ADVANCEMENTS IN CT

INTRODUCTION:

Today, CT has become one of the most important diagnostic

imaging modality.
 It delivers non-superimposed, cross-sectional images of the
body, which can show smaller contrast differences much better
than conventional x-ray images. This allows better visualization of
various types of soft tissues (e.g. gray matter, white matter,
tumor, CSF etc.) which could other wise not be visualized
satisfactorily.
 CT exams are now quicker and more patient friendly than ever
before. Tremendous research and development has been made to
provide excellent image quality for diagnostic confidence at the
lowest possible x-ray dose.
 CT GENERATIONS
Ist generation Features: -
Brain scanner
Head was enclosed in water bath to provide
homogeneity b/w X ray tube & a pair of
detectors below .
A third reference detector intercepted a portion
of the beam before it reached the patient.
Patient remain stationary & Gantry moves
through two types of motion: one is linear. &
other rotary
Beam- narrow pencil beam, filtered with 6mm
Al eq.
Tube - oil cooled stationary anode, focal ROTATE/TRANSLATE, PENCIL BEAM
spot 2.25 x12mm operated at 120kvp &
33mA.
Each slice of 180 degree rotation took 5 min
so total time for clinical study was approx
25-30 min
Matrix 80x80, spatial resolution was 3
lp/cm
 2 GENERATION:
nd

Features: -

Based on translate-rotate system

No. of detectors were increased i.e.
up to 30.
A fan beam with 20-30 degree
divergence.
Rotary movement was in arc of 30º
& linear movements were 6 as
compare to EMI scanner
Scan time for head 10-90 sec. Body
scanning was also possible
 3 GENERATION
rd

Features: -

Rotate – Rotate Configuration.

Wider Fan Beam Geometry (260 – 450).
Pre & Post Collimation.
700 - 750 Detectors in A Single Array
(Xenon Gas).
Scanning Time reduced to 1 sec.
Disadvantage -ring artifact.
 4 GENERATION
th

4th - Generation CT scanners were designed

to overcome the problem of ring artifacts.
It is based on the Rotate – Fixed
Configuration.
The x-ray tube rotates but the detector
assembly does not.
A ring of detectors (1000-2000) surrounds
the patient.
The x-ray tube rotates in a circular inside the
detector ring & x-ray beam was collimated to
form a fan beam.
Scan time is ≤ 1 Sec.
Disadvantages
High cost because more no of detector use
More scatter radiation
 5 GENERATION
th

Also known as “Milli Second Scanner System”

First used by Mayo Clinic’s.
They used 28 X-ray tubes position around a semicircular gantry,
aligned with 28 light amplifiers & TV cameras that are placed
behind a single curved fluorescent screen.
The entire assembly rotated around the patient at a rate of 15 rpm
to provide 28 views every 1/60 second (16ms).
Disadvantages
• High cost
• Heavy structure mechanical motion difficult
 EBCT
The EBCT is often referred to as “Ultra
Fast CT” (UFCT). It was initially referred
to as a Cardiovascular CT (CVCT)
scanner.
An electron gun 320cm long
with its focusing & deflecting
coils (electron are accelerated at
130keV)
4Tungsten targets rings 180cm
in dia.
A ring of detectors arranged in
an arc of 210 degree
The transmitted X ray photons
are measured by integrated
crystals photo-diode detector
system and digitized by an
acquisition system.
Scan time very less 50-100
msec. because there is no
HELICAL/SPIRAL/VOLUME CT:
The technology is a great innovation in the
history of CT Technology which completely
eliminates the “Inters-can Delay” & give the new
dimension of volumetric data acquisition.
 Spiral CT is made possible by the use of slip
ring technology. Slips rings are an
electromechanical devices that conduct electricity
and electrical signals through ring & brushes
from a rotating surface onto fixed surface & vice-
versa.
During rotation the table move continuously
through the gantry so examination area can be
covered in a short time period in a single breath
hold, this gives volumetric data which are further
reconstructed in defined slice thickness.
 PITCH:
The physical parameters comes into play known as pitch which
is ratio of table feed per 3600 gantry rotation by physical
collimation or slice thickness.
Pitch = Table Feed/3600 Gantry Rotation
-----------------------------------------
Slice Thickness
If, Pitch value is >1 = Larger Area Coverage with less dose
<1 = Small Area coverage with higher dose
 Multislice CT

