CT Physics

INTRODUCTION

Designed by Godfrey N. Hounsfield

to overcome the visual representation
challenges in radiography and
conventional tomography by
collimating the X-ray beam and
transmitting it only through small
cross-sections of the body
 G.N.HOUNSFIELD ALLAN M. CORMACK

In 1979, G.N. Hounsfield shared the Nobel Prize in Physiology & Medicine
with Allan MacLeod Cormack, Physics Professor who developed solutions to
mathematical problems involved in CT.
 Important events
YEAR EVENTS

1969 G.N. Hounsfield developed first clinically useful CT head scanner

1971 First clinically useful CT head scanner was installed at Atkinson-Morley

Hospital (England)

1972 First paper on CT presented to British Institute of Radiology by

Hounsfield and Dr. Ambrose

1974 Dr. Ledley introduced the whole body CT scanner (ACTA scanner)

1979 G.N. Hounsfield shared the Nobel Prize with Allan MacLeod Cormack
 C.T. scan
 Computed tomography (CT) scan machines
uses X-rays, a powerful form of
electromagnetic energy.
 CT combines X radiation and radiation detectors
coupled with a computer to create cross
sectional image of any part of the body.
 Cross-sectional slices
Think like looking into a loaf of bread by cutting it
into thin slices and then viewing the slices
individually.
 BASIC PRINCIPLE

 The internal structure of an object

can be reconstructed from
multiple projections of the object.

 CT scanning is a systematic
collection and representation of
projection data.
 Comparison of CT with Conventional Radiography

 Conventional radiography
suffers from the collapsing
of 3D structures onto a 2D
image

 CT gives accurate
diagnostic information
about the distribution of
structures inside the body
 Comparison of CT with Conventional Radiography
A conventional X-ray image is basically a shadow.
Shadows give you an incomplete picture of an object's shape.

This is the basic idea of computer aided tomography. In a CT scan machine, the X-ray beam
moves all around the patient, scanning from hundreds of different angles.
 INTRODUCTION
COMPUTED TOMOGRAPHY is well accepted
imaging modality for evaluation of the entire body.
• The images are obtained directly in the axial plane
of varying tissue thickness with the help of a
computer.

•Some pathology can be seen in sagital or coronal

plane by reconstruction of the images by computer.

•CT has undergone several evolutions & now the

days multi-detectors CT scanners have been
evolved which have application in the clinical field.
 PRINCIPLE OF COMPUTED TOMOGRAPHY

The internal structure of an object can be reconstructed from

multiple projections of the object.

Mathematical principles of CT were first developed

in 1917 by Radon

Proved that an image of an unknown object could be

produced if one had an infinite number of projections
through the object
Basically, a narrow beam of X ray
scans across a patient in synchrony
with a radiation detector on the
opposite side of the patient.

The sufficient no. of transmission

measurements are taken at different
orientation of X ray source &
detectors, the distribution of
attenuation coefficients within the layer
may be determined.

By assigning different levels to

different attenuation coefficients, an
image can be reconstructed with aid of
com. that represent various
structures with diff attenuation
properties.
 Basic principles (cont.)

• Plain film imaging reduces the 3D patient

anatomy to a 2D projection image
• Density at a given point on an image
represents the x-ray attenuation properties
within the patient along a line between the x-
ray focal spot and the point on the detector
corresponding to the point on the image
 Basic principles (cont.)
• With a conventional radiograph, information
with respect to the dimension parallel to the x-
ray beam is lost
• Limitation can be overcome, to some degree,
by acquiring two images at an angle of 90
degrees to one another
• For objects that can be identified in both
images, the two films provide location
information
 CT Scan Methodology
•X-ray tube and detectors rotate around the patient, with the axis
of rotation running from the patient’s head to toe
•Detectors measure the average linear attenuation coefficient, µ,
between the tube and detectors
•Attenuation coefficient reflects the degree to which the X-ray
intensity is reduced by the material it passes through
•2D measurement are taken in a helical manner all around the
patient
•Attenuation data is summed up from thousands of angles used in
a process called reconstruction
•Contrast dye is sometimes used to make the internal organs more
visible in the image
 Methodology continued….
Radiation detection system is composed of detection elements, such as
scintillating crystals and photodiodes
•Data acquisition system measures the radiation data transmitted through the
object and digitizes it so the computer system can read it
•Computer reconstructs the image from raw scan data then a picture is created by
a cathode ray tube
•Computer allows the technologist to shade, rotate, correlate and measure the
organs in the image
•Bone appears white; gases and liquids are black; tissues are gray
•Measurements taken in Hounsfield units (Hu), calibrated universally with air at -
1000 Hu and water at 0 Hu (other typical values include fat ~-50 Hu, muscle ~40
Hu, and bone ~1000 Hu)
•The same study data can show bone structure or soft tissue detail, simply by
altering the window and leveling (ie, which Hu range will the 0-255 greyscale
values will correspond to)
 Tomographic images
• The tomographic image is a picture of a slab of the
patient’s anatomy
• The 2D CT image corresponds to a 3D section of
the patient
• CT slice thickness is very thin (1 to 10 mm) and is
approximately uniform
• The 2D array of pixels in the CT image
corresponds to an equal number of 3D voxels
(volume elements) in the patient
• Each pixel on the CT image displays the average
x-ray attenuation properties of the tissue in the
corresponding voxel
 CT THEORY
Since CT images are related to x-ray radiation, attenuation is
followed by Lambert's law of absorption. In the simplest case, the
linear absorption coefficient can be expressed by

