CT scan

From Wikipedia, the free encyclopedia

"Computed tomography" redirects here. For non-medical computed tomography,
see industrial computed tomography scanning.
CT scan
Intervention

Modern CT scanner
Synonyms

X-ray computed tomography (X-ray

CT), computerized axial tomography
scan (CAT scan)[1]

ICD-10-PCS

B?2

ICD-9-CM

88.38

MeSH

D014057

OPS-301 code 320...326

MedlinePlus

003330
[edit on Wikidata]

A CT scan makes use of computer-processed combinations of many X-ray images

taken from different angles to produce cross-sectional (tomographic) images (virtual

"slices") of specific areas of a scanned object, allowing the user to see inside the object
without cutting.
Digital geometry processing is used to generate a three-dimensional image of the inside
of the object from a large series of two-dimensional radiographic images taken around a
single axis of rotation.[2] Medical imaging is the most common application of X-ray CT.
Its cross-sectional images are used for diagnostic and therapeutic purposes in various
medical disciplines.[3] The rest of this article discusses medical-imaging X-ray CT;
industrial applications of X-ray CT are discussed at industrial computed tomography
scanning.
As X-ray CT is the most common form of CT in medicine and various other contexts, the
term computed tomography alone (or CT) is often used to refer to X-ray CT, although
other types exist, such as positron emission tomography(PET) and single-photon
emission computed tomography (SPECT). Older and less preferred terms that also refer
to X-ray CT are computed axial tomography (CAT scan) and computer-aided/assisted
tomography. X-ray CT is a form of radiography, although the word "radiography" used
alone usually refers, by wide convention, to non-tomographic radiography.
CT produces a volume of data that can be manipulated in order to demonstrate various
bodily structures based on their ability to block the X-ray beam. Although, historically,
the images generated were in the axial or transverse plane, perpendicular to the long
axis of the body, modern scanners allow this volume of data to be reformatted in various
planes or even as volumetric (3D) representations of structures. Although most common
in medicine, CT is also used in other fields, such as nondestructive materials testing.
Another example is archaeological uses such as imaging the contents of sarcophagi.
Individuals responsible for performing CT exams are called radiographers or radiologic
technologists.[4][5]
Use of CT has increased dramatically over the last two decades in many countries. [6] An
estimated 72 million scans were performed in the United States in 2007. [7] One study
estimated that as many as 0.4% of current cancers in the United States are due to CTs
performed in the past and that this may increase to as high as 1.5 to 2% with 2007 rates
of CT use;[8] however, this estimate is disputed,[9] as there is not a consensus about the
existence of damage from low levels of radiation. Kidney problems may occasionally
occur following intravenous contrast agents used in some types of studies. [10]
Contents
[hide]

1Medical use
o 1.1Head
o 1.2Lungs
o 1.3Pulmonary angiogram

o 1.4Cardiac
o 1.5Abdominal and pelvic
o 1.6Extremities

2Advantages

3Adverse effects
o 3.1Cancer
o 3.2Contrast

4Scan dose
o 4.1Radiation dose units
o 4.2Excess doses
o 4.3Campaigns

5Prevalence

6Process

7Three-dimensional reconstruction
o 7.1Multiplanar reconstruction
o 7.23D rendering techniques

8Image quality
o 8.1Artifacts
o 8.2Dose versus image quality

9Industrial use

10History
o 10.1Origins of tomography

o 10.2Mathematical theory
o 10.3Commercial scanners
o 10.4Etymology

11Types of machines
o 11.1Previous studies

12Research

13See also

14References

15External links

Medical use[edit]

Picture of a CT scout (akascanogram or topogram) as used for planning every scan

slice.
Since its introduction in the 1970s, CT has become an important tool in medical
imaging to supplement X-rays and medical ultrasonography. It has more recently been
used for preventive medicine or screening for disease, for example CT colonography for
people with a high risk of colon cancer, or full-motion heart scans for people with high
risk of heart disease. A number of institutions offer full-body scans for the general
population although this practice goes against the advice and official position of many
professional organizations in the field.[11]
Head[edit]
Main article: Computed tomography of the head

Computed tomography of human brain, from base of the skull to top. Taken with
intravenous contrast medium.

Bone reconstructed in 3D
CT scanning of the head is typically used to detect infarction,
tumors, calcifications, haemorrhage and bone trauma. Of the above, hypodense (dark)
structures can indicate edema and infarction, hyperdense (bright) structures indicate
calcifications and haemorrhage and bone trauma can be seen as disjunction in bone
windows. Tumors can be detected by the swelling and anatomical distortion they cause,
or by surrounding edema. Ambulances equipped with small bore multi-sliced CT
scanners respond to cases involving stroke or head trauma. CT scanning of the head is
also used in CT-guided stereotactic surgery and radiosurgery for treatment of
intracranial tumors, arteriovenous malformations and other surgically treatable
conditions using a device known as the N-localizer.[12][13][14][15][16][17]
Magnetic resonance imaging (MRI) of the head provides superior information as
compared to CT scans when seeking information about headache to confirm a
diagnosis of neoplasm, vascular disease, posterior cranial fossa lesions,
cervicomedullary lesions, or intracranial pressure disorders.[18] It also does not carry the
risks of exposing the patient toionizing radiation.[18] CT scans may be used to diagnose
headache when neuroimaging is indicated and MRI is not available, or in emergency
settings when hemorrhage, stroke, or traumatic brain injury are suspected.[18] Even in
emergency situations, when a head injury is minor as determined by a physician's
evaluation and based on established guidelines, CT of the head should be avoided for
adults and delayed pending clinical observation in the emergency department for
children.[19]

