incoming electron (1) can push the target electron (2) out of its place on the shell. This event will leave an unstable atom behind. The gap on the shell will be filled immediately by an electron (3) from an outer shell or even from the conduction band of the target material. This replacement electron will thereby change its energy by a well defined amount depending on the binding energy levels of the electrons in the target material, which are characteristic for that material. The resulting X-rays (4) with very distinct photon energy values are therefore called characteristic radiation. As the binding energy values for the outer shells are not high enough for most elements to generate photons of noticeable energy, usually only characteristic radiation generated by electrons jumping into the K-shell is considered.

Characteristic Radiation Bremsstrahlung Radiation

X-RAYS PRODUCTION:
The first X-ray tube was the Crookes tube, a partially evacuated glass bulb containing two electrodes, named after its designer, the British chemist and physicist Sir William Crookes. When an electric current passes through such a tube, the residual gas is ionized and positive ions, striking the cathode, eject electrons from it. These electrons, in the form of a beam of cathode rays, bombard the glass walls of the tube and produce X rays. Such tubes produce only soft X rays of low energy. An early improvement in the X-ray tube was the introduction of a curved cathode to focus the beam of electrons on a heavy-metal target, called the anticathode, or anode. This type generates harder rays of shorter wavelengths and of greater energy than those produced by the original Crookes tube, but the operation of such tubes is erratic because the X-ray production depends on the gas pressure within the tube. The next great improvement was made in 1913 by the American physicist William David Coolidge. The Coolidge tube is highly evacuated and contains a heated filament and a target. It is essentially a thermionic vacuum tube in which the cathode emits electrons because the cathode is heated by an auxiliary current and not because it is struck by ions as in the earlier types of tubes. The electrons emitted from the heated cathode are accelerated by the application of a high voltage across the tube. As the voltage is increased, the minimum wavelength of the radiation decreases. X-ray tubes are often modified Coolidge tubes. The larger and more powerful tubes have water-cooled anodes to prevent melting under the impact of the electron bombardment. The shockproof tube is a modification of the Coolidge tube with improved insulation of the envelope (by oil) and grounded power cables. Such devices as the betatron are used to produce extremely hard X rays, of shorter

wavelength than the gamma rays emitted by naturally radioactive elements. A more powerful type of particle accelerator called a synchrotron can also be used to produce X rays.

PROPERTIES OF X-RAYS:
X rays affect a photographic emulsion in the same way light does . Absorption of X radiation by any substance depends upon its density and atomic weight. The lower the atomic weight of the material, the more transparent it is to X rays of given wavelengths. When the human body is X-rayed, the bones, which are composed of elements of higher atomic weight than the surrounding flesh, absorb the radiation more effectively and therefore cast darker shadows on a photographic plate. Another type of radiation, which is known as neutron radiation and is now used in some types of radiography, produces almost opposite results. Objects that cast dark shadows in an X-ray picture are almost always light in a neutron radiograph.

X-RAY TUBE:

An X-ray tube is a vacuum tube that produces X-rays. They are part of X-ray machines. X-rays are part of electromagnetic spectrum, an ionizing radiation with wavelengths shorter than ultraviolet light. X-ray tubes evolved from experimental Crookes tube with which X-rays were first discovered in the late 1800s, and the availability of this controllable source of X-rays created

the field of radiography , the imaging of opaque objects with penetrating radiation. X-ray tubes are also used in CAT Scanners, airport luggage scanners, x ray crystallography and for industrial inspection.

X-RAY TUBE FUNCTION:

As with any vacuum tube, there is a cathode, which emits electrons into the vacuum and an anode to collect the electrons, thus establishing a flow of electrical current, known as the beam, through the tube. A high voltage power source, for example 30 to 150 kilovolts (kV), is connected across cathode and anode to accelerate the electrons. The X-ray spectrum depends on the anode material and the accelerating voltage . In many applications, the current flow (typically in the range 1mA to 1A) is able to be pulsed on for between about 1 ms to 1s. This enables consistent doses of x-rays, and taking snapshots of motion. Until the late 1980s, X-ray generators were merely high-voltage, AC to DC variable power supplies. In the late 1980s a different method of control was emerging, called high speed switching. This followed the electronics technology of switching power supplies (aka switch mode power supply), and allowed for more accurate control of the X-ray unit, higher quality results, and reduced X-ray exposures. Electrons from the cathode collide with the anode material, usually tungsten, molybdenum or copper, and accelerate other electrons, ions and nuclei within the anode material. About 1% of the energy generated is emitted/radiated, usually perpendicular to the path of the electron beam, as X-rays. Over time, tungsten will be deposited from the target onto the interior surface of the tube, including the glass surface. This will slowly darken the tube and was thought to degrade the quality of the X-ray beam, but research has suggested there is no effect (cf., Half-Value-Layer Increase Owing to Tungsten Buildup in the X-ray Tube: Fact or Fiction, John G. Stears, Joel P. Felmlee, and Joel E. Gray; Radiology, Vol 160, Number 3, pp 837 - 838, Sept 86). Eventually, the tungsten deposit may become sufficiently conductive that at high enough voltages, arcing occurs. The arc will jump from the cathode to the tungsten deposit, and then to the anode. This arcing causes an effect called "crazing" on the interior glass of the X-ray window. As time goes on, the tube becomes unstable even at lower voltages, and must be replaced. At this point, the tube assembly (also called the "tube head") is removed from the X-ray system, and replaced with a new tube assembly. The old tube assembly is shipped to a company that reloads it with a new X-ray tube. The X-Ray photon-generating effect is generally called the Bremsstrahlung effect, a contraction of the German brems for braking, and strahlung for radiation.

The range of photonic energies emitted by the system can be adjusted by changing the applied voltage, and installing aluminum filters of varying thicknesses. Aluminum filters are installed in the path of the X-ray beam to remove "soft" (non-penetrating) radiation. The number of emitted X-ray photons, or dose, are adjusted by controlling the current flow and exposure time. Simply put, the high voltage controls X-ray penetration, and thus the contrast of the image. The tube current and exposure time affect the dose and number of electrons emitted. TYPES OF X-RAY TUBES: There are two types of X-Ray tubes used in X-Ray machine: Stationary X-Ray Tube. Rotating Anode Type.

STATIONARY ANODE TYPE

The stationary anode tube is used primarily in X-Ray therapy .They are designed for continuous operation with relatively high continuous ratings. The cooling mechanism takes place by a good thermal contact through the copper cooling block and the surrounding oil. Ratings up to 4 kW. Voltages up to 300 kV.
The main components of stationary anode tube are:

Stationary Anode Tungsten. Cathode Tungsten Filament. Glass Envelope. Power Supply

X-RAY TUBE mA:

Electrons are accelerated from the cathode to the anode producing X-rays .X-ray quantity is directly proportional to the mAs. (milliampere-seconds).The number of electrons is controlled by the temperature of the cathode filament. mA change = change in the intensity.

X-RAY TUBE kV :
The penetrability of the X-rays are influenced by the kV. (kilovoltage).The higher the kV the faster the electrons move and the more energetic and penetrating is the Xray beam produced. Less is absorbed by the body. kV change = contrast.

ROTATING ANODE X-RAY TUBE:

The rotating anode tube is an improvement of the Coolidge tube. X-ray production using this method is very inefficient (99% of incident energy is converted to heat) the dissipation of heat at the focal spot is one of the main limitations on the power which can be applied. By sweeping the anode past the focal spot the heat load can be spread over a larger area, greatly increasing the power rating. With the exception of dental X-ray tubes, almost all medical X-ray tubes are of this type. The anode consists of a disc with an annular target close to the edge. The anode disc is supported on a long stem which is supported by bearings within the tube. The anode can then be rotated by electromagnetic induction from a series of stator windings outside the evacuated tube. Because the entire anode assembly has to be contained within the evacuated tube, heat removal is a serious problem, further exacerbated by the higher power rating available. Direct cooling by conduction or convection, as in the Coolidge tube, is difficult. In most tubes, the anode is suspended on ball bearings with silver powder lubrication which provide almost negligible cooling by conduction. A recent development has been liquid gallium lubricated fluid dynamic bearings , which can withstand very high temperatures without contaminating the tube vacuum. The large bearing contact surface and metal lubricant provide an effective method for conduction of heat from the anode. The anode must be constructed of high temperature materials. The focal spot temperature can reach 2500C during an exposure, and the anode assembly can reach 1000C following a series of large exposures. Typical materials are a tungsten-rhenium target on a molybdenum core, backed with graphite. The rhenium makes the tungsten more ductile and resistant to wear from impact of the electron beams. The molybdenum conducts heat from the target. The graphite provides thermal storage for the anode, and minimizes the rotating mass of the anode.

Increasing demand for high-performance CT scanning and angiography systems has driven development of very high performance medical X-ray tubes. Contemporary CT tubes have power ratings of up to 100 kW and anode heat capacity of 6 MJ, yet retain an effective focal spot area of less than 1 mm2.

Stationary anode tube

TECHNICAL DESCRIPTION OF X RAY TUBE :

1 2 3 4 5 6 7 8 9 10

Rotor with anode disc Cathode Filament supply leads High tension outlet anode side High tension outlet cathode side Stator winding Radiation window Protective casing of the tube assembly Expansion bellows X-ray beam collimator

11+12 Lead plates to limit the radiation field 13 Useful x-ray beam

In the cut housing you see the x-ray tube fixed in the centre. The anode side sticks into the stator coil (6) for the rotating anode motor and is fastened in a bayonet holder. The tube is supplied via HT(High Tension) cables (4 + 5), which includes the high tube voltage and filament current (3). The collimator(10) limits the x-ray beam to the necessary image size to avoid excessive irradiation of the patient.

