CT Principle & CT Number

Prepared By – Thaker Atri Anupam Kumar

22MSMIT002
MSc. Medical Imaging Technology
2nd Semester
 Introduction

• Computed Tomography, CT for short (also

referred to as CAT, for Computed Axial
Tomography), utilizes X-ray technology and
sophisticated computers to create images of cross-
section “slices” through the body.

• Tomography is a term that refers to the ability to

view an anatomic section or slice through the
body.

• Anatomic cross sections are most commonly refers

to transverse axial tomography
 Basic Principle
• The basic principle behind CT is that the internal
structure of an object can be reconstructed from
multiple projections of the object.

• The principle is illustrated in Figure. The object is

made up of multiple square blocks, five of which
have been removed to form a central cross (Figure).

• Projections could be obtained by passing an x-ray

beam through the blocks and measuring the
transmitted radiation. For the sake of simplicity, we
will represent the ray projections that represent
attenuated radiation, by the number of blocks in
each row.
• The horizontal sums (called "ray projections") are shown on
the right; the vertical ray sums are shown below the object.
• All the horizontal and vertical ray sums are added, like the
two shown in Figure 19-1B, to produce a numerical
reconstruction of the object. The numbers included in the
reconstruction are 4, 6, 7, 8, 9, and 10. A gray scale value is
then assigned to the numbers to produce an image like the
one shown in Figure.
• The image can be manipulated to highlight certain areas;
that is, contrast can be adjusted. For example, the gray
scale can be narrowed to include only black and white, and
applied at any point along the numerical sequence.
• In Figure, the scale is centered at the 9-10 level. Blocks
with the number 10 are white and all other blocks are
black.
• A perfect reproduction is achieved in Figure 19-1F by
centering the black-white scale at the 6-7 level.
• This simple method of reconstructing an object may illustrate
the basic ideas.
• In x-ray CT the method of forming the ray projections is
different than in our illustration, and the number of projections
and picture elements is much greater, but the principle is exactly
the same.
• The ray projections are formed by scanning a thin cross section
of the body with a narrow x-ray beam and measuring the
transmitted radiation with a sensitive radiation detector.
• The detector does not form the image.
• It merely adds up the energy of all the transmitted photons.
• The numerical data from multiple ray sums are then computer
processed to reconstruct an image.
 Principle of Imaging
Principle of CT Scan Imaging on Basis of SPIDR

o S – Scanning & Data Acquisition

o P - Processing

o I – Image of Reconstruction

o D – Display Hours

o R – Recording
 S – Scanning & Data Acquisition

1. Topogram is selected.

2. Field of view is divided into no of slices.

3. Slice is selected by collimated beam.

4. Slice is Superimposed on the Matrix.

5. X-Ray Tube is rotated around the body of the patient and multiple projections are taken.

6. Each block of tissue attenuates the beam equal to their attenuation coefficient.

7. There are 800 detector fixed in row.

8. In one projection 800 data are taken by 800 detectors and 1000 projection are taken in 1 projection.
So lakhs of data is converted into analog to digital data signal and sent to computer and sent to
computer and this is called data acquisition system.
 P – Pre Processing
• Data for each view are arranged in a specific format and stored in computer for processing

• It uses the natural algorithm of IX & Io and Submission of attenuation Coefficient.

IO = µ Pixel IX

IO – Initial Intensity

IX – Final Intensity

µ Pixel – Block of Tissue

IX = Ioe-µx
 µ pixel = 1/X log e Io/Ix

Io µ1/µ2 Ix

µ1 + µ2 = I/X Log e Io/Ix

 I – Image Reconstruction
• After enough transmission measurements have been collected by detector they are send to the computer
for processing.

• The computer use the special mathematical techniques to reconstruct CT image in finite no of steps
called image reconstruction algorithm.

• For Eg – The image reconstruction techniques used by Hounsfield to develop first CT Scanner called as
algebraic reconstruction techniques.

• Today new set of Image Reconstruction Algorithm have been developed for spiral / Helical Volume Ct
Scanner. This includes Fan beam, Filter back Projection algorithms and More recently cone beam
Imaging Reconstruction Algorithms.

• A Computer Control to the CT Process in General. This involves a Mini Computer and Associated Micro
Processor for performing a number of specific function. In Some CT Scanner Array processor perform
High Speed Calculation and specific Micro Processor carry out Image Processing Operation.
 D – Display
• CT Images have 4096 shades of grey but computer can display only 256 shades of the grey.
• Human Eye can See only 32 shades of Grey.

Computer

Process Data

Stage to Be displayed

Digital Data Associated With Each Pixel

Digital Data convert with analog signal for

display
 Storage

• CT Images can be stored on the magnetic tapes and magnetic disk more recently optical storage
technology has added a new dimension to the storage of the information from the CT Scanner.
• In Optical Storage the Store Data are read by optical means such as laser beam.
• Optical Storage media include at least 3 format disk, Tapes, Card.

 Communication

• CT Communication refers to the electronic transmission of the text data and images from the image
from the CT Scanner to the other device such as laser printers, diagnostic, Display Monitor in the
radiology department, Intensive care unit and operating trauma room in the hospital and computer
outside the hospital.

• Electronic Communication in CT Requires a Standard Protocol that facilitate Connectivity among Multi
Modalities (CT, MRI, Fluoroscopy & DR) and Multi Vendor Equipment.
• The image is usually displayed on the cathod ray tube, although other display technology are available.

For eg – Touch screen technology is used for scan set up and controlled in some scanner. However the
cathod ray tube remains the best device used for display grey scale imaginary, Although LCD are now being
used.
• Display Monitor are mounted onto control console that allow the operate technologist & Radiologist to
manipulate Store and Record Images.