•Multislice CT scanners are similar in concept to

the helical or spiral CT but there are multiple
detector rings. It began with two rings in mid
nineties, with a 2 solid state ring model
designed and built by (Elscint Haifa) called CT
Twin.
• It was followed by other manufacturers. Later,
it was presented 4, 8, 16, 32, 40 and 64 detector
rings, with increasing rotation speeds.
‫٭‬In CT, the recent advancements are occurred in the following
area: -
1. Data Acquisition Geometry (Beam Shape).
2. X-ray Tube Design: - In Anode Side (Cooling)
3. Detector Technology.
4. Multiple Detector Arrays.
 DATA ACQUISITION GEOMETRY
(BEAM SHAPE).

As the number of detectors in a multi-row

detector array increases, the beam becomes
wider to cover the 2D detector array.
Larger no. of rows in the detector array will
result in a wider beam in z-axis direction (cone
beam).
DATA ACQUISITION GEOMETRY
(BEAM SHAPE).
DEVELOPMENTS IN CT TUBE:

Early generation CT Scanners were used Oil Cooled, Stationary Anode

relatively large (2 x 16 mm) Focal Spot operated at 120 kVp & 30 mA &
heavily filtered X-ray tube as used in radiotherapy..
Now a days CT tubes are heavy duty rotating anode with higher thermal
capacity & smaller focal spot (0.6 to 1.2mm) which are air cooled with
current value up to 800mA.
“Borosilicate Glass Envelope” has been replaced with a “Metallic
Envelope (Allow of Chromium & I)” & “Ceramic Insulators (Al –
Oxide)”.
Anode disk is made up of compound materials consisting of Tungsten-
Rhenium focal track brazed to ‘Graphite’ base with “Disk Diameter” up
to 200 mm compared to 75-160 mm.
“Anode Speed” is increased up to 12000 rpm by having liquid
bearing technology for smooth rotation of disk. e.g.. Gallium Based
Liquid Metal Alloy.
Air cooled , rotating anode having smaller focal spot 0.6mm Heat
loading capacity 3.5 MHU & high heat dissipation efficiency.
Oil-water cooled tube were introduced having high heat dissipation
efficiency.
Some CT Tubes are ‘Grid Controlled’ for ‘Pulsed’ radiation to reduce
patient radiation dose.
It Should supply ‘Monochromatic X-ray Beam’ for accurate ‘Image
Reconstruction’.
CT tubes are oriented in the gantry with long axis perpendicular to
the fan beam to avoid heel effect.
 STRATON CT TUBE
One of the more interesting
developments is the Siemens Straton
x-ray tube, which is currently available
as an option on Sensation 16 scanners.
 The tube itself is a radical new
design, where the entire tube body
rotates, rather than just the anode, as is
the case with conventional designs.
This change allows all the bearings to
be located outside the evacuated tube
& enables the anode to be cooled more
efficiently.
FEATURES OF STRATON CT TUBE

The Straton has a low inherent heat capacity of 0.8

MHU, but an extremely fast cooling rate of 5 MHU / min.
This compares with typical figures of 7-8 MHU & up to
1.4 MHU / min for existing tubes.
The heat capacity & cooling rate combine to produce a
tube which Siemens claim is ‘0 MHU', implying that tube
cooling considerations are a thing of the past.
Conventional / Straton
 FLYING FOCAL SPOT:
The no. of measurements channel can be doubled by
rapid deflection of X-ray tube focal spot for each projection
increasing the image resolution.
This technology is achieved by electromagnetically
deflecting the electron beam within the X-ray Tube.
For each focus position 2 – measured interlaced
projection result, since the detector continue to move
continuously which double the sampling frequency &
enhance the spatial resolution.
 STRATON CT TUBE

NEW FLYING FOCUS

TECHENIQUE:-
Over sampling results more
z-axis resolution (isotropic
resolution)
 LIMAX (Liquid Metal Anode X-ray) by Philips:

In these tubes a liquid metal jet is subjected to fast electrons.

