Intro.

to
Computed
Tomography
Technology

Mohammed Abba, B. Rad, M.Sc., PhD

 INTRODUCTION
• Computed Tomography (CT) is an advanced medical
imaging technique that uses X-rays and computer
processing to create detailed, 3D images of the body.

• It provides vital information for diagnosis and treatment

planning, playing a crucial role in modern healthcare.
• The formation of CT image by CT
scanner is achieved in 3steps:
• Data Acquisition,
• Image Reconstruction, and
• Image Display, Manipulation,
Storage, and Recording.
How CT Scanners Work
◼ Turn scanner power ON
◼ Perform a quick test to make sure scanner is working
properly “Fast Calibration”
◼ Place the patient in the scanner bore (opening) / setup
depending on exam.
◼ Technical factors are setup by the Radiographer at the
console
◼ X rays are directed into the patient and collected by the
opposite detectors
What happens when x-ray passes through the
patient?
◼ Attenuated and measured by the detector.
◼ XRT and detectors are hidden inside the gantry of scanner and rotate
around patient during scanning
◼ Detector converts x ray photons into electrical signals (digital) b4 it
can be an input on computer
◼ Computer performs Image Reconstruction process
◼ Reconstructing an image is in numerical form and must be converted into
electrical signal so it can be displayed on a television monitor for viewing
◼ Image can be stored on magnetic tapes or optical disks and
recorded on x-ray film
 O verview of Computer Hardware and Software

Computer Hardware Computer Software Hardware-Software

Integration
• Computers are • Computer software
comprised of various includes • Efficient integration of
hardware • Operating Systems, hardware and software is
components such as • Application programs, crucial for the effective
the and operation of CT systems,
• CPU, • Device drivers that • Ensuring seamless data
• M emory, storage enable the hardware acquisition, processing,
devices, and to function and and image reconstruction.
• Input/output provide users with
peripherals. various capabilities.
What is a Computer System

◼ A machine for solving problems

◼ High-speed electronic computational machine that accepts
information in the form of data and instructions (though an input)
and process the information by performing arithmetic and logic
operations using a program stored in its memory
◼ Results of the process can be displayed/stored/recorded/transmitted
Three Components
◼ Hardware:
◼ physical component of the machine, input devices, output devices,
processing hardware
◼ Software:
◼ Instructions to solve the problem
◼ User/operator :
◼ Design hardware/software and operate the machine
Software
◼ The hardware receives instruction from the software ( instruction =
written step by step how to solve the problem/programs)
Three types:
◼ Systems software- start up, coordinate the activities
◼ Applications software- programs we run or use on the computer
◼ Software development tool- programming languages
History of Computers
◼ 1642 the abacus, counting machine
◼ 1694, calculating machine (multiplication and
division)
◼ 1890 – punch card machine
◼ Rapid development till Howard Aiken’s MARK1 (large
electromechanical calculator)
◼ 1951, UNIVAC – universal automatic computer (first
commercially available)
◼ Today's computers are fifth generations
◼ Generation – a period of significant technical
developments in hardware and software
Computer Generations

1st: 1951-1958, large, slow, heat during operation, housed

in an air-conditioned room

2nd: 1959-1963, solid-state devices (transistors and

magnetic cores) for internal memory, less heat, smaller,
less power for operation

3rd: 1963-1970, integrated circuit, silicon chips/use of

magnetic disks for storage (several programs processed
at the same time) , faster, smaller, more reliable
Generations
4th: 1971-1987, 1000’s of integrated circuits on chip

