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Biomedical Imaging

Dr. Khawar Khurshid


khawar.khurshid@seecs.edu.pk

Medical Imaging

Why?
Modalities:
- X-Rays

- CT Scan

- PET Scan
- MRI
- Ultrasound

X-Rays

History

X-rays were discovered by a German


physicist, W. K. Roentgen, in 1895
and received the Nobel Prize in 1901.

One of his earliest photographic plate


from his experiments was a film of his
wife, Bertha's hand with a ring, was
produced on Friday, November 8, 1895.

X-Ray Imaging
X-Ray Source

X-Ray Imaging

X-Ray Interactions

X-Ray Interaction (Compton Scattering)


In Compton scatter, incident photons
interact with loosely bound (outer shell)
electrons.
-A Compton interaction results in a
scattered photon that has less energy
than the incident photon and travels in a
new direction.
-A scattered electron carries the energy
lost by the incident photon (4)
-This electron loses energy by ionizing
other atoms in the tissue, thereby
contributing to the patient dose.

Attenuation of X-Rays

I = Ioe-x
where is defined as the linear attenuation coefficient with a unit of cm-1
(or dB/cm). Linear attenuation coefficient is the fraction of photons "lost"
from the beam when traveling a unit distance.
-The linear attenuation coefficient normally depends on the density of the
absorbing material.
-For any absorbing medium, the attenuation is the same with only half the
thickness but double the density.

Attenuation of X-Rays

Attenuation of X-Rays

High energy

Low energy

Subject contrast decreases with increasing photon energy.


As energy increases, so does the ability of the x-ray to penetrate, resulting
in less difference in the x-ray attenuation between the air and bone at high
energies.

Attenuation of X-Rays
Hard and soft x-ray
soft x-ray = Low energy x-ray, long
hard x-ray = High energy x-ray, shorter
X-rays from about 0.12 to 12 keV are classified as "soft" X-rays, and from
about 12 to 120 keV as "hard" X-rays.

Disadvantage of X-Rays

The Major disadvantage of X-rays imaging is the fact that this technique
uses ionizing radiation in the energy range of 50-200KeV.
Since Ionizing radiation can cause tissue damage, so there is a limit on the
number of X-ray scans a person can undergo per year.

X-Ray Images

Computed Tomography (CT)


Or
Computer Aided Tomography (CAT)

Difference between Tomographic Imaging and Projection Imaging

Computed Tomography (CT)


Computed Tomography (CT) is a technique for producing 2-D and 3-D crosssectional images of an object from the X-ray images.
In 1972 Godfrey N. Hounsfield first presented the first clinical CT scanner
which is described in [Hounsfield 1973].

A CT scanning system
consists of an X-ray unit
which functions as a
transmitter, and a data
acquisition unit which
functions as a receiver.

Computed Tomography (CT)

Computed Tomography (CT)

Computed Tomography (CT)


Image Reconstruction Backprojection

Back projection reconstruct an image by taking each view and smearing it along the
path it was originally acquired.

Computed Tomography (CT)


Spiral CT

Computed Tomography (CT)


Multi-detector CT
The coverage for multi-detector
CT (a) can be four times longer
than for single-section helical CT
(b) at the same pitch* and slice
thickness. To scan the same
volume in the same time with
single-section helical CT, one
must increase the pitch (c) or
slice thickness (d). To achieve
the same image quality with
single-section helical CT, the
scanning time would have to be
lengthened (e).

e
*Pitch = table speed / rotations per minute

Radiation Dose

Procedure

Effective Radiation

Compared to natural
Background Radiation

CT Whole Body

10 mGy

3 Years

CT - Head

2 mGy

8 Months

CT - Chest

7 mGy

2 Years

Cardiac CT

3 mGy

1 Year

Brain CT Scan

CT Contrast

Window Levels

Window Levels

Standard Views in Medical Imaging


Sagittal

Axial

Coronal

Standard Views Head Scan

Axial

Sagittal

Coronal

3D Visualization

2D Cross Section Slice

3D Volumetric Rendering

Magnetic Resonance Imaging


(MRI)

Synopsis of MRI

1) Put subject in strong magnetic field


2) Transmit radio waves into subject [2~10 ms]
3) Turn off radio wave transmitter
4) Receive radio waves re-transmitted by subject
5) Convert measured RF data to image

Many Factors Contribute to MR Imaging

Quantum properties of nuclear spins


Radio frequency (RF) excitation properties
Tissue relaxation properties
Magnetic field strength
Signal detection

What kinds of nuclei can be used for NMR?


Nucleus needs to have inherent spin.
Nuclei are made of protons and neutrons
Both have spin, and pairs of spins tend to cancel, so only atoms with
an odd number of protons and neutrons have spin

Good MR nuclei are 1H, 19F, 23Na

Hydrogen atoms are best for MRI


Biological tissues are predominantly 12C, 16O, 1H, and 14N
Hydrogen atom is the only major substance that is MR sensitive
Hydrogen is the most abundant atom in the body
Essentially all MRI is hydrogen imaging

Radio Frequency Fields


RF electromagnetic fields are used to manipulate the magnetization
of specific types of atoms.
This is because some atomic nuclei are sensitive to magnetic fields.
Externally applied RF waves can be transmitted into a subject to
perturb those nuclei.
Perturbed nuclei will generate RF signals at the same frequency
these can be detected coming out of the subject.

