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6/3/2014 1Hareesha N G, Dept of Aero Engg, DSCE
The basics of CT
• CT imaging chain
• System components
• Acquisition methods
• Image quality
• Applications
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 2
X-ray: The beginning
• X-Rays founded in 1895 by Wilhelm
Conrad Roentgen
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 3
CT: The beginning
• CT founded in 1970 by Sir Godfrey Hounsfield
– Engineer with EMI, LTD.
– first applications were in neuroradiology
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 4
CT Scanner
• X-Ray modality used to the body in
cross section
• Used to determine
– extent of trauma
– location and type of tumors
– status of blood vessels
– pre surgical planning
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 5
CT System
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 6
CT System
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 7
Basic CT scanner components
• Gantry
• X-Ray Tube
• Detector
• Control Console
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 8
Gantry
• CT X-ray tube
• High voltage generator
• Detector array
• Data acquistion system
• Slip ring
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 9
The CT X-ray Tube
• Anode heat capacity
– 3.5 MHU up to 6.5 MHU
• Determines maximum mAs
• Determines volume length
• Dictates generator size
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 10
Detector Elements
• Capture energy that has not been attenuated
by the patient
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 11
Control console
• Set scan parameters
– kVp, mA, scan time, reconstruction filter,
etc.
• Set scan mode
– Digital radiograph, axial or volume
• Houses reconstructor
• Review and archive images
• Post-processing
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 12
CT
• CT - Computed Tomography
• CAT Scan - Computerized Axial Tomography
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 13
Scanning methods
• Digital projection
– AP, PA, Lat or Oblique projection
– Surview, Scanogram
• Conventional CT
– Axial
• Start/stop
• Volumetric CT
– Helical or spiral CT
• Continuous acquisition
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 14
Digital Projection
• X-ray tube and detector remain stationary
• Patient table moves continuously
– With X-rays “on”
• Produces an image covering a range of anatomy
– Similar to a conventional X-ray image, e.g. flat plate of
the abdomen
• Image used to determine scan location
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 15
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
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 16
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
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 17
Volume Scanning: Pitch
1:1 2:1
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 18
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
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 19
Fundamentals of Multislice CT
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 20
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
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 21
Single Slice = One 10mm slice per rotation
Dual Slice = Two 5mm slices per rotation
Quad Slice = Four 2.5mm slices per rotation
Multislice Effectiveness
• Everything is better
– Resolution 2x 4x-8x
– Speed same same
– Volume same same
– Power same same
Dual Quad
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 22
. .
single detector arc dual detector arc
pre-patient collimation
post-patient collimation
x-ray tube focal spot
___
Mx8000
Dual Slice
Dual Slice Detector Optimized for 2
Slice Acquisition
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 23
Approximately 10%
more efficient than
matrix detectors
Variable Wide Area Detector
Asymmetrix™
Variable detector length Fixed detector length
Quad Detector Technology
• Philips patented variable wide area detector
• Variable slice thickness
– 4 x 1mm
– 4 x 5mm
– 4 x 2.5mm
– 2 x 0.5mm
– 2 x 8mm
– 2 x 10mm
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 24
8 Element
2-D array
4 Slices
Quad Technology
How it works
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 25
2x0.5mm
4x1mm
4x2.5mm
4x5mm
2x10mm
p-plane
fused fused
to FEE
Asymmetrix™ Technology
Variable slice thickness
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 26
CT
• CT attenuation information
• CT image quality
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 27
Attenuation
• X-ray beam passes through patient
• Each structure attenuates X-ray beam
differently
– According to individual densities
• Radiation received by detector varies
according to these densities
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 28
Density information
• Transferred from detector to CT computer
(A to D converter)
• Reconstructed by computer into a cross-sectional image
– Displayed on screen
– Each pixel displayed on monitor has varying brightness
• The greater the attenuation, the brighter the pixel
• The less attenuation, the darker the pixel
