COMPUTED

TOMOGRAPHY
 DEFINATION

•CT is medical imaging method employing

tomography where digital geometry processing is
used to generate a 3d image of internals of an
object from a large series of two dimensional X-Ray
images taken around a single axis of rotation.
•The word tomography is derived from greek Tomo
which means slice or section and graph means
describing
•It is originally known as CAT(computer axial
tomography).
 HISTORICAL PROSPECTIVES
• In 1917 Radon develop the basic mathematical equation.
• In 1920 develop the method to image the specific section of
the body known as body section radiograph.
• In 1935 Grossman define the technique and labelled it as
tomography.
• In 1937 Watson develop another tomography technique this is
known as transverse axial tomography.
• In 1940 frank and Takahashi published the basic principle of
axial ct.
• In 1956 Cormark developed the theory of image
reconstruction.
• In 1967 Hounsfield develop the clinical useful CT scanner.
• In 1972 first clinical brain scanner.
• In 1975 dynamic spatial reconstructor was installed a
biodynamic unit at the myoclinic.
• 1980 a high speed CT scanner introduced that is used electron
beam technique was used to image the cardiovascular system
to overcome motion artefact this is known as EBCT.
• In 1992 the dual slice spiral CT scanner was
introduced.
• 1998 MSCT was introduced at the radiological
society of north America in Chicago.
• In 2000 , 16 & 32 slice CT scanner was introduced.
• In 2004 , 64 slice Ct scanner was introduced.
• In 2006 dual source CT scanner was introduced-
• Two x-ray tube coupled two detector array.
• In 2006, 256 slice was introduced.
• In 2007, 320 slice was introduced.
 WORKING PRINCIPLE OF CT

• The technologist first turns on the scanner powers and

performs a quick test to ensure that the scanner is in good
working order.
• Patient is in place in the scanner opening.
• Technologist set up the technical factors as to control the
console.
• Scanning can now begins.
• When X Ray passes through the patient they are attenuated
and subsequently measured by the detectors.
•The detectors convert X Ray photons into the
electrical signals or analog signals, which in turn
must be converted into digital data or input into the
computer.

•Computer then performs the image reconstruction

process.

•Image and related data are then send to the PACS,

where a radiologist will be able to retrieve and
interpret them.

•Finally images can be stored on the magnetic tapes

or optic disks.
 CT NUMBER
•Each pixel in the reconstructed image is assigned a
CT number
•CT number are related to the linear attenuation
coefficient (μ) of the tissue that comprise the slice and
can be calculated as
CT number= k x μpixel -μwater
μwater
μpixel= Pixel linear attenuation coffecient
μwater= Water linear attenuation coefficient

k= Constant factor
•The linear attenuation coefficient (μ) is affected by
several factors, including the energy of radiation.
• In CT high voltage technique(120 kV) generally used:-
a) To reduce the dependence of attenuation
coefficients on photon energy.
b) To reduce the contrast of bone relative to soft
tissue.
c)To reproduce a high radiation flux at the detector.
• CT number may vary because of their energy
dependence.
• CT system ensure the accuracy and reliability of these
numbers because the consequences can be disastrous
and might lead to misdiagnoses.
• The system incorporate the number of correction
scheme to maintain the precision of the CT number.
 HOUNSFIELD UNIT (HU)

•It is a quantity commonly used in CT scan to

express CT numbers in a standrised and
convenient form
•HU created by named after Sir Godfrey Newbold
Hounsfield
 CT no. of various substances in human
SUBSTANCE body
HU

Air -1000

Lung -500

Fat -100 to -50

Water 0

CSF 15

Kidney 30

Blood +30 to +45

Muscle +10 to +40

Grey matter +37 to +45

White matter +20 to +30

Liver +40 to +60

Soft tissue +100 to +300

Bone 1000
 WINDOWING
•CT image is composed of a range of CT numbers
that represents varying shades of gray.
•The range of numbers is referred to as the window
width (WW), and the centre of the range is window
level (WL) or window centre (C).
•Both WW and WL are located on control console.
•These controls can alters the image contrast and
brightness.
•The process of changing the CT image grey scale in
this way as referred to as windowing.
•WW controls the image contrast, the WL or C
controls the image brightness.
•WL or C increases the image get from white
(bright) to dark (less bright).The image contrast
changes from different value of WW.
 MATRIX
•A digital image is made up of a 2dimensional array of numbers
called matrix.

•The matrix consist of column (M) and rows (N) that define small
square regions called picture elements or pixel.

•The dimensions of the image can be described by M, N, and the

size of image is given by the following relationship:

M x N x k bits

M=N, The image is square

•Operators selects the matrix size, refers to as a field of view

(FOV).
 PIXEL

•It is picture element.

