computed tomography scanningweb.eng.fiu.edu/godavart/bme4531-sp12/ct-studentppt-spring2012.… ·...
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Computed Tomography Scanning
Jared Leichner
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Advantages
Elimination of Superposition
Soft Tissue DifferentiationSoft Tissue Differentiation
Multiplanar Reformatted Imaging
Reduction of Need for Exploratory Surgery
http://www.radiologyinfo.org/en/safety/index.cfm?pg=sfty_hiw_04
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Elimination of Superposition
http://imaging.consult.com/image/chapter/Chest?title=Silicosis%20and%20Coal%20Workers%27%20Pneu
moconiosis&image=fig10&locator=gr10a&pii=S1933-0332(08)73235-X
* Note the fine details that become apparent
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Soft Tissue Differentiation
http://www.sciencephoto.com/media/302798/
http://www.sciencephoto.com/media/302800/
http://www.sciencephoto.com/media/302802/
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Unnecessary Surgery
http://www.annals.org/content/152/8/505.full
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Disadvantages
Radiation Dosage
Potential For Unnecessary Use
http://www.nejm.org/doi/full/10.1056/NEJMra072149
Potential For Unnecessary Use
Allergic Reactions to Contrast Agents
Misconceptions of Radiologists
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Large Radiation Dose
Typical Organ Radiation Doses From Various Radiologic Studies
Study Type Relevant Organ Relevant Organ Dose
(mGy)
Dental Radiography Brain 0.005
http://www.nejm.org/doi/full/10.1056/NEJMra072149
Dental Radiography Brain 0.005
P/A Chest Radiography Lung 0.01
Lateral Chest Radiography Lung 0.15
Screening Mammography Breast 3
Adult Abdominal CT Stomach 10
Neonatal Abdominal CT Stomach 20
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Large Radiation Dose
http://www.nejm.org/doi/full/10.1056/NEJMra072149
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Allergic Reactions
Reaction
Anaphylaxis
•4-8%
•1%Anaphylaxis
Death
•1%
•0.001-0.009%
http://allergycases.org/2008/08/allergic-reaction-to-intravenous.html
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Internal Misconceptions
• Survey of Radiologists & ER Physicians
– 75% Significantly Underestimated Radiation Dose
• Do CT Scans Increase the Lifetime Risk of Cancer?
– 53% of Radiologists said No.– 53% of Radiologists said No.
– 91% of ER Physicians said No.
Lee CI, Haims AH, Monico EP, Brink JA, Forman HP. Diagnostic CT scans: assessment of patient, physician,
and radiologist awareness of radiation dose and possible risks. Radiology 2004;231:393-398
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Common Medical Applications
• Screening of Lungs of a Smoker
http://healthguide.howstuffworks.com/lung-mass-right-upper-lobe-ct-scan-picture.htm
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Common Medical Applications• Virtual Colonoscopy
http://www.journey-with-crohns-disease.com/virtual-colonoscopy.html
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• Virtual Colonoscopy
Common Medical Applications
http://www.scandirectory.com/blog/default.asp?q=virtual+colonoscopy
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• Cardiac Screening
Common Medical Applications
http://pmj.bmj.com/content/86/1017/445.extract
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• Appendicitis Diagnosis
Common Medical Applications
http://radiographics.rsna.org/cgi/content-nw/full/28/2/393/F10A
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Non-Medical Applications
Thermodynamics of porous mixtures
Evaluation of Timber Evaluation of Timber Quality
Analyzing Soil Fertility
http://findarticles.com/p/articles/mi_hb3387/is_1_74/ai_n28947474/
http://www.osti.gov/accomplishments/documents/fullText/ACC0256.pdf
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Mixture Thermodynamics
http://www.osti.gov/accomplishments/documents/fullText/ACC0256.pdf
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Mixture Thermodynamics
http://www.osti.gov/accomplishments/documents/fullText/ACC0256.pdf
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Timber Quality Control
X-Ray CT Scan
http://www.fwpa.com.au/sites/default/files/PN04.3005%20resin-report%20(2).pdf
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Soil Fertility
http://www.ugent.be/bw/soilmanagement/en/research/ResearchUnitSoilFertilityandNutrientManagement/Projects
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Progression of the TechnologyProgression of the Technology
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A Brief Comparison
1975 Scan 2006 Scan
http://web2.uwindsor.ca/courses/physics/high_schools/2006/Medical_Imaging/cthistory.html