1 Evacuated glass envelope 2 Cathode 3 Anode 4 Target

The innovations on x-ray tubes keep always abreast with the newest technology. Even some of the basic principles changed since 1895 when professor W. C. Roentgen started using x-rays. The first tubes were gasfilled ones which used the glass envelope as the target (top left). The efficency was, of course, very poor and it took minutes to expose a film correctly. The tube on the right was one of the smallest ever produced and measured just 6 cm in lenght (here magnified). It had already an embedded Tungsten target. The image on the bottom left shows the first rotating anode tube.

The different tube types nowadays are closely connected with the various medical applications. Some examples shall clarify this: 1. Mammography diagnostic needs a special radiation spectrum which cannot be produced with normal x-ray tubes. As well, small x-ray sources are necessary to reproduce even finest object details. 2.; 3.; 4. Tubes for normal diagnostic application

5. A tube used for Computed Tomography (CT), produced in the beginning of the 90th. 6. Examinations in Angiography ask for tubes with very high heat storage capacity - Megalix Cat - because of long fluoroscopic times and serial exposures.

TECHNICAL DESCRIPTION OF STATIONARY AND ROTATING ANODE :

Stationary anode

Rotating anode

In general we differ between stationary and rotating anodes. The stationary anode consist of a block of copper for the heat distribution and an inlay of pure tungsten - the focal spot. Tungsten is selected because: 1. its high atomic number increases the efficiency of the radiation production (see chapter "X-Ray Physics"). 2. The very high melting point allows high power rating (see "Electrical Values"). Only units with low tube output use stationary anodes in the x-ray diagnostic, as in dental examinations, surgery for extremities, and orthopaedic. The output is limited to about 2 kW because of its small focal area which has to bear the thermal load when bombarded by electrons.

Most modern diagnostic x-ray tubes have a rotating anode.

ADVANTAGE OF ROTATING ANODE : The fundamental advantage of the rotating anode is that a much higher thermal load can be applied per unit time and focal area. The loading is related to the - diameter of the focal track, - maximum thermal stress of the material, and - speed of rotation. This makes possible

ANODE MOTOR

An external electromagnetic field, produced by a winding (stator) outside the glass envelope, drives the rotor. Both together works as an asynchronous motor. The air gap between rotor and stator isolates both from each other, since the winding is In principle, the rotating anode electrically close to ground and the anode lays on high potential during operation. On the is the moving part of an other hand the gap reduces the efficiency of electric motor, running in a vacuum. The rotor carries the the rotating anode motor significantly. Due to this distance, the power supply for the anode. motor must be relatively high, in order to speed up the anode in an acceptable short time.

The Rotor consists of a copper cylinder and rests in ball bearings for smooth movement. The bearings cannot be lubricated with ordinary grease because it would affect the vacuum and, as a consequence, the high tension characteristics of the tube. Soft metals such as lead and silver are applied to separate the ball bearings and the running surfaces, in order to prevent the possibility of "jamming" in the vacuum. This form of lubrication limits the life time of the bearings in the x-ray tube to about 1000 hours. Therefore, the running time needs to be as short as possible, which does not allow continuous rotation. The rotation is controlled when a radiography is started.

X-RAY GENERATORS:
X-Ray generator is a device which supplies electric power to the X-ray tube and permits selection of X-ray energy (kVp), X-ray quantity (mA), and exposure time. Generally the generator used in X-Ray Machine in Siemens is POLYDOROS SX/LX.

There are Two Types of X-Ray Generators : Conventional Single pulse Multi pulse

HFMP (High Frequency Multi Pulse Generator)

Characteristics of HFMP : Very slow soft radiation. Minimizes unwanted radiation. More doses i.e. 60% higher. Less exposure time. High dose efficiency.

Electrical Circuits Of X Ray Generator : The generator has three main interrelated electric circuits to serve three main functions : 1) The filament circuit supplies the power needed to heat the cathode filament and boil off electrons. 2) The high-voltage circuit supplies the high-voltage needed to accelerate these electrons from the cathode to the anode for production of X-rays. 3) The timer circuit (exposure timer) controls the length of the X-ray production.

Components Of X Ray Generator : A generator may be considered to have two main components: 1) The console or control panel assembly. 2) The transformer assembly.

The control panel allows the operator to select the exposure parameters kVp, mA and exposure time; the actual mA and kVp during exposure are shown by meters on the control panel. There is usually an exposure button with a standby function that starts rotation of the anode and heats the cathode filament prior the actual exposure.

The transformer assembly has a low voltage filament transformer which is a step-down transformer, and a high-voltage step-up transformer. The transformer assembly also includes rectifiers for the high-voltage circuit. Due to the high potential differences between the high-voltage circuit and filament circuit (up to 150 kV), the transformers and rectifiers are usually immersed in oil which serves as an insulator and prevents sparking.

X-RAY MACHINE :
An X-ray machine is a device used by radiographers to acquire an x-ray image. They are used in various fields, notably medicine and security. An X-ray imaging system consists of a X-ray source or generator (X-ray tube), and an image detection system which can either be comprised of film (analog technology) or a digital capture system (such as a picture archiving and communication system).

X-ray sources :
In the typical X-ray source of less than 450 kV, X-ray photons are produced by an electron beam striking a target. The electrons that make up the beam are emitted from a heated cathode filament. The electrons are then focused and accelerated towards an angled anode target. The point where the electron beam strikes the target is called the focal spot. Most of the kinetic energy contained in the electron beam is converted to heat, but around 1% of the energy is converted into X-ray photons, the excess heat is dissipated via a heat sink. At the focal spot, X-ray photons are emitted in all directions from the target surface, the highest intensity being around 60deg to 90deg from the beam due to the angle of the anode target to the approaching X-ray photons. There is a small round window in the X-ray tube directly above the angled target. This window allows the X-ray to exit

the tube with little attenuation while maintaining a vacuum seal required for the X-ray tube operation. X-ray machines work by applying controlled voltage and current to the Xray tube, which results in a beam of X-rays. The beam is projected on matter. Some of the X-ray beam will pass through the object, while some are absorbed. The resulting pattern of the radiation is then ultimately detected by a detection medium including rare earth screens (which surround photographic film), semiconductor detectors, or X-ray image intensifiers.

DETECTION In healthcare applications in particular, the x-ray detection system rarely consists of the detection medium. For example, a typical stationary radiographic x-ray machine also includes an ion chamber and grid. The ion chamber is basically a hollow plate located between the detection medium and the object being imaged. It determines the level of exposure by measuring the amount of x-rays that have passed through the electrically charged, gas-filled gap inside the plate. This allows for minimization of patient radiation exposure by both ensuring that an image is not underdeveloped to the point the exam needs to be repeated and ensuring that more radiation than needed is not applied. The grid is usually located between the ion chamber and object and consists of many aluminum slats stacked next to each other (resembling a polaroid lens). In this manner, the grid allows straight x-rays to pass through to the detection medium but absorbs reflected x-rays. This improves image quality by preventing scattered (non-diagnostic) x-rays from reaching the detection medium, but using a grid creates higher exam radiation doses overall. Images taken with such devices are known as X-ray photographs or radiographs. The older term Rentgenogram continues to be used by radiologists. Applications

X-ray technology is used in health care for visualising bone structures and other dense tissues such as tumours. Non-medicial applications include security and material analysis. (Xerographic Radiation).

MEDICINE The two main fields in which x-ray machines are used in medicine are radiography and dentistry. Radiography is used for fast, highly penetrating images, and is usually used in areas with a high bone content. Some forms of radiography include:

orthopantomogram a panoramic x-ray of the jaw showing all the teeth at once mammography x-rays of breast tissue tomography x-ray imaging in sections

Radiotherapy the use of x-ray radiation to treat malignant cancer cells, a non-imaging application Fluoroscopy is used in cases where real-time visualization is necessary (and is most commonly encountered in everyday life at airport security). Some medical applications of fluorography include:

angiography used to examine blood vessels in real time barium enema a procedure used to examine problems of the colon and lower gastrointestinal tract barium swallow similar to a barium enema, but used to examine the upper gastroinstestional tract biopsy the removal of tissue for examination

X-rays are highly penetrating, ionizing radiation, therefore X-ray machines are used to take pictures of dense tissues such as bones and teeth. This is because bones absorb the radiation more than the less dense soft tissue. Xrays from a source pass through the body and onto a photographic cassette. Areas where radiation is absorbed show up as lighter shades of grey (closer to white). This can be used to diagnose broken or fractured bones. In fluoroscopy, imaging of the digestive tract is done with the help of a radiocontrast agent such as barium sulfate, which is opaque to X-rays. SECURITY X-ray machines are used to screen objects non-invasively. Luggage at airports and student baggage at many schools are examined for possible weapons, including bombs. These machines are very low dose and safe to be

around. The main parts of an X-ray Baggage Inspection System are the generator used to generate x-rays, the detector to detect radiation after passing through the baggage, signal processor unit (usually a PC) to process the incoming signal from the detector, and a conveyor system for moving baggage into the system.

OPERATION When baggage is placed on the conveyor, it is moved into the machine by the operator. There is an infrared transmitter and receiver assembly to detect the baggage when it enters the tunnel. This assembly gives the signal to switch on the generator and signal processing system. The signal processing system processes incoming signals from the detector and reproduce an image based upon the type of material and material density inside the baggage. This image is then sent to the display unit.

ADVANCES IN X RAY TECHONOLOGIES A film of carbon nanotubes (as a cathode) that emits electrons at room temperature when exposed to an electrical field has been fashioned into an X-ray device. An array of these emitters can be placed around a target item to be scanned and the images from each emitter can be assembled by computer software to provide a 3-dimensional image of the target in a fraction of the time it takes using a conventional X-ray device. The carbon nanotube emitters also use less energy than conventional X-ray tubes leading to lower operational costs.

