COMPUTED TOMOGRAPHY

DEFINITION BRIEF HISTORY

COMPUTED TOMOGRAPHY 1930’S – ALLESANDRO VALLEBONA

 Creation of a cross-sectional tomographic  Proposed a method to represent a single
section of the body with a rotating fan beam, slice of the body on the radiographic film
a detector array and computed (TOPOGRAPHY)
reconstruction
 Other Names: Computed Axial 1970 – GODFREY NEWBOID HOUNSFIELD
Tomography (CAT), Computed Transaxial  First demonstrated the CT technique
Tomography (CTAT), Computed
Reconstruction Tomography (CRT), Digital 1972-1974
Axial Tomography (DAT), Body Section  First clinical CT scanners were installed
Roentgenography
 Greek Word: “Tomos” = slice/section; 1979
“Graphia” = describing  Hounsfield & Allan Mcleod Cormack
shared the Nobel Prize in Physics
CT SCANNER
 Consists of an x-ray source emitting finely 1980
collimated x-ray beam and a single detector  CT scan machine became widely available
both moving synchronously in a translate or
rotate mode or a combination of both EMI SCANNER
 1st CT scan machine
 180 translation/1o rotation
INTRODUCTION
ACTA
COMPUTERS  1st CT system that could make images of any
 Used Binary System part of the body
 Did not require water tank
BINARY DIGIT/BIT
 Can code for 2 values or 2 shades of gray
which correspond to white and black PRINCIPLES OF OPERATION
 8 bits=1 byte
 2 bytes=1 word CONVENTIONAL/AXIAL TOMOGRAPHY
 16 bits=1 word  Plane of the image is parallel to the long
axis of the body
STORAGE REQUIREMNENT  Produces sagittal and coronal images
 Kilobytes, megabytes, gigabyte or terabytes
COMPUTED TOMOGRAPHY
 Plane of image is perpendicular to the long
axis of the body
 Produces a transverse image
1
 COMPUTED TOMOGRAPHY

CT IMAGE 2ND GENERATION

 A transaxial/transverse image  Has a narrow fan beam and multiple
detectors
TRANSLATION/SWEEP
 It refers to movement of source-detector 3RD GENERATION
assembly across the patient  Has a wide fan beam
 Results in a projection
 Projection: represents the attenuation 4TH GENERATION
pattern of patient profile  Equipped with a detector ring
 Detector signal: has a dynamic range of 12
bits (4096 gray levels) 5TH GENERATION
 The electron beam tomography CT
PROJECTION
 An intensity profile 6TH GENERATION
 The helical (or spiral) CT scanner
ALGORITHM
 Computer-adapted mathematical calculation 7TH GENERATION
applied to raw date during image  The multi-detector row CT.
reconstruction
SEVEN GENERATIONS
RECONSTRUCTION
 Creation of an image from date FIRST GENERATION
 A demonstration project
RECONSTRUCTION TIME  Characteristic: translate/rotate (Bushong )
 Time needed for the computer to present a or rotate/translate (Reveldez)
digital image after an examination has been  X-ray Beam Shape: pencil beam
computed  Detector: single detector
 Time between the end of imaging and the  Imaging Time: 5-minute imaging time
appearance of an image
SECOND GENERATION
 Characteristic: translate/rotate (Bushong )
GENERATIONS OF COMPUTED or rotate/translate (Reveldez)
TOMOGRAPHY  X-ray Beam Shape: narrow fan beam
 Detector: multiple detector (5-30)
GENERATION OVERVIEW  Imaging Time: 30 seconds
 Advantage: speed
1ST GENERATION
o Rationale: consist of multiple
 Has a pencil beam and one detector
detectors
 Disadvantages:
o Increased scattered radiation
2
 COMPUTED TOMOGRAPHY

