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Medical Imaging • X-ray • Fluoroscopy • Computerized Tomography (CT Scan) • Positron Emission Tomography (PET Scan) • Ultrasound • Magnetic Resonance Imaging (MRI) • Biophotonics X-RAYS X-ray source (x-ray attenuation) OPAQUE: Bone, Metals, Iodinated contrast agents Shadow X-Rays – high energy photons • Absorbed by denser tissues (attenuated) to produce a lighter image on the film (radiograph) • Can be used to diagnose some cancers, respiratory and cardiovascular diseases such as enlargement of the heart and structure of blood vessels • Dentists use to determine health of teeth and jaw • The high energy radiation of x-rays can cause mutations to DNA Chest X-Ray X-Ray of a murder victim killed with 30 nails Normal Hand X-Ray Rheumatoid Arthritis Hand X-Ray Knee Joint X-Ray Broken Neck X-Ray Swollowed Scissors X-Ray X-Ray Photobomb... This is why high heels hurt your feet! Fluoroscopy – uses a continuous beam of X-rays to view a radioactive contrast agent • The most commonly used x-ray dye is barium sulfate, a white-chalky substance. • Fluoroscopic X-Ray images the gastro-intestinal system and blood vessels of the brain and heart • Images of the opaque dye travelling through the arteries to locate a blockage is called an angiogram • The advantage of Fluoroscopic x-ray over conventional x-ray is that you can view in real time on a television monitor the image • This means that movement of the peristalsis and normal function of the body's systems can be captured and recorded on videotape • Because fluoroscopy involves the use of x-rays, ionizing radiation, all fluoroscopic procedures pose some health risks. Barium Fluoroscopy Compare the image of the normal heart on the LT. with the image on the Rt.. In the Rt. image you see a patient with congestive heart failure whose heart has lost its ability to pump blood efficiently. The heart on the Rt. significantly enlarged, a key indicator of heart failure. Fluoroscopy X-Ray – Dog Neck and Shoulder Computerized Tomography (CT) X-ray source x,y) (x-ray attenuation) Collect projections at all angles Digital Reconstruction on a computer Shadow CT –SCAN – uses X-rays as well • X-rays are directed all around the patient from various angles to create a 3-D image of the tissues • Detailed, cross-sectional images are used to diagnose cancer, abnormalities of skeletal tissue and the circulatory system • Relatively quick and painless CT Scan - Heart CT Scan – 3D of various views of the Heart Nuclear medicine (PET Scans) PET = Positron Emission Tomography • After the patient is given a radioisotope that emits positrons (positively charged electrons), PET scanning is used to detect cancer, as well as a number of cardiovascular and neurological abnormalities (such as Alzheimer’s and epilepsy). • Cancer cells, for example, have a much higher level of metabolic activity than normal cells. Cancer cells therefore ‘consume’ radioactive isotopes (such as radioactive iodine). PET scanning detects that increased metabolic rate and can therefore: • Show whether a tumor is benign (non-cancerous) or malignant (cancerous) • Help doctors determine the extent of disease • Illustrate metastatic disease (spread) • Help doctors evaluate the effectiveness of chemotherapy PET Scan – Tumours before Chemotherapy (Lt.) and after (Rt.) PET Scan PET Scan - cancer of the head and neck with extensive metastatic disease PET Scans can detect metabolic changes in different tissue types • Certain neurological disorders have characteristic metabolic changes. These are readily apparent on PET images. Alzheimer’s disease, for example, has a unique appearance on PET scans. This appearance can differentiate Alzheimer’s from other forms of dementia, and give the patient earlier access to appropriate treatments. • In cardiovascular disease, PET images provide information about blood flow and the presence of damaged muscle tissue. This information is key to planning appropriate treatments and disease management. PET scan images superimposed on MRI scan images shows a healthy medical student's brain function when performing arithmetical tasks at the same time as being exposed to speech. PET Scan of the Brain of a 20 yr old man (Lt.) vs 80 yr old man (Rt.) Your Brain on Drugs (the red areas indicate glucose uptake (= metabolism and brain function)) Ultrasound r(x,y,z) acoustic reflectivity Propagate sound pulse and receive reflection Compute position and velocity of reflection (Doppler shift) QuickTime™ and a Microsoft Video 1 decompressor are needed to see this picture. 2D 3D Ultrasound of a normal human uterus Ultrasound of Human gall bladders Magnetic Resonance Imaging (MRI) The MRI provides excellent differentiation between various types of soft tissues compared to radiographs (X-rays and CT). MRI can be used to visualize the brain, heart, liver, spinal cord, eyes, nasal cavities, inner ears, joints, and bones without injecting any contrast material. It is the most sensitive imaging for early disease detection of the above tissues and for cancer diagnosis. A functional MRI (fMRI) allows us to view the images in real time on a television monitor How the MRI works: • Uses powerful magnets and radiowaves as a non-invasive imaging technique with no damaging radiation • These magnetic and radiowave fields influence the behaviour of hydrogen nuclei in water • The behaviour of these hydrogen nuclei is detected and analysed by computers that generate detailed images of the tissues MRI Systems $2-3 million MRI – Section through head MRI – Cross Section of Head f-MRI – Where in the brain is hand/eye coordination? MRI – Neck Region MRI – Knee Joint Mammogram (X-Ray) vs MRI MRI of Blood Flow in the Brain MRI – Dog Skull Biophotonics • Biophotonics offers the ability to diagnose and monitor disease nearly at the speed of light, based on the way light interacts with tissue and is scattered by the molecules and atoms. • With biophotonics, healthcare professionals will know in moments what before took hours or days with traditional tests, enabling treatment to begin immediately. • Since normal tissue scatters light differently than abnormal tissues, Biophotonics also allows for studying human tissue at the cellular and molecular level for the purposes of detecting, diagnosing and monitoring disease. Exposure of chicken embryos to laser light to detect changed in development and stages of cell specialization/differentiation Imaging cerebral blood flow in mice using light with skull left intact