X RAY MACHINE : - SIEMENS AXIOM ARISTOS

AXIOM ARISTOS

Here you see a modern x-ray system consisting of the x-ray tube assembly (2) installed to a ceiling column (1) and the patient table (3). With the collimator (4) close to the x-ray window the operator sets the radiation field size. The cable harness (6) contains all necessary supplies and controls for tube assembly; collimator; ceiling column;

Operating console (5).

X RAYS IMAGE INTENSIFIRES :

An X-ray image intensifier (XRII), sometimes referred to as a C-Arm or Fluoroscope in medical settings, is a highly complex piece of equipment which uses x-rays and produces a 'live' image feed which is displayed on a TV screen. The term image intensifier refers to a special component of the machine, which allows low intensity x-rays to be amplified, resulting in a smaller dose to the patient. The overall system consists of an x-ray source, input window, input phosphor, photocathode, vacuum and electron optics,

output phosphor and output window. It allows for lower x-ray doses to be used on patients by magnifying the intensity produced in the output image, enabling the viewer to easily see the structure of the object being imaged Clinical Applications of An Image Intensifier An image intensifier or II is used in two ways:

As a fixed piece of equipment in a dedicated screening room Mobile Equipment for use in theatre

Components of an Image Intensifier System

C-Arm (encompasses the actual X-ray source and Image intensifier) Table Radiographic exposure and program controls Post processing software Viewing monitors

Fixed

IMAGE INTENSIFIRES :
These are used in most x-ray departments as 'screening rooms'. The types of investigations for which this machine can be used for is vast. Examples include:

Barium Studies (Swallows, Meals, Enemas) Endoscopy Studies (ERCP) Fertility Studies (HSG) Angiography Studies (Peripheral, Central and Cerebral)

BLOCK DIAGRAM IF IMAGE INTENSIFIER : Input phosphor - converts X-ray to visible-light. Photocathode - gives off electrons in proportion to the intensity of the light . Electron optics - focus the electrons onto an output phosphor which is much smaller than the input. Anode - used to accelerate the electrons to the output phosphor where considerably brighter visible-light is created.

Block Diagram Of Image Intensifier

Generator and range of exposures Modern systems use a digital high frequency generator with typically 20,000 cycles per second. The range of kVp settings may be from 40kV to 110kV. The tube current is typically 0.1mA to 6mA for fluoroscopy examinations. For radiographic mode the mA is fixed at about 20mA to 60mA. mAs values vary from 0.16 to 160 for radiographic application. The electronic timer varies from 0.1sec to 4.0sec for radiographic exposures.

Image Intensifiers, size and features They may be fitted with a range of different types of image intensifiers; typically 16 cm or 22 cm. Typical specifications for a 16 cm intensifier are:

Maximum resolution is 44 lp/cm at the centre of the screen. Anti-scatter grid of 8:1, focused at 90 cm. Removable cassette holder that is mounted on the image intensifier and holds a 24X30 film. Rotation 360 degrees

Typical specifications for a 22 cm intensifier are:

Resolution is 44 lp/cm at the centre of the screen. Magnification mode - allows a maximum resolution of 51 lp/cm at the centre of the screen Stationary anti-scatter grid 10:1, focused at 90 cm. Removable cassette holder that is mounted on the image intensifier and holds a 24X30 film. Rotation 360 degrees

Type of TV camera and coupling to Image Intensifiers: Older machines may have a vidicon type pickup tube, with direct fiber-optic coupling to the image intensifier. Modern machines may have a CCD camera. Radiation safety features

Pulsed fluoroscopy Single pulse fluoroscopy mode Manual mode in order to reduce dose (ALARA) Fluoroscopy timer warning Last image hold
Movements of II allow distance between patient and image detector low, so therefore reducing dose to patient. Beam limitation devices to minimize beam area

Special features

Real time viewing Remote control keypad Removable cassette holder, for both fluroscopy and plain film images Contrast correction Zoom Edge enhancement Digital subtraction Wheels fitted with cable deflectors

Potential radiation safety issues Failure of the x-ray beam collimation may lead to primary beam x-ray exposure outside of the image intensifier housing, potentially irradiating personnel. If the c-arm or fittings are damaged, the x-ray tube and intensifier may be come misaligned, also leading to the potential for direct irradiation of personnel.

Technical Capabilities Image intensifiers are usually set up for two purposes. For either plain fluoroscopy or Digital Subtraction Angiography (DSA). All image intensifiers are set up with software capable of adjusting settings to suit different user requirements, depending on the procedure and body area being imaged. In simple fluoroscopy for example, imaging of the throat would not require the same amount of exposure as that of the abdomen. And on DSA capable models, preset programs are available which enables the user to decide a rate of how many images or frames per second are acquired.

TECHINICAL DESCRIPTION OF IMAGE INTENSIFIRES :

An Image Intensifier (I.I.) is a vacuum tube used to convert the X-ray image into a visible image.This image can then be viewed via a television system at an image monitor. On some systems the I.I. output image is additionally recorded photographically by Cameras.

X-RAY IMAGE : The X-ray beam which leaves the X-ray tube penetrates the object to be photographed and projects the X-ray image at the input of the Image Intensifier in the form of X-ray energy.

INPUT SCREEN : The X-ray quanta first penetrate the envelope of the I.I. tube prior to striking the input phosphor (fluorescent screen). In order to have a low absorption by the envelope, since 1973 aluminum is used instead of glass. .When the X-ray quanta reach the input screen, they excite the input phosphor, and light photons are emitted, which in turn excite the photo cathode to emit electrons. ELECTRON OPTIC : The electrons are accelerated by the Electron Optic towards the output screen. The photo cathode is on 0 Volts, the anode on a very high voltage, e.g. 30 KV and the grids E1 to E3 voltages are in between. On the 40 cm I.I. the grids E1 and E2 are distributed into the grids E1a, E1b and E2a, E2b.

The voltages on the grids determine the focus and the size of the image to be projected onto the output screen OUTPUT SCREEN, BASE LENS: On the output screen the electrons are converted to a visible image. Compared with the light density of the fluorescent screen of the I.I. input, the light density at the output is much higher. Gain factors of 20.000 are possible.

The I.I. output image is very small. It has a diameter of appr. 25 mm. For further processing the image is transferred via the base lens of the I.I. to a TV camera, CINE camera or SIRCAM camera. EXAMPLE :

System with Image Intensifier and TV-camera (POLYSTAR T.O.P.)

BLOCK DIAGRAM OF X RAY IMAGING CHAIN :

TYPES OF RADIOGRAPHY

DIRECT RADIOGRAPHY :
All exposures, where the photographic effect of radiation is used in a film screen combination, is considered to be direct radiography.Basically a film is produced directly from radiation, as opposed to the output of an image intensifier. X-ray passes through the patient onto a piece of film that is contained in a cassette or film holder. The developed film is variously known as a patient image, an exposure, x-ray or radiograph.

INDIRECT RADIOGRAPHY :

X-ray passes through the patient, hits the image intensifier and is converted into light. The light is viewed by the TV camera and is then digitized and displayed. This patient image can now be viewed on the monitor and / or sent to a laser printer for hard copy.

APPLICATIONS OF X-RAYS
The uses of x rays in the fields of medicine and dentistry have been extremely important. X-ray photographs utilize the fact that portions of the body such as bones and teeth with higher density are less transparent to x rays than other parts of the human body. X rays are widely used for diagnostic purposes in these fields. Examples might include the observation of the broken bones and torn ligaments of football players, or the discovery of cavities and impacted wisdom teeth. A relatively new technique for using x rays in the field of medicine is called computerized axial tomography, producing what are called CAT scans. These scans produce a cross-sectional picture of a part of the body which is much sharper than a normal x ray. This is because a normal x ray, taken through the body, often shows organs and body parts superimposed on one another. To produce a CAT scan, a narrow beam of x rays is sent through the region of interest from many different angles and a computer is used to reconstruct the cross-sectional picture of that region.

Moseley found that various natural elements can be identified by measuring the energy of their characteristic x rays. This fact makes a useful form of elemental analysis possible. If x rays of sufficient energy impact a sample of unknown composition, electrons will be knocked out of the atoms of the various elements in the sample and characteristic x rays will be given off by these atoms. Measurement of the energy of these x rays permits a determination of the elements present in the sample. This technique is known as x-ray fluorescence analysis. It is often used by chemists to perform a nondestructive elemental analysis and by law enforcement agencies when it is necessary to know what elements are present in a sample of hair or blood or some other material being used as evidence in a criminal investigation. X rays are used in business and industry in many other ways. For example, x-ray pictures of whole engines or engine parts can be taken to look for defects in a nondestructive manner. Similarly, sections of pipe lines for oil or natural gas can be examined for cracks or defective welds. Airlines also use x-ray detectors to check the baggage of passengers for guns or other illegal objects. In recent years an interesting new source of x rays has been developed called synchrotron radiation. Many particle accelerators accelerate charged particles such as electrons or protons by giving them repeated small increases in energy as they move in a circular path in the accelerator. A circular ring of magnets keeps the particles in this circular path. Any object moving in a circular path experiences an acceleration toward the center of the circle, so the charged particles moving in these paths must radiate and therefore lose energy. Many years ago, the builders of accelerators for research in nuclear physics considered this energy loss a nuisance, but gradually scientists realized that accelerators could be built to take advantage of the fact that this radiation could be made very intense. Electrons turn out to be the best particle for use in these machines, called electron synchrotrons, and now accelerators are built for the sole purpose of producing this radiation which can be adjusted to produce radiation anywhere from the visible region up to the x ray region. This synchrotron radiation, from which very intense beams at nearly one wavelength can be produced, is extremely useful in learning about the arrangement of atoms in various compounds of interest to biologists, chemists, and physicists. One of the more important commercial applications of synchrotron radiation is in the field of x-ray lithography, used in the electronics industry in the manufacture of high density integrated circuits. The integrated circuit chips are made by etching successive layers of electric circuitry into a wafer of semiconducting material such as silicon. The details of the circuitry are defined by coating the wafer with a light sensitive substance called a photoresist and shining light on the coated surface through a stencil like

mask. The pattern of the electric circuits is cut into the mask and the exposed photoresist can easily be washed away leaving the circuit outlines in the remaining photoresist. The size of the circuit elements is limited by the wavelength of the light-the shorter the wavelength the smaller the circuit elements. If x rays are used instead of light, the circuits on the wafer can be made much smaller and many more elements can be put on a wafer of a given size, permitting the manufacture of smaller electronic devices such as computers.