o Increased radiation intensity toward However, detectors are calibrated twice during each
the edges of the beam rotation of the x-ray source, proving a self-
 Compensation: used of bow- calibrating system. Third generation system are
tie filter calibrated only once every few hours.
 Bow-tie Filter: equalize the radiation
intensity that reaches the detector array FIFTH GENERATION (early 1980’s)
 Electron beam CT
THIRD GENERATION  Ultrafast CT scanner
 Characteristic: rotate/rotate  X-ray tube rotation is mechanical
 X-ray Beam Shape: wide fan beam  No moving parts
 Detector: curvilinear detector array (30)  Electron Gun: produces a focused electron
 Imaging Time: <1 second beam that generates a rotating x-ray fan
 Advantages: beam after being steered along tungsten
o Better x-ray beam collimation target rings
o Decreased scattered radiation
o Good image reconstruction SIXTH GENERATION (early 1990’s)
 Disadvantage: ring artifacts  Helical/Spiral CT
o Compensation: software connected  Volumetric scanners
image reconstruction algorithm  Introduced by Will Kalender and Kazuhiro
Katada
NOTE: Third generation designs have the  Uses slip ring technology
advantage that thin tungsten SEPTA can be place  Excels in 3D multiplanar reformation
between each detector in the array and focused on  Slip Ring: electromechanical device that
the x-ray source to REJECT SCATTERED conduct electricity and electric signals
RADIATION through rings and brushes across a rotating
surface onto a fixed surface
FOURTH GENERATION
 Characteristic: rotate/stationary SEVENTH GENERATION
 X-ray Beam Shape: wide fan beam  64-Slice CT
 Detector: fixed circular detector array  Multiple detector array
(4000) with detector ring IMAGING SYSTEM DESIGN
 Imaging Time: <1 second
 Advantage: no ring artifacts 3 MAJOR COMPONENTS
 Disadvantage: 1.) Gantry
o Increased patient dose 2.) Operating Console
3.) Computer
o High cost

GANTRY
NOTE: The detectors are no longer coupled to the
 Largest component
x-ray source and hence cannot make used of
focused SEPTA to reject scattered radiation.
3
 COMPUTED TOMOGRAPHY

 Subsystems: x-ray tube, detector array, high o Gas detector:

voltage generator, patient couch and o Basis: ionization of gas
mechanical support o Three types:
 Ionization chamber
X-RAY TUBE  Proportional counter
 Special requirements:  Geiger-Muller counter
o Power capacity: must be high o Characteristics:
 >120 kVp  Excellent stability
 400 mA  Large dynamic range
o High speed rotors: for heat  Low quantum efficiency
dissipation o Scintillation detector:
o Anode heat capacity: 7 MHU o Characteristic: high x-ray detection
(Spiral CT) efficiency (90%)
o Heat storage capacity: 8 MHU  Reduces patient dose
o Anode cooling rates: 1MHU/min  Allows faster imaging time
o Focal spot size: small  Improves image quality
 Takenote: CT scanners o Crystals used: Sodium iodide
designed for high spatial o Replaced by:
resolution imaging not for  Bismuth germinate (BGO)
direct projection imaging  Cesium iodide (CsI)
o Limiting characteristics: o Current crystal of choice:
 Focal spot design: must be  Cadmium tungstate (CdWO4)
robust or strong  Special ceramics
 Heat dissipation o Photodiode: converts light into electrical
o X-ray tube life: approx. 5000 signal
exposures (Conventional CT) o Characteristics:
 Focal-Spot Cooling Algorithms:  Small,
o Design to predict the focal spot  Cheap
thermal state  Does not require power
o To adjust the mA setting accordingly supply

DETECTORY ARRAY THREE IMPORTANT FACTORS

o Group of detectors CONTRIBUTING TO DETECTOR
o The image receptor in CT EFFICIENCY
o Detector: absorbs radiation and converts it
to electrical signal 1.) GEOMETRIC EFFICIENCY
o Types:  The area of the detectors sensitive to
o Gas-filled detector – previously used radiation as a fraction of the total exposed
area
o Scintillation & solid-state detectors –
2.) QUANTUM EFFICIENCY
recently used
4
 COMPUTED TOMOGRAPHY

 The fraction of incident x-rays on the o Construction: low-Z material (Carbon

detector that area absorbed and contribute to fiber)
the measured signal o Rationale: it does not interfere with
3.) CONVERSION EFFICIENCY x-ray beam transmission & patient
 The ability to accurately convert absorbed x- imaging
ray signal to electrical signal o Features: should be
o Smoothly and accurately motor
OVERALL/DOSE EFFICIENCY driven
 The product of geometric, quantum and  Rationale: precise
conversion efficiency positioning is possible
 Normal value: b/n 0.45-0.85 o Capable of automatic indexing
 Value <1: non ideal detector system  Rationale: operator does not
o Result: increased in patient dose to have to enter the room
maintain image quality between each scan

