U/S

MRI
 Contents
Introduction
Basic principles
Geometry and Historical Development
Detector and detector arrays
Details of acquisition
Tomographic reconstruction
Digital image display
Radiation dose
Image quality
 Artifacts

1/22/25 2
 1.1. INTRODUCTION
Clinical Computed Tomography (CT) was
introduced in 1971 - limited to axial imaging
of the brain in neuroradiology
It developed into a versatile 3D whole body
imaging modality for a wide range of
applications in for example
Oncology, vascular radiology, cardiology,
traumatology and interventional radiology.
Computed tomography can be used for;
 Diagnosis and follow-up studies of patients
 Planning of radiotherapy treatment

 Screening of healthy subpopulations with specific

risk factors.
Cont…
Nowadays dedicated CT scanners are
available for special clinical applications,
such as;
For radiotherapy planning - these CT
scanners offer an extra wide bore, allowing
the CT scans to be made with a large field of
view.
The integration of CT scanners in multi
modality imaging applications, for example
by integration of a CT scanner with a PET
scanner or a SPECT scanner.
 Cont…
Other new achievements for dedicated
diagnostic imaging new achievements
concerns for example;
the development of a dual source CT scanner
(a CT scanner that is equipped with two x-ray
tubes)
volumetric CT scanner
(a 320 detector row CT scanner that allows for
scanning entire organs within one rotation)
Cont…

CT scanning is perfectly suited for 3D

imaging and used in, for example, brain,
cardiac, musculoskeletal, and whole body CT
imaging
The images can be presented as impressive
colored 3D rendered images, but radiologists
usually rely more on black and white, 2D
images
 Parts of CT scanner
Out side Gantry

Aperture
Controls

Housing

Couch
Typical CT scanner (Inside)
Slip Ring

Generator

Detector

X-ray
Tube
ct
 THE CT IMAGING SYSTEM
Gantry and table
The CT gantry contains all devices
that are required to record
transmission profiles of a patient,
since transmission profiles have to
be recorded under different angles
these devices are mounted on a
support that can be rotated.
Gantry and table…
On the rotating part of the gantry are
mounted for example
the x-ray tube, the detector, the high voltage
generator for the x-ray tube, the (water or air)
cooling of the x-ray tube, the data acquisition
system, the collimator, and the beam shaping
filters. D
R

T
T X-ray tube
X
D X-ray detectors
X X-ray beam
R Gantry rotation

[Link] [Link]
Review of Radiology Physics: A Handbook for Teachers and Students - 1.1.1 Slide 1
Cont…
Electrical power is
generally supplied to the
rotating gantry through rotating gantry – with
tube and detectors slip
contacts (brushes) from contact
brushes
rings

stationary slip rings.

Projection profiles are power

transmitted from the

gantry to a computer
usually by wireless brush
communication (or slip compute

ring contacts).
r

[Link]
Cont…
The position of the patient on the table can
be
head first or feet first
supine or prone
The position is usually recorded with the scan
data.

[Link]

Review of Radiology Physics: A Handbook for Teachers and Students - 1.1.1 Slide 1
 The X-ray tube and generator
An x ray tube (with a rotating tungsten
anode) and high voltage generator are used
for generating the x ray beam.
The beam is collimated to create the ‘dose
slice’ (or’cone’)
High Voltage 70 - 150
kV
Tube housing
- Rotor +
Anode

Filamen Stator
Vacuum
t tube
Electron beam Thin window
Z-axis (patient axis) Movable Collimator: 1 – 160 mm depending on the scann

X-ray beam
Filtration…
Beam shaping filters are being used to
create a gradient in the intensity of the x-ray
beam
They are sometimes called “bow-tie” filters
They are mounted close to the x-ray tube.
The purpose of the beam shaping filter is to;
Reduce the dynamic range of the signal
recorded by the CT detector
Reduce the dose to the periphery of the
patient
Attempt to normalize the beam hardening of
the beam
Filtration…
 Schematic figure showing the fan beam, flat and
beam shaping (‘bow-tie’) filters

x-ray tube

flat filter
‘bow-tie’
filter
X-ray fan
beam

detectors

ImPACT
Detectors

CT scanner detectors

~ 800-1000 detector elements along the
detector arc
1 – 320 detectors along z-axis
CT detectors are curved in the axial plane
(x-y plane), and rectangular along the
longitudinal axis (z-axis)

outer
detectors
used for
calibration

x-y plane z-axis

 BASIC PRINCIPLES OF CT
The mathematical principles of CT were
first developed by Radon in 1917.
Proved that an image of an unknown
object could be produced if one had an
infinite number of projections through
the object.