APPLICATIONS IN CANCER Detection of breast cancer in women. Since x rays can be produced with energies sufficient to ionize the atoms making up human tissue, it is not surprising that x rays can be used to kill these cells. This is just what is done in some types of cancer therapy in which the radiation is directed against the malignancy in the hope of destroying it while doing minimal damage to nearby normal tissue. Unfortunately, too much exposure of normal tissue to x rays can cause the development of cancer, a fact that was learned too late for many of the early workers in this field. For this reason, great care is taken by physicians and dentists when taking x rays of any type to be sure that the exposure to the rest of the body is kept at an absolute minimum. o Detection of stomach, lung, colon, uterine and oral cancer.
o
o

COMPUTED TOMOGRAPHY
Basic Working Principle Of a CT Scan
It is as simple as passing X-rays through the patient and obtaining information with a detector on the other side. The X-ray source and the detector are interconnected and rotated around the patient during scanning period. Digital computers then assemble the data that is obtained and integrate it to provide a cross sectional image (tomogram) that is displayed on a computer screen. The image can be photographed or stored for later retrieval and use as the case may be. X-rays are electromagnetic waves. The main reason why X-rays is used in diagnosis is because all substances and tissues differ in their ability to absorb X-rays. Some substances are more permeable to X-rays while some others impermeable. Owing to this difference, different tissues seem different when the X-ray film is developed. Dense tissues such as the bones appear white on a CT film while the soft tissues such as the brain or kidney appear gray. The cavities filled with air such as the lungs appear black.

Purpose
CT scanners produce thin cross-sectional images of the human body for a wide variety of diagnostic procedures. CT is a non-invasive radiographic technique that involves the reconstruction of a tomographic plane of the body (a slice) from a large number of collected xray absorption measurements taken during a scan around the bodys periphery. The result of a CT study is usually a set of transaxial slices, which can be mathematically manipulated to produce sagittal or coronal image slices. With isotropic imaging, an image can be reconstructed in any arbitrary plane. CT is clinically useful in a wide variety of imaging exams, including spine and head, gastrointestinal, and vascular.

Principles of Operation
The X-rays from the beams are detected after they have passed through the body and their strength is measured. Beams that have passed through less dense tissue such as the lungs will be stronger, whereas beams that have passed through denser tissue such as bone will be weaker. A computer can use this information to work out the relative density of the tissues examined. Each set of measurements made by the scanner is, in effect, a cross-section through the body. The computer processes the results, displaying them as a two-dimensional picture shown on a monitor. The technique of CT scanning was developed by

the British inventor Sir Godfrey Hounsfield, who was awarded the Nobel Prize for his work.

Components of a CT system
A CT system consists of; An x-ray subsystem; A gantry; A patient table, and; A controlling computer. Data acquisition system; Image processing unit.

A high-voltage x-ray generator supplies electric power to the x-ray tube, which usually has a rotating anode and is capable of withstanding the high heat loads generated during rapid multiple-slice acquisition. The gantry houses the x-ray tube, detector system, collimators, and rotational circuitry; in some scanners, it also contains a compact, high-frequency x-ray generator. Most solid-state detectors are made of ceramic materials that produce light when exposed to ionizing radiation. Silicon photodiodes convert this light into an electrical signal. Collimators located near the x-ray tube and at each detector are aligned so that scatter radiation is minimized and the x-ray beam is properly defined for scanning. The patient table can be moved both vertically and horizontally to accommodate various scanning positions. During a CT scan, the table moves the patient into the gantry and the x-ray tube rotates around the patient. As x-rays pass through the patient to the detectors, the computer acquires and processes data to form an image. The computer also controls the x-ray production, gantry motions, table motions, and image display and storage.

THE X-RAY

SUB SYSTEM

X-ray Production: The first thing needed before a CT image can be acquired is a source of Xrays. They are produced from a device known as an X-ray tube and come in two basic types: with a stationary anode or a rotating anode. The latter is employed in most modern CT's and that's where this text will focus. Several things are needed to produce a controlled supply of X-rays. They are: An X-ray Tube, which consists of : cathode, anode, filament and focusing cup, stator and rotor. A High Voltage Generator, which consists of: a High Voltage section, an anode rotation control, and a Filament control section

Fig. X-ray generation unit

The filament: A filament in an X-ray Tube is very similar to a filament in an ordinary household light bulb. It basically consists of a piece of wire, of a high resistivity metal to which an electrical current is applied, kept in a partial vacuum to prevent its oxidation. When an electric current flows through the filament, dissipation of energy takes place due to ohmic loses. The

energy lost causes the filament to glow. This glowing has the potential to emit electrons. To accomplish this in an X-ray Tube a special material for the filament, usually Tungsten, primarily because it has a very high resistance to melting. This is important, because to give off electrons, the filament has to be extremely hot - the temperature of the filament is proportional to the amount of electrons produced by the filament. This is how we control the amount of X-rays produced - by varying the temperature of the filament.

The focusing cup:

Fig. Focusing Cup

The filament is a part of the cathode and is contained within a focusing cup. The latter is a metal container that has a very high negative potential across it. This negative potential is used to repel and direct the negatively charged electrons towards the anode. The Anode:

The anode is the target for the electrons emitted by the filament. It is usually made up of Tungsten or an alloy thereof because of its high melting point. Producing X-rays is a very inefficient process. About 99 percent of the process is wasted in heat production. This is the primary reason that the target has to be constantly moved, which is done by rotating it. The place where the

electron beam impinges on the anode is known as the focal spot. The anode is placed at a very high potential (positive) opposite to that of the Cathode and filament to attract the electrons directed towards it. The electrons being negative are now accelerated towards the anode and strike it with high energy. The higher the voltage, the higher the energy of the resulting X-ray emissions. The stator and rotor: The terms stator and rotor describe the components that make up the motor used to rotate the anode of the X-ray tube. The anode is rotated to help dissipate the heat generated at the point of impact by the electrons, otherwise there would be a high probability of the anode being melted. The rotor is actually part of the shaft attached to the anode located within a vacuum inside the tube. The Stator is made up of many turns of wire and is positioned on the outside of the tube around the rotor. When a voltage is applied to the windings of the stator, it causes the rotor to turn, thus rotating the anode. The high voltage generator: The High Voltage Generator is just that. It's a group of electronics responsible for producing and maintaining a constant but variable high voltage supply to the Xray tube. This is selectable by the operator of the CT based on their needs. It is also used to control the rotation of the anode, and supply a constant, but also variable current through the filament. By varying the filament current, the radiation dose to the patient can be regulated. This parameter can also be chosen by the operator. Collimation: The primary function of a collimation system is to limit the amount of X-rays impinging upon the patient, to that which contributes to the attenuation profile. For this reason collimators are installed at least on the X-ray tube side and sometimes also on the detector side. The purpose of the tube side collimator is to restrict the fan beam in the Z direction. The resultant opening actually determines the slice thickness of the scan. Most CT units on the market today, have a range of slices available to the customer; the smallest slice of any use is about 1 mm and the largest is about 12 mm. Thus a collimation system must be able to accurately change the size of it's opening to accommodate a variety of slices; determine if any faults occur within its subsystem; and provide some type of feedback to scan control as to its current position. Another type of collimator is installed on most modern CT units at the tube side to limit the diameter of the "scan field." This unit is factory adjusted and fixed to limit the width of the fan beam to that of the detector array. This assures that the patient won't receive

secondary radiation (scatter) as a result of X-rays outside the field of view.

CT DETECTORS There are three basic types of detector systems that were used throughout the history of CT. They are PMT or Photo Multiplier Tube Solid State Detector Gas Filled Detector Without some type of electronic transducer to detect and measure the intensity of the X-rays as they exit from an object, Hounsfield would not have been able to create a CT scanner as we know it. The detector is an electronic device that creates a current flow proportional to the intensity of the X-rays impinging upon it. The detector can be thought of as electronic film, because its job is to record the intensity of the attenuated X-rays, just like film does. The difference is of course, the detector emits electrical signals, which are then eventually processed into an image by a special computer. On the other hand, a piece of film has only to be developed to reveal its latent image. PMT's: The PMT (Photo Multiplier Tube) is no longer utilized in modern CT scanners. It was a rather large vacuum tube device that could not convert the attenuated X-rays directly into a useful electronic signal. It was designed to respond to visible light. Therefore, a PMT had to be packaged so that it was shielded from all external light sources. At the same time, it had to be mechanically bonded to a scintillation crystal. The latter is a device that fluoresces or emits visible light in proportion to the intensity of the X-rays impinging upon it. The PMT received these light signals and in turn converted them into a proportional current flow. This act of converting from X-rays to light to a current flow has a tag attached to it called "conversion efficiency". The efficiency of these combination devices ran around 50%. If the PMT packaging had any light leaks or the bonding of the crystal was not right, then the efficiency went down. If this happened the units were usually replaced. Their demise came as the quest for higher resolution and more detailed images grew. The replacement technology took two simultaneous paths some manufacturers used a solid-state detector system and the others used an ionization type filled with Xenon gas.