Liquid metal, eutectics of SnPb, GaInSn, or PbBiInSn, turbulently streaming
through a tube close to the cathode, is heated at the focal spot.
While the heated material is transported through the tubing, cold metal enters
the focal spot area.
The liquid metal is cooled effectively by circulation through a heat
exchanger.
The liquid metal is separated from the vacuum by a diamond, tungsten or
molybdenum window of several microns in thickness In comparison to
stationary anode X-ray tubes, the LIMAX design has shown a significant
improvement in its ability to be continuously loaded.
However, in the current state of development, the peak power does not reach
values, to the order of 150 kV, that are required for the latest CT generation.
A liquid metal - filled spiral - groove bearing allows very high continuous
power compared with conventional ball bearings.
ADVANCEMENT IN DETECTORS
‫٭‬The current MDCT scanners acquire 2, 4, 6, 8, 10, 16 ,32, 40, 64
simultaneous sections. Scanners with 128, 256 & 320 slice CT are
now also available.
‫٭‬The actual number of detector rows is usually much larger than the
active number of detector rows in order to achieve more than one
collimation setting.
‫٭‬This is achieved by collimating & adding together the signals of
neighbouring detector rows.
‫٭‬There are three types of detector arrays: -
1. Matrix Array (Linear Uniform).
2. Adaptive Array (Non – Uniform).
3. Hybrid Array.
 MATRIX ARRAY:
A detector design that is subdivided into equal elements, or
portions, is called “Uniform,” “Matrix,” or “Mosaic”.
 GE Healthcare (Waukesha, Wis), the first CT manufacturer to bring
a Multiple - Row Detector CT scanner design to the market, used this
design in their 4 & 8 - channel scanners. It has also been adapted for
use in several more recent scanner designs (i.e., 40 & 64 channel
scanners).
Mosaic detectors have elements that are all a uniform size. The
thickness of the sections that can be generated from these detectors is
a multiple value of the uniform size of the detector element. (In this
case, sections can have a thickness of 1.25, 2.5, 3.75, 5, 7.5, or 10
mm).
 ADAPTIVE ARRAY:
‫٭‬A different approach uses an adaptive array detector design, which
comprises detector rows with different sizes in the longitudinal direction.
‫٭‬Variable or non-uniform detectors are composed of elements that are
not uniform in size but can be combined with a post-patient collimator
unit to generate sections with several different thickness values. (In this
case, sections can have a thickness of 1, 2.5, 5, or 10 mm.)
‫٭‬Philips & Siemens have opted for an adaptive array configuration for
their 4-Slice systems (Siemens also for their 6-Slice system).
 HYBRID ARRAY:
Toshiba was the first to introduce the combination of two discrete
detector element sizes in its four-channel CT scanner (&
subsequently in its 8, 16, 32, & 64 channel scanners).
This detector design has a number of narrow detector elements in
the centre of the detector & a different number of wider detectors
(usually double the width of the narrow detectors) on both sides of
the span of narrow detectors.
ADVANCEMENTS IN DETECTOR TECHNOLOGY

Siemens has introduced UFC ( Ultra fast

ceramic) detectors in the 1998.
based on doped rare earth compounds
such as yttria and gadolinium oxide
ultrafast ceramic (UFC)
•Have great dynamic range
•Have high absorption &conversion
efficiency
•Smaller in size
•Less calibration required
 ADVANCEMENT IN DETECTORS

Solid-State Flat-Panel CT Detectors: -

Use of FPDs for CT imaging which have been developed for
radiographic applications is currently under investigation.
FPDs offer excellent performance for the imaging of high contrast
structures with high spatial resolution.
Low contrast resolution & dose efficiency however, is not at part of
dedicated CT detectors.
FPDs appear primarily suited for special applications in CT as for 3D
angiography or intra-operative imaging which also allows improvements
in work flow, but at present are not recommended for standard diagnostic
CTs due to dose reasons.
 2 – SLICE CT SCANNER:

