RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr.

Lothar Schad 12/9/2008 | Page 1

Masters Program in Medical Physics

Physics of Imaging Systems Basic Principles of Computer Tomography (CT) I

Prof. Dr. Lothar Schad

Chair in Computer Assisted Clinical Medicine Faculty of Medicine Mannheim University of Heidelberg Theodor-Kutzer-Ufer 1-3 D-68167 Mannheim, Germany Lothar.Schad@MedMa.Uni-Heidelberg.de www.ma.uni-heidelberg.de/inst/cbtm/ckm/

RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 2

Literature I

Kalender: Computertomographie. Grundlagen, Gertetechnologie, Bildqualitt, Anwendungen, 2006

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RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 3

Literature II

Dssel: Bildgebende Verfahren in der Medizin, Chapter 4, 2000

RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 4

Computer Tomography Introduction

Computer Tomography Introduction

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RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 5

Literature

source: Kalender. Computertomographie, Publicis MCD Verlag 2000

RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 6

Mean Effective Dose per Head in 1997

nuclear diagnostic

radon with derivates other radiation sources (nuclear wappons & fallout, Tschernobyl reactor accident, nuclear units, science, technic, household)

X-ray diagnostic

food terrestic radiation cosmic radiation at see level

Regulla et al. ZMP 2003

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RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 7

Radiodiagnostic Examinations in 1997

percentage of typical radiodiagnostic examinations to the collective effective dose and their frequency
thorax skeletal esophagus uretic system Mammography angiography CT else

collective effective dose

incidence

Regulla et al. ZMP 2003

RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 8

Visionary Idea in 1896

Und lt man der Phantasie weiter die Zgel schieen, stellt man sich vor, da es gelingen wrde, die neue Methode des photographischen Prozesses mit Hilfe der Strahlen aus den Crookeschen Rhren so zu vervollkommnen, da nur eine Partie der Weichteile des menschlichen Krpers durchsichtig bleibt, eine tiefer liegende Schicht aber auf der Platte fixiert werden kann, so wre ein unschtzbarer Behelf fr die Diagnose zahlloser anderer Krankheitsgruppen als die Knochen gewonnen.

Frankfurter Zeitung, 7. Januar 1896

source: Kalender. Computertomographie, Publicis MCD Verlag 2000

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RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 9

CT History

1895 1917 1963 1972 1974 1975 1979 1989 1998 2000

W. C. Rntgen discovers a new kind of radiation he calls X-ray, later called Rntgenstrahlen J. H. Radon develops the mathematical basis for calculation of crosssections from transmission measurements A. M. Cormack describes o method for calculation of the absorption distribution of the human body G. N. Hounsfield and J. Ambrose develop the first CT and doing first clinical examinations about 60 clinical CT installations (EMI head scanner) first whole body CT with clinical examinations Nobel prize for G. N. Hounsfield and A. M. Cormack W. A. Kalender and P. Vock develop the first spiral CT and doing first clinical examinations introduction of multi-row detector system about 30.000 clinical CT installations (whole body scanner)

RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 10

Computer Tomography 1973

original EMI CT head scanner 1973 (Mayo Clinic, Rochester, USA) and 80 x 80 matrix head CT image obtained with it
source: Gray and Orton. Radiology 2000

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RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 11

Brain Image 1974, Matrix 80 x 80

source: Kalender. Computertomographie, Publicis MCD Verlag 2000

RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 12

Historical Question

in the early years of CT, an often-heard remark was

Why would anyone want a new X-ray technique that when compared with traditional X-ray imaging:
yields 10 times more coarse spatial resolution

is 1/100 as fast in collecting image data costs 10 times more

Hendee and Ritenour. Medical Imaging Physics, 4th ed. Wiley, 2002

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RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 13

and Answer !
Ct volume data set, matrix 1024 1024

source: Kalender. Computertomographie, Publicis MCD Verlag 2000

RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 14

X-Ray and CT Contrast

source: Kalender. Computertomographie, Publicis MCD Verlag 2000

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RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 15

Why Cross-Sections ?

1. no superposition higher contrast 2. three-dimensional localization

RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 16

CT Contrast

CT image high local contrast of soft tissue structure

X-ray image low soft tissue contrast due to superimposed bone

source: Kalender. Computertomographie, Publicis MCD Verlag 2000

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RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 17

Computer Tomography Principle

Computer Tomography Principle

RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 18

CT Measurement: Principle I

- gives system of equations for each projection - generate enough projections to solve system of equations

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RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 19