DATA ACQUISITON SYSTEM (DAS) COLLIMATION

 Computer-controlled electronic amplifier  Restricts the volume of tissue irradiated
and switching device  Purpose:
 Where signal from each radiation detector is o Reduces patient dose
connected o Improved image contrast
 Consists of:  Types: post patient & prepatient collimator
o Preamplifier  Prepatient Collimator
o Integrator o Limits the area of the patient that
o Multiplexer intercepts the useful beam
o Logarithmic o Mounted on the x-ray tube housing
o Amplifier or adjacent to it
o Analog-to-digital converter o Purpose: to decrease patient dose
o Determines:
HIGH VOLTAGE GENERATOR  Dose profile
o High frequency power  Patient dose
o High voltage step-up transformer  Predetector/Post Patient Collimator
o Power: 50 kW o Restricts the x-ray beam viewed by
o Accommodates higher x-ray tube rotor the detector array
speeds o Purpose:
o Accommodates instantaneous power surges  To decrease scattered
characteristic of pulsed system radiation
 To improved contrast
PATIENT COUCH o Determines:
o Supports the patient comfortably  Slice thickness
 Sensitivity profile
5
 COMPUTED TOMOGRAPHY

o mA: 400 (maximum)

OPERATING CONSOLE  varied according to
 Contains meters and controls  patient thickness to reduce
o For selection of proper imaging patient dose
technique factors o Slice thickness: 0.5-5 mm
o For proper mechanical movement of  Physician’s work station: allows the
the gantry and patient couch physician
o For the use of computer commands o To call up any previous image
 Allow image reconstruction o To manipulate image to optimize
and transfer diagnostic information
 2-3 operating consoles  Scan time: length of time required per scan
o 2 for CT radiologic technologists
 1st: To operate imaging COMPUTER
system  Unique subsystem of the CT imaging system
 2nd: to post-process images  Microprocessor & primary memory: heart
for filming and filing of the computer
o 1 for physician o Determine reconstruction time
 To view the images  Array processors:
 To manipulate contrast, size o Mostly used in CT instead of
& general visual appearance microprocessors
 Accepts the reconstructed o Rationale:
image from operator’s  Does many calculations
console  Faster than microprocessors
 Displays reconstructed image (<1 sec reconstruction time)
for viewing and diagnosis  Computer memories: ROM & RAM
 Two monitors:
 Random access memory: temporary
o 1st: provided for operator
memory that stores information while
 To annotate patient data on software is used
the image (e.g. hospital  Read only memory: for storage data only
identification, name, patient and cannot be overwritten
number, age, gender)
 Central Processing Unit (CPU): performs
 To provide identification for
calculations and logical operations under
each image (e.g. number,
control of software instruction
technique, couch position)
nd
o Heart of the computer
o 2 : allows the operator to view the
resulting image before transferring it
 Special requirements:
to hard copy or physician’s viewing
o Controlled environment
console
o Relative Humidity: <30%
 Technique factors:
o Temperature: <20oC
o kVp: <120

6
 COMPUTED TOMOGRAPHY

o High humidity and temperature:  Field of view (FOV): the diameter of image
contribute to computer failure reconstruction
o FOV increased, fixed matrix size
SLIP-RING TECHNOLOGY  Result: increase/larger pixel
 Slip ring: electromechanical device that size
conducts electricity and electrical signals o Fixed FOV, increase matrix size
through rings and brushes  Result: decrease/smaller
o Allows the gantry to rotate pixel size
continuously without interruption
o Made MSCT possible
 Brushes: transmit power to the gantry
components CT NUMBER/HOUNSFIELD UNIT (HU)
o Composition: silver graphite alloy  Used to assess the nature of tissue
 Used as sliding contact  HU: scale of CT number
o Replacement of brushes:  Range: -1000 – +3000
 Every year  Formula: CT Number = k (µt-µw/ µw)
 During preventive o k: constant that determines the scale
maintenance factor for the range of CT number
o µt: attenuation coefficient of the
tissue in the pixel under analysis
IMAGE CHARACTERISTICS o µw: x-ray attenuation coefficient of
water
IMAGING MATRIX
 Layout of cells in rows and columns CT NUMBER FOR VARIOUS TISSUES
 Original EMI: 80x80 matrix
o 6000 cells of information APPROXIMATE CT
TISSUES
 Current system: 512x512 matrix NUMBER
o 262,144 cells of information Dense bone 3000
 Pixel: a picture element
o Each cell of information Bone 1000
o Two-dimensional
Liver 40-60
 Pixel Size = FOV ÷ matrix size
 Voxel: a volume element Muscle 50
o The tissue volume
White matter 45
 Voxel (mm3) = pixel size (mm2) x slice
thickness (mm) Gray matter 40
 CT number/Hounsfield unit: the numeric
information contained in each pixel Kidney 30
 Matrix: rows and columns of pixels
Blood 20
displayed on a digital image
7
 COMPUTED TOMOGRAPHY