‫‘٭‬Dual – Slice’ scanners introduced by

‘Elscint’ in 1991.
‫٭‬Relatively easy extension to Single – Slice.
‫٭‬Two parallel detector banks, two data sets
per gantry rotation.
‫٭‬Slice width chosen by varying beam width.
‫٭‬Twice the speed of single width scanning for
the same width.
‫٭‬Narrow collimations down to 2 x 0.5 mm.
‫٭‬Extended patient coverage for the same tube
loading.
 4 – SLICE CT SCANNER
The introduction of four-slice CT in1998 constituted a funda-
mental evolutionary step in the development & ongoing
refinement of CT imaging techniques.
Improved longitudinal resolution went hand in hand with faster
volume coverage, considerably reduced examination times &
better utilization of the available X-ray power.
 Multi-slice CT (MSCT) also dramatically expanded into areas
previously considered beyond the scope of third-generation CT
scanners based on the mechanical rotation of X-ray tube &
detector, such as cardiac imaging with the addition of ECG gating
capability.
 4 – SLICE CT SCANNER:
Introduced in 1998
0.8 sec rotation time
Faster coverage by inc table feed /rot
1.0 – 2.54 mm collimation.
Ceramic highlight detector with 14592 elements
Improved Temporal Resolution 125-250msec
But motion artifacts are still presents.
 16 – SLICE CT SCANNER:
‫٭‬16-slice CT for the first time allowed to cover substantial
anatomical volumes, such as the entire thorax & abdomen, with
isotropic sub millimeter resolution in short breath-hold times.
‫٭‬With the introduction of 16-slice CT, a volume coverage speed
of up to 48 mm/s could be achieved with sub millimeter slices,
which proved to be sufficient for the vast majority of clinical
applications.
 16 – SLICE
‫٭‬Introduced in 2002.
‫٭‬Gantry rotation 0.4-0.5 sec.
‫٭‬Thinner collimation0.625-0.75.
‫٭‬Ultra fast ceramic detector with16128 elements.
‫٭‬Motion free cardiac imagining for heart rates up
to 80 beat/min.
 16 - SLICE SCANNER:

Features GE Philips Siemens Toshiba

LightSpeed MX8000 Sensatin Aquilion
Plus IDT MX8000

Length of Detector Array 20 20 24 32

Min Slice Width 0.63x16 0.73x16 0.75x16 0.5x16
Min Rot. Time 0.5 0.4 0.4 0.4
 64 – SLICE:
For the new generation of 64-slice CT scanners, clinical
progress is more likely be expected from further improved
spatial & temporal resolution rather than from a mere increase in
the volume coverage speed.
Hence, innovative approaches such as refined z-sampling
techniques enabled by a periodic motion of the focal spot in the
z-direction (z-Sharp Technology™) have been developed to
further enhance longitudinal resolution & image quality in
clinical routine.
COMPARISON OF DIFFERENT CT SYSTEM AT PGIMER:
573
Features HiSpeed Dxi (Single LightSpeed Plus Somatom Sensation Toshiba aquillon (64
Slice) GE(4 – Slice) Siemens(16 – Slice) slice)

Min. Slice Width 1.0mm 0.625mm 0.75mm 0.5mm

Min. Tube Rotation 1 sec full 0.5 sec 0.42 sec 0.33sec
0.7sec partial

No. of Slices/ 1 4 16 64
Rotation

No. of Detector, One rows 16 Rows X 912 = 24 Rows X 672= 64rows x896=57344
Rows & Element 740 Elements 14592 Elements 16128 Elements

Type of Detector Scintillator Scintillator Scintillator Solid state

Hi – Light Ceramic Hi – Light Ceramic UFC

Type of Detector Active Array Matrix Adaptive hybrid

Arrangement
 256 – 320 SLICE CT
At RSNA 2007, Philips announced a 256-slice scanner, while Toshiba
announced a "dynamic volume" scanner based on 320 slices. The majority
of published data with regard to both technical & clinical aspects of the
systems have been related to the prototype unit made by Toshiba Medical
Systems.
In February 2007, a prototype CT scanner with 256 channels was
installed for clinical use at Johns Hopkins Hospital with a coverage of 12.8
cm at the iso-centre per gantry rotation. The goal is to scan the entire
cardiac region in a single gantry rotation. The “slice war” appears to be
continuing with little slowdown in sight.
The technology currently remains in a development phase but has
demonstrated the potential to significantly reduce radiation exposure by
eliminating the requirement for a helical examination in both cardiac CT
angiography & whole brain perfusion studies for the evaluation of stroke.
256 – SLICE CT SCANNER:
Aquilion One
‫٭‬The trend towards a larger number of slices in the future will
therefore not be driven by the need to increase scan speed in
spiral acquisition modes, but rather by the desire to increase
volume coverage in non- spiral dynamic acquisitions, e.g. by the
introduction of area detectors large enough to cover entire
organs, such as the heart, the kidneys or the brain, in one axial
scan ( 120 mm scan range).
 Flat panel volume CT

