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Shravani
Basic principle
The internal structure of an object can be reconstructed from multiple projections of the same. The ray projections are formed by thin cross sections of the scanning part with a narrow x-ray beam The transmitted radiation from this beam is measured by using a sensitive radiation detector. This measured radiation is fed into a computer and analysed by using mathematical algorithms and reconstructed as a tomographic image.
"slice"
Patient is placed in the center of the measurement field X-ray is passed through the patients slice from many direction along a 360 path The transmitted beams are captured by the detectors which digitizes these signals These digitized signals called raw data are sent to a computer which create the CT image
The attenuation values are transferred to the computer where they are coded & used to create a slice image
DATA ACQUISITION
The scanning process begins with data acquisition.
Data Acquisition refers to a method by which the patient is systematically scanned by the X ray tube and detectors to collect enough information for image reconstruction.
A basic data acquisition scheme consists of X ray tube Filters Collimators Detectors
Image reconstruction
The HU of common substances:
Substance Air Fat Water Muscle Contrast Bone HU -1000 -120 0 +40 +130 +400 or more
of the tissue(s) that it corresponds to on a scale from +3071 (most attenuating) to -1024 (least attenuating) on the Hounsfield scale Voxel is a volumetric pixel
CT Gantry
6.Stationary computer
X-RAY TUBE
Rotating anode type More heat loading and heat dissipation capabilities Small focal spot size (0.6mm) to improve spatial resolution
FILTERS
Compensation filter is being used To absorb low energy x rays To reduce patient dose To provide a more uniform beam
COLLIMATORS
To decrease scatter radiation To reduce patient dose To improve image quality Collimator width determines the slice thickness
DETECTORS
The detectors gather information by measuring the x-ray transmission through the patient. Two types:
When X ray Photons are absorbed by these materials the convert them into light photons and again converted into electric signals by photo multiplier diode.
Translate - rotate one detector. Total Scan time : 25-30 minutes (5 minutes per section). Uses pencil beam to scan the body. Arc of rotation of the gantry by 1 degree.
Scan Modes
Spiral (helical) CT Conventional (incremental) CT (helical motion of X-ray tube, (short pause , several minutes) reducing time and radiation exposure)
22
Spiral CT
Newer method
X-ray tube moves continuously with slip-ring technique, the outer fixed detector ring and inner rotating x-ray tube ring having brushes that remain in electrical contact with the inside of outer ring.
X-ray tube moves continuously with patient moving cephalad with constant rate producing a spiral or helix around the patient.
Slip-ring Technology
Power is transmitted through parallel sets of conductive rings instead of electrical cables.
Slip-ring Scanner
DATA ACQUSITION-ENTIRE TISSUE IS BEING SCANNED DURING ONE BREATH HOLD IMAGE RECONSTRUCTION-INTERPOLATION USED TO GENERATE SLICES. FILTERED BACK PROJECTION USED TO REDUCE BLURR.
DATA
ACQUSITION
Z-AXIS
Reconstruction of arbitrary slices (either contiguous or overlapping) within the scanned volume Distance between the slices is called Increment.
B
Volume Data A
During the scanning procedure, the tube is rotating & emitting x-rays at all time. The patient is advanced at a constant speed through the rotating gantry This produced a volume data set from which multiple slices can be reconstructed either in a contiguous or overlapping manner. The images can be produced at any position within the scanned volume A & B
Increment
Overlap
Increment < Slice Thickness Overlap of slices Closer image interval More images created
Increment
Increment > Slice Thickness Gaps between slices Images are further apart Less images created
Increment
Deep Inspiration
Shallow Inspiration Conventional CT scanning is slow because it requires multiple slice acquisition to cover the volume of interest Despite the fact that scanning are performed with consecutive slices, it is easy to miss small lesion when the patient varies his depth of inspiration from scan to scan. It is also difficult to reduce partial volume effect. In order to do so, the lesion must be captured fully, not partially within the slice. Several overlapping scans may be repeated, with the hope that the patient hold his breath at the same depth each time.
SPIRAL CT MODES
SINGLE SLICE
SPIRAL CT MODES
MULTI - SLICE
Conventional CT
Alternate translation & xray exposure is done. Each rotation of x-ray tube generates data of a transaxial image Prospective selection of slice positioning and spacing
Spiral CT
Both are done simultaneously Each rotation yields data Specific to an angled plane of section. From this, by interpolation, transaxial image is reconstructed.
Done retrospectively .
5 to 8mm for abdomen scan. 7 to 10 mm for chest scan. 5 mm for neck scan. 2 to 3 mm to scan small structures like lung nodules, smaller blood vessels. It affects effective slice thickness of reconstructed transaxial scan and its longitudinal resolution.
Applications:
CT angiography. Cardiac CT with gating to freeze cardiac motion. Coronary artery imaging including calcium scoring. Tumor permeability studies. Functional and perfusion imaging. In Emergency acute abdomen cases.
Despite high heart rate of 90 bmp, motion free visualization of the coronary arteries.
Hepatic focal fibrosis misdiagnosed as hepatocellular carcinoma. Axial helical CT images obtained during hepatic arterial and portal venous phases reveal multiple round, hypo attenuating areas (arrows) in right and left liver lobes. This finding simulated hypo vascular mass and was originally misdiagnosed as possible tumour.
ARTIFACT
Any discrepancy between the CT numbers represented in the image and the expected CT number based on the linear attenuation coefficient
MOTION
MOTION
MOTION
MOTION
REMEDY:
VOLUNTARY MOTION: Explanation Of The Procedure And Good Communication With A Patient. INVOLUNTARY MOTION: Short Scan Time.
BEAM HARDENING
It occurs when the average energy of an x-ray beam passing through the patient increases. Beam is hardened high energy photons are attenuated less by the tissue. As a result, they are pass through the patient and reach the detectors. This artifact is also called cupping artifact because the hardening is most pronounced in the center and less at the periphery. It resembles a cup.
BEAM HARDENING
BEAM HARDENING
REMEDY
INCREASE kvp Decrease slice thickness Increase filtration bowtie filter
METAL ARTIFACT
Manifest itself as star streaking artifact. Its caused by presence of metallic objects inside or outside the patient. Metallic object absorbs the photons causing an incomplete profile
METAL ARTIFACT
REMEDY:
Selection of larger sfov Taping patient tissue Raising patients arms above their head on the scan of chest and abdomen
RING
RING
TUBE ARCING
Tungsten vapor from anode and cathode intercepts the projectile electrons intended for collisions with the target. Crackling sound!!!!
TUBE ARCING
REMEDY
GAS BURNOFF TUBE REPLACEMENT
LINE IN TOPOGRAM
BAD DETECTOR CAUSES CONTINUOUS LINE ON THE TOPOGRAM
STAIRCASE
Improper selection of slice thickness and slice incrementation when generation mpr and 3-d images
REMEDY
THIN SLICE USE 50% OVERLAP ON RECON SLICE INCREMENTATION
Thank You