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 29
Density information
• Density values
correspond to a
range of numbers
– Hounsfield scale
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 30
Window settings
• Window width
– Determines range of CT numbers displayed on an image
• Values above this range = white
• Values below this range = black
– Window level
• Sets the center CT number displayed on the monitor
• Determines the location on the Hounsfield scale about which the window
width will be centered
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 31
CT image quality
• Spatial resolution
– Ability to resolve small
objects in an image
– Measured in lp/cm
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 32
Isotropic Imaging
• True 0.5mm Isotropic imaging
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 33
CT image quality
• Contrast resolution
– Ability to differentiate small density differences in an image
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 34
Post Processing Options
• Visualization of
vasculature in
relation to pathology
– Show course of vessels
– Show stent placement
– Define vascular stricture
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 35
Cervical Spine
Spiral Acquisition
Rotation – 0.75 sec
Coverage – 160 mm
Pitch – 0.875
Acq. Time – 36 sec
FOV – 250 mm
ST – 1.0 mm
Rec. Incr. – 0.6 mm
Std Res. – 8 lp/cm
120 kV, 200 mAs
CTDI100w – 39 mGy
CTDIFDAw – 17 mGy
Thin-Slice Spiral Neck
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 36
Neuro-Angiography
Circle of Willis
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 37
Thin-SliceSpiralLungs
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 38
MIP 4D-Angio
MasterCut
Panoramic View
RenalArteries
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 39
Ext. Spiral Acq.
Spiral Acquisition
UltraFast – 0.5 sec
Coverage – 1400mm
Pitch – 1.75
Acq. Time – 41.5 sec
FOV – 420 mm
ST –2.5 mm
Rec. Incr. – 1.6 mm
Std Res. – 8 lp/cm
120 kV, 96 mAs
CTDI100w – 7.3 mGy
CTDIFDAw – 4.9 mGy
Extended Spiral Acquisition
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 40
CT Scanners
• Provide a window into the body
• Customer considerations
– How many patients
– Referring physicians
– Budget
– Upgrade expectations
• Philips has ALL the answers
6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 41

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Basic principles of CT scanning

  • 1. 6/3/2014 1Hareesha N G, Dept of Aero Engg, DSCE
  • 2. The basics of CT • CT imaging chain • System components • Acquisition methods • Image quality • Applications 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 2
  • 3. X-ray: The beginning • X-Rays founded in 1895 by Wilhelm Conrad Roentgen 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 3
  • 4. CT: The beginning • CT founded in 1970 by Sir Godfrey Hounsfield – Engineer with EMI, LTD. – first applications were in neuroradiology 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 4
  • 5. CT Scanner • X-Ray modality used to the body in cross section • Used to determine – extent of trauma – location and type of tumors – status of blood vessels – pre surgical planning 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 5
  • 6. CT System 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 6
  • 7. CT System 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 7
  • 8. Basic CT scanner components • Gantry • X-Ray Tube • Detector • Control Console 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 8
  • 9. Gantry • CT X-ray tube • High voltage generator • Detector array • Data acquistion system • Slip ring 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 9
  • 10. The CT X-ray Tube • Anode heat capacity – 3.5 MHU up to 6.5 MHU • Determines maximum mAs • Determines volume length • Dictates generator size 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 10
  • 11. Detector Elements • Capture energy that has not been attenuated by the patient 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 11
  • 12. Control console • Set scan parameters – kVp, mA, scan time, reconstruction filter, etc. • Set scan mode – Digital radiograph, axial or volume • Houses reconstructor • Review and archive images • Post-processing 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 12
  • 13. CT • CT - Computed Tomography • CAT Scan - Computerized Axial Tomography 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 13
  • 14. Scanning methods • Digital projection – AP, PA, Lat or Oblique projection – Surview, Scanogram • Conventional CT – Axial • Start/stop • Volumetric CT – Helical or spiral CT • Continuous acquisition 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 14
  • 15. Digital Projection • X-ray tube and detector remain stationary • Patient table moves continuously – With X-rays “on” • Produces an image covering a range of anatomy – Similar to a conventional X-ray image, e.g. flat plate of the abdomen • Image used to determine scan location 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 15
