Computed Tomography

(Basics, generations and post processing)

CT scanners are
complex X ray
machines
attached to
computers
using complicated
mathematics to
build up
images of our insides.
 Matrix
 The image is
represented as a
MATRIX of numbers.
 Matrix :- A two
dimensional array of
numbers arranged in
rows and columns.
 Each number
represents the value
of the image at that
location
 VOXEL

 Each individual
element or number in
the image matrix
represents a three
dimensional volume
element in the object,
called a VOXEL
 PIXEL
 The VOXEL is
represented in the
image as a two-
dimensional element
called PIXEL -
(picture element)
 CT numbers
 The numbers in the
image matrix are
called CT numbers.

 Each pixel has a

number which
represents the x-ray
attenuation in the
corresponding voxel
of the object
 Visual image & Gray Scale
 To obtain a visual
image, the CT
numbers are
assigned different
shades of gray on a
gray scale.
 Each shade of gray
represents the x-ray
attenuation within the
corresponding voxel
The patient is placed on a bed
The scanner (X ray machine) is the shape of a ring

The patient is slowly moved through the ring

as the scan takes place…
 X ray tube
X Rays are
produced in an
X ray tube, pass
through the
patient and are
detected by the
detector
Patient

The scanner
rotates the X ray
tube and
detector so the
patient is
scanned from all
angles
X ray detector
 There are no photographic plates in CT scanners. All images are
created by computers using the information they receive from the
x-ray detector
ribs

spine

The image produced is like a “slice” through the

body.
 CT Image
• Not produced on film
• Mathematically reconstructed from many
projection measurements of radiation intensity
• Digital Image calculated

Acme
Mini-
Compu-
ter
Digital Image
Measure Intensity of a Pencil Beam

X-Ray
Source

Radiation
Detector
 CT Image
• Measure a bunch of pencil beam intensities
 CT Image
• Now make measurements from every
angle
 CT Image
• When we get done, multiple pencil
beams have gone through every point
in body
 Image Reconstruction
X-Ray
Source

Acme
Mini-
Computer

Radiation Pixel
Detector (calculated)
Data
Projection
(raw)
Data
 Digital Image
2-dimensional array of individual image
points calculated
each point called a pixel
picture element
each pixel has a value
value represents x-ray transmission
(attenuation)
 Digital Image Matrix

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

 Numbers / Gray Shades
Each number of a digital image
corresponds to a gray shade for one
pixel
 Data Acquisition
• cross sectional image reconstructed from
many straight line transmission measurements
made in different directions

Tube

Detector
 Phases of CT imaging
1. Scanning the patient
2. Data Acquisition
I. Tube or tube and detector move
II. Multiple attenuation measurements are
taken around the object
3. Image reconstruction
4. Image Display
5. Image archival (recording)
 DATA ACQUISITION
 Basic components
 X-ray tube
 filters
X-ray
 Collimators Collimators
tube
 Detector/s Detector
 Collimated x-ray beam
traverses the object and
enters the detector.
 The attenuation is
determined from the
difference between
incident intensity and
transmitted intensity.
Filters
• Absorb low energy x rays that does not
contribute to acquisition of ct image
• Pt dose is reduced
• Beam quality improves, more penetrating—
beam hardening
• Produce more uniform x ray beam
Collimators
• Decrease the penumbra
• Decrease the scatter
• X-ray beam is collimated at 2 points
• Close to x-ray tube—to decrease the penumbra
• Close to the detectors—to control scatter radiation

• It also control slice thickness

• Detectors
• Scintillation
• Xenon gas ionization chamber

Scintillation detector
• Used in third and fourth generation scanners
• These crystals produce light when ionising radiation
reacts with them
• Crystals used are
– NaI
– CsI
– Bismuth germnate
– Cadmium tungstate-m/c used
• When x-rays are absorbed by the crystals