Lungs[edit]
CT scan can be used for detecting both acute and chronic changes in
the lung parenchyma, that is, the internals of the lungs. It is particularly relevant here
because normal two-dimensional X-rays do not show such defects. A variety of
techniques are used, depending on the suspected abnormality. For evaluation of
chronic interstitial processes (emphysema,fibrosis, and so forth), thin sections with high
spatial frequency reconstructions are used; often scans are performed both in
inspiration and expiration. This special technique is called high resolution CT. Therefore,
it produces a sampling of the lung and not continuous images.
An incidentally found nodule in the absence of symptoms (sometimes referred to as
an incidentaloma) may raise concerns that it might represent a tumor, either benign
or malignant.[20] Perhaps persuaded by fear, patients and doctors sometimes agree to
an intensive schedule of CT scans, sometimes up to every three months and beyond
the recommended guidelines, in an attempt to do surveillance on the nodules.
[21]
However, established guidelines advise that patients without a prior history of cancer
and whose solid nodules have not grown over a two-year period are unlikely to have
any malignant cancer.[21] For this reason, and because no research provides supporting
evidence that intensive surveillance gives better outcomes, and because of risks
associated with having CT scans, patients should not receive CT screening in excess of
those recommended by established guidelines.[21]
Pulmonary angiogram[edit]

Example of a CTPA, demonstrating a saddle embolus (dark horizontal line) occluding

the pulmonary arteries(bright white triangle)
CT pulmonary angiogram (CTPA) is a medical diagnostic test used to
diagnose pulmonary embolism (PE). It employs computed tomography and an iodine
based contrast agent to obtain an image of the pulmonary arteries.
Cardiac[edit]
Main article: Cardiac CT
With the advent of subsecond rotation combined with multi-slice CT (up to 320-slices),
high resolution and high speed can be obtained at the same time, allowing excellent
imaging of the coronary arteries (cardiac CT angiography).
Abdominal and pelvic[edit]
Main article: Abdominal and pelvic CT

CT Scan of 11 cm Wilms' tumor of right kidney in 13-month-old.

CT is a sensitive method for diagnosis of abdominal diseases. It is used frequently to
determine stage of cancer and to follow progress. It is also a useful test to investigate
acute abdominal pain.
Extremities[edit]
CT is often used to image complex fractures, especially ones around joints, because of
its ability to reconstruct the area of interest in multiple planes. Fractures, ligamentous
injuries and dislocations can easily be recognised with a 0.2 mm resolution.[22][23]
Advantages[edit]
There are several advantages that CT has over traditional 2D medical radiography.
First, CT completely eliminates the superimposition of images of structures outside the
area of interest. Second, because of the inherent high-contrast resolution of CT,
differences between tissues that differ in physical density by less than 1% can be
distinguished. Finally, data from a single CT imaging procedure consisting of either
multiple contiguous or one helical scan can be viewed as images in theaxial, coronal,
or sagittal planes, depending on the diagnostic task. This is referred to as multiplanar
reformatted imaging.
CT is regarded as a moderate- to high-radiation diagnostic technique. The improved
resolution of CT has permitted the development of new investigations, which may have
advantages; compared to conventional radiography, for example, CT angiography
avoids the invasive insertion of a catheter. CT colonography (also known as virtual
colonoscopy or VC for short) may be as useful as a barium enema for detection of
tumors, but may use a lower radiation dose. CT VC is increasingly being used in
the UK as a diagnostic test for bowel cancer and can negate the need for
a colonoscopy.
The radiation dose for a particular study depends on multiple factors: volume scanned,
patient build, number and type of scan sequences, and desired resolution and image
quality.[24] In addition, two helical CT scanning parameters that can be adjusted easily
and that have a profound effect on radiation dose are tube current and pitch. Computed
tomography (CT) scan has been shown to be more accurate than radiographs in
evaluating anterior interbody fusion but may still over-read the extent of fusion. [25]

Adverse effects[edit]
Cancer[edit]
The radiation used in CT scans can damage body cells, including DNA molecules,
which can lead to cancer.[8] According to the National Council on Radiation Protection
and Measurements, between the 1980s and 2006, the use of CT scans has increased
sixfold (600%). The radiation doses received from CT scans are 100 to 1,000 times
higher than conventional X-rays.[26] A study by a New York hospital found that nearly a
third of its patients who underwent multiple scans received the equivalent of 5,000 chest
X-rays.[26]
Some experts note that CT scans are known to be "overused," and "there is
distressingly little evidence of better health outcomes associated with the current high
rate of scans."[26]
Early estimates of harm from CT are partly based on similar radiation exposures
experienced by those present during the atomic bomb explosions in Japan after
theSecond World War and those of nuclear industry workers.[8] A more recent study by
the National Cancer Institute in 2009, based on scans made in 2007, estimated that
29,000 excess cancer cases and 14,500 excess deaths would be caused over the
lifetime of the patients. Some experts project that in the future, between three and five
percent of all cancers would result from medical imaging. [26]
An Australian study of 10.9 million people reported that the increased incidence of
cancer after CT scan exposure in this cohort was mostly due to irradiation. In this group
one in every 1800 CT scans was followed by an excess cancer. If the lifetime risk of
developing cancer is 40% then the absolute risk rises to 40.05% after a CT.[27][28]
A person's age plays a significant role in the subsequent risk of cancer.[29] Estimated
lifetime cancer mortality risks from an abdominal CT of a 1-year-old is 0.1% or 1:1000
scans.[29] The risk for someone who is 40 years old is half that of someone who is 20
years old with substantially less risk in the elderly.[29] The International Commission on
Radiological Protection estimates that the risk to a fetus being exposed to 10 mGy (a
unit of radiation exposure, see Gray (unit)) increases the rate of cancer before 20 years
of age from 0.03% to 0.04% (for reference a CT pulmonary angiogram exposes a fetus
to 4 mGy).[30] A 2012 review did not find an association between medical radiation and
cancer risk in children noting however the existence of limitations in the evidences over
which the review is based.[31]
CT scans can be performed with different settings for lower exposure in children with
most manufacturers of CT scans as of 2007 having this function built in. [32]Furthermore,
certain conditions can require children to be exposed to multiple CT scans. [8] Studies
support informing parents of the risks of pediatric CT scanning. [33]
Contrast[edit]
In the United States half of CT scans involve intravenously injected radiocontrast
agents.[34] The most common reactions from these agents are mild, including nausea,
vomiting and an itching rash; however, more severe reactions may occur.[35] Overall
reactions occur in 1 to 3% with nonionic contrast and 4 to 12% of people with ionic
contrast.[36] Skin rashes may appear within a week to 3% of people. [35]