5th: 1987-date, gallium based circuitry instead of silicon, parallel processing,

many processors are used to operate on data at the same time

◼ These computer developments affected development in other technologies

and medical imaging is a important example
Classification

◼ Depending on their processing capabilities

◼ Supercomputers-large, high capacity, processes data at
extremely high speed
◼ Use: weather forecasting, oil exploration, scientific modeling
CRAY2, one of the fastest computers available today
Cont.
◼ Mainframe Computers- large, high speed computation, large
memories, terminals enable multiple users access to primary
memory (use in banks, universities) Millions of Instructions Per
Second
◼ multiple operating systems, and thereby operate not as a single computer but as
a number of virtual machines. In this role, a single mainframe can replace
dozens or even hundreds of smaller servers.
Cont.
◼ Minicomputers- mid level computer built to perform
complex computations while dealing with high level of input
and output for users connected via terminals (multi user
computer) much smaller than mainframes (fill a room)
◼ minicomputers will be discussed more when we talk about CT
components
Cont.
◼ Microcomputers- small digital computers/ personal computers,
built so all circuitry is placed in a single chip or multiple circuit
boards (microprocessor, central processing unit CPU)
◼ Microprocessor is a digital integrated circuit that processes data, controls work
of microcomputer
◼ The processing capability is related to number of bits, binary digits(0 and 1)used
to represent data
Cont.
◼ 8-bit (28)processor = represents 256 numbers
◼ 16-bit (216) processor = 65,536 numbers can be represented
◼ 32-bit(232)
◼ 2 types of computers Digital and Analog

◼ Digital operate on digital data (discrete units) and analog operate on continuous
physical quantities

◼ Digital computes are most common, they operate on digital data through arithmetic
and logic operations, used in radiological applications, its important that we
understand the nature of digital systems
Numbering Systems
◼ Decimal numbers system = based on ten
◼ 0,1,2,3,4,5,6,7,8,9
◼ Any number written must be a sum of these digits
multiplied by 10x
◼ Example 321
◼ Unit/tens/hundreds/thousands/ten thousands/hundreds
thousands/million
Why
◼ When we enter information on computer, the characters we
use are converted into binary codes, two famous ones are
ASCII and EBCDIC
Computers in Radiology

◼ 1955, to calculate radiation dose

distribution in cancer patients
◼ Mathematical approaches in radiology
◼ Two categories: imaging and no imaging
Imaging
◼ Information from the patient needs
processing
◼ Digital image processing techniques
◼ Digital images: digital radiography, digital
fluoroscopy, MRI, CT
Non-imaging
◼ Radiology information system (RIS), like patient admission, billing,
film library, word processing..
◼ An electronic system for archiving, transmitting, viewing, and
manipulating images
◼ (Picture Archiving and Communication Systems PACS) HIS
(hospital information system)
◼ Mechanical view boxes are being replaced by workstations
◼ workstation = powerful stand alone computer with high graphic
capability
Data Acquisition
◼ Collection of x ray transmission measurements
◼ After passing through patient they fall onto detectors
◼ Detector measures the attenuation value
◼ Reconstruct an image, enough data needed (transmission
measurements)
◼ Data collection scheme: Example
◼ tube & detector move in a straight line (translate) across
body part (from left to right); after collecting number of
transmission measurements they rotate 1 degree and start
again bt from right to left
◼ Translate-rotate-stop-rotate (repeated 180 times) 180°
◼ More efficient scanning schemes were developed
Image Reconstruction
◼ After enough transmission measurements (detector)
◼ Sent to the computer for processing
◼ Computer (uses mathematical techniques to reconstruct the CT image)
◼ Reconstruction algorithms (example: algebraic reconstruction technique)
◼ Need: minicomputer and microprocessors for performing the function/ or array
processors for calculations.
Image Display/Manipulation/Storage/Recording

◼ After image reconstruction

◼ Image displayed on CRT (cathode ray tube), best for a gray scale image
◼ These monitors are on the console allowing the Radiographers and radiologist
(doctors console)
◼ Manipulation: transverse axial images can be reformatted into coronal , sagital, and
paraxial sections./ and three dimensional processing
◼ Storage: magnetic tapes and magnetic disks and optical storage.
Principles of D igital Image
Acquisition
Digitization
The process of converting an analog image into a digital format, consisting of
a grid of pixels with defined intensity values.

Spatial Resolution
The number of pixels per unit length, determining the level of detail and
sharpness in the digital image.