Solid State Detectors: The Solid State Detector works along similar lines to the PMT. Like the PMT, a scintillation device must be used to convert the X-ray energy to visible light. The materials used for this purpose can be either crystalline or ceramic in structure. Instead of the PMT, we use a photodiode; a solid state device that converts light to a proportional current flow. The two components are bonded together during manufacturing in a manner that allows the light to pass with very little loss to the photodiode. The whole assembly is then placed into a light proof package. This results in a device that is very sensitive to small changes in the attenuated X-ray beam, a very desirable trait in a detector. This type of unit is still employed in modern CT scanners today. It boasts a conversion efficiency of greater than 90%. Detector element in CT units consists of an array of individual elements or modules. Eg. Old third generation (refer history of CT) units consisted of individual element was soldered side by side to a printed circuit board.

Fig. Single X-ray detector (right); Detector array(right) There are two general categories that solid state detector material falls into today - one is crystalline in nature and the other is a ceramic. Either material may be used to make a highly efficient detector package; however, both also are susceptible to drift with respect to sensitivity in response to temperature changes. For this reason, precise temperature control may be necessary to maintain image quality. The scintillation crystal must be grown in a laboratory and then precision cut into very small wafers. The entire process is tedious and does not always produce ideal results. The manufacture of the ceramic material is done through an industrial process using heat and pressure to achieve the desired result. The end product is generally more uniform and easier to manufacture than its' crystal predecessor. Siemens manufacturers a patented ceramic material called UFC (Ultra Fast Ceramic). This material features a very low persistence in comparison to various types of crystal materials currently used. This is a very desirable trait since CT scanners are now able to acquire a single slice in less than one second.

Gas (Ionization) Detectors: The Gas Filled Detector (ionization chamber) came into existence about the same time as the solid state devices. These work on an entirely different principle than the previous two detector types discussed. The gas detector consists of a long narrow box, separated internally into many very thin compartments. Each one has a small opening to the next. This design allows a manufacturer to equally pressurize all compartments with a gas, usually Xenon. The result is an array of chambers, each one identical to the next. The act of pressurizing the Xenon, forces its molecules closer together. This is important because this detector functions on the ionization principle. As the attenuated X-rays impinge upon the Xenon molecules, a loosely bonded electron can be knocked from an outer shell of a Xenon atom. The result is a free electron and a Xenon ion or a positively charged atom (i.e. - normally an atom is neutral in charge). The walls of each chamber are supplied with a positive voltage while a centre conductor positioned in between serves as the negative pole. This negative pole attracts the positively charged ions that will in turn generate a current flow proportional to the degree of ionization that takes place. This represents the amount of X-ray quanta received, which is then captured by the Data Acquisition System for further processing.

Fig. Functioning of a gas filled (ionisation) detector These detectors can boast an efficiency of as high as 85 percent. One drawback to this detector is that it requires a higher dose to the patient to be able to function (when compared to solid state). On the other hand, due to the nature of it's construction, it's sensitivity remains relatively constant throughout a wide temperature range, a big advantage over most solid state units. In addition, the manufacture of this type of detector is more simplistic and can be made with a much higher degree of accuracy when compared to a solid state array.

Fig. Gas ionisation detector

GANTRY AND PATIENT TABLE CONTROLS :

This section includes all gantry components as well as the High Tension generator and patient table. Scan control receives commands and parameters chosen by the operator via the host computer. The parameters give the machine direction as to what type of scan is to be performed; how fast the gantry will rotate; how long of an exposure; and how wide of a slice to name a few. Another function of scan control is to pass information back to the host computer that it collects from other parts of the CT scanner. This information can be normal status (scan complete) or indicate that an error has occurred (interruption of the scan). "Scan Control" usually plays a role in handling another type of information transfer. This information relates to the patient in the scan field and has to be transmitted to a special computer system to be evaluated; that system is known as the Image Processor. The gantry is readily recognized as it is the largest component within a CT system. The main function of the gantry is to mechanically support the various subassemblies contained within. The gantry consists of two parts, a stationary one and a rotating one. Let's examine some functional components of a gantry. Scan Control Rotation Collimation Flying Focus SCAN CONTROL : Scan Control is a term applied to a group of electronics that in general, interfaces the gantry to the host computer system. Via this interface, information is exchanged between gantry components and the host. This information can be parameter values to the sub-assemblies contained within the gantry, such a collimator settings, rotation speed, number of readings requested, etc. or it can be in the form of error reports back to the host. The host is a general purpose computer system that runs the necessary software to make a CT scanner functional. GANTY ROTATION : In order to reconstruct a CT Image, we must gather a number of intensity profiles (also known as readings or projections) from different views around an object. In third generation (refer History of CT) CT units this is accomplished by rotating the X-ray tube and detector around an object positioned in the scan field. The angular displacement between each of these readings must be equal for accurate image reconstruction. It is also necessary to define repeatable start and stop positions for data acquisition. Considering the previous -- A rotation system must be able to maintain a constant speed during data acquisition, record the actual position, and start/stop measurements at pre-defined points (known as the data window.) Finally, this must be accomplished in a manner that provides safety to both patient and hardware. Different manufacturers employ different methods of turning the rotating frame of the gantry. Some vendors use hydraulics, others use a DC or AC motor with a belt drive, and still others employs direct drive motors. The one thing that all have in common is that

some type of device is used to generate pulses as the gantry moves. By counting theses pulses and measuring the time from one to the next, we can track the position of the gantry, as well as determine the speed of rotation. This information is then typically used to assure that rotation speed is within the specified tolerance, position the X-ray tube to a pre-defined angular displacement for a Topogram(refer Modes of CT Scan) study, and provide angular position information to the Image Processor.

Fig. Gantry control block diagram

Fig. Gantry positions while taking different reading (left);Pulse generation control for gantry movement.

PATIENT TABLE :
The primary function of the patient table, also referred to as the PPU (patient positioning unit), is to safely and accurately move the patient into and out from the scan field. This simple statement rings true but involves a fair amount of hardware and software to fulfill it's purpose. The table may be required to work in three modes of operation: Tomogram mode- incremental movement typically from 1 mm to 10 mm per step Topogram mode- continuous movement (without gantry rotation) by a DC motor Spiral mode - continuous movement throughout the scan range (while gantry is rotating )by stepper motor control.These three modes are all referring to linear table motion. Another task of the table is to raise and lower the patient so that they may be properly positioned within the scan field. It is also important to be able to keep track of the exact position of the table for linear movement as well as vertical. Vertical becomes particularly important when the gantry is tilted to accommodate certain CT studies, such as head or spine. Today, CT systems may have the ability to tilt as much as +/- 30 degrees. Even with lesser tilts, it is still important to constantly monitor the vertical table height, linear position and tilt to maintain the safety of the patient. This is usually accomplished by switches, transducers, or a combination of both. If these safety concerns were not addressed, a patient could conceivably be seriously injured.

FLYING FOCUS :
Flying focus or Multifan are terms used by Siemens interchangeably. One implies a focal shift and the other refers to the X-ray fan shift. They are both correct. It takes an accelerated stream of electrons impinging upon the anode of an X-ray tube to produce an output of X-ray quanta. The point where the electrons strike the anode is known as the focal spot. It is from this point that all X-rays emanate into a conical shaped beam. As a result of the collimation used in CT, the cone shape is modified into a flatter shape resembling a fan, thus the term fan beam. If we were to shift the point of impact of the electron beam on the anode, then we would also see a shift of the fan beam. X-rays themselves cannot be electronically deflected, but we can deflect a stream of electrons. This is the technical basis of flying focal spot. A controlled magnetic field is applied around the electron stream to sweep it back and forth at a high rate of speed producing the multifan effect. The concept of flying focus helps us to achieve this by shifting the focal spot while the gantry is rotating. The net result can yield many more samples than without it or it can also be used to emulate a detector array with twice as many elements dan it actually hs
Fig. of Multifan beam multifan (right)

(left); Production

COMPUTER CONTROL SYSTEM :

This includes the Control Console and Host Computer. These two components serve as an interface to the CT in two ways. The first is between "man and machine" and the second is between "machine and machine". An operator of a CT scanner can "communicate" with the unit, by entering commands through the Control Console. This is also where the machine would be powered on/off and allow conversation/instructions to the patient via an intercom system that it typically contains. In the first interface, the operator is "communicating" via a software program running on a general purpose computer. This computer is then connected to other parts of the CT machine. In modern CT's, this connection is usually made through a network of computers, each controlling some very specific group of functions. The main connection point begins with a component normally known as Scan Control.