The old radiocontrast agents caused anaphylaxis in 1% of cases while the newer, lowerosmolar agents cause reactions in 0.010.04% of cases. [35][37] Death occurs in about two
to 30 people per 1,000,000 administrations, with newer agents being safer.[36][38] There is
a higher risk of mortality in those who are female, elderly or in poor health, usually
secondary to either anaphylaxis or acute renal failure. [34]
The contrast agent may induce contrast-induced nephropathy.[10] This occurs in 2 to 7%
of people who receive these agents, with greater risk in those who have
preexisting renal insufficiency,[10] preexisting diabetes, or reduced intravascular volume.
People with mild kidney impairment are usually advised to ensure full hydration for
several hours before and after the injection. For moderate kidney failure, the use
of iodinated contrast should be avoided; this may mean using an alternative technique
instead of CT. Those with severe renal failure requiring dialysis require less strict
precautions, as their kidneys have so little function remaining that any further damage
would not be noticeable and the dialysis will remove the contrast agent; it is normally
recommended, however, to arrange dialysis as soon as possible following contrast
administration to minimize any adverse effects of the contrast.
In addition to the use of intravenous contrast, orally administered contrast agents are
frequently used when examining the abdomen. These are frequently the same as the
intravenous contrast agents, merely diluted to approximately 10% of the concentration.
However, oral alternatives to iodinated contrast exist, such as very dilute (0.51%
w/v) barium sulfate suspensions. Dilute barium sulfate has the advantage that it does
not cause allergic-type reactions or kidney failure, but cannot be used in patients with
suspected bowel perforation or suspected bowel injury, as leakage of barium sulfate
from damaged bowel can cause fatal peritonitis.
Scan dose[edit]

Examination

Typical effective
dose (mSv)
to the whole body

Typical absorbed
dose (mGy)
to the organ in question

Annual background radiation

2.4[39]

2.4[39]

Chest X-ray

0.02[40]

0.010.15[41]

Head CT

12[29]

56[42]

Screening mammography

0.4[30]

3[8][41]

Abdomen CT

8[40]

14[42]

Examination

Typical effective
dose (mSv)
to the whole body

Typical absorbed
dose (mGy)
to the organ in question

Chest CT

57[29]

13[42]

CT colonography

611[29]

Chest, abdomen and pelvis CT

9.9[42]

12[42]

Cardiac CT angiogram

912[29]

40100[41]

Barium enema

15[8]

15[41]

Neonatal abdominal CT

20[8]

20[41]

The table reports average radiation exposures, however, there can be a wide variation
in radiation doses between similar scan types, where the highest dose could be as
much as 22 times higher than the lowest dose.[29] A typical plain film X-ray involves
radiation dose of 0.01 to 0.15 mGy, while a typical CT can involve 1020 mGy for
specific organs, and can go up to 80 mGy for certain specialized CT scans.[41]
For purposes of comparison, the world average dose rate from naturally occurring
sources of background radiation is 2.4 mSv per year, equal for practical purposes in this
application to 2.4 mGy per year.[39] While there is some variation, most people (99%)
received less than 7 mSv per year as background radiation. [43] Medical imaging as of
2007 accounted for half of the radiation exposure of those in the United States with CT
scans making up two thirds of this amount.[29] In the United Kingdom it accounts for 15%
of radiation exposure.[30] The average radiation dose from medical sources is ~0.6 mSv
per person globally as of 2007.[29] Those in the nuclear industry in the United States are
limited to doses of 50 mSv a year and 100 mSv every 5 years.[29]
Radiation dose units[edit]
The radiation dose reported in the gray or mGy unit is proportional to the amount of
energy that the irradiated body part is expected to absorb, and the physical effect (such

as DNA double strand breaks) on the cells' chemical bonds by X-ray radiation is
proportional to that energy.[44]
The sievert unit is used in the report of the effective dose. The sievert unit, in the context
of CT scans, does not correspond to the actual radiation dose that the scanned body
part absorbs but to another radiation dose of another scenario, the whole body
absorbing the other radiation dose and the other radiation dose being of a magnitude,
estimated to have the same probability to induce cancer as the CT scan. [45] Thus, as is
shown in the table above, the actual radiation that is absorbed by a scanned body part
is often much larger than the effective dose suggests. A specific measure, termed
the computed tomography dose index (CTDI), is commonly used as an estimate of the
radiation absorbed dose for tissue within the scan region, and is automatically
computed by medical CT scanners.[46]
The equivalent dose is the effective dose of a case, in which the whole body would
actually absorb the same radiation dose, and the sievert unit is used in its report. In the
case of non-uniform radiation, or radiation given to only part of the body, which is
common for CT examinations, using the local equivalent dose alone would overstate the
biological risks to the entire organism.
Excess doses[edit]
In October, 2009, the US Food and Drug Administration (FDA) initiated an investigation
of brain perfusion CT (PCT) scans, based on overdoses of radiation caused by incorrect
settings at one particular facility for this particular type of CT scan. Over 256 patients
over an 18-month period were exposed, over 40% lost patches of hair, and prompted
the editorial to call for increased CT quality assurance programs, while also noting that
"while unnecessary radiation exposure should be avoided, a medically needed CT scan
obtained with appropriate acquisition parameter has benefits that outweigh the radiation
risks."[29][47] Similar problems have been reported at other centers. [29] These incidents are
believed to be due to human error.[29]
Campaigns[edit]
In response to increased concern by the public and the ongoing progress of best
practices, The Alliance for Radiation Safety in Pediatric Imaging was formed within
the Society for Pediatric Radiology. In concert with The American Society of Radiologic
Technologists, The American College of Radiology and The American Association of
Physicists in Medicine, the Society for Pediatric Radiology developed and launched the
Image Gently Campaign which is designed to maintain high quality imaging studies
while using the lowest doses and best radiation safety practices available on pediatric
patients.[48] This initiative has been endorsed and applied by a growing list of various
professional medical organizations around the world and has received support and
assistance from companies that manufacture equipment used in Radiology.
Following upon the success of the Image Gently campaign, the American College of
Radiology, the Radiological Society of North America, the American Association of
Physicists in Medicine and the American Society of Radiologic Technologists have
launched a similar campaign to address this issue in the adult population calledImage
Wisely.[49]