where I is the intensity of the transmitted x-ray beam after passing

through thickness x, I0 is the intensity of the incident beam, and 
is the linear absorption coefficient. When x-rays penetrate a non-
homogeneous material, the general expression for absorption
should be

where,  (s) is the linear absorption coefficient at each point on the

x-ray path.
Each square in the image
matrix was called a pixel,
And it represent a tiny
elongated block of tissue
Called a voxel.

The size of pixel was determined by the computer

Program and not by the dimensions of x-ray beam.
 Tomographic acquisition
• Single transmission measurement through the
patient made by a single detector at a given
moment in time is called a ray
• A series of rays that pass through the patient at the
same orientation is called a projection or view
• Two projection geometries have been used in CT
imaging:
– Parallel beam geometry with all rays in a projection
parallel to one another
– Fan beam geometry, in which the rays at a given
projection angle diverge
 Slice / Cut
 The cross sectional
portion of the body
which is scanned for the
production of CT image
is called a slice.
 The slice has width and
therefore volume.
 The width is determined
by the width of the x-
ray beam
 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
CT Image
 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)
 Scanning the patient - Evolution of CT
scanners
1st Generation 2nd Generation

3rd Generation
4th Generation
 3 4
1 8

3 4 7
1 8 9
 3 4 7
1 8 9

3 4
5 4 12 11
8
1
7 7
4
9 9
11
18 11
1 10 20

4 12

3
5
22 23 8
14 32

25 28
19 40
 25 28
19 40

7+9=16
Subtract 16 from each we get

9 12
3 24

Divide by 3

3 4
1 8
 Generations
 First Generation Scanners
 Translation/Rotation
 Tube produced a finely collimated beam or pencil
beam
 1 to 3 detectors were placed opposite the tube for
radiation detection
 4.5 minutes to gather enough information for one
slice
 Tube was only able to rotate 180 degrees
 Second Generation
 Fan-shaped x-ray beam
 30 or more detectors
 20 seconds per slice or 10 minutes for a 40
slice exam
 180 degree rotation
 Long data reconstruction time
 Third Generation
 Fan-shaped x-ray beam
 960 detectors opposite the x-ray tube
 Complete 360 degree rotation Rotate/Rotate
movement
 One rotation = one slice
 Second data acquisition could be made as the
tube and detectors move in the opposite
direction.
 Time reduced to 1 sec per slice
3 generation configuration
rd
 Fourth Generation
 Developed in 1980’s
 Fixed ring of as many as 4800 detectors,
completely surrounding the patient, Rotate
only movement
 Rotating x-ray tube provides short bursts of
radiation
 Detectors collect the remnant radiation to
reconstruct into an image
 1 minute for multiple slices
 4th generation
configuration
Fifth Generation
EBCT
 Modern Scanners
 No longer categorize into Generations
 Contemporary CT scanners are either third or
fourth generation designs
 Scanners are categorized by tube and detector
movement
 Slip Ring Technology: connects generator
with tube (no cables)
Slip Rings
 DATA ACQUISITION
 Basic components
 X-ray tube
 Collimators
X-ray Collimators
 Detector/s tube
 Collimated x-ray beam Detector
traverses the object and
enters the detector.
 The attenuation is
determined from the
difference between
incident intensity and
transmitted intensity
 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 Sum – Attenuation Ray
along a Ray
View – The set of ray
sums in one direction