CT Measurement: Principle II
- intensity of X-ray radiation can be used to calculate the attenuation- or projection-value P which can lead to the absorption coefficient in a simple case (homogeneous object) - can not be calculated in inhomogeneous objects since is a function of (x, y) tomographic method !
case 3: inhomogeneous object, polychromatic radiation

case 1: homogeneous object, monochromatic radiation

case 2: inhomogeneous object, monochromatic radiation

source: Kalender. Computertomographie, Publicis MCD Verlag 2000

RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 20

CT Measurement: Principle III

collimator detector with electronic collimator

X-ray tube

intensity profile

attenuation profile = projection

ge i ma

sor es c o pr

in the simplest case object is scanned linearly by a needle beam at different angles to determine the attenuation profile
source: Kalender. Computertomographie, Publicis MCD Verlag 2000

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RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 21

CT Measurement: Principle IV

algebraic reconstruction technique (ART)

source: Kalender. Computertomographie, Publicis MCD Verlag 2000

RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 22

CT Image Reconstruction and Convolution

X-ray tube collimator collimator detector with electronic

without convolution

back projection

with convolution

attenuation profile (simplified)

- corresponds to high pass filter

profile cut
source: Kalender. Computertomographie, Publicis MCD Verlag 2000

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RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 23

Hounsfield Values

definition CT-value: CT-values contain the linear absorption coefficients of the underlying tissue in every volume element with respect to the -value of water. Using this definition the CT-values of different organs are relatively stable and independent of the X-ray spectrum.

CT-value = ( - water) / water x 1000 HU

RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 24

Hounsfield Scale
compact bone

CT-number [HU]

liver blood spongy bone water fat pancreas kidney

lung air

4096 values 212 12 Bit

source: Kalender. Computertomographie, Publicis MCD Verlag 2000

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RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 25

CT Windowing

CT-number [HU]

bone window

- windowing of Hounsfield values at different evaluations of CT images

mediastinum window

- human eye can distinguish only 60-80 grey values !

lung window

source: Kalender. Computertomographie, Publicis MCD Verlag 2000

RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 26

Radon Transformation I

= 0 - 180 s = smin - smax

source: Dssel. Bildgebende Verfahren in der Medizin 2000

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RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 27

Radon Transformation II

p(,s)-diagram projection p(s) = series of numbers of all line integrals of f(x,y) at constant angle and variable distance s to the coordinate origin

source: Dssel. Bildgebende Verfahren in der Medizin 2000

RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 28

Radon Transformation: Example

inside outside

radius of area

source: Dssel. Bildgebende Verfahren in der Medizin 2000

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RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 29

Fourier-Slice-Theorem I

RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 30

Fourier-Slice-Theorem II

- given is a function f(x,y) an its 2D Fourier transformation F(u,v) f(x,y)

2D-FT

F(u,v)

- given is also p(s) defined as a projection of f(x,y) (i.e. a line of the Radon transformation with = const.) and P(w) its 1D Fourier transformation p(s)
1D-FT

P(w)

- then P(w) describes the values of F(u,v) on a radial beam at angle - how to get from the Radon transformation p(,s) back to the function f(x,y) ? evaluate from all projections p(s) the 1D Fourier transformation P(w) take the values of the radial beam at and put them into the function F(u,v) find f(x,y) by doing the inverse 2D Fourier transformation

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RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 31

X-Ray Pencil Beam Through a Body

incoming X-ray intensity outgoing X-ray intensity X-ray absorption coefficient

J J 0 e 1 l e 2 l ..... e N l = J 0 e
( l ) dl J = J0 e

i l
i =1

J ln J 0

( l ) dl

RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 32

CT Reconstruction Principle I
- idea of backprojection: transform measured -values into line thickness for all projections and add up !

in the order of 1000 projections with 1000 channels are acquired per detector slice and rotation
courtesy: Kachelriess, Erlangen

y x

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RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 33

CT Reconstruction Principle II
function (x,y) X-ray absorption coefficient as a function of (x,y) in a body slice all line integrals over (x,y) i.e. Radon transformation of the wanted function (x,y)

- wanted: - measured:

- generation of images: Fourier reconstruction

measurement of as many as possible projections with a large number of points (p(s)) projections p(s) are 1D Fourier transformed into (P(w)) transformed projections are recorded in a matrix F(u,v) problem: interpolation between known values on radial beams and required values on a cartesian grid (F(u,v) complex) multiplication of F(u,v) with a filter function inverse 2D Fourier transformation

RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 34

CT Sinogram I

absorpti o abso rption absorption n

x x

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RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 35

CT Sinogram II

sinogram = sum of all projections

- sinogram: = sum of all projections = Radon transformation of (x,y)

scanning angle

- absorption strength = brightness

scanning distance x

RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 36

CT: Back Projection

sinogram

CT image

reconstruction: back projection

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RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 37

CT: Filtering
filtered sinogram

sinogram

filtering

filter kernel

convolution kernel

unfiltered profile

filtered profile

RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 38

CT: Filtered Back Projection

filtered sinogram

CT image

reconstruction: filtered back projection

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RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 39