The World Health Organization and International Atomic Energy Agency (IAEA) of the
United Nations have also been working in this area and have ongoing projects designed
to broaden best practices and lower patient radiation dose. [50][51]
Prevalence[edit]
Use of CT has increased dramatically over the last two decades. [6] An estimated 72
million scans were performed in the United States in 2007. [7] Of these, six to eleven
percent are done in children,[30] an increase of seven to eightfold from 1980.[29] Similar
increases have been seen in Europe and Asia. [29] In Calgary, Canada 12.1% of people
who present to the emergency with an urgent complaint received a CT scan, most
commonly either of the head or of the abdomen. The percentage who received CT,
however, varied markedly by the emergency physician who saw them from 1.8% to
25%.[52] In the emergency department in the United States, CT or MRI imaging is done
in 15% of people who present with injuries as of 2007 (up from 6% in 1998).[53]
The increased use of CT scans has been the greatest in two fields: screening of adults
(screening CT of the lung in smokers, virtual colonoscopy, CT cardiac screening, and
whole-body CT in asymptomatic patients) and CT imaging of children. Shortening of the
scanning time to around 1 second, eliminating the strict need for the subject to remain
still or be sedated, is one of the main reasons for the large increase in the pediatric
population (especially for the diagnosis ofappendicitis).[8] As of 2007 in the United States
a proportion of CT scans are performed unnecessarily.[32] Some estimates place this
number at 30%.[30] There are a number of reasons for this including: legal concerns,
financial incentives, and desire by the public.[32] For example, some healthy people
avidly pay to receive full-body CT scans as screening, but it is not at all clear that the
benefits outweigh the risks and costs, because deciding whether and how to
treat incidentalomas is fraught with complexity, radiation exposure is cumulative and not
negligible, and the money for the scans involves opportunity cost (it may have been
more effectively spent on more targeted screening or other health care strategies). [32]
Process[edit]

3D reconstruction of the brain and eyes from CT scanned DICOM images. In this
image, areas with the density of bone or air were made transparent, and the slices
stacked up in an approximate free-space alignment. The outer ring of material around
the brain are the soft tissues of skin and muscle on the outside of the skull. A black box

encloses the slices to provide the black background. Since these are simply 2D images
stacked up, when viewed on edge the slices disappear since they have effectively zero
thickness. Each DICOM scan represents about 5mm of material averaged into a thin
slice.
X-ray slice data is generated using an X-ray source that rotates around the object; X-ray
sensors are positioned on the opposite side of the circle from the X-ray source. The
earliest sensors were scintillation detectors, with photomultiplier tubesexcited by
(typically) cesium iodide crystals. Cesium iodide was replaced during the 1980s by ion
chambers containing high-pressure xenon gas. These systems were in turn replaced by
scintillation systems based on photodiodes instead of photomultipliers and modern
scintillation materials (for example rare earth garnet or rare earth oxide ceramics) with
more desirable characteristics.
Initial machines would rotate the X-ray source and detectors around a stationary object.
Following a complete rotation, the object would be moved along its axis, and the next
rotation started. Newer machines permitted continuous rotation with the object to be
imaged slowly and smoothly slid through the X-ray ring. These are
called helical or spiral CT machines. A subsequent development of helical CT was multislice (or multi-detector) CT; instead of a single row of detectors, multiple rows of
detectors are used effectively capturing multiple cross-sections simultaneously. Systems
with a very large number of detector rows, such that the z-axis coverage is comparable
to the xy-axis coverage are often termed cone beam CT, due to the shape of the X-ray
beam (strictly, the beam is pyramidal in shape, rather than conical).
In conventional CT machines, an X-ray tube and detector are physically rotated behind
a circular shroud (see the image above right). An alternative, short lived design, known
as electron beam tomography (EBT), used electromagnetic deflection of an electron
beam within a very large conical X-ray tube and a stationary array of detectors to
achieve very high temporal resolution, for imaging of rapidly moving structures, for
example the coronary arteries. Cone-beam CT functionality is also an increasingly
common function found in medical fluoroscopy equipment; by rotating the fluoroscope
around the patient, a geometry similar to CT can be obtained, and by treating the 2D Xray detector in a manner similar to a CT detector with a massive number of rows, it is
possible to reconstruct a 3D volume from a single rotation using suitable software.

CT scanner with cover removed to show internal components. Legend:

T: X-ray tube
D: X-ray detectors
X: X-ray beam
R: Gantry rotation
CT is used in medicine as a diagnostic tool and as a guide for interventional
procedures. Sometimes contrast materials such as intravenous iodinated contrast are
used. This is useful to highlight structures such as blood vessels that otherwise would
be difficult to delineate from their surroundings. Using contrast material can also help to
obtain functional information about tissues.
A visual representation of the raw data obtained is called a sinogram, yet it is not
sufficient for interpretation. Once the scan data has been acquired, the data must be
processed using a form of tomographic reconstruction, which produces a series of
cross-sectional images. In terms of mathematics, the raw data acquired by the scanner
consists of multiple "projections" of the object being scanned. These projections are
effectively the Radon transformation of the structure of the object. Reconstruction,
essentially involves solving the inverse Radon transformation.
The technique of filtered back projection is one of the most established algorithmic
techniques for this problem. It is conceptually simple, tunable and deterministic. It is
also computationally undemanding, with modern scanners requiring only a few
milliseconds per image. However, this is not the only technique available: the original
EMI scanner solved the tomographic reconstruction problem by linear algebra, but this
approach was limited by its high computational complexity, especially given the
computer technology available at the time. More recently, manufacturers have
developed iterativephysical model-based maximum likelihood expectation
maximization techniques. These techniques are advantageous because they use an
internal model of the scanner's physical properties and of the physical laws of X-ray
interactions. Earlier methods, such as filtered back projection, assume a perfect
scanner and highly simplified physics, which leads to a number of artifacts, high noise
and impaired image resolution. Iterative techniques provide images with improved
resolution, reduced noise and fewer artifacts, as well as the ability to greatly reduce the
radiation dose in certain circumstances.[54] The disadvantage is a very high
computational requirement, but advances in computer technology and highperformance computing techniques, such as use of highly parallel GPU algorithms or
use of specialized hardware such as FPGAs or ASICs, now allow practical use.
Pixels in an image obtained by CT scanning are displayed in terms of
relative radiodensity. The pixel itself is displayed according to the mean attenuation of
the tissue(s) that it corresponds to on a scale from +3071 (most attenuating) to 1024
(least attenuating) on the Hounsfield scale. Pixel is a two dimensional unit based on the
matrix size and the field of view. When the CT slice thickness is also factored in, the unit
is known as a Voxel, which is a three-dimensional unit. The phenomenon that one part
of the detector cannot differentiate between different tissues is called the "Partial
Volume Effect". That means that a big amount of cartilage and a thin layer of compact

