MULTISLICE COMPUTED TOMOGRAPHY

Axial CT
• X-ray tube and detector
rotate 360°
• Patient table is stationary
– With X-ray’s “on”
• Produces one cross-
sectional image
• Once this is complete patient
is moved to next position
– Process starts again at the
beginning
Volume CT
• X-ray tube and detector rotate 360°
• Patient table moves continuously
– With X-ray’s “on”
• Produces a helix of image information
– This is reconstructed into 30 to 1000 images
Konvensional VS Spiral CT
 Topografi CT Vertebra

Single Slice Multi Slice

M S Perkembangan CT Scan dari Single Slice ke Multi Slice
C T Multi Slice Computed Tomography
64 Slice
Scanning

04 06

Dual Source
Scanning
 IMPROVE OF CT
• TUBE
The MRC tube
(metal rotarix ceramic)
Conventional CT X-ray tubes:
# 1 cause of death is the ball bearing
due to mechanical stress and heat.

Ball bearing blocked and stopped the rotation:

track is melted – death of the tube

With MRC´s spiral groove bearing this

is eliminated !
. . . . by gliding smoothly on
a liquid-metal film with
no wear, no tear
 X-ray Tube
Spiral Groove Bearing Technology

. . . . by sliding on
a liquid metal film

. . . same
principle
is used
 No wear – no tear
• Started once in the morning the
anode glides smoothly on a
liquid metal film
• Always ready for the next scan
• No boost-up time needed which
delays Trauma or CT
Fluoroscopy applications
• The benefit: highest availability
any minute, day by day.

Liquid-metal film
 X-ray Tube
Dynamic Focal Spot Technology
(DFS)
– The electron beam is rapidly deflected back and forth
during scanning to effectively double the number
samples from each detector
 X-ray Tube
Dynamic Focal Spot Technology
(DFS)
 Speed4D – the STRATON Tube
A Paradigm Shift in X-Ray Tube Technology

• Direct oil cooling of the anode,

compact design

Conventional Tube STRATON Tube

 RET: Tube assembly – Realization

Heat storage
and cooling
Innovations:
RET
Emitter Oil
!
 Anode and x-ray window
!
cooled by convection
Rotating
Festanode
Stationary
 Bearings outside the vacuum
Anode!
Anode
!!
 Improved HV-stability
 Variable focal spots
 Enormous power capability
Deflection magnet
Drive
Ball bearings
Electron beam
Housing X-rays

The rotating envelope tube solves thermal problems

as well as mechanical problems at one time!
 The STRATON tube
Highest power with only 120 mm anode diameter!
Anode 12 cm

e-beam

X-rays

Cathode
 IMPROVE OF CT
• DETECTOR
 Detector Alignment

- Symmetry type

- Asymmetry type
 Detector Alignment
Dose efficiency :
Geometric efficiency of the detector
• How much of the detector array is active and not a gap
• Asymmetric design is >10% more efficient than matrix
design

Asymmetric

Matrix
 Quad Detector Technology
• Philips patented variable wide area detector
• Variable slice thickness
– 4 x 1mm
Asymmetrix™
– 4 x 5mm
Variable detector length Fixed detector length
– 4 x 2.5mm
– 2 x 0.5mm
– 2 x 8mm
– 2 x 10mm

Approximately 10%
more efficient than
matrix detectors
 Quad Technology
How it works
8 Element
2-D array

4 Slices
CT 6-slice configuration
24-row Detector consisting of:
• 2-D mosaic of solid state detectors
• 6-channel DAS
• 24mm maximum thick slice coverage
• 4.5mm maximum thin slice coverage
• 0.4mm resolution in Z-axis in hi-res
mode

6 x 0.75 mm
4.5mm
24mm (4 x 6.0mm)
CT 10-slice configuration
24-row Detector consisting of:
• 2-D mosaic of solid state detectors
• 10-channel DAS
• 24mm maximum thick slice coverage
• 7.5mm maximum thin slice coverage
• 0.4mm resolution in Z-axis in hi-res
mode

10x 0.75 mm
7.5mm
24mm (8 x 3mm)
 CT 16-slice configuration

24-row Detector consisting of:

• 2-D mosaic of solid state detectors
• 16-channel DAS
• 24mm maximum thick slice coverage
• 12mm maximum thin slice coverage
• 0.4mm resolution in Z-axis in hi-res mode

4 x 1.5 mm 16 x 0.75 mm 4 x 1.5 mm

12mm
24mm (16 x 1.5mm)
16 slices Configuration
 40-slice configuration
52-row Large Area Detector consisting of:
• 2-D mosaic of TILEABLE detector
modules
• 40 channel DAS
• 40mm thick slice coverage
• 25mm thin slice coverage
• 0.34mm resolution in Z-axis in High
resolution mode

6 x 1.25 mm 40 x 0.62mm,25mm 6 x 1.25 mm

40mm (32 x 1.25)