Unfiltered and Filtered Projections

measurement

unfiltered back projection of one measurement

unfiltered back projection of all measurements

measurement

filtered back projection of one measurement

filtered back projection of all measurements

source: Dssel. Bildgebende Verfahren in der Medizin 2000

RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 40

CT: Projections and Filtered Projections

inverse Fourier transformation of

w e

summing up all filtered projections

source: Dssel. Bildgebende Verfahren in der Medizin, 2000

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RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 41

CT: Filtered Back Projection Principle

filtering of all measured projections p(s) with |w| gives ~ p(s) following all filtered projections ~ p(s) with respect to for the whole matrix and adding up all values of the filtered projections into the imaging matrix

source: Dssel. Bildgebende Verfahren in der Medizin 2000

RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 42

Filter Functions I
- filter limiting:

~ ( s ) = P (w ) H (w ) e i 2 w s dw p
- filter functions
cernel from:

even, 0
a = detector distance

odd

filter functions H(w)

source: Dssel. Bildgebende Verfahren in der Medizin 2000

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RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 43

Filter Functions II

source: Dssel. Bildgebende Verfahren in der Medizin 2000

RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 44

CT: Iterative Reconstruction

pencil beam j

- unknown:
512x512 = 262 144 pixel

- measured: part of area wij

1000 projections with 800 detectors = 800 000 equations

can be algebraic solved !

source: Dssel. Bildgebende Verfahren in der Medizin 2000

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RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 45

CT: Iterative Reconstruction Solution

processing of 1. projection data value is distributed in equal shares to involved projection pixels processing of 2. projection difference between forward calculated data values and really measured values is used for correction in equal shares to involved projection pixels processing of all other projections in the same way about 1h calculation time for 512 x 512 !
source: Dssel. Bildgebende Verfahren in der Medizin 2000

RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 46

CT Scanner Generations 1-2

I.
CT scanner 1. generation pencil beam (1970)

II.
CT scanner 2. generation partly fan beam (1975) 30 detectors, fan: 10

source: Kalender. Computertomographie, Publicis MCD Verlag 2000

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RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 47

CT Scanner Generation 1: EMI-Scanner

RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 48

CT Scanner Generation 2
multi-detector-translational-rotating system

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RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 49

CT Scanner Generation 3
CT scanner 3. generation fan beam (1976) 500 800 detectors fan: 40 - 60 (whole body) 1000 projections / sec but cable problems: 360 forward rotation stop 360 backward rotation stop

III.

rotating detector arch

rotation without translation

souirce: Kalender. Computertomographie, Publicis MCD Verlag 2000

RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 50

CT 3. Generation: Collimation
fan beam scanner

trajectory of X-ray tube

collimator lamellae

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RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 51

CT Scanner Generation 3: Principle

tube 0

tube rotation beam at tube 180

beam at tube 0

III.

detectors

tube 180 beam at tube 180 and 0

jumping focus

source: Dssel. Bildgebende Verfahren in der Medizin 2000

RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 52

CT Scanner Generation 3: Jumping Focus

tan = z RF

C
cooling oil cathode

2z

2RF
B anode

straton tube
courtesy: Kachelriess, Erlangen

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RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 53

CT Scanner Generation 3-4

III.

fancy beam unit

IV.

ring detector unit

rotation axis collimator lamellae Xe-chamber

electrodes rotating detector arch (Xe high-pressure chamber)

fix detector arch (scintillators)

RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 54

CT Scanner Generation 4

fix detector ring

CT scanner 4. generation fan beam up to 5000 detectors problem: no collimation possible very high scatter radiation very expensive

IV.

souirce: Kalender. Computertomographie, Publicis MCD Verlag 2000

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RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 55

CT Scanner Generation 3-4

Mayo Monster

RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 56

Typical CT Examination Room

souirce: Kalender. Computertomographie, Publicis MCD Verlag 2000

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RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 57

Contact Ring Technique

X-ray tube

detector detector electronic

high voltage

projection data

schematic illustration of the contact ring technique for electric energy supply of the X-ray components and for signal transfer from the detectors to computer
souirce: Kalender. Computertomographie, Publicis MCD Verlag 2000

RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 58

Contact Ring Mounting and Testing

souirce: Kalender. Computertomographie, Publicis MCD Verlag 2000

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RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 59

CT Components Geometry

X-ray tube
form filter fix aperture adjustable aperture

gantry opening

field-of-view

rotation center adjustable aperture fix aperture

scatter radiation collimator detector array

souirce: Kalender. Computertomographie, Publicis MCD Verlag 2000

RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 60

Subsecond CT

1 sec. rotation time

0.5 sec. rotation time

- mechanic forces: acceleration ~ 10-20 g, X-ray tube ~ 200 kg 20-40 000 N ! - mechanic stability: 0.1 mm !

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