University of Technology

Biomedical Engineering Department

Stage: 5th class –morning study
Branch: Medical Device

Medical device lab

" CT Scan "

By:
Ahmed Nasser Hussein
Abdullah Ayad Salim
Yousif AbdullKareem Yousif
Hussein Essam Adnan

2022 1443
1. Introduction
A CT scan or computed tomography scan is a medical imaging technique used in radiology to get detailed
images of the body noninvasively for diagnostic purposes. The personnel that perform CT scans are called
radiographers or radiology technologists.[1][2] CT scanners use a rotating x-ray tube and a row of
detectors placed in the gantry to measure X-ray attenuations by different tissues inside the body. The
multiple X-ray measurements taken from different angles are then processed on a computer using
reconstruction algorithms to produce tomographic (cross-sectional) images (virtual "slices") of a body.
The use of ionizing radiations sometimes restricts its use owing to its adverse effects. However, CT can
be used in patients with metallic implants or pacemakers where MRI is a contraindication. Since its
development in the 1970s, CT has proven to be a versatile imaging technique. While CT is most
prominently used in diagnostic medicine, it also may be used to form images of non-living objects. The
1979 Nobel Prize in Physiology or Medicine was awarded jointly to South African American physicist
Allan M. Cormack and British electrical engineer Godfrey N. Hounsfield "for the development of
computer-assisted tomography".[3]

Figure 1 A modern computed tomography

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2. Types

2.1 Spiral CT
Spinning tube, commonly called spiral CT, or helical CT, is an imaging technique in which an entire Xray
tube is spun around the central axis of the area being scanned. These are the dominant type of scanners on
the market because they have been manufactured longer and offer a lower cost of production and purchase.
The main limitation of this type of CT is the bulk and inertia of the equipment (X-ray tube assembly and
detector array on the opposite side of the circle) which limits the speed at which the equipment can spin.
Some designs use two X-ray sources and detector arrays offset by an angle, as a technique to improve
temporal resolution.[4][5]

2.2 Electron beam tomography

Electron beam tomography (EBT) is a specific form of CT in which a large enough X-ray tube is
constructed so that only the path of the electrons, travelling between the cathode and anode of the X-ray
tube, are spun using deflection coils. [6] This type had a major advantage since sweep speeds can be much
faster, allowing for less blurry imaging of moving structures, such as the heart and arteries. [7] Fewer
scanners of this design have been produced when compared with spinning tube types, mainly due to the
higher cost associated with building a much larger X-ray tube and detector array and limited anatomical
coverage. [8]

2.3 CT perfusion imaging

CT perfusion imaging is a specific form of CT to assess flow through blood vessels whilst injecting a
contrast agent. [9] Blood flow, blood transit time, and organ blood volume, can all be calculated with
reasonable sensitivity and specificity. [9] This type of CT may be used on the heart, although sensitivity
and specificity for detecting abnormalities are still lower than for other forms of CT. [10] This may also
be used on the brain, where CT perfusion imaging can often detect poor brain perfusion well before it is
detected using a conventional spiral CT scan. [9][11] This is better for stroke diagnosis than other CT
types. [11]

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3. Mechanism
Computed tomography operates by using an X-ray generator that rotates around the object; X-ray
detectors are positioned on the opposite side of the circle from the X-ray source.[12] As the X-rays
pass through the patient, they are attenuated differently by various tissues according to the tissue
density. A visual representation of the raw data obtained is called a sinogram, yet it is not sufficient
for interpretation. Once the scan data has been acquired, the data must be processed using a form of
tomographic reconstruction, which produces a series of cross-sectional images. These cross-sectional
images are made up of small units of pixels or voxels. Pixels in an image obtained by CT scanning are
displayed in terms of relative radio density. The pixel itself is displayed according to the mean
attenuation of the tissue(s) that it corresponds to on a scale from +3,071 (most attenuating) to −1,024
(least attenuating) on the Hounsfield scale. Pixel is a two dimensional unit based on the matrix size
and the field of view. When the CT slice thickness is also factored in, the unit is known as a voxel,
which is a three-dimensional unit. Water has an attenuation of 0 Hounsfield units (HU), while air is
−1,000 HU, cancellous bone is typically +400 HU, and cranial bone can reach 2,000 HU or more (os
temporale) and can cause artifacts. The attenuation of metallic implants depends on the atomic number
of the element used: Titanium usually has an amount of +1000 HU, iron steel can completely
extinguish the X-ray and is, therefore, responsible for well-known line-artifacts in computed
tomograms. Artifacts are caused by abrupt transitions between low- and high-density materials, which
results in data values that exceed the dynamic range of the processing electronics. Two-dimensional
CT images are conventionally rendered so that the view is as though looking up at it from the patient's
feet.[13] Hence, the left side of the image is to the patient's right and vice versa, while anterior in the
image also is the patient's anterior and vice versa. This left-right interchange corresponds to the view
that physicians generally have in reality when positioned in front of patients. Initially, the images
generated in CT scans were in the transverse (axial) anatomical plane, perpendicular to the long axis
of the body. Modern scanners allow the scan data to be reformatted as images in other planes. Digital
geometry processing can generate a three-dimensional image of an object inside the body from a series
of two-dimensional radiographic images taken by rotation around a fixed axis. These cross-sectional
images are widely used for medical diagnosis and therapy. [14]