The attenuation for each ray

sum when plotted as View Attenuation
function of its position is profile
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
 Image reconstruction
 The image is created by BACK PROJECTION
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
 Formation of Star artifact and streaks
 Consider a
scan of a
single high
density object
suspended in
air
 The attenuation profile for this object has a single
impulse signal
 The back projections take the form of a stripe through
the center of the object
 Back projections are crated for each profile
 Addition of the attenuation profiles create an image
with star and streak artifacts

Final back projection

To be continued – CT Complementary 3
 Correction for star artifacts - Filtering
 A filter function is applied to each point along the
attenuation profile to eliminate these artifacts
 Different filter functions are used to create sharper
(higher resolution) or smoother (lower noise) images

Attenuation
profile
Filter function Filtered profile
 Convolution?
 The process of applying the filter function to
the attenuation profile is called
CONVOLUTION
(Super imposition of the filter function and the
attenuation profile)
 Result of convolution
 The convolution minimizes the artifacts by changing
the back projected information .
  The dark and white bands in the illustration add up in
such a way as to yield an image which accurately
represents scanned object

Impulse signals from

linear traverses following
angular rotations

3rd back Final back projection

projection

2nd back
projection

1st back
projection
 Practical method of Generation of
Attenuation profiles
 Attenuation profiles are a recording of X-ray attenuation
verses position in the object.
 Attenuation is related to the ratio between incident
intensity (I0) and transmitted intensity (It)

I0
It
 X-ray intensity is measured by a DETECTOR which
converts x-ray photons to electrical current
 The reference (Input) detector measures the incident
intensity (I0)
 The output detector measures the transmitted
intensity (It )

I0= incident intensity = tube output

It
 I0 should remain constant
 It will change depending on the attenuation of the
object scanned (e.g. centered, round object of
uniform density)
It
It=1000

Io=1000
 Calibration profile
 If the object scanned is a centered, round water bath
each attenuation profile is called a CALIBRATION
PROFILE. and the set of profiles are called the
Calibration File or Cal file
 DATA Calibration
 Subtraction of
calibration file
from the
attenuation
profiles of the
object called
data calibration
 (consider an
object
containing two
areas of different
densities as
shown)
 Scan Data File
 The difference profile
are stored as numerical
values as a function of
position in the profile.
 This data is used in the
image reconstruction
process
 The set of difference
profiles for a complete
scan is called SCAN
DATA FILE or raw data
 Back projection of scan data
1. Back projection of
the corrected
attenuation profiles
is accomplished by
feeding the
numerical values of
each point along the
profile into a matrix.
(Since the scanning
motion is circular, --
the matrix is usually
round)
2. Close rays are averaged
to attain a pixel value
from the ray that passes
closest to its center
3. Every pixel is assigned
one value per view.
4. The final value is the
sum of these divided
by the number of
views (as shown)
 Acquisition (cont.)
• Purpose of CT scanner hardware is to acquire a
large number of transmission measurements
through the patient at different positions
• Single CT image may involve approximately 800
rays taken at 1,000 different projection angles
• Before the acquisition of the next slice, the table
that the patient lies on is moved slightly in the
cranial-caudal direction (the “z-axis” of the
scanner)
 IMAGE RECONSTRUCTION

Since composition and thickness of voxel along with quality

Of beam determine the degree of attenuation.
So for a single block of homogeneous tissue and
monochromatic beam of x–ray

N = N0e-µx
Since e is natural log
N0 is initial photon
N is transmitted photon
X is the thickness of slab
 Similarly if N no. of block is there then the equation becomes

N = N0e-(µ1+µ2+µ3…………………µn)x
Since to solve this problem we must have transmission reading
taken from at least to different direction .
Since the more is projection and lines more is equation formed
As for example orignal EMI scanner 28,800 reading
Fan beam scanner can took 1 lak to2 lak. Readings.
CORRECTION FACTOR INCORPORATED INTO CT
PROGRAMME

1. Hetro-chromatic beam
2. Weighting factor

Since hetro-chromatic radiation passes through an absorber

Filtration increases its mean energy .

And secondly weighting factor to compensate the difference

Between the size and shape of the scanning beam and the picture
Matrix.
 ALGORITHMS FOR IMAGE RECONSTRUCTION

An algorithm is a mathematical method for solving a problem.

Thousand of equation must be solved to determine the linear

Attenuation coefficient of all pixel in the image matrix.

The three mathematical method of image recontstruction

Will be described are:-
1.Back projection
2.Iterative methods
3.Analytical methods
 BACK PROJECTION

1.Also called summation method

2.Is the oldest means of image reconstruction
3.its principle demonstrates When a ray from two projection is
superimosed, or back projected They produce a crude
repoduction of orignal object.