 Image Manipulation and Digital Image

• Images can be modified through image manipulation to make them more useful to the observer.
• For eg – Transverse Axial Images can be reformatted into coronal, sagittal & Para-Axial Sections.
• In Addition Images can also be Subjected to other image smoothening, edge enhancement, grey scale
manipulation & 3D Processing.
• The standard use for the purpose is the digital imaging and the communication in the medicine
(DICOM) Standard Stabilised by the American College of the radiology (Asia).

• CT departments are now operate in the picture archiving and communication system (PACS) that
allows the flow of a CT data and Images among the Device and People not only in the radiology
department but throughout the hospital as well.

• The Additionally the PACS is Connected to Radiology Information System which in turn
Connected to Hospital Information System (HIS).
 R – Recording

• Recording The Image by CT Scanner is Usually done with Multiformat Camera.

• Now a days recording system done by laser beam to directly record the image on the film
 Tomographic Images
• The tomographic image is a picture of a slab of the patient’s
anatomy
• The 2D CT image corresponds to a 3D section of the patient
• CT slice thickness is very thin (1 to 10 mm) and is
approximately uniform
• The 2D array of pixels in the CT image corresponds to an
equal number of 3D voxels (volume elements) in the patient
• Each pixel on the CT image displays the average x-ray
attenuation properties of the tissue in the corresponding
voxel
• Linear Attenuation Coefficient depends on

A. Tissue composition

B. Tissue density

C. Photon energy
 Tomographic acquisition
• Single transmission measurement through the patient made by
a single detector at a given moment in time is called a ray.
• A series of rays that pass through the patient at the same
orientation is called a projection or view.
• Two projection geometries have been used in CT imaging:
A. Parallel beam geometry with all rays in a projection
parallel to one another
B. Fan beam geometry, in which the rays at a given
projection angle diverge.
• Purpose of CT scanner hardware is to acquire a large number
of transmission measurements through the patient at different
positions.
• Single CT image may involve approximately 800 rays
taken at 1,000 different projection angles.
• Before the acquisition of the next slice, the table that the
patient lies on is moved slightly in the cranial-caudal
direction (the “z-axis” of the scanner).
 Tomographic Reconstruction

• Each ray acquired in CT is a

transmission measurement through the
patient along a line

• The unattenuated intensity of the x-ray

beam is also measured during the scan
by a reference detector
• There are numerous reconstruction algorithms.

• Filtered back projection reconstruction is most widely

used in clinical CT scanners.

• Builds up the CT image by essentially reversing the

acquisition steps.

• The  value for each ray is smeared along this same path
in the image of the patient.

• As data from a large number of rays are back projected

onto the image matrix, areas of high attenuation tend to
reinforce one another, as do areas of low attenuation,
building up the image.
 How CT Scan Works
• The technologist first turns on the scanner’s power and performs a quick test to ensure that the scanner is
in good working order.
• The patient is in place in the scanner opening, with appropriate positioning for the particular examination.
• The technologist sets up the technical factors at the control console. Scanning can now begin.
• When x rays pass through the patient, they are attenuated and subsequently measured by the detectors.
• The x-ray tube and detectors are inside the gantry of the scanner and rotate around the patient during
scanning.
• The detectors convert the x-ray photons (attenuation data) into electrical signals, or analog signals,
which in turn must be converted into digital (numerical) data for input into the computer.
• The computer then performs the image reconstruction process. The reconstructed image is in
numerical form and must be converted into electrical signals for the technologist to view on a television
monitor.
• The images and related data are then sent to the PACS, where a radiologist will be able to retrieve and
interpret them. Finally, the image can be stored on optical disks .
 What are we measuring ?

• The average linear attenuation coefficient (µ),

between tube and detectors.

• Attenuation coefficient reflects the degree to which the

X-ray intensity is reduced by a material.
 CT Number & Hounsfield Unit (HU)
• Each pixel in the reconstructed image is assigned a CT
number.
• CT numbers are related to the linear attenuation
coefficients (μ) of the tissues that comprise the slice and
can be calculated as follows :

• CT numbers obtained with this factor are referred to as the

Hounsfield Unit (HU).
CT numbers for bone and water can be calculated:

Thus the CT number for bone is 1000. Thus the CT number

for water is 0.

In CT, a high-kilovolt technique (about 120 kV) is generally

used for the following reasons:
• To reduce the dependence of attenuation coefficients on
photon energy
• To reduce the contrast of bone relative to soft tissues
• To produce a high radiation flux at the detector.
CT numbers range from about –1,000 to +3,000
where –1,000 corresponds to air, soft tissues
range from –300 to –100, water is 0, and dense
bone and areas filled with contrast agent range
up to +3,000 .

These reasons are important to ensure optimum detector

response (e.g., to reduce artifacts caused by changes in skull
thickness, which can conceal small changes in attenuation in
soft tissues, and to minimize artifacts resulting from beam-
hardening effects).
• CT numbers may vary because of their energy
dependence. It is therefore essential that the CT
system ensure the accuracy and reliability of these
numbers because the consequences can be disastrous
and might lead to a misdiagnosis. The system
incorporates a number of correction schemes to
maintain the precision of the CT numbers.
 References

• COMPUTED TOMOGRAPHY Physical Principles, Clinical Applications, and Quality Control BY Dr.
EUCLID SEERAM, PhD, MSc, BSc, FCAMRT

• Basic principle of ct and ct generations (slideshare.net)

• https://www.dspguide.com/ch25/5.htm
Thank You