18
 CT PRINCIPLES
X-ray projection, attenuation and acquisition of
transmission profiles

The purpose of a CT acquisition is to

measure x-ray transmission through a
patient for a large number of views.
x-ray tube

attenuated beam
attenuated beam

detector
element
 X-ray projection, attenuation and acquisition of
transmission profiles

 A CT image is composed of a matrix of pixels

representing the average linear attenuation co-
efficient in the associated volume elements
(voxels).
pixel
array
voxe
l
4 basic Principles of CT
BASIC PROCESS
• ACQUISITION
– process of exposing the patient to x-rays and
acquiring
the image converting it into digital data
• RECONSTRUCTION
– computer “reads” the data and generates a cross-
sectional image
• DISPLAY
– the reconstructed image is displayed on a
monitor
• ARCHIVE –
the images are stored either softcopy or hardcopy
 Tomographic Acquisition
A 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
There are two projection geometries that
have been used in CT imaging
 parallel beam geometry in which all of the rays in
a projection are parallel to each other
 fan beam geometry, the rays at a given projection
angle diverge and have the appearance of a fan

22
Cont….
All modern CT scanners incorporate fan
beam geometry in the acquisition and
reconstruction process
The acquisition of a single axial CT image
may involve approximately 800 rays taken
at 1,000 different projection angles
for a total of approximately 800,000
transmission measurements

23
 Computed tomographic (CT) images are produced from a large
number of x- ray transmission measurements called rays.
 A group of rays acquired in a certain geometry is called a
projection or view.

Two different geometries have been used in CT, parallel beam

projection and fan beam projection, as shown in this figure.
24
1.2. GEOMETRY AND HISTORICAL
DEVELOPMENT

25
Advancements in CT technology

Recent advances in
acquisition geometry,
detector technology,
x-ray tube design have led to scan times
now measured in fractions of second

26
.

CT Generations

27
First Generation: Rotate/Translate, Pencil Beam
Only two x-ray detectors were used
They measured the transmission of x-rays
through the patient for two different slices
This system used parallel ray geometry

28
FIGURE. First-generation (rotate/translate)
• The x-ray tube and a single detector (per CT slice) translate across
the field of view, producing a series of parallel rays.
•The system then rotates slightly and translates back across the field
of view, producing ray measurements at a different angle.
•This process is repeated at 1-degree intervals over 180 degrees,
resulting in the complete CT data set.

29
Second Generation: Rotate/Translate, Narrow Fan Beam
has the incorporation of a linear array of 30
detectors
this has increased the utilization of the x-ray
beam by 30 times, compared with the single
detector used per slice in first-generation
systems
A relatively narrow fan angle of 10 degrees
was used
has a reduction in scan time of about 30-fold
could be expected

30
Detector geometry

31
Cont..
The pencil beam
allowed very efficient scatter reduction
because scatter that was deflected away from
the pencil ray was not measured by a detector.

32
 Cont…
Pencil beam geometry makes inefficient use of the x ray
source, but it provides excellent x-ray scatter rejection.
 X-rays that are scattered away from the primary pencil
beam do not strike the detector and are not measured.
Fan beam geometry makes use of a linear x-ray detector
and a divergent fan beam of x-rays.
 X-rays that are scattered in the same plane as the detector
can be detected, but x-rays that are scattered out of plane
miss the linear detector array and are not detected.
Scattered radiation accounts for approximately 5% of the
signal in typical fan beam scanners.
 Open beam geometry, which is used in projection
radiography, results in the highest detection of scatter.
Depending on the dimensions and the x-ray energy used,
open beam geometries can lead to four detected scatter
events for every detected primary photon
33
Third Generation : Rotate/Rotate, Wide Fan Beam
The number of detectors used in third-
generation scanners was increased
substantially (to more than 800
detectors), and the angle of the fan beam
was increased