40-slice configuration

Detector configuration, 52 rows

40 x 0.625mm = 25mm

32 x 1.25mm = 40mm
64-channel configuration
64-row Large Area Detector consisting of:
• 2-D mosaic of TILEABLE detector
modules
• 64-channel DAS
• 40mm coverage
• 0.33 x 0.33 x 0.34 mm voxel size
• 0.34mm resolution in Z-axis in High
resolution mode

40 x 0.625 mm
40mm (32 x 1.25)
40mm (64 x 0.625)
 Three levels of multi channel CT development
Year of introduction, number of channels and detector array configuration

1998 4-channel CT
5.0 2.5 1.5 1 1 1.5 2.5 5.0

2002 16-channel CT
4 X 1.5 mm 16 X 0.75 mm 4 X 1.5 mm

2003 40-channel CT
6 X 1.25 mm 40 X 0.625 mm 6 X 1.25 mm
CT 40 - detector row configuration
CT 40 detector is the predecessor of 64 channel. The 12 outermost
detector rows CT 40 are 1.25 mm wide while the innermost 40
detector rows are 0.625 mm wide.
CT 40 is limited to 40 electronic channels.

6 X 1.25 mm 40 X 0.625 mm 6 X 1.25 mm

0.625 0.625 1.25

CT 64 - detector row configuration

CT 40
6 X 1.25 mm 40 X 0.625 mm 6 X 1.25 mm

CT 64

64 X 0.625 mm
 IMPROVE OF CT
• Flying Focal Spot/Dynamic
Deflection Focal Spot
Double z-Sampling: Focal Spot
Position 1
0,6 mm

32 Slice Detection
Double z-Sampling: Focal Spot
Position 2

0,6 mm

32 Slice Detection
Double z-Sampling: Overlap
Doubles Information

0,6 mm

Oversampling
0,6 mm

Up to 64 Slices
per Rotation

32 Slice Detector
64 Slice DAS
Double z-Sampling: Focal Spot
Position 1 and 2

0,6 mm 0,6 mm

32 Slice Detection
 IMPROVE OF CT
• X-ray Beam Colimator
–SSP (SliceSensitiity Profile)
X-ray Beam Collimator
X-ray Beam Collimator
 IMPROVE OF CT
• Cone Beam Recontruction
– 3D filtered back projection reconstruction
• Toshiba
• Philips COBRA
» ( Cone Beam Reconstruction Alogarithms)
– Variations and extentions of nutating slice
alogarithms
• Siemens AMPR
» (adaptive multiple plane reconstruction)
• GE WHR
» (weighted hyperplane reconstruction)
Image Reconstruction
 ConeBeam vs Fan Beam
• Systems of a previous
generation assume
multiple parallel fan
beams

• Significant artifacts
appear if number of
slices > 4

• Cone Beam
Reconstruction Algorithm
takes in to account the
shape of the beam
 3-D Cone Beam Reconstruction
Z-axis Coverage
ConeBeam – important in determining
precise voxel location
• Even in the same plane, some
voxels have different apparent
locations (see blue vs. green voxel).
• In a single slice scanner the fan
beam would dissect the blue and
green voxel simultaneously.
• In multi-slice the fan beam acquires
information about the blue and
green voxel at different angles and
different times.
• With 3-D ConeBeam the
information is reconstructed as it Voxel Location
truly exists.
 Image Reconstruction:
Cone Angle
Focus
Slice width ‘’Slice blurring’’, cone artifacts
S dS

Scan FOV Scan direction

 Up to 4 slices: dS <= S,
cone angle of the rays may be neglected
 ConeBeam Reconstruction

Image from outer detector row

Center detector row image
> 4 detector rows with fan beam reconstruction
 ConeBeam Reconstruction

Image from outer detector row

Center detector row image
> 4 detector rows with Cone Beam reconstruction
ConeBeam Reconstruction
Frontal Head Artifacts
COBRA 2D Fan Beam
ConeBeam Reconstruction
Posterior-Fossa Artifacts
COBRA 2D Fan Beam
 ConeBeam Reconstruction
Very High Density & Metal Artifacts
COBRA 2D Fan Beam
 ConeBeam Reconstruction
Peristaltic & Motion Artifacts
COBRA 2D Fan Beam
ConeBeam Reconstrucion
Partial volume Artifacts
COBRA 2D Fan Beam
 ConeBeam Reconstruction
Sharp Edges Bone Artifacts
COBRA 2D Fan Beam
 2D vs. 3D ConeBeam
Reconstruction
• 2D methods break down as the cone angle grows larger.
• True 3D reconstruction is necessary to maintain artifact-free images.

