INTRODUCTION TO MEDICAL IMAGING SYSTEMS Dr.

Areen Al-Bashir

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WHAT IS MEDICAL IMAGING?  Using an instrument to see the inside of a human body

 Non-invasive

 Some with exposure to small amount of radiation (X-ray, CT and nuclear medicine)

 Some w/o (MRI and ultrasound)

The properties imaged vary depending on the imaging modality

 X-ray (projection or CT): attenuation coefficient to X-ray

 Nuclear medicine (PET, SPECT): distribution of introduced radio source

 Ultrasound: sound reflectivity

 MRI: hydrogen proton density, spin relaxation

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COMMON IMAGING MODALITIES

 Projection radiography (X-ray)

 Computed Tomography (CT scan or CAT Scan)

 Nuclear Medicine (SPECT, PET)

 Ultrasound imaging

 MRI

 Optical imaging

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Anatomical vs. Functional Imaging

• Some modalities are very good at depicting anatomical (bone) structure

- X-ray, X-ray CT

- MRI

• Some modalities do not depict anatomical structures well, but reflect the functional status (blood
flow, oxygenation, etc.)

- Ultrasound

- PET, functional MRI

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1. PROJECTION RADIOGRAPHY
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RADIOGRAPHIC SYSTEM

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LIMITATION OF PROJECTION RADIOGRAPHY

Projection radiography

 Projection of a 2D slice along one direction only

 Can only see the “shadow” of the 3D body

CT: generating many 1D projections in different angles

 When the angle spacing is sufficiently small, can reconstruct the 2D slice very well

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2. Computed Tomography

• Year discovered: 1972 (Hounsfield, NP 1979)

• Form of radiation: X-rays

• Energy / wavelength of radiation: 10 - 100 keV / 0.1 - 0.01 nm (ionizing)

• Imaging principle: X-ray images are taken under many angles from which tomographic ("sliced")
views are computed

• Imaging volume: Whole body

• Resolution: High (mm)

• Applications: Soft tissue imaging (brain, cardiovascular, GI)

Projection: A single image is created for a 3D body, which is a “shadow” of the body in a particular
direction (integration through the body)

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PROJECTION VS. TOMOGRAPHY

Tomography:

 A series of images are generated, one from each slice of a 3D object in a particular direction
(axial, coronal, sagital)

 To form image of each slice, projections along different directions are first obtained, images are
then reconstructed from projections (back-projection, Radon transform)

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3. Nuclear Medicine
• Images can only be made when appropriate radioactive substances (called radiotracer) are
introduced into the body that emit gamma rays.

• A nuclear medicine image reflects the local concentration of a radiotracer within the body

• Three types

- Conventional radionuclide imaging or scintigraphy

- Single photon emission computed tomography (SPECT)

- Positron emission tomography (PET)

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• Year discovered: 1953 (PET), 1963 (SPECT)

• Form of radiation: Gamma rays

• Energy / wavelength of radiation: > 100 keV / < 0.01 nm (ionizing)

• Imaging principle: Accumulation or "washout" of radioactive isotopes in the body

• Imaging volume: Whole body

• Resolution: Medium - Low (mm - cm)

• Applications: Functional imaging (cancer detection, metabolic processes.

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WHAT IS NUCLEAR MEDICINE
 Also known as nuclide imaging

 Introduce radioactive substance into body

 Allow for distribution and uptake/metabolism of compound Functional Imaging!

 Detect regional variations of radioactivity as indication of presence or absence of specific

 Detection by “gamma camera” or detector array

 (Image reconstruction)

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EXAMPLES: PET VS. CT
 X-ray projection and tomography:

 X-ray transmitted through a body from a outside source to a detector (transmission imaging)

 Measuring anatomic structure

 Nuclear medicine:

 Gamma rays emitted from within a body (emission imaging)

 Imaging of functional or metabolic contrasts (not anatomic)

 Nuclear Imaging Applications:

 Brain perfusion, function

 Myocardial perfusion

 Tumor detection (metastases)

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SPECT APPLICATIONS
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PET APPLICATIONS

 Brain:

 Tumor detection

 Neurological function (pathologic, neuroscience app.)

 Perfusion

 Cardiac

 Blood flow

 Metabolism

 Tumor detection (metastatic cancer)

 CT: provides high resolution anatomical information

 PET: Low resolution functional imaging

 Traditional approach:

 Obtain CT and PET images separately

 Registration of CT and PET images, to help interpretation of PET images

 Combined PET/CT: Performing PET and CT measurements within the same system without moving
the patient relative to the table

 Make the registration problem easier

 But measurement are still taken separately with quite long time lag

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4. Ultrasound Imaging

• Year discovered: 1952 (clinical: 1962)

• Form of radiation: Sound waves (non-ionizing) NOT EM radiation!

• Frequency / wavelength of radiation: 1 - 10 MHz / 1 - 0.1 mm

• Imaging principle: Echoes from discontinuities in tissue density/speed of sound are registered.

• Imaging volume: < 20 cm

• Resolution: frequency dependent US frequency increase; resolution incresed

• Applications: (Doppler) Soft tissue, blood flow

 Measure the reflectivity of tissue to sound waves

 Can also measure velocity of moving objects, e.g. blood flow (Doppler imaging)

 No radiation exposure, completely non-invasive and safe

 Fast

 Inexpensive

 Medical applications: imaging fetus, heart, and many others

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ACOUSTIC WAVE

 Pressure waves that propagate through matter via compression and expansion of the material

 Requires a material medium through which to propagate

 Classification (increasing in frequency):

 Infra sound, audible sound, ultrasound

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ACOUSTIC WAVE ENERGY RANGES

 Just as there are infrared, visible, and ultraviolet ranges in the EM spectrum, so there are
infrasound (“infra” = “below,” “beneath”), audible (i.e., sound) and ultrasound (“ultra” = “beyond,”
“above”) ranges of acoustic wave frequencies
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5. Magnetic Resonance Imaging (MRI)

• Year discovered: 1945 ([NMR] Bloch, NP 1952) 1973 (Lauterbur, NP 2003) 1977 (Mansfield, NP
2003) 1971 (Damadian, SUNY DMS)

• Form of radiation: ) Radio frequency (RF). (non-ionizing)

• Energy / wavelength of radiation: 10 - 100 MHz / 30 - 3 m (~10-7 eV)

• Imaging principle: Proton spin flips are induced and the RF emitted by their response (echo) is
detected.

• Imaging volume: Whole body

• Resolution: High (mm)

• Applications: Soft tissue, functional imaging

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16.3 MAGNETIC RESONANCE IMAGING (MRI)

 Provide high resolution anatomic structure (as with X-ray CT)

 Provide high contrast between different soft tissues (X-ray CT cannot)

 No exposure to radiation and hence safe

 More complicated instrumentation

 Takes longer to acquire a scan than CT, more susceptible to patient motion

CT MRI PET
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BASIC PRINCIPLE OF MRI

 The hydrogen (1^H) atom inside body possess “spin”

 In the absence of external magnetic field, the spin directions of all atoms are random and cancel
each other.

 When placed in an external magnetic field, the spins align with the external field.

 By applying an rotating magnetic field in the direction orthogonal to the static field, the spins can
be pulled away from the z-axis with an angle \alpha

 The bulk magnetization vector rotates around z at the Larmor frequency (precess)

 The precession relaxes gradually, with the xy-component reduces in time, z-component increases

 The xy component of the magnetization vector produces a voltage signal, which is the NMR signal
we measure

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RELAXATION
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PD weighted T2- weighted T1- weighted