DATA ACQISTATION SYSTEM :

The Data Acquisition System or DAS for short, is a crucial part of a CT scanner. It's function is basically to collect, integrate and convert from analog to digital, a huge amount of data from a detector array. It must also serialize and transmit the same over to an Image Processor for reconstruction into an image .On top of it all, it must perform all of these functions in a very short period of time. It must also be capable of discerning signals from as small as one ten thousandth of a volt to ten volts with equal accuracy. For example, let's look at a Somatom Plus. It can perform all of the required operations above for a detector array containing 768 elements or "channels" -- 1,242 times in one second. The act of reading out all of the channels of a detector array one time is called a "reading". Therefore, we may say that the Somatom Plus can process 1,242 readings per second. Let's break down the DAS into it's primary components. They are as follows: -Integrators -PGA/ADC 's -Transmitter

INTEGRATOR :
An integrator is made up of electronic components whose function is to accumulate a varying electrical signal over time and yield a single output. There are at least as many integrators in a DAS as there are detector channels. Each integrator is tied to supporting electronics that allows it to be reset in between measurements. One reading equates to the reading out of all channels of a detector array at a time. Eg. Somatom Plus CT scanner manufactured by Siemens could process 1,242

readings per second. This means that an integrator is storing information from a single detector element for less than one thousandth of one second.

PGA/ADC:
PGA or Programmable Gain Amplifier is an electronic device that receives the integrated intensity value from any channel of the detector array. It then assesses the amplitude of the incoming signal and compares it to three voltage ranges. Depending upon the range, it may amplify the signal by a factor of approximately 1, 8 or 64. In parallel to this process it assigns a code to be passed along with this "new" signal, that is on it's way to the ADC. The "code" is called the PGA code and consists of two digits that will eventually notify the Image Processor (IRS) how these signals were changed, so that it may convert them back to their original form before further processing. An ADC or Analog to Digital Converter is used to change the analog signals processed by the PGA into a digital form. This step is necessary because the Image Processor, which is a specialized high speed computer, is digital in nature. It can only understand and process 1's and 0's. It's job is to take this data and reconstruct it into an image.

gain amplifier,

Fig. Programmable block diagram

TRANSMITTER :

The transmitter may or may not be considered part of the DAS. It's basic function is to store the digital information as it comes from the ADC into a memory buffer. The next step is to convert this information from a parallel format to a serial one. Finally it governs the actual transmission of the data to the Image Processor according to a communication protocol. In currently manufactured CT's, the transmitter is usually integrated into a multifunction circuit board to minimize cost and reduce the overall number of components in a system.

Another function of the transmitter in current CT units is known as sorting. To understand this, let's back up and review the term reading. A reading may be defined as one cycle of the DAS. During this time all channels of the detector array are read out once each. As a matter of design, the channels are not read out in an ascending order; instead, they are read out in terms of importance -- meaning the centre channels are usually read out first, continuing on at least two separate paths; one ascending and one descending. The result is a reading whose individual channel values are not in chronological order. This must be the case before image reconstruction can be possible. In older CT's the act of sorting was done by a software routine on the receiving end that is in the image processor itself. Today, this is a hardware process performed by the transmitter before the data is sent to the image processor. The transmitter contains two memory buffers. The first is filled with the channel values of a reading in the same order which they were read out. The second buffer will accommodate the next reading while the first buffer is read out, at the same time arranging the channels in ascending order. This is accomplished by addressing the RAM via a sequence programmed into a PAL chip.

Fig .First filled with the

memory buffer channel values

Fig. Second memory buffer for sorting the output

IMAGE PROCESSOR :

Over time, different types of processors have been used to perform the duties of the image processor. Currently, most CT systems use a PC based computer systems along with some special hardware to do the job. This section is known as the IRS or Image Reconstruction System. The basic role of this device is to receive and process the data collected though scan control. This data is collected as the X-ray tube and detector array rotate around the patient. At predetermined angular positions, a snapshot is taken, each known as a reading (same as an attenuation profile). The information contained in each reading relates to how much the object in the scan field blocks (attenuates) the X-ray beam at that point. If we take readings for at least 180, then the image processor can create an accurate picture based on these attenuation profiles through a mathematical process known as back projection. The tasks of the Image Processor are many. It begins by rendering the data that it receives from the DAS (Data Acquisition System) free of any machine induced irregularities. This first step is called preprocessing. It then applies a mathematical algorithm called "convolution" (a kind of digital filtering) to the same data. This is a necessary pre-requisite to the last step. Finally, it carries out another mathematical process, known as backprojection. The end result is an image displayed on a video monitor. An Image Processor typically is not a single computer, but a combination of several computers arranged into an "array processor" configuration. This simply means that this type of computer is designed to process a group or array of similar data very quickly. This differs from

the way a traditional serial computer functions, such as a PC. A PC type design can only deal with relatively small "chunks" of data and therefore would not be practical for this type of image processing. For this reason, every CT system usually consists of a general purpose computer (host) to run the software application program that allows one to perform a scan and archive images. Image Processor has several functional groups as follows: Receiver Preprocessing Section Convolution Section Image Reconstruction (Backprojection) Imager/Video Display Section

Fig. Image processing operations

IMAGE PROCESSING OPERATIONS:

Convolution: Convolution in itself describes a mathematical process. It's usage in CT is critical to removing most of the blurring, inherent to the physics of CT image reconstruction using a technique called "backprojection". This is accomplished by applying a digital filter, known as a kernel, to all attenuation profiles in the same way. Kernels can also be designed to enhance edges in an image yielding a sharper appearance thus increasing high contrast resolution or it can soften the image, thus reducing the appearance of noise structures, and improving low contrast resolution. Convolution involves multiplying a data profile (1 reading from our DAS) point for point with a kernel. The kernel is then shifted and the process is repeated until all data points are processed. The result is a convoluted data set ready to be sent on to Image Reconstruction. Reconstruction: The reconstruction process involves specially designed hardware to perform "Backprojection." This step takes each attenuation profile that has been preprocessed and convoluted, and determines the contribution of each channel to

an image reconstruction matrix. This matrix typically consists of "512 by 512" or 262,144 cells. As each profile (also known as a projection) is processed the result is written into the matrix combining with the data that may already be present. The end result is an image of all the attenuation profiles collected during the scan. Since backprojection requires many repeated mathematical operations on a large amount of data, there is usually more than a single backprojector in a modern Image Processor. For example, In Siemens Somatom Plus 4 there are 8 backprojectors for speed of processing within its SMI5 (Siemens Medical Imager 5). It is conceivable add more, but there comes a trade-off to cost verses speed of image reconstruction. This image can be further processed and displayed in a video monitor. Video Imager: The main function of the "imager" is to take the resultant data from backprojection and format each row of data into a TV line, at the same time applying all the necessary timing associated with a particular video standard. A normal TV image consists of 525 horizontal lines. A current Siemens CT image is displayed on a video system consisting of 1249 lines. This allows images displayed to reveal much smaller "bits" of information than could be seen on a regular TV system. The "bits" mentioned are technically referred to as pixels. It takes many pixels to make a large object, while it may take only a few pixels to display a small object. Thus smaller the pixel translates into the better image quality thus allowing visualisation of smaller objects.

3 DIMENSIONAL IMAGE RECONSTRUCTION :

The principle:
Because contemporary CT scanners offer isotropi , or near isotropic, resolution, display of images does not need to be restricted to the conventional axial images. Instead, it is possible for a software program to build a volume by 'stacking' the individual slices one on top of the other. The program may then display the volume in an alternative manner.

Multiplanar reconstruction:

Fig. Typical screen layout of diagnostic software showing one 3-D(top left) and three MPR views

Multiplanar reconstruction (MPR) is the simplest method of reconstruction. A volume is built by stacking the axial slices. The software then cuts slices through the volume in a different plane (usually orthogonal). Optionally, a special projection method, such as maximum-intensity projection(MIP) or minimum-intensity projection (mIP), can be used to build the reconstructed slices. MPR is frequently used for examining the spine. Axial images through the spine will only show one vertebral body at a time and cannot reliably show the intervertebral discs. By reformatting the volume, it becomes much easier to visualise the position of one vertebral body in relation to the others. Modern software allows reconstruction in non-orthogonal (oblique) planes so that the optimal plane can be chosen to display an anatomical structure. This may be particularly useful for visualising the structure of the bronchi as these do not lie orthogonal to the direction of the scan. For vascular imaging, curved-plane reconstruction can be performed. This allows bends in a vessel to be 'straightened' so that the entire length can be visualised on one image, or a short series of images. Once a vessel has been 'straightened' in this way, quantitative measurements of length and cross sectional area can be made, so that surgery or interventional treatment can be planned. MIP reconstructions enhance areas of high radiodensity, and so are useful for angiographic studies. mIP reconstructions tend to enhance air spaces so are useful for assessing lung structure.

Host Computer:
The basic hardware makeup of a computer is a Central Processing Unit (CPU), Memory, and Input/Output (I/O) section such as shown below. A Computed Tomography system is made up of many components, none less important than the other. All are required to perform properly in order for the CT to function. The Host Computer is the primary component in a CT system that ties all of the other components together. It is usually a mini computer and it's function is to run the software that makes a CT scanner functional. There are many things going on at once during the normal operation of a CT scanner and the host is the initiator of many of these tasks. It also serves as a "traffic cop," monitors for any

error conditions or illegal operations that might occur, handles the situation, and reports the result back to the operator. To accomplish all of these functions, generally two types of software packages are required. One is called the "operating system" and it's primary purpose is turn a few handfuls of electronic components in your computer into a useful working device; without an operating system, you have about the equivalent of a small boat anchor. You might say the operating system puts the "basic brains" into the computer, thus giving it the ability to handle the hardware within and perform complex tasks. The latter is gained by loading "application programs" into it's memory. These programs give the computer specific instructions to perform a function, such as make the gantry rotate or register a patient, etc. Another example of an application program would be the Word Processor, Spread Sheet, Database, etc. that you use on your PC. The application program used on our current CT's is called SOMARIS, and is made up of many instructions (called lines of code) which are in turn interpreted by the operating system to make the hardware respond accordingly. The name of the operating system varies according to the type of computer used. For example, a PC might run DOS or WIN95; a DEC computer might run VMS, and a SUN (SPARC processor) computer might run UNIX.