•It is the smallest division of data set of image in a slice.
•It has two dimensions (length and breadth).
•If pixel size is small the image quality would be better.
•If pixel size is large the image quality would be poor.
•If pixel size will increase the artefact will be increase.
•Each pixel contains a number ( discrete value) that
represents the brightness level.
•Pixel size is calculated by :
Pixel size= FOV/matrix size
• The larger the matrix size the smaller is the pixel size and
better the spatial resolution
 VOXEL

•Voxel is a smallest division of rows and columns in a

slice of organ
•It has three dimensions(length, breadth and height)

•Smaller is the voxel better will be the image quality

•Larger is the voxel poor will be image quality

•Each pixel correspond to a voxel in the slice

•Voxel information is converted into numerical values

contained in the pixel and these numbers are
assigned brightness level
 BIT DEPTH
•Relationship between M x N x k bits

•The term k bits implies at every pixel in a digital

image matrix M x N is represented by k binary
digits
•Number of bits per pixel is the bit depth.

•The binary system uses the base 2, k bits = 2k

•Each pixel will have 2k grey level

 PHYSICAL PRINCIPLE OF CT

The physical principle involves physics and

mathematics concept to understand the way the
image is produced, and the technological
consideration involves the practical implementations
of scientific and engineering principle such as
computer science and technology.

CT includes three process:-

•Data acquisition
•Data processing
•Image display, storage & communication
 SCANNING AND DATA
ACQUISITION

•Topogram is selected.
•Field of view is divided into number of slices.
•Slice is selected by collimated beam.
•Slice is superimposed on matrix grid.
•X Ray tube is rotated around the body of patient and
multiple projections are taken.
•Each block of tissue attenuates the beam equal to
their attenuation coefficient
μpixel= 1 loge Io
x Ix
•There are 800 detectors fixed in a row.
•In one projection 800 data are taken by 800
detectors and thousands of projections are taken
in one rotation , so lakhs of data are converted into
analog to digital signal by converter and send to
computer.
•This is called data acquisition system which
acquire data.
 RADIATION ATTENUATION

• Attenuation is the reduction of the intensity of a

beam of radiation passes through an object.
• Attenuation depends on the electron per gram ,
atomic number, tissue density and radiation energy
used.
• Attenuation in CT depends on the effective atomic
density (atoms / volume), the atomic number (Z) of
the absorber and the photon energy.
 DATA PROCESSING
• Data processing is basically a two step process:
a) The raw data (Data received from the detectors)
undergo some form of preprocessing, in which
correction are made and some reformatting data
are occurs.
b) The scan data which represent attenuation
readings are converted into a digital image
characterized by a CT number.
• Conversion of attenuation reading into a CT image
is accomplished by a mathematical procedure
referred to as a reconstruction algorithms.
• These algorithm includes (a) simple back projection
(b) Iterative method
(c) Analytical method
• After data processing the reconstructed image is displayed
for viewing and subsequently sent for storage or
communication through PACS (picture archiving and
communication system) to remote sites for review.
 Image display, storage &
communication
• After the CT image has been reconstructed, it exists in
computer in a digital form.
• This must be converted to a form that is suitable for
viewing and meaningful to the observer.
• The gray scale image is displayed on a TV monitor using
a CRT (cathode ray tube) or liquid crystal display which
is an essential component of control or viewing console.
• Resolution is an important physical parameter of gray
scale display monitor and is displayed to the related size
of pixel matrix or matrix size.
• The display matrix is ranges from 64 X 64 to 2048 X
2048 matrix which is highest performance.
 ADVANTAGES AND LIMITATIONS
OF CT
Advantages :-
■ CT offers the best low contrast resolution compared with
Radiography, Nuclear Medicine, Ultrasonography.
■ By changing the window width and window level settings
in image windowing, the contrast scale of the image can
be varied to suit the need of the observer.
■ Improvement in 3D imaging , multi planar image
reformatting and other application such as continuous
imaging CT Angiography or CT Endoscopy.
■ CT has made available a variety of techniques to
facilitates the diagnostic process sic as xenon CT to study
blood flow , quantitative CT to determine blood mineral
content, Dynamic CT to study physiology, perfusion CT
and high spatial resolution CT to optimize the spatial
resolution.
■ 3D imaging : CT now produces 3D images routinely
Limitations:-
■ The spatial resolution of CT is notably poorer compared
with radiography for ex; spatial resolution for CT is 2 for
NM, USG, MRI the spatial resolution is 0.1 ,0.25 and 2.
■ The dose in CT is generally is higher for similar
anatomical regions.
■ In CT it is difficult to image anatomic regions in which
soft tissues are surrounded by large amount of bone
such as posterior fossa , spinal cord, and the pituitary
fossa which may cause artifacts that may obscure
diagnosis.
■ Presence of metallic objects on the patient produce
streak artifact on CT images.
Note : By no means have these limitations hindered
the development of the CT and restricted its use.
At present CT continuous to be a useful
diagnostic tool in medicine , and more and more
research is underway to improve the performance
of CT scanner
 EVOLUTION OF CT
SCANNER

