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Computed Tomography Historical Perspective Meaning Tomography – from the Greek word tomos meaning section Early images lacked enough detail and clarity to be useful CT had to wait until the discovery of higher order mathematics and computers CT now overcomes limitations by using image computer reconstruction from projections to produce sharp, clear cross-sectional images Conventional Tomography Radiograph obtained with a moving x-ray tube Results in an image with superimposed tissues (CT does not) Tissues are blurred above and below the focal plane – no improvement in spatial resolution Image Reconstruction from Projections 1917 – Radon proved that a 2d or 3d model could be produced by collecting a large number of projections from different projections This method is used in a variety of applications including astronomy and electron microscopy Cormack developed reconstruction by back projection in the 1950’s and 1960’s Projections In CT radiation passed through each cross-section in a specific way and is projected onto a detector that sends signals to a computer for processing. After processing a clear, sharp, digital image is produced. Technical Definition Herman (1980) – Image reconstruction from projections is the process of producing an image of a two dimensional distribution from estimates of its line integrals long a finite number of lines of known locations. Image Reconstruction in Medicine Hounsfield (1967) – applied reconstruction techniques to produce the worlds first useful CT scanner for imaging the brain. Hounsfield’s studies resulted in emission CT (nuclear medicine) and transmission CT (computed tomography). Hounsfields first machine used a gamma source Output too low Source too large Image reconstruction is also used in Ultrasound and MRI Evolution of Terms Hounsfield first coined the term computerized transverse axial scanning. Other terms include: Computerized transverse axial tomography, computerized transverse axial tomography, computer-assisted tomography, computerized axial tomography, computerized transaxial transmission reconstructive tomography. Terms The term Computed Tomography was established by the Radiological Society of North America in their major journal Radiology Additionally the American Journal of Roentgenology accepted this term. The term Computed Tomography is considered the correct term Process Data acquisition Image reconstruction Image display, manipulation, storage, recording, and communication Data Acquisition Data acquisition – refers to the collection of x-ray transmission measurements from the patient Patient -> detector = transmission values/attenuation values Initial scanners took an inordinate amount of time to complete one slice Image Reconstruction Transmission measurements are sent to a computer The computer uses mathematical techniques to reconstruct the CT image in a finite number of steps called reconstruction algorithms Hounsfield developed an algorithm called the algebraic reconstruction technique Image Reconstruction A variety of computers are integral to the reconstruction process Computer equipment includes array processor, minicomputer, and microprocessors Image Display, Manipulation, Storage, Recording, and Communications After reconstruction the images can be displayed, recorded, and analyzed Typically images are displayed on a cathode ray tube. Monitors allow a variety of individuals to view and manipulate the images Manipulation Many computer packages allow images to be manipulated after the scan is complete (post-processing) Images can be reconstructed in a variety of planes, can be colored, and 3d models may be created. Storage Images can be recorded and stored on a variety of archive media Archive media include radiographic film, mag tapes, optical disks, and cd-rom Communications CT scanners can be connected to a wide array of devices: Laser printers, diagnostic workstations, display monitors, and computers outside the hospital. Many different types of CT systems and equipment can communicate through a standard protocol called Digital Imaging and Communication in Medicine(dicom) Brief History of CT 1895 – Roentgen discovers x-rays 1917 – Radon develops reconstruction mathematics 1963 – Cormack formulates x-ray absorption in tissue 1972 – Hounsfield demonstrates CT 1974 – Convolution and back projection Brief History of CT 1975 – First whole body CT 1976 – Somatom scanner operating on fan beam principle, 5s scan with instant image reconstruction 1978 – Topogram 1979 – Hounsfield and Cormack Nobel Prize 1981 – 512 squared matrix 1983 – High frequency generators & EBCT Brief history of CT 1984 – Opti 155 CT tube with 1.75 MHU, 70cm gantry opening, +/- 25 degree tilt 1986 – Osteo CT (BMD), xenon CT (measures cerebral blood flow) 1987 – Continuous rotation flying focal spot CT tube 1989 – Spiral CT 1991 – Multislice CT introduced Brief history of CT 1991 – intuitive mouse-driven Windows interface 1992 – Integrated CT angiography 1994 – Routine sub second spiral CT 1996 – Spiral “4” everything; neuro and high-resolution spiral 1997 – multi detector arrays; volume scans Nobel Laureate Godfrey Hounsfield Associated Press Monday, August 23, 2004; Page B05 Godfrey Hounsfield, 84, who developed the first practical CAT scan machine and shared a Nobel Prize in 1979 for inventing CAT scan technology, died Aug. 12 at a hospital in Kingston upon Thames, England. The cause of death was not reported. Nobel Laureate Godfrey Hounsfield The Nobel committee described Mr. Hounsfield, who worked at EMI laboratories' medical research division, as "the central figure in computer-assisted tomography." The device uses X-rays to scan from different angles and a computer to assemble the images into a cross section. EMI Electric and Musical Industries Not only did EMI employ Hounsfield and market the first UK “CAT” Scanner, they also signed contracts with The Beatles Pink Floyd Queen Emission vs. Transmission Emission CT involves nuclear medicine and Gamma-ray emission from the patient Computed Tomography utilizes x-ray transmission through a patient Limitations of CT Spatial resolution Relatively high patient dose Z-axis reformation Distinct artifacts Advantages of CT Better contrast resolution No superimposition of tissues Less scatter radiation 3D imaging Bone mineral assay