34
Cont..
Because detectors and the associated
electronics are expensive, this led to more
expensive CT scanners

The multiple detectors in the detector array

capture the same number of ray
measurements in one instant as was
required by a complete translation in the
earlier scanner systems

35
Cont…
The mechanically joined x-ray tube and
detector array rotate together around
the patient without translation
The motion of third-generation CT is
“rotate/rotate,” referring to the rotation
of the x-ray tube and the rotation of the
detector array
By elimination of the translational
motion, the scan time is reduced
substantially

36
FIGURE Third-generation (rotate/rotate) computed tomography.
In this geometry, the x-ray tube and detector array are mechanically
attached and rotate together inside the gantry.
The detector array is long enough so that the fan angle encompasses
the entire width of the patient

37
Cont…
 third-generation scanners,
 even a slight imbalance between
detectors affects the t values that
are back- projected to produce the
CT image, causing the ring
artifacts.

38
Fourth Generation: Rotate/Stationary
Fourth-generation CT scanners
were designed to overcome the problem of ring
artifacts.
With fourth-generation scanners,
the detectors are removed from the rotating
gantry and are placed in a stationary 360-degree
ring around the patient requiring many more
detector
 Modern fourth-generation CT systems use
about 4,800 individual detectors
Because the x-ray tube rotates and the
detectors are stationary, fourth-generation
CT is said to use a rotate/stationary geometry
39
FIGURE . Fourth-generation (rotate/stationary) computed tomography
•The x-ray tube rotates within a complete circular array of detectors,
which are stationary.
•This design requires about six times more individual detectors than a
third-generation CT scanner does.
• At any point during the scan, a divergent fan of x-rays is detected by a
group of x-ray detectors
40
Helical CT
Helical CT (also inaccurately called spiral CT)
scanners
 acquire data while the table is moving;
 the x-ray source moves in a helical pattern around the
patient being scanned
 helical scanning allows the use of less contrast agent
The total scan time required to image the patient
can be much shorter
(e.g., 30 seconds for the entire abdomen).
In some instances the entire scan can be performed
within a single breath-hold of the patient, avoiding
inconsistent levels of inspiration.

41
.

With helical CT,

• the x-ray tube rotates around the patient while the patient
and the table are translated through the gantry.
• The net effect of these two motions results in the x-ray
tube traveling in a helical path around the patient

42
Cont…
If the x-ray tube can rotate constantly, the
patient can then be moved continuously
through the beam, making the examination
much faster

43
 Continuous &
Simultaneous
• Source rotation
• Patient translation
• Data acquisition

44
Helical scanning

45
Cont…
The speed of the table motion relative to the
rotation of the CT gantry is a very important
consideration, and the pitch is the parameter
that describes this relationship

46
47
48
Disadvantage
-Artifact

49
 1.3. DETECTORS AND DETECTOR
ARRAYS

50
A. Xenon Detectors
Use high-pressure (about 25atm)
non-radioactive xenon gas, in long
thin cells between two metal plates

51
• Xenon detector arrays are a series of highly directional
xenon-filled ionization chambers.
• As x-rays ionize xenon atoms, the charged ions are
collected as electric current at the electrodes.
• The current is proportional to the x-ray fluence

52
Cont…
The metal that separate the individual
xenon detectors is made quite thin,
and this improves the geometric
efficiency by reducing dead space
between detectors
Must be positioned in a fixed
orientation with respect to the x-ray
source.

53
Cont…
Xenon detectors can be used only for third-
generation systems.

 As x-rays interact with the xenon atoms

and cause ionization (positive atoms and
negative electrons),
The electric field (volts per centimeter)
between the plates causes the ions to
move to the electrodes, where the
electronic charge is collected.

54
Cont…
The electronic signal is;
amplified and then digitized,
its numerical value is directly
proportional to the x-ray intensity
striking the detector.

