Basic Principles of CT Scanning

The basics of CT
CT imaging chain System components Acquisition methods Image quality Applications

X-ray: The beginning

X-Rays founded in 1895 by Wilhelm Conrad Roentgen

CT: The beginning

CT founded in 1970 by Sir Godfrey Hounsfield
Engineer with EMI, LTD. first applications were in neuroradiology

CT Scanner
X-Ray modality used to the body in cross section Used to determine
extent of trauma location and type of tumors status of blood vessels pre surgical planning

CT System

Basic CT scanner components

Gantry X-Ray Tube Detector Control Console

Gantry
CT X-ray tube High voltage generator Detector array Data acquistion system Slip ring

The CT X-ray Tube

Anode heat capacity
3.5 MHU up to 28 MHU
Determines maximum mAs Determines volume length Dictates generator size

Detector Elements
Capture energy that has not been attenuated by the patient

Control console
Set scan parameters
kVp, mA, scan time, reconstruction filter, etc.

Set scan mode

Surview, Axial or Spiral

IRS (Image reconstruction System) Review and archive images Post-processing

CT
CT - Computed Tomography CAT Scan - Computerized Axial Tomography

Scanning methods
Surview
AP,Lat Surview, Scanogram , Topogram.

Conventional CT
Axial
Start/stop

Volumetric CT
Helical or spiral CT
Continuous acquisition

Digital Projection
X-ray tube and detector remain stationary Patient table moves continuously
With X-rays on

Produces an image covering a range of anatomy

Similar to a conventional X-ray image, e.g. flat plate of the abdomen

Image used to determine scan location

Axial CT
X-ray tube and detector rotate 360 Patient table is stationary
With X-rays on

Produces one cross-sectional image Once this is complete patient is moved to next position
Process starts again at the beginning

Volume CT
X-ray tube and detector rotate 360 Patient table moves continuously
With X-rays on

Produces a helix of image information

This is reconstructed into 30 to 1000 images

Volume Scanning: Pitch

1:1 2:1

Advantages of Volume CT
More coverage in a breath-hold
Chest, Vascular studies, trauma

Reduced misregistration of slices

Improved MPR, 3D and MIP images

Potentially less IV contrast required Gapless coverage Arbitrary slice positioning

Fundamentals of Multislice CT

Multislice Fundamentals
Everything is better (R)esolution
Z-axis, spatial, low contrast

(S)peed
Temporal bolus capture, stopped motion

(V)olume
Thin slice organ-specific coverage

(P)ower
Enough photons uncompromising image quality

Multislice Effectiveness
Everything is better
Resolution Speed Volume Power
Single Slice = Dual Slice = Quad Slice =

Dual

Quad

2x same same same

4x-8x same same same

One 10mm slice per rotation Two 5mm slices per rotation Four 2.5mm slices per rotation

Dual Slice Detector Optimized for 2 Slice Acquisition

Mx8000 Dual Slice

x-ray tube focal spot pre-patient collimation

post-patient collimation

__

single detector arc

dual detector arc

Quad Detector Technology

variable wide area detector Variable slice thickness Asymmetrix
4 x 1mm 4 x 5mm 4 x 2.5mm 2 x 0.5mm 2 x 8mm 2 x 10mm
Variable detector length Fixed detector length

Approximately 10% more efficient than matrix detectors

Variable Wide Area Detector

Quad Technology
How it works

8 Element

2-D array

4 Slices

CT
CT attenuation information CT image quality

Attenuation
X-ray beam passes through patient Each structure attenuates X-ray beam differently
According to individual densities

Radiation received by detector varies according to these densities

Density information
Transferred from detector to CT computer (A to D converter) Reconstructed by computer into a cross-sectional image
Displayed on screen Each pixel displayed on monitor has varying brightness
The greater the attenuation, the brighter the pixel The less attenuation, the darker the pixel

Density information
Density values correspond to a range of numbers
Hounsfield scale

Window settings
Window width
Determines range of CT numbers displayed on an image
Values above this range = white Values below this range = black

Window level
Sets the center CT number displayed on the monitor Determines the location on the Hounsfield scale about which the window width will be centered

CT image quality
Spatial resolution
Ability to resolve small objects in an image Measured in lp/cm

CT image quality
Spatial resolution
Ability to resolve small objects in an image Measured in lp/cm

Isotropic Imaging
True 0.5mm Isotropic imaging

CT image quality
Contrast resolution
Ability to differentiate small density differences in an image

Post Processing Options

Visualization of vasculature in relation to pathology
Show course of vessels Show stent placement Define vascular stricture

Thin-Slice Spiral Neck

Cervical Spine
Spiral Acquisition Rotation 0.75 sec Coverage 160 mm Pitch 0.875 Acq. Time 36 sec FOV 250 mm ST 1.0 mm Rec. Incr. 0.6 mm Std Res. 8 lp/cm 120 kV, 200 mAs CTDI100w 39 mGy CTDIFDAw 17 mGy

Neuro-Angiography
Circle of Willis

Thin-Slice Spiral Lungs

Renal Arteries

MasterCut
Panoramic View

MIP

4D-Angio

Extended Spiral Acquisition

Ext. Spiral Acq.
Spiral Acquisition UltraFast 0.5 sec Coverage 1400mm Pitch 1.75 Acq. Time 41.5 sec FOV 420 mm ST 2.5 mm Rec. Incr. 1.6 mm Std Res. 8 lp/cm 120 kV, 96 mAs CTDI100w 7.3 mGy CTDIFDAw 4.9 mGy