Fundamental Principles
and Technology

Flat-panel volume CT scanners can be thought of as

conventional multi detector CT scanners in which the
detector rows have been replaced by an area
detector.
Flat-panel volume computed tomography (CT)
systems have an innovative design that allows:
 Coverage of a large volume per rotation
 Fluoroscopic and dynamic imaging.
 High spatial resolution that permits visualization of
complex human anatomy such as fine temporal
bone structures and trabecular bone architecture.
 Has wide z-axis coverage that enables imaging of
entire organs in one axial acquisition
 useful for intra operative and vascular applications
enable depiction of dynamic processes such as
coronary blood flow and whole-brain perfusion.
 General design
The prototype consists of a modified gantry
(Sensation 16;Siemens) that is integrated with a
wide-angle X-ray tube, filters and beam formers, a
collimator, and a Digital flat-panel detector
The scanner typically operates at 3–20seconds per
rotation to maximize the number of projections
collected in one rotation per second.
The flat-panel detector may be positioned at any
arbitrary angle around the 360° span of the gantry to
acquire projection images at 30 frames per second.
This capability effectively converts the scanner into a
fluoroscopic unit.
X ray source , filters and collimators
 X-ray tubes have a considerably wider anode angle
to allow true cone-beam geometry the anode
angle is about 16° the source-to-detector and source
to- iso center distances are approximately 93 cm and
57 cm, respectively.
 Is pulsed operated, the tube current is activated
only during the acquisition of a 2D projection image
(duty cycle of 50%) to reduce the overall x-ray dose
and motion blurring.
 The use of a small focal spot (approximately 0.57
mm) minimizes the penumbra effect and preserves
sufficient photon flux and energy for high-resolution
imaging.
 Flat panel detector
 Active imaging area of 40 × 30 cm divided
into a matrix of 2048 × 1536 detector
elements, and it provides a field of view of 25
× 25 × 18 cm when geometric magnifications
are taken into account.
 It consists of a film of cesium iodide
scintillator crystals that is cast onto a matrix
of photographic detectors made of amorphous
silicon.
 Close interface between the cesium iodide
crystals and the photosensitive diodes.
 Yields ultra-high isotropic spatial resolution
(up to 150 μm) compared with multi detector
 X ray dose
 Dose considerations for flat-panel volume CT are similar to
those for multi detector CT
 18-cm z-axis coverage of flat-panel volume CT exceeds the
length of the standard16-cm phantoms that are used to
measure dose for multi detector CT
 An extended approach to dose measurement has been
proposed, with the use of two modified metrics: volumetric CTDI
and volumetric DLP
 The actual dose measurement must be performed with a
phantom that has a length that covers at least 18 cm of the z-
axis extent of the field of view, plus an additional 5–8 cm to
account for scatter radiation. The axial dose profile can be
estimated by using a phantom with a 16-cm diameter and a 32-
cm length that is fitted with thermo luminescent dosimeters
along the center line of the phantom. By using this dose
distribution profile along the z-axis, a conversion factor can be
computed to determine the volumetric DLP from the volumetric
 Advantages and Disadvantages of
FPVCT

Advantage Disadvantages
High spatial resolution Lower contrast resolution

Real-time fluoroscopy Slower scintillation material

Volumetric coverage in Longer scan time(3-20sec)

one rotation

Flexible C-arm–like Lower dynamic range

orientation

Dynamic imaging Lower SNR in very thin sections

 Comparison of Flat-Panel Volume CT with
Multidetector CT:
 superior in its spatial resolution -imaging calcified atherosclerotic
plaque, clipped aneurysms, and endovascular stents

 has a wide 2D field of view that can be refreshed at the video frame
rate. Coupled with its ability to image at any arbitrary angle, flat-panel
volume CT functions like a conventional fluoroscopic device

 Volumetric scanning and continuous rotation also make dynamic

imaging, such as whole-organ perfusion studies, feasible

 Contrast resolution of flat-panel volume CT is slightly inferior to that of

multidetector CT

 Multi detector CT also allows a faster scanning time, because it can

acquire900–1200 projections during a single 0.5-second rotation. In flat-
panel volume CT, the slow cesium iodide scintillator limits the
projection acquisition time to 100 frames per second and the overall
volumetric acquisition time to 3–20 seconds.
 In terms of dose, the equivalent CTDI and effective dose for flat-panel
volume CT are similar to those for multidetector CT. However, flat-panel
volume CT allows thinner sections (ie,more sections per image set)