• Crystals produce flash of light

• Light is directed to photo multiplier tube

• Light strikes photocathode to produce electrons

• Electron cascade through a series of dynodes and as they

do more and more electrons are generated

• Electron amplification-Large number of electrons are

produced--Constitute output signal
• Amount of light produced by crystal is
proportional to energy of absorbed x-rays
• No of electron emitted by photocathode is
proportional to amount of light falling on it
NaI problems
• Hygroscopic and requires an airtight container
• Very long after glow

Photo multiplier tube have been replaced with

silicon photodiodes
Scintillation crystal detector used in I & II gen. CT scanners
Scintillation crystal detector used in III and IV gen. CT scanners
Detector Cross-talk
• Detector cross talk occurs when a
photon strikes a detector, is
partially absorbed and then enters
the adjacent detector and is
detected again.

• Crosstalk produces two weak and

signals coming from two different
detectors.

• Crosstalk is bad because it

decreases resolution.

• Crosstalk is minimized by using a

crystal that is highly efficient in
absorbing X-rays (high stopping
power).
Xenon gas ionization chamber
• X-ray photon enters the chamber

• Ionizes the gas atom into electron and ion

• Electron moves towards the anode and ion move

towards the cathode

• Electron reaches the anode,they produce a small

current in the anode

• Output signal from detectors

• Gas filled detectors may operate in one of the 3 modes
• Low-only negative ions produced by cathode are
collected by anode
• High-ions moving under the influence of voltage
acquire sufficient energy to produce secondary
ionization of gas atoms
• Output signal is proportional to the energy of photons

Very high-secondary ionisation is very high and the

energy is proportionally lost—all incoming photons
register same size signal—large signals are easily
recordable
 Gas filled detector’s efficiency
Gas filled detectors are less efficient than solid state detectors.
The problem can be partially overcome by the following 3 ways.
• By using Xenon (z=54), the heaviest of the inert gases
• By compressing the Xenon 8 to 11 atmospheres to increase its density
• By using a long chamber to increase the number of atoms along the
path of the beam. Anode-copper, cathode--tantalum
 Disadvantage of Xenon gas detector

Efficiency - 50 to 60%

This low efficiency is caused by two factors.

• Low density of the absorbing material
• Absorption of X-rays by the front window, which is
needed to contain the high pressure gas
 Translate rotate system

 In the basic CT
system the x-ray
tube and detector
are translated
linearly so that the
beam scans the
object (eg. A disc of
uniform density)
 Ray, Ray sum, View & Attenuation Profile
Ray – Imaginary line
between Tube &
Detector Ray sums
Ray
Ray Sum – Attenuation
along a Ray
View – The set of ray
sums in one direction

The attenuation for each

ray sum when plotted View Attenuation
as function of its profile
position is called an
attenuation profile
 Attenuation profile of different
structures
 Attenuation of objects
with different
densities will change
the attenuation profile

Object with low

attenuation

Object with high

attenuation
 Attenuation profile at different
positions
 In a translate –rotate
CT, after a view is
recorded, the tube
and detector rotate a
small angle and the
entire process is
repeated until many
views have been
recorded for the same
slice
Views & attenuation profiles for a slice

2
4
3
 CT Early Units/first generation

• 4 minute scans
• 5 minute reconstruction
• 80 X 80 matrix
• head only
– water bag fit tightly around
head
 Beam Translation

• beam collimated to small round spot

– collimated at tube and collimator

X-ray
Tube

Detector
 Beam Translation
• Tube/detector translates left to right
• Entire assembly rotates 1o to right
• Tube/detector translates right to left

X-ray
Tube

Detector
 Translate - Rotate
• 180 translations in alternate directions
• 1 degree rotational increments between
translations
 Projection Measurements

• Radiation detector generates a

voltage proportional to radiation
intensity
 Image Reconstruction
• Minicomputer does its thing
Analog to Digital
(A to D)
conversion
 Digital Image Matrix
Digital Matrix contains many numbers which may
be
Displayed on CRT
Manipulated
Stored
125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

• The original 1971 prototype took 160 parallel readings
through 180 angles, each 1° apart, with each scan taking a
little over five minutes. The images from these scans took 2.5
hours to be processed by algebraic reconstruction techniques
on a large computer.