Fig. Basic Computer Block for a CT-scan unit.

MODES OF CT SCAN:
THE TOPOGRAM:
Topogram - sometimes referred to as a scout view, is used to determine the region of interest when planning to perform a series of Tomograms. The net result of this procedure is to locate the exact starting and ending points of scanning thus eliminating unnecessary dose to the patient. The production of this scan is similar to a conventional X-ray procedure. A two dimensional image is produced of a three dimensional object, the patient. This image will have objects superimposed over each other and geometric magnification effects, all problems of a conventional Xray image. The image will give the operator a view of anatomical landmarks within the patient and how these relate to the CT scanners spatial frame of reference. A Topogram is automatically requested by all of Siemens CT units, just as registering

a patient is. The act of producing a Topogram and selecting tomogram slice locations will lockout the operator's ability to ZERO the patient feed counter. This has the effect of referencing table feed to the patient and not to some arbitrary mechanical point of the table.

How a topogram is performed:

Topograms are performed by placing the detector array in a stationary position, either Lateral or Anterior/Posterior in relation to the patient. The table will then be continuously fed through the scan-field. Individual "strips" of data will be acquired. The width of these strips is determined by the slice thickness selected. These individual strips will be filtered, sized and recombined to produce a Topographic image. It must be noted that the Topogram was NOT designed for diagnostic measurements; however, these images are of diagnostic quality on currently produced CT units.

Fig. Performing a

topogram

THE TOMOGRAM:
Tomograms are representations of the density values of a trans-axial slice through the patient. These images will represent a trans-axial cut through the patient that is divided into a matrix of volume units known as voxels. The dimensions of these units in the X-Y plane are determined by the scanner geometry and the scan zoom parameter. The dimension of the volume units along the Z axis is determined by the slice thickness. When viewing a Tomogram, the X-Y plane represents the pixels making up the image. The Z axis represents the average density of the voxel that is represented by a grayscale value for each pixel. All density values are referenced to water. Water has a value of 0 Hounsfield units "HU". Air has a value of -1000 HU and bone, etc. will be above 0 HU. The actual grayscale value attached to any HU value will be determined by the window and centering controls. Windowing will determine the number of HU units applied to each grayscale, 256 values are available. Centering will determine where the Center of these 256 values is located relative to the system range of -1000 HU to +3095 HU. Computed Tomograms have historically been produced by rotating a mobile X-ray source and/or detector array about the area of interest and capturing attenuation data from a large number of view perspectives. This occurred by either the use of a moving detector array and X-ray tube (third generation systems) or through the use of a rotating X-ray tube and a fixed array of detectors (fourth generation systems.) The minimum view angle for all voxels located within the field of interest is 180 degrees. This is why some scanners will have a head and body region; this usually occurs in systems that utilize an offset detector array, for example the Somatom ARC manufactured by Siemens. Other than these small differences in mechanization of the mechanical systems, the process of producing a scan is relatively unchanged from scanner to scanner.
Fig. 3D Voxel model

These steps are: 1. Incrementally move the patient into the scan field so that the region of interest is accurately located within the X, Y and Z field 2. Rotate the X-ray Tube and detector array, in third generation machines, about the scan field at a known velocity.

3. Gather intensity data for X-rays exiting the object and impinging upon the detector array. Match these measurements with the position at which they were acquired. 4. Transmit the intensity and position data to a computer or array of computers to compute density values for each voxel as seen from each measurement position. 5. Combine the measurement reading density values taken from at least 180 degrees of rotation. This generates an average density for each voxel. 6. Convert the voxel density data into an image that can be viewed and manipulated by the operator.

Tomogram properties:
With standard CT scanning the table is incremented between scans or "slices". This allows one to view the internal structure of the patient over an area larger than the single slice thickness (i.e.-a typical slice would range from 1 to 10 millimeters.) Typically, table movement between scans will be equal to the selected slice or greater. If the feed increment of the table is equal to the slice, then the possibility exists, that anatomical detail smaller than the slice width might be rendered inaccurately or obscured by being averaged together with adjacent larger objects making up the remainder of the voxel(s) (i.e.-see partial volume.). When a smaller slice is selected, the probability of this error occurring becomes significantly less. In addition, slice thickness is chosen with respect to the region of anatomy being studied For example, rather thick slices can normally be used in soft tissue studies (e.g.-cerebrum, thorax, extremities), while thinner slices are selected when one would expect to encounter small bones or fine structures (e.g.-nasal cavities, eye area, spine.) On almost all current CT scanners the slice is incorporated into a "mode", which includes other parameters such as KV and mAS to name a few. It is then given a name equating to a specific region of anatomy, for example "lungs". This means that this mode now contains the manufacturer recommended settings to achieve the best image quality for that anatomical area, alleviating a lot of the decision making on part of the operator. If the increment of the distance moved by the table is less than the slice thickness then the probability of partial volume occurring is lowered, but it also has some drawbacks. Scan times will usually be longer and the possibility of higher patient dose exists. If the increment of the table position is greater than the slice thickness then some internal detail will go unseen, since there will be areas of no measurement. The table may not be incremented at all, if the dynamic change in an anatomical structure or process is to be measured. This will allow the operator to follow the change in the patient, in a particular anatomic region, as time passes. An example of use would be to determine if blood is flowing through a kidney; this is accomplished by injecting the patient with a "contrast agent" and then repeatedly scanning the same area without table feed. The resultant images would normally show a change indicating the flow of blood.

SPIRAL SCANNING:
Spiral scanning is a take-off from regular Computed Tomography. The procedure is only possible with the advent of continuous rotation scanning, fast data acquisition systems and lots of memory space. These enabling technologies have lead to a

technique where intensity data is gathered continuously, while the table is incremented at a constant speed. This allows a continuous stream of intensity data with its associated gantry position data to be correlated with table position data. Using this data it is possible to mathematically calculate which data acquisitions, or parts thereof, are utilized in each scan slice. The computer will examine each data acquisition, scale its intensity data and apply the data to each slice in which the measurement holds voxel intensity data.

Spiral scanning steps:

The steps for performing a spiral scan are very similar to those used in a conventional Tomogram. These steps are: Continuously move the patient through the scan field, so that the region of interest is accurately located within the X, Y and Z field. This requires highly accurate and precise table feed to ensure that the measurement data and slice location properly match. Speeds of 1 to 2 x Slice thickness are possible. Rotate the X-ray Tube and detector array continuously, in third generation machines, about the scan field at a constant selected velocity. The velocity of the mechanical measurement system and sample timing circuitry must maintain a high degree of accuracy and precision. This is needed to ensure that the measurement data and slice locations are accurately correlated. Gather intensity data that reflects the attenuation profiles of the object being scanned. Match these measurements with the position at which they where acquired. Transmit the intensity and position data to a computer or array of computers to calculate density values for each voxel as seen from each measurement position. Combine the measurement reading density values taken from at least 180 degrees of rotation. This generates an average density for each voxel in each image. Convert the voxel density data into an image/s that can be viewed and manipulated by the operator.

Spiral scanning properties:

If feed on a spiral scan is less than the slice thickness, then more than 360 degrees of data are used to generate each image. This will have the effect of increasing the MAS of the scan and enhance signal to noise characteristics. The patient dose may be increased and scan time may also increase. If feed is more than the slice thickness, then less than 360 degrees of data is used to generate each image. The limit is set at feed being two times the Slice thickness. This yields a data set composed of 180 degrees of data. This will decrease the image quality by increasing the noise, due to less MAS per slice. This will also result in a decrease in dose to the patient and a decrease in scan time.

APPLICATIONS OF CT SCAN

Since its introduction in the 1970s, CT has become an important tool in medical imaging to supplement X-rays and medical ultrasonography. Although it is still quite expensive, it is the gold standard in the diagnosis of a large number of different disease entities. It has more recently begun to also be used for preventive medicine or screening for disease, for example CT colonography for patients with a high risk of colon cancer. Although a number of institutions offer full-body scans for the general population, this practice remains controversial due to its lack of proven benefit, cost, radiation exposure, and the risk of finding 'incidental' abnormalities that may trigger additional investigations.

Head:
CT scanning of the head is typically used to detect: bleeding, brain injury and skull fractures bleeding due to a ruptured/leaking aneurysm in a patient with a sudden severe headache a blood clot or bleeding within the brain shortly after a patient exhibits symptoms of a stroke a stroke brain tumors enlarged brain cavities in patients with hydrocephalus diseases/malformations of the skull evaluate the extent of bone and soft tissue damage in patients with facial trauma, and planning surgical reconstruction diagnose diseases of the temporal bone on the side of the skull, which may be causing hearing problems determine whether inflammation or other changes are present in the paranasal sinuses plan radiation therapy for cancer of the brain or other tissues guide the passage of a needle used to obtain a tissue sample (biopsy) from the brain assess aneurysms or arteriovenous malformations

Chest:
CT can be used for detecting both acute and chronic changes in the lung parenchyma, that is, the internals of the lungs. It is particularly relevant here because normal two dimensional x-rays do not show such defects. A variety of different techniques are used depending on the suspected abnormality. For evaluation of chronic interstitial processes (emphysema, fibrosis, and so forth), thin sections with high spatial frequency reconstructions are used - often scans are performed both in inspiration and expiration. This special technique is called High Resolution CT(HRCT). HRCT is normally done with thin section with skipped areas between the thin sections. Therefore it produces a sampling of the lung and not continuous images. Continuous images are provided in a standard CT of the chest. For detection of airspace disease (such as pneumonia) or cancer, relatively thick sections and general purpose image reconstruction techniques may be adequate. IV

contrast may also be used as it clarifies the anatomy and boundaries of the great vessels and improves assessment of the mediastinum and hilar regions for lymphadenopathy; this is particularly important for accurate assessment of cancer. CT angiography of the chest is also becoming the primary method for detecting pulmonary embolism (PE) and aortic dissection, and requires accurately timed rapid injections of contrast (Bolus Tracking) and high-speed helical scanners. CT is the standard method of evaluating abnormalities seen on chest X-ray and of following findings of uncertain acute significance.