Since the development of the very first CT scanner in the

1970s, the industry has seen a variety of changes applied to
the CT scanner instrumentation leading to the evolution of
seven different generations of CT scanners. Each
generation of scanner is unique and varies based on the
arrangement of the x-ray tube and detectors.
 AIM OF EVOLUTION:

•To provide faster acquisition time

•Provide better spatial resolution
•To shorten the image reconstruction time
 FIRST GENERATION CT SCANNER/EMI
SCANNER
(ROTATE/TRANSLATE, PENCIL BEAM)

• Godfrey Newbold Hounsfield developed the first CT

scanner with the help of a company called Electric
and Musical Industries.
•In order to produce such a narrow beam of x-ray
photons, the first generation scanner used a pinhole
collimator to ensure that only a single beam of x-ray
was interacting with the patient.
•It was made up of only one X Ray tube and two x-
ray detectors and both were located just opposite to
each other
•The first generation CT scanners were used for head
scans in which head was enclosed in water bath.
EMI Scanner gantry
• The two detectors were capable of measuring the amount of
x-rays that successfully passed through the patient for only
two slices of that body part.

• In order to acquire every slice across a part of the body, the

x-ray tube and detectors had to be moved linearly, before
rotating the position of the x-ray tube to acquire images at a
different projection angle. So, gantry moved through two
different types of motion linear as well as rotatory.
•Gantry used to rotate about 180o.

•It required 30 minutes to complete the head scan.

•Pixel size was 3x3 mm

•Voxel size was 3x3x13 mm

First generation CT: Rotate/Translate
 ADVANTAGES
•Decrease in the amount of scatter radiation which was
interacting with the detectors.

DISADVANTAGES
•It was designed only for head.

•Poor spatial resolution.

•Scan time was more.

•Tl activated NaI detectors were used.

•Low efficiency.
 SECOND GENERATION
(ROTATE/TRANSLATE, NARROW FAN BEAM)

•The angle of the fan beam was not large and still
required the linear movement of the x-ray tube and
detectors at each projection angle.
•It included a linear array of upto 30 detectors.
•There was an increase in number of data and
number of projections.
•The acquisition time of scan was decreased by two
to three minutes per slice.
•This generation of CT scanners was measured to be
fifteen times faster than the first generation, which
was a massive improvement.

•Gantry used to rotate about 180o.

•Scan time reduced to 20 sec to 3.5 minutes.
Second generation CT:Rotate/Translate
 ADVANTAGE
•Scan time was reduced.

DISADVANTAGE
•More scatter radiation.
•Poor spatial resolution.
•Tl activated NaI detectors were used.
•Low efficiency.
 THIRD GENERATION
(ROTATE/ROTATE, WIDE FAN BEAM)

•In third generation CT, X-Ray tube and detectors

both were rotated, so tube and detectors were
rotating around the patient.
•There were arch shaped detectors used in third
generation CT.
•Upto 750 detectors were used in this generation, so
there were improvement in detector data
acquisition technology.
•In this slip ring technology was used.
•With the use of wide aperture fan beam the x-ray
tube and the detectors could now rotate freely
through each of the projection angles without
stopping to collect multiple slices per projection
angle.
•Third generation CT acquired the images by the
gantry rotation of 360o.
•The scan time was 4.9 sec
Third generation CT: Rotate/Rotate
 ADVANTAGE

•Time of scan was reduced.

•Continuous rotation.
•Xenon detectors were used.
 DISADVANTAGE

• There was more scatter radiation produced in

third generation.
• Low efficiency.
• There was appearance of ring artifact due to the
failure of detectors.
 SLIP RING TECHNOLOGY

•Slip ring technology was introduced in 1989.