• The first production X-ray CT machine (called the EMI-

Scanner) was limited to making tomographic sections of the
brain, but acquired the image data in about 4 minutes
(scanning two adjacent slices) and the computation time was
about 7 minutes per picture.

• This scanner required the use of a water-filled Perspex tank

with a pre-shaped rubber "head-cap" at the front, which
enclosed the patient's head. The water-tank was used to
reduce the dynamic range of the radiation reaching the
detectors (between scanning outside the head compared with
scanning through the bone of the skull).
EMI scanner
 Tomosynthesis

• Simple motion of a tube and Detector was used

before CT to create images at a given depth.
• All anatomy not at the target level was blurred. This
gave a somewhat crude image and was quickly
replaced by CT.
• With the advent of digital detectors and the ability
to post process this imaging method is making a
comeback.
 2nd Generation CT

• arc beam used instead Tube

of pencil beam
• several detectors
instead of just one
– detectors intercepted arc
Detectors
– radiation absorbent
septa between detectors
• reduced scatter
• acted like grid
 2nd Generation CT
10o
• arc beam allowed 10
degree rotational
increments
• scan times reduced
– 20 sec - 2 min
• 2 slices obtained
simultaneously
– double row of detectors
 1st & 2nd generation

• In the first and second generation designs, the X-ray beam

was not wide enough to cover the entire width of the 'slice' of
interest.
• A mechanical arrangement was required to move the X-ray
source and detector horizontally across the field of view.
• After a sweep, the source/detector assembly would be
rotated a few degrees, and another sweep performed.
• This process would be repeated until 360 degrees (or 180
degrees) had been covered. The complex motion placed a
limit on the minimum scan time at approximately 20 seconds
per image.
3rd Generation CT

• Wide angle fan beam

• rotational motion only /
no translation
– detectors rotate with tube

• 30o beam
• Many more detectors
• scan times < 10 seconds
 3rd Generation CT

Z-axis orientation
perpendicular to plane

Patient
 4th Generation CT
• Fixed annulus of detectors
– tube rotates (no translation)
inside stationary detector ring
• only a fraction of detectors
active at once
 3rd & 4th Generation (Non-spiral) CT
Tube rotates once around patient
Table stationary
data for one slice collected

Table increments one slice thickness

Repeat
Tube rotates opposite direction
 3rd / 4th Generation Image Quality
Improvements

• Faster scan times

– reduces motion artifacts
• Improved spatial resolution
• Improved contrast resolution
• Increased tube heat capacity
– less wait between scans / patients
– better throughput
 3rd & 4th generation

• In the 3rd and 4th generation designs, the X-

ray beam is able to cover the entire field of
view of the scanner.
• This avoids the need for any horizontal
motion; an entire 'line' can be captured in an
instant.
• This allowed simplification of the motion to
rotation of the X-ray source.
• Third and fourth generation designs differ in
the arrangement of the detectors.
• In 3rd generation, the detector array is as wide
as the beam, and must therefore rotate as the
source rotates.
• In 4th generation, an entire ring of stationary
detectors are used.
 Electron Beam CT

• It is a method of improving the temporal resolution

of CT scanners.

• Because the X-ray source has to rotate by over 180

degrees in order to capture an image the technique
is inherently unable to capture dynamic events or
movements that are quicker than the rotation time.
• Instead of rotating a conventional X-ray tube around the
patient, the EBCT machine houses a huge vacuum tube in
which an electron beam is electro-magnetically steered
towards an array of tungsten X-ray anodes arranged circularly
around the patient.

• Each anode is hit in turn by the electron beam and emits X-

rays that are collimated and detected as in conventional CT.

• The lack of moving parts allows very quick scanning, with

single slice making the technique ideal for capturing images of
the heart.