CSF 15  Recently: applied to virtual colonoscopy

Water 0 IMAGE QUALITY

Fat -100
FIVE PRINCIPAL CHARACTERISTICS OF
Lungs -200 CT IMAGE
1.) Spatial resolution
Air -1000 2.) Contrast resolution
3.) Noise
4.) Linearity
5.) Uniformity
IMAGE RECONSTRUCTION

SPATIAL RESOLUTION
FILTER BACK PROJECTION
 Ability to image small object that have high
 Process by which an image is acquired
subject contrast
during CT and stored in computer memory
is reconstructed  Expressed in: linepairs/millimeter (lp/mm)
 Filter: refers to mathematical function  A function of pixel size
 Takenote: SR for a CT image is limited to
MULTIPLANAR REFORMATION (MPR) the size of the pixel
 A method for generating coronal, sagittal, or  Image reconstruction and postprocessing
oblique images from the original axial image tasks: powerful way to affect SR
data  Formula: SR (cm) = ½ {1/SF (lp/cm)}
 MSCT: excels in 3D MPR
 3D MPR Algorithm: most frequently used FACTORS AFFECTING/INFLUENCING
SPATIAL RESOLUTION
THREE 3D MPR ALGORITHMS 1.) Pixel size
2.) Slice thickness
1.) MAXIMUM INTENSITY PROJECTION 3.) Voxel size
(MIP) 4.) Design of prepatient and predetector collimators
5.) Detector size
 Reconstruct an image by selecting the
highest value pixels along the arbitrary line
EFFECT IN
 Widely used in CT Angiography
FACTORS SPATIAL
2.) SHADED SURFACE DISPLAY (SSD)
RESOLUTION
 Computer-aided technique that identifies
narrow range of values as belonging to the Thick slice thickness Poor SR
object to be imaged
3.) SHADED VOLUME DISPLAY (SVD) Thin slice thickness Better SR
 Very sensitive to the operator-selected pixel
Large pixel size Poor SR
range
 Previously: applied to bone imaging Small pixel size Better SR
8
 COMPUTED TOMOGRAPHY

3.) Mechanical/electrical gantry control

4.) Reconstruction algorithm
Large voxel size Poor SR
IMAGE FIDELITY
Small voxel size Better SR
 Measured by determining the optical density
Large detector size Poor SR along the axis of the image

Small detector size Better SR LIMITING RESOLUTION

 Spatial frequency at MTF equal to 0.1
LINE PAIR
IMPORTANT MEASURES OF IMAGING
 One bar and its interspace of equal width
SYSTEM PERFORMANCE
1.) Artifacts generation
SPATIAL FREQUENCY
2.) Contrast resolution
 Used to describe CT spatial resolution
3.) Spatial resolution
 Low SF: represents large objects
 High SF: represents small objects
CONTRAST RESOLUTION
 The ability to distinguish one soft tissue
EDGE RESPONSE FUNCTION (ERF)
from another without regard for size or
 Mathematical expression of the ability of the
shape
CT scanner to reproduced a high-contrast
 Takenote: CR is superior to CT
edge with accuracy
o Rationale: better x-ray beam
collimation
MODULATION TRANSFER FUNCTION
 Ability to image low-contrast objects:
(MTF)
o Limited by:
 Mathematical expression for measuring
 Size and uniformity of the
resolution
object
 The ratio of the image to the object as a
 Noise of the system
function of spatial frequency
 Used to describe CT spatial resolution
X-RAY ABSORPTION IN TISSUE
 MTF = 1: faithfully represents the object
 Determined by the mass density of the body
 MTF = 0: image is blank and contain no
part
information
 Characterized by x-ray linear attenuation
 MTF = intermediate values: intermediate
coefficient
levels of fidelity
X-RAY LINEAR ATTENUATION
CHARACTERISTICS OF CT IMAGING
COEFFICIENT
SYSTEM CONTRIBUTING TO IMAGE
 A function of x-ray energy and atomic
DEGRADATION
number of the tissue
1.) Collimation
2.) Detector size and concentration
NOISE
9
 COMPUTED TOMOGRAPHY