  • 16. 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 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 16
  • 17. 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 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 17
  • 18. Volume Scanning: Pitch 1:1 2:1 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 18
  • 19. 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 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 19
  • 20. Fundamentals of Multislice CT 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 20
  • 21. 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 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 21
  • 22. Single Slice = One 10mm slice per rotation Dual Slice = Two 5mm slices per rotation Quad Slice = Four 2.5mm slices per rotation Multislice Effectiveness • Everything is better – Resolution 2x 4x-8x – Speed same same – Volume same same – Power same same Dual Quad 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 22
  • 23. . . single detector arc dual detector arc pre-patient collimation post-patient collimation x-ray tube focal spot ___ Mx8000 Dual Slice Dual Slice Detector Optimized for 2 Slice Acquisition 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 23
  • 24. Approximately 10% more efficient than matrix detectors Variable Wide Area Detector Asymmetrix™ Variable detector length Fixed detector length Quad Detector Technology • Philips patented variable wide area detector • Variable slice thickness – 4 x 1mm – 4 x 5mm – 4 x 2.5mm – 2 x 0.5mm – 2 x 8mm – 2 x 10mm 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 24
  • 25. 8 Element 2-D array 4 Slices Quad Technology How it works 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 25
  • 26. 2x0.5mm 4x1mm 4x2.5mm 4x5mm 2x10mm p-plane fused fused to FEE Asymmetrix™ Technology Variable slice thickness 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 26
  • 27. CT • CT attenuation information • CT image quality 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 27
  • 28. Attenuation • X-ray beam passes through patient • Each structure attenuates X-ray beam differently – According to individual densities • Radiation received by detector varies according to these densities 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 28
  • 29. Density information • Transferred from detector to CT computer (A to D converter) • Reconstructed by computer into a cross-sectional image – Displayed on screen – Each pixel displayed on monitor has varying brightness • The greater the attenuation, the brighter the pixel • The less attenuation, the darker the pixel 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 29
  • 30. Density information • Density values correspond to a range of numbers – Hounsfield scale 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 30
  • 31. Window settings • Window width – Determines range of CT numbers displayed on an image • Values above this range = white • Values below this range = black – Window level • Sets the center CT number displayed on the monitor • Determines the location on the Hounsfield scale about which the window width will be centered 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 31
  • 32. CT image quality • Spatial resolution – Ability to resolve small objects in an image – Measured in lp/cm 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 32
  • 33. Isotropic Imaging • True 0.5mm Isotropic imaging 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 33
  • 34. CT image quality • Contrast resolution – Ability to differentiate small density differences in an image 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 34
  • 35. Post Processing Options • Visualization of vasculature in relation to pathology – Show course of vessels – Show stent placement – Define vascular stricture 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 35
  • 36. Cervical Spine Spiral Acquisition Rotation – 0.75 sec Coverage – 160 mm Pitch – 0.875 Acq. Time – 36 sec FOV – 250 mm ST – 1.0 mm Rec. Incr. – 0.6 mm Std Res. – 8 lp/cm 120 kV, 200 mAs CTDI100w – 39 mGy CTDIFDAw – 17 mGy Thin-Slice Spiral Neck 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 36
  • 37. Neuro-Angiography Circle of Willis 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 37
  • 38. Thin-SliceSpiralLungs 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 38
  • 39. MIP 4D-Angio MasterCut Panoramic View RenalArteries 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 39
  • 40. Ext. Spiral Acq. Spiral Acquisition UltraFast – 0.5 sec Coverage – 1400mm Pitch – 1.75 Acq. Time – 41.5 sec FOV – 420 mm ST –2.5 mm Rec. Incr. – 1.6 mm Std Res. – 8 lp/cm 120 kV, 96 mAs CTDI100w – 7.3 mGy CTDIFDAw – 4.9 mGy Extended Spiral Acquisition 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 40
  • 41. CT Scanners • Provide a window into the body • Customer considerations – How many patients – Referring physicians – Budget – Upgrade expectations • Philips has ALL the answers 6/3/2014 Hareesha N G, Dept of Aero Engg, DSCE 41