55
 Xenon detectors
_
X-ray

+ Xenon
PositiveAtom
xenon ion
Negative electron -

Electrical signal
+
56
B. Solid-State Detectors
Composed of a scintillator coupled tightly to
a photo detector

Photodiode is an electronic device that converts

light intensity into an electrical signal
proportional to the light intensity

The scintillator emits visible light when

it is struck by x-rays

The light emitted by the scintillator

reaches the photo-detector

57
Ceramic scintillators
X-ray

Scintillator
Visible photon

Photo-diode
Electrical signal

58
Cont…
Because the density and effective atomic
number of scintillators are substantially
higher than those of pressurized xenon
gas, solid-state detectors typically have
better x-ray absorption efficiency
Solid-state detectors;
are required for fourth-generation CT
scanners
their top surface is essentially flat
 This implies it is capable of x-ray detection over a
wide range of angles, unlike the xenon detector

59
FIGURE .
• Solid-state detectors comprise a scintillator coupled to a
photodiode.

• X-rays interact in the scintillator, releasing visible light, which strikes

the photodiode and produces an electric signal proportional to the x-
ray fluence.

60
Detectors compared
Xenon filled ionization chambers were used till
~ year 2000
Fewer ring artefacts
Lower detection efficiency
Currently solid state detectors are used
better detection efficiency

Detector Type Efficiency

Xenon gas filled 70%

Solid state Approaching 100%

Review of Radiology Physics: A Handbook for Teachers and Students - 1.1.1 Slide 1
 Physical characteristics of detectors

Essential physical characteristics of the CT

detectors are;
Good detection efficiency
Fast response (and little afterglow)
Good transparency for the generated light
1.4. DETAILS OF ACQUISITION

63
Slice Thickness: Single Detector Array Scanners
The slice thickness in single detector
array CT systems :
is determined by the physical collimation of the
incident x-ray beam with two lead jaws
As the gap between the two lead jaws widens,
the slice thickness increases
The width of the detectors in the single
detector array places an upper limit on slice
thickness
Opening the collimation beyond this point
would do nothing to increase slice thickness,
but would increase both the dose to the patient
and the amount of scattered radiation.
For the same KVp and mAs values, increasing
slice thickness linearly increases the number of
photons detected and also SNR increases. 64
Effects of slice thickness
Larger slices
yield better contrast resolution
(higher SNR)
the spatial/detail resolution in the
slice thickness dimension is reduced
Thin slices
 improve spatial resolution
 reduce partial volume averaging
 forthin slices, mAs is usually increased
to compensate for the loss of photons
resulting from collimation
65
Slice Thickness: Multiple Detector Array Scanners

Determined not by the collimation, but

rather by the width of the detectors in

the slice thickness dimension

66
A: In a single detector array CT scanners:
 the width of the CT slice is determined by the collimator.
 the collimator width is always smaller than the maximum detector
width.
 Slice thickness is changed by mechanically changing the collimator
position

B: Multiple detector array CT scanners

 acquire several slices simultaneously (four slices shown here),
 Slice thickness is determined by binning different numbers of detector

subunits together and by physically moving the collimator to the

outer 67
edges of all four slices.
Pitch
 Is important component of the scan
protocol,
 It fundamentally influences
 radiation dose to the patient,
 image quality, and
 scan time
 table distance traveled in one 360° gantry
rotation divided by beam collimation

68
Cont…

Pitch
 is a scan parameter that comes to play
when helical scan protocols are used

69
Cont….
A pitch of less than 1.0 implies
a higher radiation dose to the
patient
may result in some slight
improvement in image quality
 Pitches greater than 1.0, and
pitches up to
1.5 are commonly used

70
Cont…
Pitches with values greater than
1.0 imply
 faster scan time,
 less patient motion, and
 use of a smaller volume of
contrast agent

71
Collimator and detector
pitch
The detector pitch for multiple detector
array scanners, and it is defined as:

72
 Collimator pitch is defined as T/C, and
 Detector pitch is defined by T/D.

73
Cont…
For a multiple detector array
scanner with N detector arrays,

74
Cont…
Collimator pitches range between 0.75 and
1.5
For scanners with four detector arrays,
detector pitches running from 3 to 6 are
used.
Example
A detector pitch of 3 for a four-detector array
scanner is equivalent to a collimator pitch of
0.75 (3/4), and a detector pitch of 6
corresponds to a collimator pitch of 1.5 (6/4)
 For a multiple detector array CT scanner with four detector arrays, a collimator
pitch of 1.0 is equal to a detector pitch of 4.0.