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1972 - Inception
• Invention by Godfried N. Hounsfield
• Non-Superimposed Images of a Cross-Section
• Several Hours / Slice
• Several Days / Reconstructed Image• Several Days / Reconstructed Image
http://www.medical.siemens.com/siemens/zh_CN/gg_ct_FBAs/files/brochures/CT_History_and_Technology.pdf
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1st Generation
Highly Collimated Pencil Beam
Excellent Scatter Rejection
Long Scan Times (5 min)
http://www.youtube.com/watch?v=fNaCxhhhZTE
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2nd Generation
Shorter Scan Time
(Faster Angular Component)
Complicated Reconstruction
http://www.youtube.com/watch?v=Ni4Hsi3GhXo
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3rd Generation
Full Rotation
No Translation
1 Second Scan
http://www.youtube.com/watch?v=bdf0kXn5Eeg
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4th Generation
600-4800 Fixed Detectors
Rotating Fan Beam
http://www.youtube.com/watch?v=AWVz3yke_bY
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5th Generation
No Moving Parts
Subsecond Scan Time
Stationary Detector Array
http://www.youtube.com/watch?v=wvw2TZBagDc&feature=related
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1974 - Commercialization
• Dedicated to Head Imaging
SIRETOM
• Dedicated to Head Imaging
• Only Two Sold
\http://www.medical.siemens.com/siemens/en_GB/rg_marcom_FBAs/files/brochures/mag
azin2_2004/P8-9_CoverStory_CT-History.pdf
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1976 – Full Body Scans
• Introduction of a Gantry
SOMATOM
• Introduction of a Gantry
• 5s Scan Time/Slice
\http://www.medical.siemens.com/siemens/zh_CN/gg_ct_FBAs/files/brochures/CT_History
_and_Technology.pdf
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1978-1983
• ECG Synchronized CT Image
Somatom II - 1978
• 3s Scan Time/Slice
Somatom DR III - 1983
http://www.medical.siemens.com/siemens/zh_CN/gg_ct_FBAs/files/brochures/CT_History
_and_Technology.pdf
• 3s Scan Time/Slice
• 1 mm Slice Width
• 25 Degree Gantry Tilt Angle
• Integrated Multi Planar Reformatting
Somatom DRH - 1985
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1988-1994
• Continuous Rotation of Tube and Detector
• 1s Scan Time/Slice
Somatom Plus - 1988
Somatom AR - 1991
http://www.medical.siemens.com/siemens/zh_CN/gg_ct_FBAs/files/brochures/CT_History
_and_Technology.pdf
• Windows User Interface
• Spiral CT Scanner
Somatom AR - 1991
• 0.5s Scan Time / Slice
Somatom Plus 4 - 1994
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1998-2002
• 125ms Temporal Resolution during Cardiac Surgery
• ‘Sureview’ Reconstruction Algorithm
Somatom Volume Zoom - 1998
http://www.medical.siemens.com/siemens/zh_CN/gg_ct_FBAs/files/brochures/CT_History
_and_Technology.pdf
• Multislice Scanning – 16 per Rotation
• 105ms Temporal Resolution during Cardiac Surgery
Somatom Sensation - 2002
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State of the Art CT
Scanner
• X Ray Tube – Various Focal Spot Sizes
• Shielding – Grids, Collimators, Filters
Detector
• Single Row Detectors
http://www.medical.siemens.com/siemens/zh_CN/gg_ct_FBAs/files/brochures/CT_History
_and_Technology.pdf
• Single Row Detectors
• Multi Row Detectors
Image Reconstruction
• Volume Rendering
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Most Recent Challenge
Reducing Unnecessary Radiation From Spiral Scans
Red Zone – Unnecessary
Radiation
Solution: ‘Breathing’ Tube
Becker, C. Reiser. M. Multi-slice CT. Page 20. Acquired from Google Books
Solution: ‘Breathing’ Tube
Side Collimator
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Typical Device Cost
• 1992 Somatom AR.T (4.5k)
• 2000 Somatom+ 4 (45k)
• 2002 Somatom Sensation 16 (850k)
• 2005 Somatom Sensation 64 (650k)• 2005 Somatom Sensation 64 (650k)
• 2008 Somatom Definition (380k – 580k)
• 2011 Somatom AS+ (3 Million)
– Two x-ray sourceshttp://www.medwow.com/used-ct-scanner-equipment/210.medhttp://www.forbes.com/2005/11/17/cat-scanners-cardiac_cx_dal_1118CAT.html
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Typical Scan Cost
• ($600-$3000)
• ($300-$1500)
• $3000• $3000
• 40% Discount for
Uninsured Patients
& Payment Plan
http://www.comparecatscancost.com/http://blog.remakehealth.com/blog_Healthcare_Consumers-0/bid/7499/How-much-does-a-CT-Scan-cost
http://answers.yahoo.com/question/index?qid=20061006104857AAXgwOxhttp://answers.yahoo.com/question/index?qid=20080224095624AA1PFHhhttp://motherjones.com/kevin-drum/2009/11/cost-technology-revisited
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Annual Use in the USA
http://www.nejm.org/doi/full/10.1056/NEJMra072149