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 Figure 2 CT scanner with cover removed to show internal components. Legend:

T: X-ray tube, D: X-ray detectors, X: X-ray beam ,R: Gantry rotation

4. Components of the CT Scanners

CT scanners are composed of many different connected parts, with many different components
involved in the process of creating an image. More to the complexity, different CT scan manufacturers
often modify the design of various components. To understand the basic function of each components,
and some of the major variations in their design. From a broad perspective, all make and models of
CT scanner are similar in that they consist of a scanning gantry, x-ray generator, computer system,
operator’s console or the console panel and physician’s viewing console. Although hard copy filming
has largely been replaced by workstation viewing and electronic archiving, most CT system still
include a laser printer for transferring CT images to film. Data are acquired when the x-ray pass
through a patient to strike a detector and are recorded. The major components that are involved in this
phase of image creation are the gantry and the patient table.

4.1 GANTRY
The gantry is the donut like or ring shaped part of the CT scanner. It houses many of the components
necessary to produce and detect x-rays. These components are mounted on a rotating scan frame. The
gantry houses many of the components necessary to produce and detect x-rays. The gantry cover is
removed on this third-generation scanner configuration to reveal the components necessary for data
acquisition, including the x-ray tube and detector array. Image courtesy of Siemens AG.
Component of the gantry are mounted on a rotating scan frame. Gantries vary in total size as well as in
the diameter of the opening or aperture. The range size of aperture is typically 70 to 90 cm. The gantry
is designed to be tilted either forward or backward as needed to accommodate a variety of patients and
examination protocols. The gantry can be tilted varies among systems, but more or less 15 degrees to
30 degrees is usual. The gantry also include a laser light that is used to position the patient within the

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scanner. Control panels located on either side of the gantry opening allow the radiologic technologist
to control the alignment lights, gantry tilt, and movement of the table. In most scanners, these functions
may also be controlled via the operator’s console. A microphone is installed in the gantry to allow
communication between the patient and the radiologic technologist throughout the scanning procedure.

4.2 Slip Rings

Old model design CT scanner used recoiling system cables to rotate the gantry frame. This design
limited the scan method to the step and shoot mode and considerably limited the gantry rotation times.
Newer systems use electromechanical devices called slip rings. Slip rings use a brush like apparatus to
provide continuous electrical power and electronic communication across a rotating surface. They
permit the gantry frame to rotate continuously, eliminating the need to straighten twisted system cables.
Slip rings allows the gantry frame to rotate continuously making helical scan modes possible.

4.3 Generator
High frequency generator is currently used in CT scanners. The generator are designed to be small
enough so that it can be located within the gantry. Highly stable 3-phase generators have also been
used, but because these are stand-alone units located near the gantry and require cables, they have
become obsolete.
Generators produce high voltage and transmit it to the x-ray tube. The power capacity of the generator
is listed in kilowatts (kW). The power capacity of the generator determines the range of exposure
techniques like kV and mA settings, available on a particular system. CT generator produce high kV
generally 120 – 140 kV to increase the intensity of the beam and thereby reduce patient dose. In
addition, a higher kV setting will help to reduce the heat load on the x-ray tube by allowing a lower
mA setting and reducing the heat load on the x-ray tube will extend the life of the tube.

4.4 Cooling Systems

Cooling mechanisms are included in the gantry. They can take different forms, such as blowers, filters,
or devices that perform oil to air heat exchange. Cooling mechanisms are important because many
components can be affected by temperature fluctuations.