Pulmonary angiogram
CT pulmonary angiogram (CTPA) is a medical diagnostic test used to diagnose pulmonary embolism (PE). It employs computed tomography to obtain an image of the pulmonary arteries. It is a preferred choice of imaging in the diagnosis of PE due to its minimally invasive nature for the patient, whose only requirement for the scan is a cannula (usually a 20G). MDCT (multi detector CT) scanners give the optimum resolution and image quality for this test. Images are usually taken on a 0.625 mm slice thickness, although 2 mm is sufficient. 50 - 100 mls of contrast is given to the patient at a rate of 4 ml/s. The tracker/locator is placed at the level of the Pulmonary Arteries, which sit roughly at the level of the carina. Images are acquired with the maximum intensity of radio-opaque contrast in the Pulmonary Arteries. This is done using bolus tracking. CT machines are now so sophisticated that the test can be done with a patient visit of 5 minutes with an approximate scan time of only 5 seconds or less. A normal CTPA scan will show the contrast filling the pulmonary vessels, looking bright white. Ideally the aorta should be empty of contrast, to reduce any partial volume artifact which may result in a false positive. Any mass filling defects, such as an embolus, will appear dark in place of the contrast, filling / blocking the space where blood should be flowing into the lungs.

Cardiac:
With the advent of subsecond rotation combined with multi-slice CT (up to 64-slice), high resolution and high speed can be obtained at the same time, allowing excellent imaging of the coronary arteries (cardiac CT angiography). Images with an even higher temporal resolution can be formed using retrospective ECG gating. In this technique, each portion of the heart is imaged more than once while an ECG trace is recorded. The ECG is then used to correlate the CT data with their corresponding phases of cardiac contraction. Once this correlation is complete, all data that were recorded while the heart was in motion (systole) can be ignored and images can be made from the remaining data that happened to be acquired while the heart was at rest (diastole). In this way, individual frames in a cardiac CT investigation have a better temporal resolution than the shortest tube rotation time. Because the heart is effectively imaged more than once (as described above), cardiac CT angiography results in a relatively high radiation exposure around

12 mSv. For the sake of comparison, a chest X-ray carries a dose of approximately 0.02 to 0.2 mSv and natural background radiation exposure is around 0.01 mSv/day. Thus, cardiac CTA is equivalent to approximately 100-600 chest X-rays or over 3 years worth of natural background radiation. Methods are available to decrease this exposure, however, such as prospectively decreasing radiation output based on the concurrently acquired ECG (aka tube current modulation.) This can result in a significant decrease in radiation exposure, at the risk of compromising image quality if there is any arrhythmia during the acquisition. The significance of radiation doses in the diagnostic imaging range has not been proven, although the possibility of inducing an increased cancer risk across a population is a source of significant concern. This potential risk must be weighed against the competing risk of not performing a test and potentially not diagnosing a significant health problem such as coronary artery disease. It is uncertain whether this modality will replace invasive coronary catheterization. Currently, it appears that the greatest utility of cardiac CT lies in ruling out coronary artery disease rather than ruling it in. This is because the test has a high sensitivity (greater than 90%) and thus a negative test result means that a patient is very unlikely to have coronary artery disease and can be worked up for other causes of their chest symptoms. This is termed a high negative predictive value. A positive result is less conclusive and often will be confirmed (and possibly treated) with subsequent invasive angiography. The positive predictive value of cardiac CTA is estimated at approximately 82% and the negative predictive value is around 93%. Dual Source CT scanners, introduced in 2005, allow higher temporal resolution by acquiring a full CT slice in only half a rotation, thus reducing motion blurring at high heart rates and potentially allowing for shorter breath-hold time. This is particularly useful for ill patients who have difficulty holding their breath or who are unable to take heart-rate lowering medication. The speed advantages of 64-slice MSCT have rapidly established it as the minimum standard for newly installed CT scanners intended for cardiac scanning. Manufacturers are now actively developing 256-slice and true 'volumetric' scanners, primarily for their improved cardiac scanning performance. The latest MSCT scanners acquire images only at 70-80% of the R-R interval (late diastole). This prospective gating can reduce effective dose from 10-15mSv to as little as 1.2mSv in follow-up patients acquiring at 75% of the R-R interval. Effective doses at a centre with well trained staff doing coronary imaging can average less than the doses for conventional coronary angiography.

Abdominal and pelvic

CT is a sensitive method for diagnosis of abdominal diseases. It is used frequently to determine stage of cancer and to follow progress. It is also a useful test to investigate acute abdominal pain (especially of the lower quadrants, whereas ultrasound is the preferred first line investigation for right upper quadrant pain). Renal stones, appendicitis, pancreatitis, diverticulitis, abdominal aortic aneurysm, and bowel obstruction are conditions that are readily diagnosed and assessed with CT. CT is also the first line for detecting solid organ injury after trauma. Oral and/or rectal contrast may be used depending on the indications for the scan. A dilute (2% w/v) suspension of barium sulfate is most commonly used. The concentrated barium sulfate preparations used for fluoroscopy e.g. barium

enema are too dense and cause severe artifacts on CT. Iodinate contrast agents may be used if barium is contraindicated (for example, suspicion of bowel injury). Other agents may be required to optimize the imaging of specific organs, such as rectally administered gas (air or carbon dioxide) or fluid (water) for a colon study, or oral water for a stomach study. CT is far more expensive, and subjects patients to much higher levels of ionizing radiation, so it is used infrequently.

ADVANTAGES OF CT OVER TRADITIONAL RADIOGRAPHY

There are several advantages that CT has over traditional 2D medical radiography. First, CT completely eliminates the superimposition of images of structures outside the area of interest. Second, because of the inherent high-contrast resolution of CT, differences between tissues that differ in physical density by less than 1% can be distinguished. Finally, data from a single CT imaging procedure consisting of either multiple contiguous or one helical scan can be viewed as images in the axial, coronal, or sagittal planes, depending on the diagnostic task. This is referred to as multiplanar reformatted imaging. CT is regarded as a moderate to high radiation diagnostic technique. While technical advances have improved radiation efficiency, there has been simultaneous pressure to obtain higher-resolution imaging and use more complex scan techniques, both of which require higher doses of radiation. The improved resolution of CT has permitted the development of new investigations, which may have advantages; compared to conventional angiography for example, CT angiography avoids the invasive insertion of an arterial catheter and guidewire; CT colonography (also known as virtual colonoscopy or VC for short) may be as useful as a barium enema for detection of tumors, but may use a lower radiation dose. CT VC is increasingly being used in the UK as a diagnostic test for bowel cancer and can negate the need for a colonoscopy. The greatly increased availability of CT, together with its value for an increasing number of conditions, has been responsible for a large rise in popularity. So large has been this rise that, in the most recent comprehensive survey in the United Kingdom, CT scans constituted 7% of all radiologic examinations, but contributed 47% of the total collective dose from medical X-ray examinations in 2000/2001. Increased CT usage has led to an overall rise in the total amount of medical radiation used, despite reductions in other areas. In the United States and Japan for example, there were 26 and 64 CT scanners per 1 million population in 1996. In the U.S., there were about 3 million CT scans performed in 1980, compared to an estimated 62 million scans in 2006. The radiation dose for a particular study depends on multiple factors: volume scanned, patient build, number and type of scan sequences, and desired resolution and image quality. Additionally, two helical CT scanning parameters that can be adjusted easily and that have a profound effect on radiation dose are tube current and pitch. The increased use of CT scans has been the greatest in two fields: screening of adults (screening CT of the lung in smokers, virtual colonoscopy, CT cardiac screening and whole-body CT in asymptomatic patients) and CT imaging of children.

Shortening of the scanning time to around one second, eliminating the strict need for subject to remain still or be sedated, is one of the main reasons for large increase in the pediatric population (especially for the diagnosis of appendicitis). CT scans of children have been estimated to produce non-negligible increases in the probability of lifetime cancer mortality leading to calls for the use of reduced current settings for CT scans of children. These calculations are based on the assumption of a linear relationship between radiation dose and cancer risk; this claim is controversial, as some but not all evidence shows that smaller radiation doses are less harmful. Estimated lifetime cancer mortality risks attributable to the radiation exposure from a CT scans can be performed with different settings for lower exposure in children, although these techniques are often not employed.

LOW-DOSE CT SCAN:
The main issue within radiology today is how to reduce the radiation dose during CT examinations without compromising the image quality. Generally, a high radiation dose results in high-quality images. A lower dose leads to increased image noise and results in unsharp images. Unfortunately, as the radiation dose increases, so does the associated risk of radiation induced cancer - even though this is extremely small. A radiation exposure of around 1200 mrem (similar to a 4-view mammogram) carried a radiation-induced cancer risk of about a million to one. However, there are several methods that can be used in order to lower the exposure to ionizing radiation during a CT scan. New software technology can significantly reduce the radiation dose. The software works as a filter that reduces random noise and enhances structures. In this way, it is possible to get high-quality images and at the same time lower the dose by as much as 30 to 70 percent. Individualize the examination and adjust the radiation dose to the body type and body organ examined. Different body types and organs require different amounts of radiation. Prior to every CT examination, evaluate the appropriateness of the exam whether it is motivated or if another type of examination is more suitable