75
Helical pitch
table speed 
pitch 

76
.

1.5. Tomographic
Reconstruction

77
IMAGE RECONSTRUCTION AND PROCESSING
General concepts

During a CT scan, numerous measurements

of the transmission of x-rays through a
patient are acquired at many angles
This is the basis for reconstruction of the CT
image.
x-ray tube

I0

attenuation

I(d)
x-y plane
detector element
ImPACT
Cont…
The figure below shows;
(a) the x-ray projection under a certain angle
(b) leading to one transmission profile
The back projection distributes the
measured signal evenly over the area
(c) under the same angle as the projection
Cont…

Algebraic reconstruction solves a number of

simultaneous equations.
For example
Projections in two horizontal, two
vertical, and two diagonal directions
yield six projection values.
These values can be used to solve
an over complete set of six equations.
The equations can be solved
and they yield the 2 x 2 image matrix.
CT axis’
axial coronal SAGITTAL
.Example
Simple Back projection Reconstruction
to determine pixel values(A,B, C, D)

83
Cont…
The mathematical problem posed by
computed tomographic (CT)
reconstruction is to calculate image data
(the pixel values—A, B, C, and D) from
the projection values (arrows).
For the simple image of four pixels
shown here, algebra can be used to solve
for the pixel values.
For the larger images of clinical CT,
algebraic solutions become unfeasible,
and filtered back projection methods are
used.
84
Cont…
A modern CT image
Contains about 800,000 projections represent
an individual equation.
 Solving this kind of a problem is beyond

simple algebra, and back projection is the

method of choice
Simple back projection is a
mathematical process, based on
trigonometry, which is designed to
emulate the acquisition process in
reverse
85
 1.6. DIGITAL IMAGE DISPLAY

 Once images from the patient examination have been

reconstructed, the image data must be conveyed to the
physician for review and diagnosis

86
 Hounsfield Units(HU)
 In CT image, the matrix of reconstructed
linear attenuation coefficient (μmaterial) is
transformed into a corresponding matrix of
hounsfield units (HUmaterial),
 HU scale is expressed relative to the linear
attenuation coefficient of water (μwater) at
room temperature.

87
Cont…
The number CT(x, y) in each pixel, (x,y), of the
image is converted using the following
expression

Where, is the floating point number of the (x,y)

pixel before conversion,
water is the attenuation coefficient of water and

CT(x,y) is the CT number (or Hounsfield unit) that

ends up in the final clinical CT image

88
Cont..
The value of water is , about 0.195 for the x-
ray beam energies typically used in CT
scanning.
This normalization results in CT numbers
ranging from about —1,000 to +3,000,
Where,
 — 1,000 corresponds to air,
 soft tissues range from —300 to —100,
 water is 0, and
 dense bone and areas filled with contrast
agent range up to +3,000
89
90
Windowing and Leveling
Are post processing techniques
that are applied to display all CT
images
CT images typically possess 4,096
shades of gray
Electronic display devices such as
computer monitors have the ability
to display 256 shades of gray
For resolving relative differences
in gray scale as in viewing medical
images, the human eye has limited
ability (30 to 90 shades of gray) 91
Cont…
The window width defines the range of HUs
that is represented by the mapped values
(ranging from white to black) and;
The window level defines the central HU
value within the selected window width.
Optimal visualization of the tissues of
interest in the image can only be achieved by
selecting the most appropriate window width
and window level.
Consequently, different settings of the
window width and window level are used to
visualize soft tissue, lung tissue or bone.
92
Cont..
 The most common way to perform this post
processing task (which nondestructively
adjusts the image contrast and brightness),
is to window and level the CT image

