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RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 1 Master‘s Program in Medical Physics Physics of Imaging Systems (ROE, CT, MRI) 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 [email protected] www.ma.uni-heidelberg.de/inst/cbtm/ckm/ RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 2 www.ma.uni-heidelberg.de/inst/cbtm/ckm/ Seite 1 1 RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 3 Introduction Introduction RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 4 Nobel Prize 2003 Nobel Prize is awarded for MRI technology landmark achievement transformed healthcare in 20th century Paul Lauterbur (1929 - 2007) Sir Peter Mansfield (1933 - ) Seite 2 2 RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 5 Diagnostic Imaging: Milestones 1901 W. C. Röntgen (Germany, 1845 - 1923) discovery of X-rays 1952 Felix Bloch (USA, 1905 - 1983) Edward M. Purcell (USA, 1912 - 1997) development of a new precision method of nuclear magnetism (NMR) 1979 Allan M. Cormack (USA, 1924 - 1998) Godfrey N. Hounsfield (UK, 1919 - ) development of Computer-Tomography (CT) 1991 Richard R. Ernst (CH, 1933 - ) development of high resolution magnetic resonance spectroscopy (MRS) 2003 Paul C. Lauterbur (USA, 1929 - 2007) Peter Mansfield (UK, 1933 - ) development of magnetic resonance imaging (MRI) RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 6 Diagnostic Imaging: Pioneers ROE PET “The Making of a Science” CT MRI source: ECR Newsletter 1/2003 Seite 3 3 RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 7 Motivation Why do we need imaging systems ? „Addiction“ to image information ? source: Siemens “100 Jahre Röntgen” 1995 RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 8 Information Flow of Sense Organs - information recording of all sense organs from our surroundings: self-aware data processing: 100 bit/s short-term storage: 10 bit/s long-term storage: 1 bit/s ≈ 109 bit/s → selection and filtering 1:10 million ! information flow see hear 108 bit/s 5×104 bit/s smell 102 bit/s taste 10 bit/s CNS flowing capacity to shortterm storage: 16 bit/s is recognized by the human awareness source: Drischel. „Einführung in die Biokybernetik“, Akademie-Verlag 1972 Seite 4 4 RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 9 Conclusion Imaging Systems are supporting the most effective and powerful sensor ! RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 10 Physicians´ Ranking of Innovations 2001 Fuchs and Sox. Health Affairs - Sept/Oct 2001 Seite 5 5 RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 11 Diagnostic Imaging: Principal object (human, animal, plant, ...) radiation source(s) detector(s) external X-rays (Röntgen) ultrasound (US) radiofrequency (NMR) external film (Röntgen) piezo-crystal (US) RF-coil (NMR) internal radioactive tracers (PET, SPECT) internal RF-coil source: http://bio.physik.uni-würzburg.de/public/medphys RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 12 Goal To look into the object without cutting or destroying (non-invasively) ! Seite 6 6 RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 13 Diagnostic Imaging: Definition definition: • interaction of energy with biological tissue in order to get spatially resolved information about the physical properties of the underlying biological structure • energy has to penetrate through the body for interaction (absorption, scattering, …) interpretation of imaging information: • importance of measured physical properties with respect to differentiate between normal and diseased tissue (pathology) • not fully understood RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 14 Diagnostic Imaging: Electromagnetic Wave PET and MRI are at the end of the spectrum OCT NIRF Visible Infrared nuclear medicine / PET 100keV 10keV Ultraviolet X-ray 10 19 TV satellite dish Hz 10 18 Hz 10 17Hz 16 10 Hz 15 10 Hz 14 10 Hz Millimeter THz Gap gap 13 10 Hz 12 10 Hz 11 10 Hz Micro- wave and RF 10 10 Hz Frequency X-ray / CT imaging terahertz pulse imaging (TPI) ionizing non-ionizing magnetic resonance imaging MRI different energies means different interaction with tissue Seite 7 7 RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 15 Electromagnetic Wave Penetration RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 16 Diagnostic Imaging: Overview Bildgebende Verfahren without ionizing radiation Nuclear Magnetic Resonance spectroscopy (MRS) tomography (MRI) with ionizing radiation Ultrasound X-rays planar tomography (CT) Nuclear Medical Techniques planar emission tomography (PET) Seite 8 8 RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 17 Diagnostic Imaging: Anatomy image by courtesy of Helmut Newton source: ECR Newsletter 4/2002 RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 18 Diagnostic Imaging: Pathology Seite 9 9 RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 19 Diagnostic Imaging: Animals RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 20 Diagnostic Imaging: System Combination - anatomic / metabolic imaging PET / MRI Set-up of the McPET system inside the 1.5 T clinical scanner. McPET’s ring of detectors is placed inside the MRI coil (white arrow) and transmits its output to the MC-PMTs, enclosed in the RF-shielded box in the foreground, via doubleclad optical fibers (black arrow). PET / CT The brain shows a large, left posterior / temporal / parietal metastasis. In the transaxial views, a hyper-metabolic area, measuring 2.2 x 2.1 cm with a solid center, is seen, surrounded by edema (arrow on fused image details hypermetabolic area). A pair of PET (a) and MR (b) images contemporaneously obtained from the C-phantom at 1.5 T. source: GE Medical Systems Farahani et al. JMR 1999 Seite 10 10 RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 21 Biomedical Imaging source: ECR Newsletter 4/2002 RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 22 Diagnostic Imaging: Field of Application main focus of diagnostic imaging • diagnostic • therapy-planning and -monitoring • screening • monitoring of interventions Seite 11 11 RUPRECHT-KARLSUNIVERSITY HEIDELBERG Computer Assisted Clinical Medicine Prof. Dr. Lothar Schad 12/9/2008 | Page 23 Diagnostic Imaging: Properties X-Ray CT MR US +++ –/+ ++ – – +++ – ++ – ++ + ++ ++ ++ ++ – + + ++ + * + + ++ psychological stress physical stress invasiv small high no medium high no high small no small small no costs (EUR) ca. 40 ca. 100 ca. 400 ca. 10 imaging of bone soft tissue vessel function volume real-time Seite 12 12