• EBCT has found particular use for assessment of coronary

artery calcium, a means of predicting risk of coronary artery
disease.
 Cine CT (Imatron)
four tungsten target rings surround
patient
replaces conventional x-ray tube
no moving parts
like 4 moving focal spots
electron beam sweeps over each annular
target ring
can be done at electronic speeds
2 detector rings
2 slices detected

maximum scan rate

24 frames per second
Imatron Cine CT
 Generations

generation configuration detector beam Min scan time

first Translate -rotate 1-2 Pencil thin 2.5min

second Translate -rotate 3-52 Narrow fan 10sec

Third Rotate- rotate 256-1000 Wide fan 0.5sec

fourth Rotate- fixed 600-4800 Wide fan 1sec

fifth Electron beam 1284 Wide fan 33ns

electron beam
 Helical or Spiral CT

• In older CT scanners, the X-ray source would move in

a circular fashion to acquire a single 'slice', once the
slice had been completed, the scanner table would
move to position the patient for the next slice;
meanwhile the X-ray source/detectors would reverse
direction to avoid tangling their cables.
• In helical CT the X-ray source are attached to a freely rotating
gantry.
• During a scan, the table moves the patient smoothly through
the scanner; the name derives from the helical path traced
out by the X-ray beam.
• The two technologies that made helical CT practical are slip
rings to transfer power and data on and off the rotating
gantry, and the switched mode power supply powerful
enough to supply the X-ray tube, but small enough to be
installed on the gantry.
 Spiral CT
• Continuous rotation of gantry
• Patient moves slowly through gantry
• cables of old scanners allowed only 360o
rotation (or just a little more)
– tube had to stop and reverse direction
– no imaging done during this time
• no delay between slices
– dynamic studies now limited only by tube
heating considerations
 Spiral CT

Z-axis orientation
perpendicular to page

Patient
 Multislice CT
• Multislice CT scanners are similar in concept to the helical or spiral CT but
there are more than one detector ring.

• It began with two rings with a 2 solid state ring model , with one second
rotation.

• Later, it was presented 4, 8, 16, 32, 40 and 64 detector rings, with

increasing rotation speeds. Current models have up to 3 rotations per
second, and isotropic resolution of 0.35mm voxels with z-axis scan speed
of up to 18 cm/s.

• This resolution exceeds that of High Resolution CT techniques with single-

slice scanners, yet it is practical to scan adjacent, or overlapping, slices -
however, image noise and radiation exposure significantly limit the use of
such resolutions.
 Multi-slice CT
• Multiple rows of fan beam detectors
• Wider fan beam in axial direction
• Table moves much faster
• Substantially greater throughput
• The major benefit of multi-slice CT is the increased
speed of volume coverage. This allows large volumes
to be scanned at the optimal time .
• The ability of multi-slice scanners to achieve isotropic
resolution even on routine studies means that
maximum image quality is not restricted to images in
the axial plane - and studies can be freely viewed in
any desired plane.
 Dual Source CT

• Dual sources increase the temporal resolution by reducing

the rotation angle required to acquire a complete image, thus
permitting cardiac studies without the use of heart rate
lowering medication, as well as permitting imaging of the
heart in systole.
• The use of two x-ray units makes possible the use of dual
energy imaging.
 Advantages

• First ,CT completely eliminates the superimposition of images

of structures outside the area of interest.
• Second, because of the inherent high-contrast resolution of
CT, differences between tissues that differ in physical density
by less than 1% can be distinguished.
• Third, data from a single CT imaging procedure consisting of
either multiple contiguous or one helical scan can be viewed
as images in the axial, coronal, or sagittal planes, depending
on the diagnostic task. This is referred to as multiplanar
reformatted imaging.
 ATTENUTION COEFFICIENT

Attenuation coefficient reflects the degree to which the

X-ray intensity is reduced by a material

The average linear attenuation coefficient (µ), between

tube and detectors is measured in ct
 Linear attenuation coefficient

• The linear attenuation coefficient () of

each pixel is determined by :
1. Composition of the voxel µ
2. Thickness of the voxel
3. Quality of the radiation beam
 CT RECONSTRUCTION
Algorithms for image reconstruction
• An algorithm is a mathematical method for solving a
problem
• The linear attenuation coefficients of all the pixels in
the image matrix should be determined by solving
thousands of equations.
• All algorithms attempt to solve the equations as
rapidly as possible without compromising accuracy.
IMAGE RECONSTRUCTION
Process of generating an image from the raw data or set of
unprocessed measurements made by the imaging system.