 The level (L) is the CT number at the

center of the window

93
Cont…
Windowing
•is the process used to select the
range of CT numbers to be displayed
•window width is the range of CT
numbers that will be displayed
•window level is the midpoint of the
range selected by the width
CT window width/level

Tight Window Wide Window

Level 50, Width 2 Level 50, Width 1000
96
The window and level values are used to
manipulate the contrast of the CT image
A narrow window produces a very high
contrast image, corresponding to a large
slope on the figure.
CT numbers below the window (lower
than P1) will be displayed on the image
as black;
CT numbers above the window (higher
than P2 will be displayed as white.
Only CT numbers between P1 and P2
will be displayed in a meaningful
manner.
97
1.7. IMAGE QUALITY
&
ARTIFACTS

98
 Image Quality (IQ)
Spatial (Detail)Resolution
• is the ability to portray/separate 2 objects
that are located immediately next to each other
Cont…
• As the speed of the scan increases, the
spatial resolution decreases because of
the increase in image noise

• Speed of scan is factor to consider when

scanning elderly patients (limited breath
hold) and uncooperative patients
Cont…
 Contrast Resolution
• Is the ability to portray /indicate the difference
between 2 objects with similar densities
• average scanner can detect a density difference of
0.4%
Noise
• Is variation in contrast due to
interactions with the detector that does
not represent the attenuation of the
patient (ie. scatter)
• The more photons that strike the
detector, the less noise (SNR)
• larger patients decrease the amount of
photons reaching the detector and
increase noise
• The greater the mA results in less noise
Cont…
Noise
Cont…
Compared with x-ray radiography,
CT has significantly
worse spatial resolution,
better contrast resolution

 CT has, by far, the best contrast

resolution of any clinical x-ray
modality

104
 Factors Affecting Spatial Resolution
Focal spot size
 larger focal spots cause more geometric un
sharpness in the detected image and reduce
spatial resolution
Slice thickness
 Large slice thicknesses clearly reduce spatial
resolution
Helical pitch:
 greater pitches reduce resolution

Patient motion:
 If there is involuntary motion (e.g., heart) or motion
resulting from patient noncompliance (e.g.,
respiratory), the CT image will experience blurring
proportional to the distance of the motion during the
scan 105
 Factors Affecting Contrast Resolution
mAs:
Increasing the mAs of the study
 improves contrast resolution
 dose increases linearly with mAs per scan
 the comments for decreasing mAs apply here.
Slice thickness
 The slice thickness has a strong (linear) influence
on the number of photons used to produce the
image
Patient size:
 larger patients attenuate more x rays, resulting in
detection of fewer x-rays.
 This reduces the SNR and therefore the contrast
resolution.
106
Cont…
Gantry rotation speed
faster gantry rotations result in reduced mAs

used to produce each CT image, reducing

contrast

107
.
1.8. ARTIFACTS

108
[Link] artifact
Probably the most common mechanical
artifact
The image of one or more rings appears
with in the image
This is due to detector fault

109
Cont…
Ring Artifacts
• as the detector rotates around, it will cause an
incorrect reading at a fixed radius which
appear as dark rings
• may be corrected with calibration or else
service will be needed
2. Noise Artifact
This appears as gaining on the image
Is caused by a low signal to noise ratio
(SNR)
common when a thin slice thickness is
used
It can also occur when the KV or mA is too
low

111
Noise…
• dependent on amount of photons striking
detector
• fewer photons mean more noise and a weaker
signal (graininess)
• Noise is reduced with optimal patient
positioning and scanning parameters
3. Motion artifact
This is seen as blurring which is caused by
patient movement
Is not so much a problem these days with
faster scanning times in use of MDCT

113
Cont…

-movement during the acquisition…such as

patient motion, cardiac motion, and respiration
-minor motion results in blurring, significant
motion results in streaks
-caused by an inconsistency in the measured
attenuation during a 360 degree scan
-to reduce motion…clear breathing instructions,
anti-peristalsis drugs, decrease scan time
Example…
Motion artifacts
4. Beam hardening
CT uses poly energetic x-rays (25-120kvp)
After passing through a given patient
thickness, low energy x-rays are attenuated
to a greater extent than high energy x-rays
are
Average energy of the beam becomes
greater (harder)
Occurs when there is a more attenuation in
the center of the object than around the
edge