bone can cause the same attenuation in a voxel as hyperdense cartilage alone. Water
has an attenuation of 0 Hounsfield units(HU), while air is 1000 HU, cancellous bone is
typically +400 HU, cranial bone can reach 2000 HU or more (os temporale) and can
cause artifacts. The attenuation of metallic implants depends on atomic number of the
element used: Titanium usually has an amount of +1000 HU, iron steel can completely
extinguish the X-ray and is, therefore, responsible for well-known line-artifacts in
computed tomograms. Artifacts are caused by abrupt transitions between low- and highdensity materials, which results in data values that exceed the dynamic range of the
processing electronics.
Contrast mediums used for X-ray CT, as well as for plain film X-ray, are
called radiocontrasts. Radiocontrasts for X-ray CT are, in general, iodine-based.
[55]
Often, images are taken both with and without radiocontrast. CT images are
called precontrast or native-phase images before any radiocontrast has been
administrated, and postcontrast after radiocontrast administration.[56]
Two-dimensional CT images are conventionally rendered so that the view is as though
looking up at it from the patient's feet.[57] Hence, the left side of the image is to the
patient's right and vice versa, while anterior in the image also is the patient's anterior
and vice versa. This left-right interchange corresponds to the view that physicians
generally have in reality when positioned in front of patients.
CT data sets have a very high dynamic range which must be reduced for display or
printing. This is typically done via a process of "windowing", which maps a range (the
"window") of pixel values to a greyscale ramp. For example, CT images of the brain are
commonly viewed with a window extending from 0 HU to 80 HU. Pixel values of 0 and
lower, are displayed as black; values of 80 and higher are displayed as white; values
within the window are displayed as a grey intensity proportional to position within the
window. The window used for display must be matched to the X-ray density of the
object of interest, in order to optimize the visible detail.
Three-dimensional reconstruction[edit]
Because contemporary CT scanners offer isotropic or near isotropic resolution, display
of images does not need to be restricted to the conventional axial images. Instead, it is
possible for a software program to build a volume by "stacking" the individual slices one
on top of the other. The program may then display the volume in an alternative manner.
[58]

Multiplanar reconstruction[edit]

Typical screen layout for diagnostic software, showing one 3D and three MPR views
Multiplanar reconstruction (MPR) is the simplest method of reconstruction. A volume is
built by stacking the axial slices. The software then cuts slices through the volume in a
different plane (usually orthogonal). As an option, a special projection method, such
as maximum-intensity projection (MIP) or minimum-intensity projection (mIP/MinIP), can
be used to build the reconstructed slices.
MPR is frequently used for examining the spine. Axial images through the spine will only
show one vertebral body at a time and cannot reliably show the intervertebral discs. By
reformatting the volume, it becomes much easier to visualise the position of one
vertebral body in relation to the others.
Modern software allows reconstruction in non-orthogonal (oblique) planes so that the
optimal plane can be chosen to display an anatomical structure. This may be
particularly useful for visualising the structure of the bronchi as these do not lie
orthogonal to the direction of the scan.
For vascular imaging, curved-plane reconstruction can be performed. This allows bends
in a vessel to be "straightened" so that the entire length can be visualised on one
image, or a short series of images. Once a vessel has been "straightened" in this way,
quantitative measurements of length and cross sectional area can be made, so that
surgery or interventional treatment can be planned.
MIP reconstructions enhance areas of high radiodensity, and so are useful for
angiographic studies. MIP reconstructions tend to enhance air spaces so are useful for
assessing lung structure.
3D rendering techniques[edit]

Surface rendering of the head of the frog Atelopus franciscus, with ear parts highlighted.

Surface rendering[edit]
A threshold value of radiodensity is set by the operator (e.g., a level that corresponds to
bone). From this, a three-dimensional model can be constructed using edge
detection image processing algorithms and displayed on screen. Multiple models can be
constructed from various thresholds, allowing different colors to represent each
anatomical component such as bone, muscle, and cartilage. However, the interior
structure of each element is not visible in this mode of operation.
Volume rendering[edit]
Main article: Volume rendering
Surface rendering is limited in that it will display only surfaces that meet a threshold
density, and will display only the surface that is closest to the imaginary viewer.
In volume rendering, transparency, colors and shading are used to allow a better
representation of the volume to be shown in a single image. For example, the bones of
the pelvis could be displayed as semi-transparent, so that, even at an oblique angle,
one part of the image does not conceal another.

Reduced size 3D printed human skull from computed tomography data.

Image segmentation[edit]
Main article: Image segmentation
Where different structures have similar radiodensity, it can become impossible to
separate them simply by adjusting volume rendering parameters. The solution is called
segmentation, a manual or automatic procedure that can remove the unwanted
structures from the image.
Image quality[edit]

CT scan converted into an animated 3d model using Photoshop

Artifacts[edit]
Although images produced by CT are generally faithful representations of the scanned
volume, the technique is susceptible to a number of artifacts, such as the following: [2]
[59]Chapters 3 and 5

Streak artifact
Streaks are often seen around materials that block most
X-rays, such as metal or bone. Numerous factors
contribute to these streaks: undersampling, photon
starvation, motion, beam hardening, and Compton
scatter. This type of artifact commonly occurs in the
posterior fossa of the brain, or if there are metal
implants. The streaks can be reduced using newer
reconstruction techniques[60][61] or approaches such as
metal artifact reduction (MAR).[62] MAR techniques
include spectral imaging, where CT images are taken
with photons of different energy levels, and then
synthesized intomonochromatic images with special
software such as GSI (Gemstone Spectral Imaging).[63]
Partial volume effect
This appears as "blurring" of edges. It is due to the
scanner being unable to differentiate between a small
amount of high-density material (e.g., bone) and a larger
amount of lower density (e.g., cartilage). The
reconstruction assumes that the X-ray attenuation within
each voxel is homogenous; this may not be the case at
sharp edges. This is most commonly seen in the zdirection, due to the conventional use of
highly anisotropic voxels, which have a much lower outof-plane resolution, than in-plane resolution. This can be
partially overcome by scanning using thinner slices, or
an isotropic acquisition on a modern scanner.