Flat-panel volume CT images of a human knee. Sagittal reconstructed (left) and cross-
sectional (right) images clearly show the trabecular bone structures.
 DUAL SOURCE CT:
• Siemens introduced a CT model with dual X-ray
tube and dual array of 64 slice detectors, at the
2005 Radiological Society of North America
(RSNA) medical meeting.
• Dual sources increase the temporal resolution by
reducing the rotation angle required to acquire a
complete image, thus permitting cardiac studies
without the use of heart rate lowering medication,
as well as permitting imaging of the heart in
systole.
• The use of two x-ray units makes possible the use
of dual energy imaging, which allows an estimate
of the average atomic number in a voxel, as well
as the total attenuation. This permits automatic
differentiation of calcium (e.g. in bone, or
diseased arteries) from iodine (in contrast
medium) or titanium (in stents) - which might
otherwise be impossible to differentiate. It may
also improve the characterization of tissues
allowing better tumor differentiation.
 DUAL SOURCE CT:

‫٭‬The idea behind Dual Source CT is as simple as ingenious: it is merely

using two X-ray sources & two detectors at the same time.
‫٭‬The result? You get ‘Double Temporal resolution, Double Speed &
Twice the Power, while lowering dose even further.
‫٭‬It provides images of exceptional quality & is an amazing tool to
explore new clinical opportunities.
‫٭‬It allows us to scan at any heart rate without the need of ‘Beta Blockers’
at the ‘Lowest Radiation Dose’ ever achieved in CT.
DUAL SOURCE CT:
The benefits Dual Source CT allows to scan any
heart at any heart rate without the need of beta-
blockers – at the lowest radiation dose ever
achieved in CT.
Moreover, it provides one-stop diagnoses
regardless of size, condition, and heart rate of the
patient, saving precious time and money in acute
care.
 CARDIAC IMAGING:

Optimal cardiac imaging can be best achieved in the

diastolic phase of the heartbeat.
The faster the heart rate, the shorter this phase
becomes. With a single source CT scanner, the X-ray
source/detector system has to obtain data projections
of 180 degrees to take an image within the diastolic
phase.
With Dual Source CT, each of the two
source/detector combinations only needs to travel 90
degrees to acquire an exceptional cardiac image.
Based on 0.33 sec rotation time, this concept provides
an unprecedented temporal resolution of 83 ms,
independent of the heart rate
 CLINICAL BENEFITS
Imaging of all heart rates without ß-blockers.
Scanning of arrhythmic patients.
Reliable & reproducible plaque discrimination.
High accuracy of in-stent imaging.
Acquisition within shortest breath-hold.
 ECONOMIC BENEFITS
Patient preparation, examination & diagnosis below 10 minutes.
No ß-blocker application for heart rate control.
No physician interaction during scanning.
No pre & post scan monitoring necessary, neither on patient table,
nor in dedicated room.
Accessible for all patients up to 220 kg .
 TECHNICAL BENEFITS

‫٭‬Industry’s highest heart-rate independent

temporal resolution of 83 ms.
‫٭‬Industry’s highest spatial resolution of 0.33
mm.
 DOSE REDUCTION:
At the same time, Dual Source CT offers the lowest possible radiation exposure in
cardiac CT .
The CT gantry needs to travel only 90 degrees to acquire an exceptional cardiac
image with unprecedented temporal resolution of 83 ms, independent of the heart rate.
Monitoring the ECG in real-time , reacts to any changes of the heart rate.
Now that cardiac acquisition time is twice as fast, the time of high exposure during
the heart beat, controlled by dose modulation, can be cut by more than half compared
to single source CT scanners.
Instead of using multi segment reconstruction at higher heart rates, Dual Source
CT’s highest temporal resolution allows one to acquire cardiac images from single
heartbeats, at any heart rate.
Using automated table speed adaptation, it increases the pitch with higher heart
rates, resulting in a faster table speed & a corresponding reduction of radiation
exposure.
In other words, the higher the heart rate, the less time is required for imaging the
heart & consequently a lower dose is needed.
 OBESE PATIENTS
Scanning obese patients with single source CT usually results
in a trade-off between speed & image quality.
Dual Source CT overcomes this limitation of restricted power
reserves with a second X-ray source.
In other words, it accumulates the power of the two
independent sources resulting in unprecedented 160 kW,
providing sufficient X-ray power reserves for high quality
imaging of patients whether tall or small, thin or large – at
maximum volume coverage speed & fastest rotation time. &
because scan speeds can be increased, the higher power is used
to improve quality, while dose maintains the same as in single
source CT.
TISSUE DIFFERENTIATION:
‫٭‬It has always been an aim to collect as much information as
possible for differentiation of tissues.
‫٭‬Dual Source CT assists in opening the door beyond
visualization, thus moving into a new world of characterization.
Permitting the use of two sources simultaneously a different
energies, makes it possible to acquire two data sets
simultaneously from a single scan, running the tubes at two
different kV levels.
‫٭‬The result is two data sets with diverse information, which can
allow the user to differentiate, characterize, isolate & distinguish
the imaged tissue & material – obtaining specific details about
the scanned object beyond morphology.
 DUAL ENERGY CT:

Two designs:
‫٭‬Siemens Definition –Two sources.
‫٭‬Discovery CT750 HD - Single source.
 Dual energy CT
‫٭‬Two X-ray sources running simultaneously at different energies
acquire two data sets showing different attenuation levels. In the
resulting images, the material-specific difference in attenuation
enables an easy classification of the elementary chemical
composition of the scanned tissue. In addition, a fused image is
provided for initial diagnosis
 TECHNICAL CONSIDERATIONS:

This system consists of two x-

ray tubes mounted in one gantry at
a 90 degree angle from each
other .
Detector A is equal to the size of
a standard detector(50 cm).
Detector B has a reduced field
of view of 26 cm.

Schematic illustration of the dual source acquisition geometry using two

tubes & two corresponding detectors, mounted into the gantry with an
angular offset of 90◦
The limitation is the smaller size of B detector.

The patient may have to be positioned off center if the

location of the lesion is at periphery.
Also , it is mandatory to acquire both AP as well as Lateral

topograms to make sure that the table top is not positioned too
high or too low in the gantry.
POTENTIAL CLINICAL USES
Possible application fields are: -
Direct subtraction of either vessels or bone
during scanning,
Classification of tumors in oncology,
Characterization of plaques in vessels &
The differentiation of body fluids in
emergency diagnostics.
 DISCOVERY CT750 HD:
‫٭‬The first new detector material in 20 years; one that is, quite
literally, a gem. GE engineers discovered that, by changing the
molecular structure of real ‘Garnets’, they could develop a
scintillator capable of delivering images 100 times faster, with up to
33% greater detail through the body & up to 47% greater detail in the
heart.
‫٭‬They had unlocked the secret of the proprietary GE ‘Gemstone’
Detector™, boasting the fastest primary speed in the CT industry &
the driving force of the first of its kind "Gemstone Spectral Imaging"
process dose reduction.
Gemstone Spectral Imaging uses up to 2496 views per
rotation (a 2.5x increase) to deliver improved spatial resolution
& improved image quality across the entire field of view.
Dual energy fast kV switching registers energies at least 165
times faster than Dual Source CT at a 0.33s rotating speed. It
offers 128 slices of unique data per rotation & 101 user
selectable energy levels for viewing.
In short, it brings faster, clearer images into today's
demanding health care environment without sacrificing the
element patients & clinicians demand most: radiation dose
reduction.
PET –CT Combined
Scanners:
 With the exception of contrast-enhanced angiography and
perfusion techniques, CT, on its own, is only able to provide
morphological information, i.e., information on the shape of
objects. On the other hand, positron emission tomography (PET)
provides information on the metabolism, i.e., the biomedical
function of an anatomical region.

 PET–computed tomography (CT) is a unique combination of the

cross-sectional anatomic information provided by CT and the
metabolic information provided by PET, which are acquired
during a single examination and fused
 FDG PET–CT offers several advantages over PET alone; the most important is
the ability to accurately localize increased FDG activity to specific normal or
abnormal anatomic locations, which may be difficult or even impossible with
PET alone.

The bio graph scanner from Siemens is an integrated PET-CT

concept that can image metabolic and anatomic information
at the same time. Courtesy of Siemens Medical Solutions
Most current PET scanners use crystals composed of
bismuth germinate (BGO), cerium doped lutetium
oxyorthosilicate (LSO), or cerium-doped gadolinium
silicate (GSO), which have very high densities and
atomic numbers.