 The percentage standard deviation of a  Constancy of pixel values in all region of the
large number of pixels obtained from a reconstructed image
water bath image  Evaluation test: plotting the CT number in
 The variation in CT number above or below histogram/line graph
the average values  Acceptable value: +/- 2 mean value
 Appears as graininess (Standard Deviation)
 Takenote: the resolution of low-contrast
objects is limited by the noise of the CT
imaging system MULTISLICE SPIRAL CT IMAGING
o Evaluation test: 20-cm water bath PRINCIPLES
o Frequency: daily
ADVANTAGE OF MSCT
PIXEL VALUE NOISE  Increases the volume of tissue that can be
imaged at a given time
Equal 0 o Rationale: it has the ability to image
a larger volume of tissue in a single
Large variation High
breath-hold
Small variation Low  Helpful in:
o CT Angiography
o Radiation therapy treatment
FACTORS AFFECTING NOISE o Imaging uncooperative patients
1.) kVp and filtration
2.) Pixel size
INTERPOLATION ALGORITHMS
3.) Slice thickness
 A special computer program
4.) Detector efficiency
 1st interpolation algorithm: used 360o
5.) Patient dose – primary control of noise
linear interpolation
o Disadvantage: caused prominent
LINEARITY
blurring of the reconstructed image
 Describes the amount to which the CT
 Solution for blurring: 180o linear
number of a material is exactly proportional
interpolation
to the density of this material (in Hounsfield
o Results:
units)
 Improved Z-axis resolution
 Evaluation test: five-pin performance test
 Improved sagittal and coronal
object
reformatted views
 Frequency: daily
o It allows imaging at a pitch <1
UNIFORMITY
 Interpolation: estimation of value between
 The consistency of the CT numbers of an
two known values
image of a homogeneous material across the
scan field  Extrapolation: estimation of value beyond
the range of known values
SPATIAL UNIFORMITY
10
 COMPUTED TOMOGRAPHY

 Data interpolation: performed by  If MSCT pitch=2:1:

interpolation algorithm o Sensitivity profile: 40% wider than
conventional CT
PITCH/SPIRAL PITCH
 The relationship between patient couch
movement and x-ray beam width IMAGING TECHNIQUES
 Spiral Pitch Ratio:
o PITCH = Couch movement each TWO PRINCIPAL DISTINGUISHING
360o ÷ Beam width FEATURES OF MSCT
 MSCT Pitch: 1 1.) Several parallel detector arrays
o Rationale: 2.) Quickly energizing
 Multiple slices are obtained
 Z-axis location and MULTISLICE DETECTOR ARRAY
reconstruction width can be  Early 1990’s: initial demonstration of dual-
selected after imaging slice imaging
 CTA Pitch: <1:1  Recently: 320 slice imaging
 Pitch >1:1:  Wider slice imaging:
o Decreases Z-axis resolution o Better contrast resolution (at same
o Rationale: a wide section sensitivity mA setting)
profile  Rationale: detected signal is
larger
VOLUME IMAGING o Slight decrease in spatial resolution
 Formula:  Rationale: increased voxel
o TISSUE IMAGED = Beam width x size
Pitch x Imaging time  Smaller detector size: better spatial
 For 360o gantry rotation/sec resolution
o TISSUE IMAGED = (Beam width
x Pitch x Imaging time) ÷ gantry DUAL SOURCE MSCT
rotation  Has two x-ray tubes & two detector arrays
 If gantry rotation is not  Principal advantage: speed
360o/sec  Imaging time: 80 ms

SENSITIVITY PROFILE DATA ACQUISITION RATE

 Full Width at Half Maximum (FWHM):  Slice Acquisition Rate (SAR): one measure
o The width of sensitivity profile at of the efficiency of the MSCT imaging
one half of its maximum value system
 Formula:
 If MSCT pitch=1:1: o SAR = Slice acquired/360o ÷
o Sensitivity profile: 10% wider than Rotation time
conventional CT

11
 COMPUTED TOMOGRAPHY

Z-AXIS COVERAGE (Z) needed

 Formulas:
o Z = (N/R) x W x T x B Reduced z-axis
-increases with pitch
resolution
o Z = SAR x W x T x B
 N: number of slice acquired Increased processing -more data, more
 R: rotation time time images needed
 W: slice width
 T: time
 B: pitch