Ring artifact
Probably the most common mechanical artifact, the
image of one or many "rings" appears within an image.
They are usually caused by the variations in the
response from individual elements in a two dimensional
X-ray detector due to defect or miscalibration.[64] "Rings"
are suppressed by a transformation to polar space,
where they become linear stripes.[64] A comparative
evaluation of ring artefact reduction on X-ray
tomography images showed that the method of Sijbers
and Postnov [65] can effectively suppress ring artefacts
only when the rings and the image have common
center.
Noise
This appears as grain on the image and is caused by a
low signal to noise ratio. This occurs more commonly
when a thin slice thickness is used. It can also occur
when the power supplied to the X-ray tube is insufficient
to penetrate the anatomy.
Motion artifact
This is seen as blurring and/or streaking, which is
caused by movement of the object being imaged.
Motion blurring might be reduced using a new technique
called IFT (incompressible flow tomography). [66]
Windmill
Streaking appearances can occur when the detectors
intersect the reconstruction plane. This can be reduced
with filters or a reduction in pitch.
Beam hardening
This can give a "cupped appearance". It occurs when
there is more attenuation along a path passing through
the center of an object, than a path that grazes the
edge. This is easily corrected by filtration and software.
[60][67][68]

Dose versus image quality[edit]

An important issue within radiology
today is how to reduce the radiation
dose during CT examinations without
compromising the image quality. In
general, higher radiation doses result
in higher-resolution images,[69] while
lower doses lead to increased image
noise and unsharp images. However,
increased dosage raises increase the
adverse side effects, including the

risk of radiation induced cancer a

four-phase abdominal CT gives the
same radiation dose as 300 chest Xrays (See the Scan dose section).
Several methods that can reduce the
exposure to ionizing radiation during
a CT scan exist.[54]
1. New software technology can
significantly reduce the
required radiation dose.
2. Individualize the examination
and adjust the radiation dose
to the body type and body
organ examined. Different
body types and organs require
different amounts of radiation.
3. Prior to every CT examination,
evaluate the appropriateness
of the exam whether it is
motivated or if another type of
examination is more suitable.
Higher resolution is not always
suitable for any given
scenario, such as detection of
small pulmonary masses.[70]
Industrial use[edit]
Industrial CT Scanning (industrial
computed tomography) is a process
which utilizes X-ray equipment to
produce 3D representations of
components both externally and
internally. Industrial CT scanning has
been utilized in many areas of
industry for internal inspection of
components. Some of the key uses
for CT scanning have been flaw
detection, failure analysis, metrology,
assembly analysis, image-based
finite element methods[71] and reverse
engineering applications. CT
scanning is also employed in the

imaging and conservation of museum

artifacts.[72]
CT scanning has also found an
application in transport security
(predominantly airport security where
it is currently used in a materials
analysis context for explosives
detection CTX (explosive-detection
device)[73][74][75] and is also under
consideration for automated
baggage/parcel security scanning
using computer vision based object
recognition algorithms that target the
detection of specific threat items
based on 3D appearance (e.g. guns,
knives, liquid containers).[76][77][78]
History[edit]

The prototype CT scanner

A historic EMI-Scanner
Origins of tomography[edit]
See also: Medical imaging
Conventional tomography
In the early 1900s, the Italian
radiologist Alessandro Vallebona
proposed a method to represent a

single slice of the body on

radiographic film. This method was
known as tomography. The idea is
based on simple principles
of projective geometry: moving
synchronously and in opposite
directions the X-ray tube and the film,
which are connected together by a
rod whose pivot point is the focus; the
image created by the points on
the focal plane appears sharper,
while the images of the other points
annihilate as noise.[79] This is only
marginally effective, as blurring
occurs in only the "x" plane. Now
known as conventional tomography,
this method of acquiring tomographic
images using only mechanical
techniques advanced through the
mid-twentieth century, steadily
producing sharper images, and with a
greater ability to vary the thickness of
the cross-section being examined.
This was achieved through the
introduction of more complex,
pluridirectional devices that can move
in more than one plane and perform
more effective blurring. However,
despite the increasing sophistication
of conventional tomography, it
remained ineffective at producing
images of soft tissues.[79] With the
increasing power and availability of
computers in the 1960s, research
began into practical computational
techniques for creating tomographic
images.
Mathematical theory[edit]
The mathematical theory behind
computed tomographic reconstruction
dates back to 1917 with the invention
of Radon Transform[80][81] by an
Austrian mathematician Johann
Radon. He showed mathematically
that a function could be reconstructed
from an infinite set of its projections.

[82]

In 1937, a Polish mathematician,

named Stefan Kaczmarz, developed
a method to find an approximate
solution to a large system of linear
algebraic equations.[83][84] This led the
foundation to another powerful
reconstruction method called
"Algebraic Reconstruction
Technique (ART)" which was later
adapted by SirGodfrey Hounsfield as
the image reconstruction mechanism
in his famous invention, the first
commercial CT scanner.
In 1956, Ronald N. Bracewell used a
method similar to the Radon
Transform to reconstruct a map of
solar radiation from a set of solar
radiation measurements.[85] In
1959, William Oldendorf, a UCLA
neurologist and senior medical
investigator at the West Los Angeles
Veterans Administration hospital,
conceived an idea for "scanning a
head through a transmitted beam of
X-rays, and being able to reconstruct
the radiodensity patterns of a plane
through the head" after watching an
automated apparatus built to reject
frostbitten fruit by detecting
dehydrated portions. In 1961, he built
a prototype in which an X-ray source
and a mechanically coupled detector
rotated around the object to be
imaged. By reconstructing the image,
this instrument could get an X-ray
picture of a nail surrounded by a
circle of other nails, which made it
impossible to X-ray from any single
angle.[86] In his landmark paper
published in 1961, he described the
basic concept which was later used
by Allan McLeod Cormack to develop
the mathematics behind
computerized tomography.
In October 1963, Oldendorf received
a U.S. patent for a "radiant energy