Recording the MR signal


Need a receiver for the same RF frequency as the exciter coil.
Signal amplitude decays as net magnetization gradually realigns with
the magnetic field.

Steps in 3D Localization

Can only detect total RF signal from inside the RF coil (the detecting
antenna).

Excite and receive Mxy in a thin (2D) slice of the subject.

The RF signal we detect must come from this slice.

Reduce dimension from 3D down to 2D.

Energy of RF signal will depend on where it comes from.

Positron Emission Tomography


(PET)

Positron Emission Tomography (PET)


Different Stages of Positron Emission Tomography

- Create a Radio isotope


- Administration of Active Radio Tracer into the Body
- Positron Decay
- Collision of Positron and Electron
- Emission of anti-parallel Gamma Rays
- Coincidence Detection
- Attenuation Correction
- Image Reconstruction

Positron Emission Tomography (PET)

GE Discovery STE

Positron Emission Tomography (PET)

Annihilation
Collision of Positron and Electron

Coincidence Detection
No Physical Collimation required in case of PET

Channel 1

Isotope Distribution

Channel 2

Annihilation

Coincidences Detected

Types of Coincidence Detections


Scattered, Random, True

Multiple coincidences occur when more than two photons are detected in different
detectors within the coincidence resolving time. In this situation, it is not possible to
determine the LOR to which the event should be assigned, and the event is
rejected.

Attenuation Correction

For a 20-cm path in soft tissue, the chance of both annihilation photons of
a pair escaping the tissue without interacting is about 15%.

Attenuation causes a loss of information and, because the loss is not the
same for all lines of response (LOR), causes artifacts in the reconstructed
transverse images. Loss of information also contributes to statistical noise
in the images.

Contemporary scanners can estimate attenuation using integrated x-ray CT


equipment, however earlier equipment offered a PET transmission scan.

THEORY
Tracer Distribution

Corresponding CT Data

Annihilation
The detected gamma rays suffer variable attenuation depending on the
line of response (LOR).

Problems

Thickness of the
myocardial wall is most
impacted by views that
run parallel to the wall

LV PET activity misaligned in the CT lung tissue. Many lines of response (LOR) for LV
activity do not pass through cardiac tissue in the CTAC. Reconstruction performs
attenuation correction as if photons originating from left wall of LV passed through only
lung/air.

Problems
9.8 mm

2.9 mm

16.4 mm

Fused PET/CT images before registration

Fused PET/CT images after registration

Effect of The Cardiac Phase (Axial Plane)

The change in the size of the heart during a cardiac cycle

Effect of The Cardiac Phase (Sagittal Plane)

PET cardiac contour overlaid onto the same CT slice


location acquired at different cardiac phases.

Dual Gated CT - Setup

The EKG is added to the overall imaging protocol.


The CT data acquisition begins with the pulse signal from the EKG.
The CT images are gated in 10 uniform intervals from the first QRS peak of the EKG to the
next one.

PET Reconstruction

Time of Flight (TOF) Approach

PET Cardiac Images

Selected axial images from the PET data of 47 slices

PET Cardiac Images

Processed Image

Polar Map Generation

PET Cardiac Images

Reconstructed Cardiac Image with Artifact


(Hyper-perfusion)

CT scan with calcium deposits in the


cardiac region

The reconstructed PET shows


abnormally high uptake in the
corresponding region.

Reconstructed Brain With Artifacts

Patient 1
X = 9 mm , Axial = 5o
Y = 0 mm , Coronal = 0
Z=12 mm , Sagittal = 10o

Reconstructed PET data using misaligned and aligned CTACs. Figure (a-c) shows the
reconstructed PET slices in the axial, sagittal, and the coronal plane using the misaligned
CTAC. Figure (d-f) shows the reconstructed same PET slices in the axial, sagittal, and the
coronal plane using the aligned CTAC.

Reconstructed Brain With Artifacts

Patient 10
X = 6 mm , Axial = 0
Y = 2 mm , Coronal = 0
Z = 6 mm , Sagittal = 0

The patient only has the translational motion and no rotation of the head.

Reconstructed Brain Images

Applications

Early detection of cancer


Localization of Tumor cells
Alzheimer Disease
Dementia: Parkinson's, Epilepsy
Degradation of myocardial wall

Blood Flow analysis

MATLAB for Medical Image Processing

DICOM Digital Imaging and Communication in Medicine

MATLAB Toolbox
Dicomread;
Dicominfo;
Dicomwrite;

MATLAB for Medical Image Processing


Sample DICOM Header

End
Lecture 12

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