COMPUTED TOMOGRAPHY QUALITY

FEATURES OF MSCT
CONTROL
ADVANTAGES RATIONALE
NOISE AND UNIFORMITY
-Removes respiratory  Assessment test: 20-cm water bath
No motion artifacts
misregistration  Frequency: weekly
-Reconstructs at  Acceptable tolerance:
Improved lesion o Water: w/in +/- HU of 0
arbitrary z-axis
detection o Uniformity: not > +/- 10 HU from
intervals
center of periphery
-Reconstructs at  Assessment in quantitative CT: the
overlapping z-axis following should be changed
Reduced partial interval o CT scan parameters
volume
o Slice thickness
-Reconstructs small
than image interval o Reconstruction diameter
o Reconstruction algorithm
-Date obtained during
peak of enhancement LINEARITY
Optimized IV contrast
 Assessment test: five-pin insert
-Reduces volume of
performance
contrast agent
 Frequency: semiannually
Multiplanar images -Higher quality  Analysis: should show relationship b/n the
reconstruction HU and electron density
improved
 Acceptable tolerance:
o Correlation coefficient: at least
0.96% or 2 standard deviation
FEATURES OF MSCT  Assessment in quantitative CT: requires
precise determination of the value of tissue
LIMITATIONS RATIONALE in HU

Increased image noise -bigger x-ray tubes

12
 COMPUTED TOMOGRAPHY

GAMMEX 464  Assessment test: specially designed test

 CT test object objects
 Used to evaluate noise, spatial and contrast  Frequency: semiannually
resolution, linearity and uniformity
PATIENT DOSE
SPATIAL RESOLUTION  Specified as CT dose index (CTDI)
 Most important component of QC program  High resolution: high patient dose
 Assessment test: imaging a wire/edge/hole  Monitored by: specially designed pencil
array/bar pattern ionization chamber/TLD
 Frequency: semiannually  Frequency: semiannually
 Acceptable tolerance: w/in manufacture’s  Acceptable tolerance:
specifications o Fixed technique: patient dose not
vary from > +/- 10%
CONTRAST RESOLUTION  Should follow replacement of the tube
 Assessment test: low-contrast test objects
with built-in analytic schemes
 Frequency: semiannually CT SCAN ARTIFACTS
 Acceptable tolerance:
o CT resolving power: should be 5 ARTIFACTS
mm objects at 0.5% contrast  Systematic discrepancy in CT numbers/HU
 Unintended optical density on a radiograph
SLICE THICKNESS/SENSITIVITY PROFILE  More common in CT than in conventional
radiographs
 Assessment test: ramp, a spiral or a step
 Types:
wedged (specially designed test objects) o Streaking - due to an inconsistency
 Frequency: semiannually in a single measurement
 Acceptable tolerance: w/in 1 mm of the o Shading – due to a group of
intended slice thickness channels or views deviating
 Intended slice thickness of <5 mm: 0.5 gradually from the true measurement
mm acceptable tolerance o Rings – due to errors in an
individual detector calibration
o Distortion – due to helical
COUCH INCREMENTATION reconstruction
 Assessment test: noting the position of the  Four categories:
couch with tape measure & straightedge on o Physics-based artifacts
the couch rails  Caused: physical processes
 Frequency: monthly involved in the acquisition of
 Acceptable tolerance: w/in +/- 2 mm CT data
o Patient-based artifacts
 Caused:
LASER LOCALIZER  Patient movement
 For patient positioning  Presence of metallic
materials
13
 COMPUTED TOMOGRAPHY

o Scanner-based artifacts, Gantry tilting

 Caused: imperfections in
scanner function Appropriate FOV selection
o Helical and multisection artifacts
 Caused: image Appropriate bowtie filter
reconstruction process.
Most commonly
Bone and metal implants
PHYSICS-BASED ARTIFACTS occur
 Beam hardening artifact
o Cupping artifact
o Streak artifact CUPPING ARTIFACT
 Partial volume Beam is hardened
 Photon starvation
more in the middle
 Undersampling Description
portion of an object
BEAM-HARDENING ARTIFACT than those in the edges

Increased mean energy of Caused Beam hardening

Description the x-ray beam when it
The middle of the
passes through object
Effect image appear darker
Polychromatic nature of than the periphery
Caused
the x-ray beam
Beam hardening
Avoidance
Cupping artifact correction