Photograph (frontal view) of a hybrid PET-CT scanner shows the PET

ring detector system (red ring). There are up to 250 block detectors in
the ring. Drawing shows a detector block with 8 smaller scintillation
crystals (green and orange rectangles) linked to four photomultiplier
Photograph (side view) of a hybrid PET-CT scanner shows the PET (P) and CT
© components. The distance between the PET and CT scanners is 80 cm, and
the maximum coverage that can be achieved during a combined study is 145 cm.
The PET and CT scanners are mechanically independent and can be used in
isolation for PET or CT only.
 SPECIAL APPLICATIONS
CM Bolus Tracking Software.
CT Fluoroscopy Software & Hardware.
3D Software: -
Multi Planner Reconstruction.
Volume Rendering Technique.
Shaded Surface Display.
Multiple Intensity Projection.
Perfusion Software.
RFA, Biopsy, FNAC, Colonoscopy, Bronchoscopy & Endoscopy
Facilities.
Image Transfer Connectivity i.e. HIS, RIS & PACS.
 POSTPROCESSING
3D Display: - Views showing entire volumes
are referred to as “3D displays”.
MPR -It is a type of ‘Post – Processing’
technique in which a series of axial images are
combined to form a stack.
‫٭‬By aligning the same columns and rows of all
images of a series, the computer reconstructs Axial Image
contiguous images for any arbitrary plane.
‫٭‬This 3D data set can then be displayed either as a
complete image or as a series of ‘Sagittal’,
‘Coronal’ & ‘Oblique’ plane.
‫ ٭‬This technique is used for better visualization of
structures, such as vessels, which extend across
several slices.

MPR Image
 Surface shaded display: - It is a process used to generate 3D images
that show the surface of a structure.
‫٭‬It is achieved by selecting a suitable range of CT numbers that are
associated with that structure.
‫٭‬For threshold based surface displays a CT number, e.g. 150 HU, is
predefined as a threshold.
‫٭‬All pixels, i.e. voxels, which exceed this threshold value contribute to
the result image.
‫٭‬SSD is a computer aided technique and it was initially applied to bone
imaging.
Maximum intensity projection- - Reconstruction of brightest pixel
from stack of image data into a 3D image.
MIP are based on the voxels with the highest density, i.e. CT number.
MIP is the basis for CTA.
It provides excellent differentiation of vasculature from surrounding
tissue but lacks vessel depth because superimposed vessels are not
displayed. Multiple MIP image constructed at different angles and
viewed in rotation may be required to separate superimposed vessels. MIP Image
 VOLUME RENDERING TECHNIQUE (VRT):

VRT refers to the process of reconstructing a 3D model from a 2D

image stack. VR - Techniques go beyond SSD & MIP techniques in their
basic approach & performance.
They are not limited to a certain threshold or maximum density value.
Instead, all density values along a virtual beam which have a suitable
weighting can contribute to the result image.
Each CT number is assigned an opacity & colour via freely selectable
& interactively modifiable transfer functions.
This makes it possible to simultaneously display an extremely wide
variety of tissue structures of various density or HU value in a single
volume data set.
VRT is another post processing technique that provides depth in an
image
3-D images have better quality than in surface rendering.
Advantages: -
‫٭‬VRT allows seeing through surfaces.
‫٭‬It allows the viewer to see both internal & external structures.

VRT Vs MIP
 VIRTUAL ENDOSCOPY (VE):
‫٭‬This is also known as ‘Fly – Through Projection’
‫٭‬A special type of VRT is ‘Perspective Volume
Rendering’ (pVR), which is used mainly to generate
virtual endoscopic views. This technique is used to
obtain a perspective view of the display region.
‫٭‬Virtual endoscopy is mainly used to display the
internal walls of body structures such as: - Bronchial
Tree, Large Vessels, The Colon & Para nasal Sinuses.
‫٭‬When the endoscope is inserted in a cavity displayed
with the perspective Volume Rendering Technique
(VRT), this gives the user the impression of “Flying
Through” the displayed region (Virtual Flight).
 Summary

CT has experienced a rapid development from its beginning till now.
Multi row detectors, ultra fast data acquisition systems ,rapid
reconstruction hardware perfect reconstruction and advanced viewing
tools are the key factors to fully exploit the clinical benefits of this
technology.
The future challenge will be to make flat panel detector CT in
practice.
It is expected that this machine will perform radiography,
fluoroscopy as well as CT .
 Yo u
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h a
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 References
Radiographics Flat-Panel Volume CT:
Fundamental Principles, Technology, and
Applications
www.google.com
Christensen physics of radiology
CTdetector technology, types and
advancements by Mr. S C bansal Journal of
roentgen technology ,sep2006.
Siemens medical solution ct detector
technology, 2004
Wikipedia .com