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Module G Computed Tomography Physics, Instrumentation, and Imaging.

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1 Module G Computed Tomography Physics, Instrumentation, and Imaging

2 Disclaimer This workforce solution was funded by a grant awarded under the President’s Community-Based Job Training Grants as implemented by the U.S. Department of Labor’s Employment and Training Administration. The solution was created by the grantee and does not necessarily reflect the official position of the U.S. Department of Labor. The Department of Labor makes no guarantees, warranties, or assurances of any kind, express or implied, with respect to such information, including any information on linked sites and including, but not limited to, accuracy of the information or its completeness, timeliness, usefulness, adequacy, continued availability, or ownership. This solution is copyrighted by the institution that created it. Internal use by an organization and/or personal use by an individual for non-commercial purposes is permissible. All other uses require the prior authorization of the copyright owner. This workforce solution was funded by a grant awarded under the President’s Community-Based Job Training Grants as implemented by the U.S. Department of Labor’s Employment and Training Administration. The solution was created by the grantee and does not necessarily reflect the official position of the U.S. Department of Labor. The Department of Labor makes no guarantees, warranties, or assurances of any kind, express or implied, with respect to such information, including any information on linked sites and including, but not limited to, accuracy of the information or its completeness, timeliness, usefulness, adequacy, continued availability, or ownership. This solution is copyrighted by the institution that created it. Internal use by an organization and/or personal use by an individual for non-commercial purposes is permissible. All other uses require the prior authorization of the copyright owner.

3 SELECTABLE SCAN FACTORS

4 SFOV Scan Field of View This is the size of the FIELD in the gantry aperture. Scan Field of View This is the size of the FIELD in the gantry aperture. Tip: The field size is NOT the entire visible area you see within the aperture. Tip: The field size is NOT the entire visible area you see within the aperture. The size of the scan parameter tells the computer which data to use and which data to ignore. The size of the scan parameter tells the computer which data to use and which data to ignore. The SFOV determines the number of detectors required to collect data for a particular procedure. The SFOV determines the number of detectors required to collect data for a particular procedure. The SFOV should always be larger than the area of interest The SFOV should always be larger than the area of interest

5 SFOV When the anatomical area of the patient is OUTSIDE the SFOV, out-of-field artifacts will occur. These artifacts can present as: When the anatomical area of the patient is OUTSIDE the SFOV, out-of-field artifacts will occur. These artifacts can present as: Streaking Streaking Shading Shading Miss-assignment of CT numbers Miss-assignment of CT numbers

6 SFOV Too Large a SFOV may also produce artifacts such as: Too Large a SFOV may also produce artifacts such as: Shading Shading Streaking at the skin surface Streaking at the skin surface

7 DFOV Display Field of View Display Field of View Reconstructed field of view (RFOV) Reconstructed field of view (RFOV) Determines the size of the image viewed on the monitor Determines the size of the image viewed on the monitor DFOV plus matrix size determine the limitations of perceived detail DFOV plus matrix size determine the limitations of perceived detail DFOV should be equal to or smaller than the SFOV NEVER LARGER DFOV should be equal to or smaller than the SFOV NEVER LARGER

8 DFOV The DFOV also impacts image noise and resolution The DFOV also impacts image noise and resolution Wider DFOV’s increase the quantity of the photons from which data is retrieved Wider DFOV’s increase the quantity of the photons from which data is retrieved Image noise is reduced …however….at the expense of resolution. Image noise is reduced …however….at the expense of resolution.

9 Patient Dose Is directly proportional to the mA (tube current). Is directly proportional to the mA (tube current). Scanners have the ability to produce more than one set of reconstructed images using the same Raw Data. Scanners have the ability to produce more than one set of reconstructed images using the same Raw Data.

10 Reconstruction Filters Primarily responsible for ensuring that the scanned anatomy is accurately represented Primarily responsible for ensuring that the scanned anatomy is accurately represented Secondarily responsible for enhancing the spatial or contrast resolution of the final image Secondarily responsible for enhancing the spatial or contrast resolution of the final image High-pass (sharp) filters- provide definitive borders and edges, used for high contrast areas, musculoskeletal (increases image noise) High-pass (sharp) filters- provide definitive borders and edges, used for high contrast areas, musculoskeletal (increases image noise) Low-pass (soft) filters- do not define borders and edges to the same extent as High-pass filters. Used for low contrast areas such as brain, abd. etc. Low-pass (soft) filters- do not define borders and edges to the same extent as High-pass filters. Used for low contrast areas such as brain, abd. etc.