2D 3D COBRA

64-slice
simulation
1.4 pitch

128-slice
simulation
1.4 pitch
 The AMPR-Algorithm:
Adaptive Multiple Plane
Basic Idea: Reconstruction*
 If more than half a rotation of spiral data
contributes to an image, don’t use all the data
to reconstruct one single image
but
 distribute the data to several partial images on
double oblique image planes, which are individually
adapted to the local curvature of the spiral
 combine the partial images to the final image in a
subsequent reformation-step (z-weighting)

*Th. Flohr, S. Schaller, K. Stierstorfer, H. Bruder 2000

 The AMPR-Algorithm:
Adaptive Multiple Plane Reconstruction
 Multiple double oblique image planes for full dose utilization
and free selection of the spiral pitch

z-axis z-axis

12 slices, pitch 1.0 = pitch 12

 The AMPR-Algorithm:
Adaptive Multiple Plane Reconstruction
 Multiple double oblique image planes for full dose utilization
and free selection of the spiral pitch

Focus
 The AMPR-Algorithm:
Streak Artifacts in MPRs (e. g. Skull Base)
are Significantly Reduced

16*1mm, pitch 0.75 (12) 16*1mm, pitch 0.75 (12)

24 mm/sec 24 mm/sec
Standard Reconstruction AMPR Reconstruction
 X32: First Measured
Phantom Images
Pelvis Phantom, MPR, 16*1.5mm, 2mm slices, 0.5 sec,
spiral pitch 16 (1) , 48 mm / sec, 24 cm in 5 sec

Spiral without cone correction AMPR Scan

direction
 X32: First Measured
Phantom Images
Pelvis Phantom, MPR, 16*1.5mm, 2mm slices, 0.5 sec,
spiral pitch 16 (1) , 48 mm / sec, 24 cm in 5 sec

Spiral without cone correction AMPR Scan

direction
 X32: First Measured
Phantom Images
Thorax Phantom, MPR, 16*1.5mm, 2mm slices, 0.5 sec,
spiral pitch 24 (1.5) , 72 mm / sec, 24 cm in 3.3 sec

Spiral without cone correction AMPR

 Components in CT system
• Optical Slip Ring
 Components in CT system
Optical Slip Ring – Philips First

Advantages
• Speed
– Transfers massive amounts
of data – up to 1.1 Gb/sec
• Integrity
– Optical transmission provides
pure signal for low dose
imaging
• Scalability
– Meets the needs of today’s
and tomorrow’s scanners
 Volume Scanning: Pitch

1:1 2:1
Pitch
 Pitch

=1 Single slice >1

? ?
 Pitch

=1 Single slice >1

?
 Pitch

=1 Single slice >1

• Pitch < 1 alert the user that radiation overlap is occurring.

• Pitch > 1 alert the user that image quality may be degraded.
 Pitch

Information about table travel relative to beam collimation

table travel (mm) per gantry rotation

Pitch = (1)
beam collimation (mm)
 Pitch

=1

table travel (mm) per gantry rotation

Pitch = (1)
beam collimation (mm)
 Pitch

Classic definition is preferred because it can be

unambiguously applied to both single- and multi-
slice scanning (2, 4, 8, 16…channels).

AJR:176, May 2001

“Common terminology fo Single and Multislice Helical CT”
Silverman, Kalender and Hazle
 Advantages of Volume CT
• More coverage in a breath-hold
– Chest, Vascular studies, trauma
• Reduced misregistration of slices
– Improved MPR, 3D and MIP images
• Potentially less IV contrast required
• Gapless coverage
• Arbitrary slice positioning
 Multislice Fundamentals
• Everything is better
• (R)esolution
– Z-axis, spatial, low contrast
• (S)peed
– Temporal -
bolus capture, stopped motion
• (V)olume
– Thin slice -
– organ-specific coverage
• (P)ower
– Enough photons -
uncompromising image quality
 Multislice Effectiveness
• Everything is better Dual Quad

– Resolution 2x 4x-8x
– Speed same same
– Volume same same
– Power same same

Single Slice = One 10mm slice per rotation

Dual Slice = Two 5mm slices per rotation
Quad Slice = Four 2.5mm slices per rotation
 More coverage
Quad-Slice Dual-Slice Single-Slice

72 cm coverage 36 cm coverage 18 cm coverage

3.2 mm Eff. Slice Thickness; 28 sec; 120kV / 130mAs
 Thinner Slice
Quad-Slice Dual-Slice Single-Slice

4x2.5mm; 2.5cm/sec 2x5.0mm; 2.5cm/sec 10mm; 2.5cm/sec

72 cm coverage ; 28 sec; 120kV / 130 mAs

CT 16-slice configuration
Polytrauma CTA
Intradural mass - CT myelography
58 year old man with history of
abdominal tumor presenting with
bilateral lower extremity weakness.
Post myelogram CT demonstrates a
well circumscribed intradural mass at
T8-9 which has a broad based dural
attachment and faint intralesional
calcifications (arrows).

Detector configuration: 64 x 0.625 mm

Scan length: 62 cm
Scan time: 22 sec
Other Beneffit From MSCT