Image reconstruction algorithms

• Back projection
• Iterative methods
• Analytic methods : 2D Fourier analysis
Filtered Back Projection
 Image reconstruction
 The image is created BACK PROJECTION
by reflecting the
attenuation profiles
back in the same
direction they were
obtained
 This process is called
BACK PROJECTION
 Drawbacks in Back projection
(Artifacts - Star shape & streaks)
 The resultant image
closely resembles the
original object
 But it shows star
shaped patterns
around objects and
streaks
 These are called
‘Star’ and ‘streak’
artifacts
 Iterative method

• Assumption (for eg. all points in the matrix have

same value)
• Comparison (with the measured values)
• Correction (to bring the two into agreement)
• Repetition (of the process until the assumed and
measured values are the same or within acceptable
limits)
 Iterative method
Simultaneous reconstruction
• All projections for the entire matrix are calculated at the beginning of the
iteration, and all corrections are made simultaneously for each iteration.
Ray by Ray correction
• One ray sum is calculated and corrected and these corrections are
incorporated into future ray sums, with the process being repeated for
every ray in each iteration.
Point – by – point correction
• The calculations and corrections are made for all rays passing through one
point, and these corrections are used in ensuring calculations, again with
the process being repeated for every point.
 Two – dimensional Fourier analysis:

• Basis: Any function of time [f(t)] or space

[f(x)] can be represented by the sum of
various frequencies and amplitudes of sine
and cosine waves.
2D FOURIER ANALYSIS
 Filtered back projection
• The image is filtered or modified to counter balance the effect
of sudden density changes, which causes blurring (star –
pattern). Those frequencies responsible for blurring are
eliminated to enhance more desirable frequencies.

• The density of the projected rays is adjusted that is, the inside
margins of dense areas are enhanced while the centers and
immediately adjacent areas are repressed. The net effect is
an image more closely resembling the original object.
 Comparison of Mathematical methods

• In terms of speed, Analytical methods are faster than

iterative methods
• But with incomplete data, iterative methods are
faster than analytical methods. Analytical methods
does time – consuming interpolations to fill in
missing data, whereas iterative methods simply
average adjacent points.
 CT NUMBER & HOUNSFIELD UNIT
The computer calculates a relationship between the
linear attenuation coefficients of the pixel and water
which is given as CT number.

To image materials with  higher than dense bone

CT number larger than 1000 should be available

CT numbers based on a magnification constant of

1000 are Hounsfield units
Relationship between CT numbers & Gray scale
 Image Quality in CT

Image quality is the visibility of diagnostically

important structures in the CT image.

The factors that affect CT image quality are

• Quantum mottle (noise)
• Resolution : Spatial and contrast
• Patient exposure.

The factors are all interrelated

 Quantum mottle (Noise)

• Quantum mottle is the statistical fluctuations of X-

photons absorbed by the detector
• The only way to decrease noise is to increase the
number of photons absorbed by the detector.
• The way to increase the number of photons
absorbed is to increase x-ray dose to the patient.
• Mottle becomes more visible as the accuracy of
the reconstruction improves.
 RESOLUTION

i) Spatial resolution
• Spatial resolution is the ability of the CT
scanner to display separate images of two
objects placed close together.
ii) Contrast resolution
• Contrast resolution is the ability of the CT
scanner to display an image of a relatively
large (2 or 3mm) object that is only slightly
different in density from its surroundings.
 RADIATION DOSE
• Even distribution of radiation dose to the
tissues as exposures are from almost all
angles.
• No overlapping of scan fields takes place.
• Exposure factors used are higher to improve
spatial and contrast resolutions and to reduce
noise.
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