11 Reconstruction Filters Primarily responsible for accurate anatomy representation on the final image Primarily responsible for accurate anatomy representation on the final image Secondary responsibility for enhancing the spatial resolution Secondary responsibility for enhancing the spatial resolution High pass filters High pass filters Low pass filters Low pass filters

12 Pixel Size Pixel size can most often be chosen Pixel size can most often be chosen 512 x 512 matrix has fewer pixels than a 1024 x 1024 matrix 512 x 512 matrix has fewer pixels than a 1024 x 1024 matrix Fewer pixels = faster reconstruction = decreased information to archieved Fewer pixels = faster reconstruction = decreased information to archieved However ….. The larger the size of the pixel the less detail is presented on the image. Smaller the pixel the greater the detail. However ….. The larger the size of the pixel the less detail is presented on the image. Smaller the pixel the greater the detail.

13 Slice Thickness To reduce image noise more mAs is required. To reduce image noise more mAs is required. More mAs = greater patient exposure More mAs = greater patient exposure Thinner slices = greater detail (conventional CT) Thinner slices = greater detail (conventional CT) In spiral CT the selection of thin slices DOES NOT increase radiation dose. In spiral CT the selection of thin slices DOES NOT increase radiation dose.

14 Pitch Radiation dose is affected by the pitch of the helical scan. Radiation dose is affected by the pitch of the helical scan. 1 : 1 changed to 1.5 : 1 results in a 33% reduction in patient exposure. 1 : 1 changed to 1.5 : 1 results in a 33% reduction in patient exposure. May be significant when scanning pediatric patients. May be significant when scanning pediatric patients.

15 kVp and mAs Newer scanners have “smart scan” or “smart mA” Newer scanners have “smart scan” or “smart mA” The scanner detects the remnant radiation and will reduce the mA accordingly. The scanner detects the remnant radiation and will reduce the mA accordingly. The scanner will not increase the mA from what the technologist chooses. The scanner will not increase the mA from what the technologist chooses.

16 Sampling and scan time The rate at which a CT machine samples data is selectable at purchase….. The rate at which a CT machine samples data is selectable at purchase….. This rate does affect the scan time select ability. This rate does affect the scan time select ability. Remember not enough sampling causes artifact called aliasing. Remember not enough sampling causes artifact called aliasing.

17 IMAGE QUALITY

18 Contributing Factors to Image Quality Spatial resolution Spatial resolution Contrast resolution Contrast resolution System noise System noise Linearity Linearity Spatial uniformity Spatial uniformity

19 Spatial resolution Defined as the “degree of blurring in an image” and “the measure of the ability of the CT scanner to discriminate objects of varying densities located close together, against a uniform background” Defined as the “degree of blurring in an image” and “the measure of the ability of the CT scanner to discriminate objects of varying densities located close together, against a uniform background” Spatial resolution can be represented by: Spatial resolution can be represented by: PSF – point spread function PSF – point spread function LSF – line spread function LSF – line spread function MSF – modulation transfer function MSF – modulation transfer function

20 MTF Modulation Transfer Function (MTF) Modulation Transfer Function (MTF) - is the expression of the ratio of the fidelity of an image to the original object canned. Optimal MTF = 1 Non Optimal MTF = 0 Non Optimal MTF = 0 -MTF is measured using a line-pair Phantom with a series of descending size bars.

21 Spatial Resolution Determined by the smallest pair of lines which can be seen on the MTF phantom images. Determined by the smallest pair of lines which can be seen on the MTF phantom images. line pairs/mm or (lp/mm) line pairs/mm or (lp/mm) Optimal resolution for spatial frequency obtained from a CT scanner is 0.3mm. Optimal resolution for spatial frequency obtained from a CT scanner is 0.3mm. Spatial resolution is also affected by geometric factors Spatial resolution is also affected by geometric factors What are the geometric factors from Module F? What are the geometric factors from Module F?

22 Geometric Factors focal spot size focal spot size detector response curve detector response curve slice thickness slice thickness focal distance focal distance isocenter isocenter detector and sampling distance detector and sampling distance

23 Contrast Resolution Also called low contrast or tissue resolution. Also called low contrast or tissue resolution. By definition, it is the ability of the scanner to demonstrate small changes in tissue contrast. By definition, it is the ability of the scanner to demonstrate small changes in tissue contrast. Contrast resolution is determined by the absorption of x-ray photons in body tissue….. characterized by Hounsfield units or Linear Attenuation Coefficients (CT numbers) Contrast resolution is determined by the absorption of x-ray photons in body tissue….. characterized by Hounsfield units or Linear Attenuation Coefficients (CT numbers) Why is CT more accurate than conventional Radiography? Why is CT more accurate than conventional Radiography?