•This technology allows the gantry to rotate
continuously without any interruption.
•There are two types of slip rings design are used
a) Disk- These are in concentric and ring form
lying
parallel to the plane of rotation
b) Cylinder- Lying parallel to the axis of rotation
•There are usually three slip rings are used in gantry :
a) One provide high voltage power to X Ray tube
and
generator.
b) Second provide low voltage power to control
system.
c) Third slipping transfer digital data from rotating
detector
array.
•There are two types of rings present: stationary and
rotating rings. Between these two rings carbon or
optical brushes are present.
 FOURTH GENERATION
(ROTATE/STATIONARY, FAN BEAM)

•In this generation X Ray tube was rotated and

detectors were stationary, which were in ring shape
•Because the tube used to rotate inside the detector
ring a large ring diameter 170-180 cm was needed
to maintain tube skin distance.
•There was a fixed ring of detectors (upto 4800),
which completely surrounded the patient in a full
circle within the gantry.
•It was mainly developed to eliminate the ring
artifact
•This generation CT acquired the images by the
gantry rotation of 360o
•Scan time was half to 1 sec
Fourth generation CT: Rotate/Stationary
 ADVANTAGE
•Scanning time was less
•Higher efficiency
•CsI, BGO, CdWO4 detectors were used
•Elimination of ring artefact

DISADVANTAGE
•More patient dose
•More scatter radiation
 FIFTH GENERATION
(STATIONARY/STATIONARY)
• Also called EBCT ( Electron beam CT) or CVCT
(Cardiovascular CT)
• In this X Ray tube was not present
• There were three main components
1. Electron gun
2. Tungsten target
3. Detector ring
• It did not require any mechanical motion to acquire the
images.
• In this magnetic focusing and deflection of electronic
beam replaced the X-ray tube motion.
 Working

• Electrons ejects from the electron gun.

• These electrons strike on to the target that surrounds the
patient and is made of tungsten (180 cm diameter).
• After that X-rays are produced and passes through the
patient.
• Partially attenuated beam then interacts with the
stationary array of detectors.
Fifth generation CT: EBCT
 ADVANTAGE
•Fifth generation CT was used in cardiac tomographic
imaging
•The scan time to acquire a single slice was 50ms
and could produce 16-17 slices per second.
•CsI, BGO, CdWO4 detectors were used

DISADVANTAGE
•Equipment cost was high.
SIXTH GENERATION CT: HELICAL

•This generation essentially combine the principles

of both third and fourth generations with the
slipping technology to create a system that rotates
continuously around the patient without being
limited by electrical wires.
 PRINCIPLE

•As examination begins the X Ray tube rotates

continuously without reversing.
•When gantry rotates the table moves
simultaneously, taking spiral scan and data is
collected.
•This data can be reconstructed at any desired z axis
position along the patient.
•Raw data from helical data sets are interpolated to
approximate the acquisition planner reconstruction.
Spiral or helical CT
 PITCH RATIO

Pitch=Table movement per 360o gantry rotation

Slice thickness
Pitch= Resolution= Dose
•Pitch must be equal to 1
•If pitch is greater than 1 it imply that source of data
in patient has been skipped. It will be a loose scan
•If pitch is less than 1 it imply certain amount of data
oversampling. It will be a tight scan
 ADVANTAGE

•Improve lesion detection

•Multi planer images can obtain
•Improved 3d imaging
•Reduced scan time
•Avoid motion artefact
•CsI, BGO, CdWO4 detectors are used
 DISADVANTAGE

•Increase image noise

•Radiation dose is high
•Equipment cost is high
 SEVENTH GENERATION
• It is Multi slice detector CT
• It was introduced in 1998
• In this there are multiple array of detectors which
are made up of CsI+TFT
• Cone beam and multiple rows of detectors, up to 8
rows of detector are used
• The collimator spacing is wider and more of the x-
rays that are produced by the tube are used in
producing image data.
• With multiple detector array scanner, slice thickness
is determined by detector size, not by the
collimator.
Seventh generation
 ADVANTAGE

•Imaging time is less

•High resolution images can be obtain
•Ultrathin slices can be obtain
•Reduction in motion artefact
•Patient breath hold is less demanding
•Less contrast medium is required
 DISADVANTAGE

•Data overload
•More radiation dose
•Equipment is expensive
 Comparison of CT generations
SOURCE-
SOURCE
GENERATION SOURCE DETECTOR DETECTOR
COLLIMATION
MOVEMENT
Single X Ray A pair of Rotate/
1st Pencil beam
tube detectors Translate
Single X Ray Narrow Fan Rotate/
2nd Multiple
tube beam Translate

Single X Ray Arch shaped

3rd Wide Fan beam Rotate/Rotate
tube detectors

Single X Ray Stationary ring Rotate/

4th Fan beam
tube of detectors Stationary

Stationary
Stationary/
5th Tungsten anode semicircular Fan beam
Stationary
detector
3G/4G plus
Single X Ray
6th 3G/4G Fan beam linear patient
tube
table motion
Single X Ray Multiple array
7th Cone beam 3G/4G/5G
tube of detectors