Appearance of dark bands

or streak
Effect STREAK AND DARK BAND ARTIFACTS
(b/n metal or bone)
Appear between two
Pseeudoenhancement of Description
dense objects
renal cysts
Metals (bullets,
Avoidance BUILT-IN FEATURES: pacemaker, dental
fillings)
Filtration
Beam hardening
Calibration correction Caused
Poisson noise
Beam hardening correction
software Patient motion
BY OPERATOR: Edge effects
Patient positioning Effect High CT number on

14
 COMPUTED TOMOGRAPHY

the image photons reaching the

detector
Beam hardening
Avoidance
correction Very noise projections

Bony regions of the Increase tube current

Most commonly occur body
Use of adaptive
Used of contrast media Avoidance filtration

Automatic tube current

modulation
PARTIAL VOLUME ARTIFACTS

Distortion of signal UNDER SAMPLING ARTIFACTS

Description intensity from an
anatomy Two large an interval
Description
between projections
Anatomy that doesn’t lie
Caused totally within the slice Misregistration by the
thickness computer of information
Caused
relating to sharp edges
Averaging the linear and small objects
attenuation coefficient
Effect in a voxel that is View aliasing (fine
heterogenous in stripes appearance)
composition Effect
Ray aliasing (stripes
Thin slice selection appearance)
Avoidance Thin slice For view aliasing:
incrementation
Slower rotation speed
Most critical region Posterior cranial fossa
Avoidance For ray aliasing:

PHOTON STARVATION ARTIFACTS Quarter-detector shift

Potential source of Flying focal spot

Description
streaking artifacts

High x-ray attenuation PATIENT-BASED ARTIFACTS

Caused  Metallic materials
Highly attenuating
 Patient motion
structures  Incomplete projection
Effect Insufficient x-ray
15
 COMPUTED TOMOGRAPHY

METAL ARTIFACTS modes

Presence of metal object Software correction

Caused
in the scan field
Cardiac gating
Incomplete attenuation
profile
Effect INCOMPLETE PROJECTION
Severe streaking
artifacts Presence of anatomy
lying outside the scan
Description
Asked patient to remove field produces severe
metallic objects artifacts

Use gantry angulation Portion of anatomy lies

Caused outside the field of
Avoidance (for nonremovable
view
items)
Incomplete information
Increased kVp
of the anatomy by the
Thin slice thickness Effect computer

Generation of streaking
MOTION ARTIFACTS and shading artifacts

Patient motion Position patient so that

Caused (involuntary & Avoidance no parts lying outside
voluntary) the scan field

Effect Misregistration artifacts

Avoidance By the operator: SCANNER-BASED ARTIFACTS

 Ring artifacts
Use of positioning aids
RING ARTIFACTS
Immobilization
Artifacts seen in third
Sedation (infant) Description
generation CT scanner
Short scan time
Faulty detector
Instruct patient to hold Caused Detector out of
breath
calibration
By built-in features:
Effect Consistently erroneous
Overscan & underscan reading at each angular
16
 COMPUTED TOMOGRAPHY

position sagittal reformats seen

with helical and
Circular artifact multidetector row CT
Detector calibration Increased number of
Selecting correct scan section acquired per
Avoidance FOV rotation
Caused
(by using calibration Wider collimation
date) Increase number of
HELICAL AND MULTISECTION CT detector rows
ARTIFACTS
Artifacts similar to
 Cone beam effect (Helical)
 Stair-step artifacts (MSCT) Effect those caused by partial
 Zebra or windmill artifacts (MSCT) volume

Employing cone beam

CONE BEAM EFFECT Avoidance
reconstruction
The x-ray beam
Description becomes cone-shaped
rather than fan-shaped ZEBRA ARTIFACTS

Increased number of Periodic stripes of more

section acquired per or less noise at the
rotation Description image periphery seen on
coronal or sagittal
Caused
Wider collimation
reformats
Increase number of
detector rows Caused Helical interpolation

Fundamental deficit in Alternating high and

Effect Effect
the acquired data low noise on image

To acquire a more Employing cone beam

Avoidance
complete data set reconstruction
Avoidance
Employing cone beam
reconstruction
-THE END-
“There are no secrets to success. It is the result of
preparation, hard work learning from failure”
STAIR STEP ARTIFACTS 05/29/14

Description Serrations on coronal or

17
COMPUTED TOMOGRAPHY

18