4.5 X-ray Source – CT X-ray tube

X-ray tubes produce the x-ray photons that create the CT image. Their design is a modification of a
standard rotating anode tube, such as the type used in angiography. Tungsten, with an atomic number
of 74, is often used for the anode target material because it produces a higher intensity x-ray beam. This
is because the intensity of x-ray production is approximately proportional to the atomic number of the
target material. CT scan tubes often contain more than one size of focal spot; 0.5 and 1.0 mm are the
common size of focal spot. Just like as in standard x-ray tubes, because of reduced penumbra small
focal spot in Computed tomography tubes produce sharper images like better spatial resolution, but
because they concentrate heat onto smaller area of the anode they cannot tolerate as much of the heat.
A very large amount of stress is places on the CT scan tube. Scanning protocols often require multiple
long exposures performs on numerous patients per day. A CT scan tube must be designed to handle
such stress. The way a tube dissipate the heat that is created during x-ray production is critical. All
manufacturers list generator and tube cooling capabilities in their product specifications. These
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specification usually list the system generator’s maximum power in kW. Also listed is the anode hear
capacity in million hear units MHU and the maximum anode heat dissipation rate in thousand heat units
KHU. These specification can be help to differentiate the various CT Scan systems. It is important to
remember that these values represent the highest limit of tube performance. It is also important to
compare the length of protocols that the tube will allow and how quickly they can be repeated.

4.6 Filtration
Compensating filters are used to shape the x-ray beam. They reduce the radiation dose to the patient
and help to minimize image artifact. As our teachers tough us that, radiation emitted by CT scan x-ray
tube is polychromatic. Filtering the x-ray beam helps to reduce the range of x-ray energies that reach
the patient by removing the long wavelength or soft x-rays. These long-wavelength x-rays are readily
absorbed by the patient, therefore they do not contribute to the CT image but do contribute to the
radiation dose to the patient. In addition, creating a more uniform beam intensity improves the CT
image by reducing artifacts that result from beam hardening. Filtering the x-ray beam helps to reduce
the radiation dose taken by the patient and it also improves the image quality of the CT scanners.
Different filters are used when scanning the body then when scanning the head. Human body anatomy
having distinctive quantities has a round cross section that is thicker in the middle than in the outer
area. Hence, body scanning filters are used to reduce the beam intensity at the periphery of the beam,
corresponding to the thinner areas of a patient’s anatomy. Because of their shape they are often referred
to as bow tie areas.

Figure 3 Filtering shapes the x-ray beam intensity. Removing low-energy x-rays minimizes

Patient exposure and produces a more uniform beam.

4.7 Collimation
Collimation restrict the x-ray beam to a specific area, as a result it helps reduce scatter radiation. This
scatter radiation reduces image quality and increase the radiation dose to the patient. Reducing the
scatter radiation improves contrast resolution and decrease patient dose. Collimation control the slice
thickness by narrowing or widening the x-ray beam. The source collimator is located near the x-ray
source and limits the amount of x-ray beam before it passes through the patient it is sometimes referred
to as patient dose and determines how the dose is distributed across the slice thickness like the dose
profile. The source collimation resembles small shutters with an opening that adjusts, dependent on the

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operator’s selection of slice thickness. In MDCT systems, slice thickness is also influenced by the
detector element configuration. Scanner vary in the choices of slice thickness available. Choices range
from 0.5 to 10 mm.

4.8 Detectors
The detectors is a component of CT scan machine which collect information regarding the degree to
which each anatomic structure attenuated the beam. In Conventional radiography we used a film screen
system to record the attenuated information. In CT, we use detectors to collect the information. The
term detector refers to a single element or a single type of detector used in a CT system. The term
detector array is used to describe the entire collection of detectors included in a CT scan system.
Specifically the detector array comprises detector elements situated in an arc or a ring, each of which
measures the intensity of transmitted x-ray radiation along a beam projected from the x-ray source to
that particular detector element. Also, included in the array are elements referred to as reference
detectors that help to calibrate data and reduce artifacts.

4.8.1 TYPES OF DETECTORS

4.8.1.1 Xenon Gas Detectors
Pressurized xenon gas fills hollow chamber to produce detectors that absorb of approximately 60% to
87% of the photons that reach them. Xenon gas is used because of its ability to remain stable under
pressure. Xenon gas are significantly less expensive compared with the solid – state variety, it is also
somewhat easier to calibrate and are highly stable.

A xenon detector channel consists of 3 tungsten plates. When a photon enters the channel, it ionizes the
xenon gas. These ions are accelerated and amplified by the electric field between the plates. The
collection charge produces an electric current. This current is then processed as raw data. A
disadvantage of xenon gas is that it must be kept under pressure in a certain extent. Loss of xray photons
in the casing window and the space taken up by the plates are the major factors hampering detector
efficiency.

Figure 4 Structure of a xenon gas detector array.