Bit Depth
The number of bits used to represent the intensity value of each pixel,
affecting the range and precision of color/grayscale information.
Digital Image Processing Techniques

1 Image Segmentation 2 Filtration

Separating an image into distinct regions Applying filters to reduce noise, sharpen
or objects, enabling focused analysis and edges, or enhance specific image
feature extraction. characteristics for improved diagnostics.

3 Image Enhancement 4 Pattern Recognition

Adjusting contrast, brightness, and Identifying and classifying specific
dynamic range to improve visual clarity structures, lesions, or abnormalities within
and accentuate relevant details. the image for accurate diagnosis.
Image Reconstruction Algorithms
Computed Tomography (CT) imaging relies on sophisticated image reconstruction algorithms to
transform the raw data acquired during the scanning process into high-quality, three-dimensional images
of the patient's anatomy. These algorithms play a crucial role in ensuring the accuracy and diagnostic
value of CT scans.

Image Quality Computational E fficiency

The chart compares the performance of key image reconstruction algorithms in terms of image quality
and computational efficiency. E ach algorithm has its strengths and trade-offs, and the choice of
algorithm is often a balance between image fidelity and processing time.
Radiation Dose Considerations in CT
Imaging

Dose Optimization Dose Variability Patient-Centered

• CT imaging employs • Radiation doses can vary
Approach
ionizing radiation, so significantly depending on • CT protocols are tailored to
ensuring appropriate dose the type of CT exam, individual patients,
levels is critical. patient characteristics, and considering factors like age,
• Sophisticated dose- scanning parameters. size, and clinical indication.
reduction techniques are • Careful dose monitoring • This personalized approach
used to balance image and adjustment is essential helps minimize radiation
quality and radiation for patient safety. exposure while obtaining
exposure. diagnostic-quality images.
 Clinical Applications of CT Imaging
• Computed Tomography (CT) imaging has a wide range of
clinical applications, from
• Diagnosing and monitoring various medical conditions to
• Guiding surgical procedures.

• CT scans provide detailed, cross-sectional images of the

body, allowing healthcare professionals to identify and
analyze abnormalities with high accuracy.

• It is commonly used to evaluate traumatic injuries, detect

cancers, assess organ function, and monitor the progression
of chronic diseases.

• It is also an essential tool for pre-operative planning and

image-guided interventions, improving patient outcomes
and reducing surgical complications.
Emerging Trends and Future Developments in CT
Technology
• The field of CT imaging is rapidly evolving, with exciting new developments on the
horizon.
• Advances in detector technology, reconstruction algorithms, and data processing
are enabling faster scans, lower radiation doses, and higher image quality.

• Dual-energy CT allows for material differentiation, while

• Spectral CT promises even more detailed tissue characterization.

• Researchers are also exploring the integration of AI and machine learning

techniques to enhance image interpretation, automate analysis, and support
clinical decision-making.

• Emerging 4D CT and dynamic CT techniques provide valuable functional

information, opening up new diagnostic and monitoring capabilities.
H andling emergencies in CT
1 Patient Distress
Remain calm and attend to any patient who becomes distressed during the
CT scan, providing reassurance and adjusting the procedure as needed.

2 Power Failure
In the event of a power outage, follow emergency protocols to safely
evacuate the patient and secure the CT scanner until power is restored.

3 Equipment M alfunction
Quickly identify and address any equipment issues, such as a
malfunctioning gantry or table, to prevent harm to the patient and ensure the
safety of the procedure.
Contraindications in CT
Pregnancy Renal Allergies Metal Implants
Impairment
Pregnant women Individuals with Patients with certain
should avoid CT Patients with severe known allergies to metallic implants,
scans due to the renal impairment iodinated contrast such as
potential risks of may be at increased media should not pacemakers or
ionizing radiation risk of contrast- undergo CT scans defibrillators, may
exposure to the induced with contrast, as face safety risks or
developing fetus, nephropathy they may image distortion
unless the benefits following CT with experience adverse during CT scans,
clearly outweigh the contrast media, reactions like necessitating
risks. requiring careful anaphylaxis. alternative imaging
evaluation and techniques.
monitoring.