CT Scan: Basic Principle,

Types and Applications

 INTRODUCTION
▶ Computed Tomography (CT) scan is also called as Computer axial Tomography
(CAT) scan. It provides detailed, cross sectional views of all types of tissues in
the human body.
▶ Tomography is derived from Greek word “tomos” meaning ‘slice’ and “graphen”
meaning ‘to write’.
▶ CT scan is one of the best imaging method for analysing the chest, brain and
abdomen. It is often used for the diagnosing various cancers like lung, liver and
pancreatic cancers. The image reveals to a physician to confirm the presence of
a tumour and to measure its size, location and the extent of damage for the
near by tissue.
▶ It uses special x-ray equipment to obtain a set of image data at different angles
around the human body. The set of data processed in a computer to show a
cross – section of human body tissues and organs
▶ By using CT scan we can produce clear 2-D or 3-D cross sectional images of deep
internal organs.
CT SCAN PRINCIPLE OF OPERATION
SIMPLE BLOCK DIAGRAM
▶ In CT scan x-ray slice data is generated using an x-ray source
that rotates around the subject. X –ray sensors are placed on
the opposite side of the circle from the x –ray source.
▶ The sensors are Scintillation detectors based on photodiodes
are used.
▶ Measurements are taken by passing x-rays through out the
body. Many data scans are taken progressively from the body
and they are combined together by a mathematical procedures
know as tomographic reconstruction.
▶ The mathematical procedure is called back projection
reconstruction. By using reconstruction methods we can
reconstruct the image
IMAGE RECONSTRUCTION
DETAILED BLOCK DIAGRAM OF CT SCAN
▶ A typical CT scan machine is shown in above figure
▶ X-ray source:
The x-ray tube generates the x-ray and direct towards the subject. The x-ray tube is
fitted on a circumference of a gantry so that the image can be obtained in all 360 degrees.
The person will be placed inside the gantry. A set of x-ray detectors is placed exactly
opposite to the X-ray tube.
The radiation dose for a particular study depends on many factors such as volume
scanned, number and type of scan sequences, the desired resolution of image and the
image quality. The intensity of x-ray can be regulated by controlling the anode
voltage and beam current. The timing, anode voltage (in kV) and beam current (in mA) are
controlled by a computer through a control bus.
▶ X-ray Detector:
The x-ray detectors are placed in a ring shaped apparatus which rotate around the
patient. The detectors sense the intensity of x-ray as a function of absorption property of
the internal structure of body.
Detection should be done by scintillation system based on photo detectors. Detection
which utilizes 8,16 or 64 detectors during continuous motion of patient through the
radiation beam to obtain much clearer images with high resolution and image quality.
▶ Reconstruction of tomogram:
The CT produces a group of data which can be manipulated and processes to
demonstrate various bodily structures based on their ability to block the x-ray
beam. It is called windowing technique. The reconstruction of tomogram is done using
a suitable computational algorithm using a computer.
By using a computer the image can be produced in a television screen. This is
called tomogram and it can provide a very accurate cross sectional view of any area
of the body. To reconstruct the image a number of mathematical operations has to be
done and for this we use different computational tools.
Back projection is a simplest tomographic reconstruction method. Modern
software allows reconstruction of the tomograms in many planes so that any plane
can be selected to display an anatomical structure. This may be useful for visualising
the structure of extremely small elements of body such as bronchi.
MAJOR APPLICATION OF CT SCAN
 Early history of Radiation protection

• Wolfram Fuchs (1896) gave what is generally

recognised as the first protection advice

1. make the exposure as short as possible

2. do not stand within 12 inches (30 cm) of the X-ray
tube
3. coat the skin with Vaseline (a petroleum jelly) and
leave an extra layer on the most exposed area.
 Early history of Radiation protection