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4.8.1.2 Solid State Crystal Detector
Solid state detectors are also called scintillation detectors because they use a crystal that fluoresces
when struck by a x-ray photon. A photodiode is attached to the crystal and transforms the light energy
into electrical (analog) energy. The individual detector elements are affixed to a circuit board.

Structure of a solid-state detector array.

Solid state crystal detectors have been made from a variety of material, including cadmium tungstate,
bismuth germinate, cesium iodide, and ceramic rare earth compounds such as gadolinium or yttrium.
Because these solids have high atomic numbers and high density in comparison to gases, solid state
detectors have higher absorption coefficients. They absorb nearly 100% of the photons that reach them.

5. Difference between an X-Ray and a CT scan

While the difference between CT scan and x-ray is minor, it’s also significant. Doctors use x-rays to
detect dislocations and fractures of bones as well as detect cancers and pneumonia. However, CT scans
are a type of advanced x-ray devices doctors use for diagnosing internal organ injuries, using x-ray
images of the structure and a computer.
X-ray machines in some cases fail to diagnose problems with muscle damage, soft tissues or other body
organs, but with the CT scan, it’s entirely possible. X-ray images are in 2D, while CT scan images are
3D. The CT scanning machine rotates on an axis and takes various 2D images of an individual’s body
from multiple angles. Then, the computer will place all the cross-sectional images together on its
screen, resulting in a 3D image of the body’s inside, revealing the presence of injury or disease to the
doctor.

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6. References
[1] Patient Page". ARRT – The American Registry of Radiologic Technologists. Archived from
the original on 9 November 2014.
[2] Individual State Licensure Information". American Society of Radiologic Technologists.
Archived from the original on 18 July 2013. Retrieved 19 July 2013.
[3] "The Nobel Prize in Physiology or Medicine 1979". NobelPrize.org. Retrieved 2019-08-10.
[4] Fishman, Elliot K.; Jeffrey, R. Brooke (1995). Spiral CT: Principles, Techniques, and
Clinical Applications. Raven Press. ISBN 978-0-7817-0218-8.
[5] Hsieh, Jiang (2003). Computed Tomography: Principles, Design, Artifacts, and Recent
Advances. SPIE Press. p. 265. ISBN 978-0-8194-4425-7.
[6] Stirrup, James (2020-01-02). Cardiovascular Computed Tomography. Oxford University
Press. ISBN 978-0-19-880927-2.
[7] Talisetti, Anita; Jelnin, Vladimir; Ruiz, Carlos; John, Eunice; Benedetti, Enrico; Testa,
Giuliano; Holterman, Ai-Xuan L.; Holterman, Mark J. (December 2004). "Electron beam
CT scan is a valuable and safe imaging tool for the pediatric surgical patient". Journal of
Pediatric Surgery. 39 (12): 1859–1862. doi:10.1016/j.jpedsurg.2004.08.024. ISSN
15315037. PMID 15616951.
[8] Retsky, Michael (31 July 2008). "Electron beam computed tomography: Challenges and
opportunities". Physics Procedia. 1 (1): 149–154. Bibcode:2008PhPro...1..149R.
doi:10.1016/j.phpro.2008.07.090.
[9] Jump up to:a b c Wittsack, H.-J.; Wohlschläger, A.M.; Ritzl, E.K.; Kleiser, R.; Cohnen, M.;
Seitz, R.J.; Mödder, U. (2008-01-01). "CT-perfusion imaging of the human brain:
Advanced deconvolution analysis using circulant singular value decomposition".
Computerized Medical Imaging and Graphics. 32 (1): 67–77.
doi:10.1016/j.compmedimag.2007.09.004. ISSN 0895-6111. PMID 18029143.
[10] Williams, M.C.; Newby, D.E. (2016-08-01). "CT myocardial perfusion imaging: current
status and future directions". Clinical Radiology. 71 (8): 739–749.
doi:10.1016/j.crad.2016.03.006. ISSN 0009-9260. PMID 27091433.
[11] Jump up to:a b Donahue, Joseph; Wintermark, Max (2015-02-01). "Perfusion CT and acute
stroke imaging: Foundations, applications, and literature review". Journal of
Neuroradiology. 42 (1): 21–29.
[12] "Computed Tomography (CT)". www.nibib.nih.gov. Retrieved 2021-03-20.
[13] Computerized Tomography chapter Archived 2016-03-04 at the Wayback Machine at
University of Connecticut Health Center.
[14] "computed tomography – Definition from the Merriam-Webster Online Dictionary".
Archived from the original on 19 September 2011. Retrieved 18 August 2009.

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