apparatus for investigating selected

areas of interior objects obscured by
dense material." Oldendorf shared
the 1975 Lasker award with
Hounsfield for that discovery.[87] The
field of the mathematical methods of
computerized tomography has seen a
very active development since then,
as is evident from overview
literature[2][88][89] by Frank
Natterer and Gabor T. Herman, two of
the pioneers in this field.[90]
In 1968, Nirvana
McFadden and Michael
Saraswat established guidelines for
diagnosis of a significant variety of
common abdominal pathology
through CT scanning, including acute
appendicitis, small bowel
obstruction, Ogilvie syndrome, acute
pancreatitis, intussusception,
and apple peel atresia.[91]
Tomography has been one of the
pillars of radiologic diagnostics until
the late 1970s, when the availability
of minicomputers and of the
transverse axial scanning method led
CT to gradually supplant conventional
tomography as the preferred modality
of obtaining tomographic images.
Transverse axial scanning was due in
large part to the work of Godfrey
Hounsfield and South Africanborn Allan McLeod Cormack. In terms
of mathematics, the method is based
upon the use of the Radon
Transform. But as Cormack
remembered later,[92] he had to find
the solution himself since it was only
in 1972 that he learned of the work of
Radon, by chance.
Commercial scanners[edit]
The first commercially viable CT
scanner was invented by Sir Godfrey
Hounsfield in Hayes, United

Kingdom, at EMI Central Research

Laboratories using X-rays. Hounsfield
conceived his idea in 1967.[93] The
first EMI-Scanner was installed
in Atkinson Morley
Hospital in Wimbledon, England, and
the first patient brain-scan was done
on 1 October 1971.[94] It was publicly
announced in 1972.
The original 1971 prototype took 160
parallel readings through 180 angles,
each 1 apart, with each scan taking
a little over 5 minutes. The images
from these scans took 2.5 hours to be
processed by algebraic
reconstruction techniques on a large
computer. The scanner had a single
photomultiplier detector, and operated
on the Translate/Rotate principle.[94]
It is often claimed that revenues from
the sales of The Beatles records in
the 1960s helped fund the
development of the first CT scanner
at EMI[95] although this has recently
been disputed.[96] The first production
X-ray CT machine (in fact called the
"EMI-Scanner") was limited to making
tomographic sections of the brain, but
acquired the image data in about 4
minutes (scanning two adjacent
slices), and the computation time
(using a Data General
Nova minicomputer) was about 7
minutes per picture. This scanner
required the use of a waterfilled Perspex tank with a pre-shaped
rubber "head-cap" at the front, which
enclosed the patient's head. The
water-tank was used to reduce the
dynamic range of the radiation
reaching the detectors (between
scanning outside the head compared
with scanning through the bone of the
skull). The images were relatively low
resolution, being composed of a
matrix of only 80 80 pixels.

In the U.S., the first installation was at

the Mayo Clinic. As a tribute to the
impact of this system on medical
imaging the Mayo Clinic has an EMI
scanner on display in the Radiology
Department. Allan McLeod
Cormack of Tufts
University in Massachusetts independ
ently invented a similar process, and
both Hounsfield and Cormack shared
the 1979 Nobel Prize in Medicine.[97]
[98]

The first CT system that could make

images of any part of the body and
did not require the "water tank" was
the ACTA (Automatic Computerized
Transverse Axial) scanner designed
by Robert S. Ledley, DDS,
at Georgetown University. This
machine had 30 photomultiplier tubes
as detectors and completed a scan in
only nine translate/rotate cycles,
much faster than the EMI-Scanner. It
used a DEC PDP11/34 minicomputer
both to operate the servomechanisms and to acquire and
process the images. The Pfizer drug
company acquired the prototype from
the university, along with rights to
manufacture it. Pfizer then began
making copies of the prototype,
calling it the "200FS" (FS meaning
Fast Scan), which were selling as fast
as they could make them. This unit
produced images in a 256256
matrix, with much better definition
than the EMI-Scanner's 8080.
Since the first CT scanner, CT
technology has vastly improved.
Improvements in speed, slice count,
and image quality have been the
major focus primarily for cardiac
imaging. Scanners now produce
images much faster and with higher
resolution enabling doctors to
diagnose patients more accurately

and perform medical procedures with

greater precision. In the late 1990s
CT scanners broke into two major
groups, "Fixed CT" and "Portable
CT". "Fixed CT Scanners" are large,
require a dedicated power supply,
electrical closet, HVAC system, a
separate workstation room, and a
large lead lined room. "Fixed CT
Scanners" can also be mounted
inside large tractor trailers and driven
from site to site and are known as
"Mobile CT Scanners". "Portable CT
Scanners" are lightweight, small, and
mounted on wheels. These scanners
often have built-in lead shielding and
run off of batteries or standard wall
power.
In 2008 Siemens introduced a new
generation of scanner that was able
to take an image in less than 1
second, fast enough to produce clear
images of beating hearts and
coronary arteries.
Etymology[edit]
The word "tomography" is derived
from the Greek tomos (slice)
and graphein (to write). Computed
tomography was originally known as
the "EMI scan" as it was developed in
the early 1970s at a research branch
of EMI, a company best known today
for its music and recording business.
It was later known as computed axial
tomography (CAT or CT scan)
and body section rntgenography.
Although the term "computed
tomography" could be used to
describe positron emission
tomography or single photon
emission computed
tomography (SPECT), in practice it
usually refers to the computation of
tomography from X-ray images,

especially in older medical literature

and smaller medical facilities.
In MeSH, "computed axial
tomography" was used from 1977 to
1979, but the current indexing
explicitly includes "X-ray" in the title.
[99]