116
Cont…
Beam Hardening
• Caused by increase in the mean energy of the
beam as the lower energy photons are absorbed
• seen in high attenuation areas or large size
patients
• results in dark wide streaks between 2 dense
objects
• reduced by using a filter (beam hardener) which
evens out energy range and also via processing
during reconstruction
• Eg. Occurs b/n the petrous bones in the head, where a
spider web like artifact connects the two bones on the image
A: A beam-hardening artifact caused by four
calcium-filled cylinders is illustrated.
B: Artifacts due to motion are shown.

A. dark ‘streaks’ behind high-density objects,

e.g. dental amalgam and metallic joint
118
replacements
 5. Partial Volume Averaging

• A partial volume artifact occurs when the computed tomographic

slice interrogates a slab of tissue containing two or more different
tissue types.
• Many partial volume artifacts are obvious (e.g., with bone), but
occasionally a partial volume artifact can mimic pathologic
conditions 119
Artifacts…
Partial Volume Averaging
- occurs when a voxel contains tissues of varying
densities and the computer has to assign it only 1
CT number
- it will average the CT number for that volume
- common to occur along edges of bones
- can also occur along contrast filled and air filled
bowels and along the aortic root due to an
abundance of contrast in the SVC and cardiac
motion
- Reduced by using thin slice thickness
6. Metal artifacts
• Object absorbs so much radiation that the
detector assumes no radiation was transmitted
and fills in the missing data with calculations
along the view incorrectly
 1.9. CT dose
• CT scanners expose patients to a considerable
amount of radiation
• growing concern about the amount of dose
being given to patients
• in 1990 accounted for 20% of medical
radiation dose and in 2008 accounted for 47%
• a head scan produces an effective dose of
2mSv, which is the amount an average person
receives from background radiation in 8
months
• follow the ALARA PRINCIPLE (As Low As
Reasonably Achievable)
Factors that influence Dose from CT
1. Beam energy(kvp) & mAs
2. Pitch for helical scan
3. Slice thickness

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Methods to reduce patient dose in CT

1/22/25 Radioligical phy. by Alex.D 124

2. Increasing pitch

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Cont…
Limit the scanned volume
Reduce mAs value
Use automatic exposure control by adapting
the scanning parameters to the patient
across section

1/22/25 Radioligical phy. by Alex.D 126

What can operators do…
Use of spiral CT with pitch factor > 1
Shielding of superficial organs such as
thyroid, breast, eye lens and gonads
particularly in children and young adults.
-this results in 30-60% dose reduction to
the organ

1/22/25 Radioligical phy. by Alex.D 127

Actions for physician & radiologist
Ensure that patients are not irradiated
unjustifiably
Request for CT exam should be generated
by properly qualified medical practitioners
The physician is responsible for weighing
the benefits against the risks
Consider whether the required information
be obtained by MRI or u/s

1/22/25 Radioligical phy. by Alex.D 128

Cont…
CT scanning in pregnancy may not be
contraindicated, particularly in emergency
situations, although examinations of the
abdomen or pelvis should be carefully justified
CT examinations should be limited to the area
of interest
Clinician has to communicate to the radiologist
about previous CT exam of the patient
 CT examination for research purpose that do
not have clinical justification(no benefit to the
patient) should be subject to critical evaluation
by an ethics committee

1/22/25 Radioligical phy. by Alex.D 129

Cont…
CT examination of chest in young girls
needs to be justified in view of high breast
dose
Once the examination has been justified,
the radiologist has the primary
responsibility for ensuring that the
examination is carried out with good
technique

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CT dose
Summary
Factors Affecting Dose
CT dose…
CT dose
CT Technologists
• Everyone in medicine plays a role in
helping patients and providing care
• you play a vital role in providing clinicians
the information they need to make an
impact in someone’s life
• your responsibility is to know your craft
and optimize your skill to provide optimal
images and at the same time focus on
patient care
Questions?