24 Linear Attenuation Coefficients CT numbers are the function of: CT numbers are the function of: The energy of the photons themselves The energy of the photons themselves AS WELL AS AS WELL AS the atomic number of the body tissue scanned and its associated mass density. the atomic number of the body tissue scanned and its associated mass density.

25 Contrast Resolution The ability of a CT scanner to image low contrast objects is limited by: The ability of a CT scanner to image low contrast objects is limited by: Size of the Object Size of the Object Uniformity of the object Uniformity of the object System noise System noise

26 System Noise …..is represented as “graininess” on the CT image. …..is represented as “graininess” on the CT image. Quantum Mottle or Quantum noise Quantum Mottle or Quantum noise Noise is representative of deviations from the uniformity of the image matrix in which low contrast CT numbers slightly above or below zero (0), are interpreted as 0. Noise is representative of deviations from the uniformity of the image matrix in which low contrast CT numbers slightly above or below zero (0), are interpreted as 0.

27 Factors for Noise mAs mAs Scan time Scan time kVp and filtration kVp and filtration Slice thickness Slice thickness Object size Object size Detector efficiency Detector efficiency Pixel size Pixel size algorithm algorithm

28 Noise Equation

29 Noise ↑ = increase ↑ = increase ↓ = decrease ↓ = decrease If slice thickness ↑, Noise ↓, spatial resolution ↓ If slice thickness ↑, Noise ↓, spatial resolution ↓ If patient dose ↑, Noise ↓ If patient dose ↑, Noise ↓

30 Quality Assurance / Water bath phantom Noise should be measured daily, usually by the technologist Noise should be measured daily, usually by the technologist ROI (region of interest) are used to compute the standard deviation of the CT numbers. ROI (region of interest) are used to compute the standard deviation of the CT numbers. 20 cm water bath phantom. Within the phantom there phantom ROI areas seen on the axial images of the water bath phantom. 20 cm water bath phantom. Within the phantom there phantom ROI areas seen on the axial images of the water bath phantom. The technologist can use the “scanner ROI function” to measure the CT numbers within the Phantom ROI area seen on the axial phantom image. The technologist can use the “scanner ROI function” to measure the CT numbers within the Phantom ROI area seen on the axial phantom image. (Please see chapter 11 in Seeram’s for phanom images and additional information) (Please see chapter 11 in Seeram’s for phanom images and additional information)

31 CT Water bath Phantom test The “scanner ROI size” is adjustable and should cover an area the size of 100 pixels. The “scanner ROI size” is adjustable and should cover an area the size of 100 pixels. 5 scanner ROI’s should be used 5 scanner ROI’s should be used 4 on the periphery of the phantom ROI 4 on the periphery of the phantom ROI 1 in the center of the phantom ROI 1 in the center of the phantom ROI (Please see chapter 11 in Seeram’s for phanom images and additional information) (Please see chapter 11 in Seeram’s for phanom images and additional information)

32 Quality Assurance / Linearity Defined as the accuracy of the calibration for a CT scanner. Defined as the accuracy of the calibration for a CT scanner. 5 pin performance phantom is scanned 5 pin performance phantom is scanned CT system records the values in the performance phantom; the Standard Deviation is calculated and plotted. CT system records the values in the performance phantom; the Standard Deviation is calculated and plotted. The relationship should be a straight line if the scanner is in good working order (Bushong, 1997) The relationship should be a straight line if the scanner is in good working order (Bushong, 1997) (Please see chapter 11 in Seeram’s for phanom images and additional information) (Please see chapter 11 in Seeram’s for phanom images and additional information)

33 Pixel Values / Spatial uniformity Spatial uniformity is achieved if the pixel values are constant in every region of the scanned water bath phantom. Spatial uniformity is achieved if the pixel values are constant in every region of the scanned water bath phantom. Spatial uniformity is usually tested using an internal software package. Spatial uniformity is usually tested using an internal software package. Package allows plotting of CT numbers along any axis of an image. Package allows plotting of CT numbers along any axis of an image. Histogram is generated Histogram is generated Histogram value should be within = or – 2 standard deviations of the mean. Histogram value should be within = or – 2 standard deviations of the mean.


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