Possible tutorial time

Mon. 4 6 Mon 4-6 Tue. 12 2 Wed. ft 11 W d after 11pm Thurs. before 6 pm

Outline
Why so many imaging modalities? Why are these imaging modalities?
X X-ray Gamma-ray (Nuclear medicine ) Radio- Frequency wave ( (MRI) ) Ultrasound

Comparison of modalities
Why do we need multiple modalities? Each modality measures the interaction between energy and biological tissue. - Provides a measurement of physical properties of tissue. - Tissues similar in two physical properties may differ in a third. third Note: - Each modality must relate the p y y physical p p y it measures property to normal or abnormal tissue function if possible. Other considerations for multiple modalities include: - cost - safety - portability/availability

Comparison of modalities: X-Ray

Measures attenuation coefficient ( x, y, z) Safety: Uses ionizing radiation - risk is small, however, concern still present. - 2-3 individual lesions per 106 - population risk > individual risk i.e. i e If exam indicated it is in your interest to get indicated, exam Use: Principal imaging modality Used throughout body Distortion: X-Ray transmission is not distorted.

Comparison of modalities: Ultrasound

R(x, y, z) Measures acoustic reflectivity Safety: Appears completely safe Use: Used where there is a complete soft tissue and/or fluid path Severe distortions at air or bone interface Distortion: Reflection: Variations in c (speed) affect depth estimate Diffraction: desired resolution (~.5 mm)

Comparison of modalities: Magnetic Resonance (MR)

Multiparametric M(x,y,z) proportional to (x,y,z) (density of Hydrogen atoms) Depend on T1, T2 . ( (the relaxation time constants) ) Velocity sensitive Safety: Appears safe Static field

Higher levels - Nerve stimulation RF heating: body temperature rise < 1C - guideline Use: Used throughout body g y Distortion: Some RF penetration effects - intensity distortion

dB > 10 T/s - Some induced phosphenes dt

- No problems

Clinical Applications - Table

X-Ray/ CT Chest + widely used + CT - excellent Abdomen needs contrast + CT - excellent Head + X-ray - is good for bone CT - bl di bleeding, trauma poor

Ultrasound no except for no, + heart Nuclear + extensive use in heart + growing cardiac di applications

+ excellent problems with g gas Merge w/ CT

+ PET

MR

+ minor role

+ standard

Clinical Applications Table continued

Cardiovascular X-Ray/ + X-ray Excellent, with CT catheter-injected contrast t t Ultrasound + real-time + non invasive non-invasive + cheap but, poorer images ,p g Nuclear + functional information on perfusion MR + getting better High resolution Myocardium viability Skeletal / Muscular + strong for skeletal system

not used + Research in elastography

+ functional - bone marrow

+ excellent

Economics of modalities: Ultrasound: ~ $100K $250K CT: $400K $1 5 million (helical scanner) $1.5 MR: $350K (knee) - 4.0 million (sitting) Service: Annual costs Staff: Scans performed by technologists Hospital Income: Competitive issues Significant i Si ifi t investment and return t t d t

Strategies of medical imaging Waves propagate into the subject Waves interact with the subject
R fl ti Reflection Scattering Absorption

Waves propagate out of the subject

Attenuation relationship: photon number

N |x|N + N

N(x): the N( ) th number of photons at x b f h t t : linear attenuation coefficient (units cm-1) Transmission

Necessary Probe Properties

Body should be semi-transparent to the probe. 1 transmission > 10-1 - results i contrast problems, unable t i i lt in t t bl bl to differentiate tissues transmission < 10 -3 - results in SNR problems, weak signals

Necessary Probe Properties

Requirements: If focusing wave is used t give spatial resolution, th th f i i d to i ti l l ti then the resolution of the imaging system is around the wavelength in the best case. Therefore, wavelength must be short enough for adequate resolution. bone fractures, small vessels < 1 mm

Point sources of light from a specimen appear as Airy diffraction patterns at the microscope intermediate image plane. l

Necessary Probe Properties: Water absorption coefficient vs.

The visible region of the electromagnetic spectrum is indicated by the vertical dashed lines.