ITERATIVE METHOD

It start with assumption that all point in matrix have same

value
And it was compared with measured value and make
correction until Values come with in acceptable range.
 ITERATIVE METHOD
It start with assumption that all point in matrix have same
valueAnd it was compared with measured value and
make correction until Values come with in acceptable
range.
It contain three correction factor

1. SIMULTANEOUS RECONSTRUCTION
2. RAY BY RAY CORRECTION
3. POINT BY POINT CORRECTION
6. When all the measurements have been projected
back into the matrix and all pixel values determined,
the image can be displayed
7. The number of pixels
in the image
corresponds to the
MATRIX SIZE.
This is given as 256 x
256, 320x 320, 512 x
512. this refers to the
number of pixels
across a vertical or
horizontal diameter of
the image.
8. The actual size of a
pixel is equal to the
size of the area
scanned, called the
FIELD OF VIEW
(FOV) divided by
the matrix size.
( Small pixel sizes
helps to display
small objects that
can be resolved by
the system)
 CT Numbers
 CT numbers are calculated from the measured
attenuation values using the equation given below.
 Range of CT numbers
 Tremendous range of attenuations that might be
displayed in a CT image requires a large number
scale. +/- 1000 is commonly used and some systems
have extended this range further on the high end to
differentiate bone densities
 Limitation in display of CT numbers
 The human eye can
distinguish only about
20 levels of gray in the
gray scale and cannot
appreciate the large
range of information
contained in CT scan
 This is solved by using
the ‘window width’ &
‘window level’
 Window width
 This is the range of CT
numbers that is
displayed using the
useful levels of gray
scale
 Small window separates
one CT number from
another
 Large window
condenses more than
one CT number in each
of gray level
 Window level
 This is the centre of the
range of CT numbers
displayed by the
window
 The level control moves
the visible gray scale up
and down the CT
number scale
 Hounsfield unit system & CT
numbers
 As an honour to Hounsfield who was the
pioneer of invention of CT the CT numbers are
called Hounsfield units.
 The range of Hounsfield units is from -1000 to
+3000
 Standard reference points are -1000 for Air
and 0 for water.
 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.
Comparison of CT with Conventional Radiography
 CT ARTIFACTS

Artifacts are distortions or errors in the image

that are unrelated to the object scanned .
Most common artifacts in CT are
 Motion artifacts
 Streak artifacts
 Beam hardening artifacts
 Partial volume averaging artifacts
 Ring artifacts
 EFFECTS OF ARTIFACTS

 DETERIORATE IMAGE QUALITY

 SUBJECT INFORMATION IS
LOST
 PATHOLOGICAL DETAILS ARE
LOST
 MOTION ARTIFACTS

Cause : Patient movement

Appearance: Blurred / streaks / ghost images
Rectification:
 reduction in scan time

 Clear and concise instruction to the patient

 proper patient immobilization

 if needed,administration of
sedatives/antiperistaltic drugs
Motion artifact
 STREAK ARTIFACTS

Cause: Presence and movements of

objects of very high density(contrast
media, metallic implants,surgical clips)
Appearance: Streaks
REMEDY:-
•Remove the offending object if possible.
Use a smoothing algorithm. e.g. Standard
algorithm.
 Streaking
Streaking occurs due to inconsistency in a small
group of readings

•Partial volume
•Photon starvation
•Metal artifacts
•Patient movement
DENTURES
PRODUCING
STREAK ARTIFACT

SURGICAL
CLIP IN HEART
PRODUCING
STREAK ARTIFACT
 BEAM HARDENING
ARTIFACTS
Cause :
Polyenergetic X ray spectrum(25-120kV)
APPEARANCE:-
Wide dark streak
Rectification :
 Beam hardening correction algorithm
 PARTIAL VOLUME
AVERAGING ARTIFACTS

 Cause: presence of tissues with highly

varying absorbtion properties in a voxel.
 Rectification : Usage of Thinner CT slices
 OUT OF FIELD ARTIFACT

CAUSE:-
Scan FOV not covering
the entire anatomy
APPEARANCE:-
Shading/streaks
REMEDY:-
Ensure that scan field of
view is larger than the
object to be scanned
 RING ARTIFACTS

 CAUSE : Detector failure or miscalibration of a

detector
 APPEARANCE:-
Ring
 Rectification : regular quality assurance
checks
RING APPEARANCE