• In the early 1920s, radiation protection

regulations were prepared in several countries
• In 1925 during the first International Congress
of Radiology (ICR) considered establishing
international protection standards.
• 1925 ICRU was established by the first ICR
 ICRP Establishment
• In 1928 International Congress of Radiology
established “International X-Ray and Radium
Protection Committee (IXRPC)” now known as
ICRP
• IXRPC was Renamed as “International
Commission on Radiological Protection (ICRP)”
by Second International Congress of Radiology
in 1950
 What is ICRP?
• The Commission is an independent charity,
i.e., a non-profit-making organisation. The
Commission works closely with its sister body,
the International Commission on Radiation
Units and Measurements (ICRU)
 Association of ICRP with other bodies
Has official relationships with
• United Nations Scientific Committee on the Effects of Atomic
Radiation(UNSCEAR),
• World Health Organization (WHO),
• International Atomic Energy Agency (IAEA).
• International Labour Organization (ILO),
• United Nations Environment Programme(UNEP),
• Commission of the European Communities (‘European
Commission’,EC)
• Nuclear Energy Agency of the Organization for Economic Co-
operation and Development (OECD/NEA),
• International Organization for Standardization(ISO)
• International Electrotechnical Commission (IEC)
• International Radiation Protection Association (IRPA)
Structure Radiation protection standards
 Evolution of ICRP policies
• First recommendations (IXRPC, 1928),
• concerned with avoiding deterministic effects, initially
in a qualitative manner
• The effects to be guarded against are injuries to
superficial tissues, derangements of internal organs
and changes in the blood.
• As a remedy, a prolonged holiday and limitation of
working hours were recommended.
• No form of dose limit was proposed, but Lindell (1998)
estimated that occupational annual effective doses to
medical staff at the time may have averaged around
1000 mSv
(a) Not more than seven working hours a day.
(b) Not more than five working days a week. (c)
Not less than one month's holiday a year.
(d) Whole-time workers in hospital X-ray and
radium departments should not be called upon
for other hospital service.
• ICRP, 1951 report (post world war)
Commission recommended a maximum
permissible dose of 0.5 R in any 1 week in the
case of whole-body and 1.5 R in any 1 week in
the case of exposure of hands and forearms
• The first 60 years after the discovery of ionising
radiation, the purpose of radiological protection was
that of avoiding deterministic effects from occupational
exposures, and the principle of radiological protection
was to keep individuals below the relevant thresholds
• First recommendation on restrictions of exposures of
members of the public appeared in the Commission’s
1954 Recommendations
• Recommended 10 times lower threshold for public -
general public includes more sensitive persons such as
children and those suffering from diseases and in view
of possible genetic effects
• The concept of critical organ was now introduced
 ICRP Major publications…
• Publication 1: 1958
• The weekly dose limit was replaced by
accumulated limit of annual effective dose 5
rem (50 mSv)
• Publication 9 (ICRP, 1966): substantially
renewed the radiation protection philosophy
by moving from deterministic to stochastic
effects
 ICRP Major publications…
• ICRP Publication 26 (1977)
• Distinguished between stochastic and non-
stochastic effects
• Introduced effective dose equivalent and
collective dose
• Introduced the system of dose limitation
based on principles of justification,
optimization, and limitation (these ideas had
been around since at least 1960)
 ICRP Major publications…
• Publication 60 (1990)
• Recommendations expanded to include
consideration of waste disposal, protection
during emergencies
• Process-based system distinguished between
practices and interventions
 ICRP Major publications…
Publication 103 (2007)
Moves from process-based to situation-based
system
– Planned exposure situations
– Emergency exposure situations
– Existing exposure situations

• Distinguishes between source-related protection

using constraints and reference levels and
individual-related protection using dose limits
The Evolution of Dose limits
ICRP 60 & 103 Dose limit comparisons
ICRP & NCRP dose limit comparison
AERB Dose limit
 AERB Dose Limit to trainees
• Apprentices and trainees between 16 and 18 years of age

• an effective dose of 6 mSv (20mSv for occupational)

in a year;
• an equivalent dose to the lens of the eye of 50 mSv (
Occupational 150 mSv) in a year
• an equivalent dose to the extremities (hands and
feet) of 150 mSv ( 500 mSv) in a year and
• an equivalent dose to the skin of 150 mSv( 500 mSv)
in a year.