The term sinogram was introduced by

Paul Edholm and Bertil Jacobson in
1975.[100]
Types of machines[edit]
Spinning tube, commonly called spiral
CT, or helical CT is an imaging
technique in which an entire X-ray
tube is spun around the central axis
of the area being scanned. These are
the dominant type of scanners on the
market because they have been
manufactured longer and offer lower
cost of production and purchase. The
main limitation of this type is the bulk
and inertia of the equipment (X-ray
tube assembly and detector array on
the opposite side of the circle) which
limits the speed at which the
equipment can spin. Some designs
use two X-ray sources and detector
arrays offset by an angle, as a
technique to improve temporal
resolution.
Electron beam tomography (EBT) is a
specific form of CT in which a large
enough X-ray tube is constructed so
that only the path of the electrons,
travelling between the cathode and
anode of the X-ray tube, are spun
using deflection coils. This type had a
major advantage since sweep speeds
can be much faster, allowing for less
blurry imaging of moving structures,
such as the heart and arteries. Fewer
scanners of this design have been
produced when compared with
spinning tube types, mainly due to the

higher cost associated with building a

much larger X-ray tube and detector
array and limited anatomical
coverage. Only one manufacturer
(Imatron, later acquired by General
Electric) ever produced scanners of
this design. Production ceased in
early 2006.[101]
In multislice computed
tomography (MSCT), a higher
number of tomographic slices allow
for higher-resolution imaging.
Previous studies[edit]
Pneumoencephalography of the brain
was quickly replaced by CT. A form of
tomography can be performed by
moving the X-ray source and detector
during an exposure. Anatomy at the
target level remains sharp, while
structures at different levels are
blurred. By varying the extent and
path of motion, a variety of effects
can be obtained, with variable depth
of field and different degrees of
blurring of "out of plane" structures.
[102]:25
Although largely obsolete,
conventional tomography is still used
in specific situations such as dental
imaging (orthopantomography) or
in intravenous urography.
Research[edit]
Photon counting computed
tomography is a CT technique
currently under development. Typical
CT scanners use energy integrating
detectors; photons are measured as
a voltage on a capacitor which is
proportional to the x-rays detected.
However, this technique is
susceptible to noise and other factors
which can affect the linearity of the
voltage to x-ray intensity
relationship. [103] Photon counting
detectors (PCDs) are still affected by

noise but it does not change the

measured counts of photons. PCDs
have several potential advantages
including improving signal (and
contrast) to noise ratios, reducing
doses, improving spatial resolution
and, through use of several energies,
distinguishing multiple contrast
agents. [104][105] PCDs have only
recently become feasible in CT
scanners due to improvements in
detector technologies that can cope
with the volume and rate of data
required. As of February 2016 photon
counting CT is in use at three sites.
[106]
Some early research has found
the dose reduction potential of photon
counting CT for breast imaging to be
very promising.[107]
See also[edit]

Barium sulfate suspension

Biological effects of ionizing

radiation

Dosimetry

MRI versus CT

Tomosynthesis

Virtopsy

X-ray microtomography

Xenon-enhanced CT scanning

References[edit]
1. Jump
up^ http://www.mayoclinic.org
/tests-procedures/ct-

scan/basics/definition/prc20014610
2. ^ Jump up to:a b c Herman, G.
T., Fundamentals of
computerized tomography:
Image reconstruction from
projection, 2nd edition,
Springer, 2009
3. Jump up^ "computed
tomography Definition from
the Merriam-Webster Online
Dictionary". Retrieved 200908-18.
4. Jump up^ "Patient Page |
ARRT The American
Registry of Radiologic
Technologists". ARRT.
Retrieved 2014-01-05.
5. Jump up^ "Individual State
Licensure Information".
American Society of
Radiologic Technologists.
Retrieved 19 July 2013.
6. ^ Jump up to:a b SmithBindman R, Lipson J, Marcus
R, Kim KP, Mahesh M, Gould
R, Berrington de Gonzlez A,
Miglioretti DL (December
2009). "Radiation dose
associated with common
computed tomography
examinations and the
associated lifetime attributable
risk of cancer". Arch. Intern.
Med. 169 (22): 2078
86.doi:10.1001/archinternmed
.2009.427. PMID 20008690.
7. ^ Jump up to:a b Berrington de
Gonzlez A, Mahesh M, Kim
KP, Bhargavan M, Lewis R,

Mettler F, Land C (December

2009). "Projected cancer risks
from computed tomographic
scans performed in the United
States in 2007". Arch. Intern.
Med.169 (22): 2071
7. doi:10.1001/archinternmed.
2009.440. PMID 20008689.
8. ^ Jump up
to:a b c d e f g h Brenner DJ, Hall
EJ (November
2007). "Computed
tomography an increasing
source of radiation
exposure" (PDF). N. Engl. J.
Med. 357 (22): 2277
84. doi:10.1056/NEJMra0721
49. PMID 18046031.
9. Jump up^ Tubiana M
(February 2008). "Comment
on Computed Tomography
and Radiation Exposure". N.
Engl. J. Med. 358 (8): 852
3.doi:10.1056/NEJMc073513.
PMID 18287609.
10. ^ Jump up to:a b c Hasebroock
KM, Serkova NJ (April 2009).
"Toxicity of MRI and CT
contrast agents.". Expert
opinion on drug metabolism &
toxicology. 5 (4): 403
16.doi:10.1517/17425250902
873796. PMID 19368492.
11. Jump up^ CT Screening
12. Jump up^ Galloway, RL Jr.
(2015). "Introduction and
Historical Perspectives on
Image-Guided Surgery". In
Golby, AJ. Image-Guided
Neurosurgery. Amsterdam:
Elsevier. pp. 34.

13. Jump up^ Tse, VCK; Kalani,

MYS; Adler, JR (2015).
"Techniques of Stereotactic
Localization". In Chin, LS;
Regine, WF. Principles and
Practice of Stereotactic
Radiosurgery. New York:
Springer. p. 28.
14. Jump up^ Saleh, H; Kassas,
B (2015). "Developing
Stereotactic Frames for
Cranial Treatment". In
Benedict, SH; Schlesinger,
DJ; Goetsch, SJ; Kavanagh,
BD.Stereotactic Radiosurgery
and Stereotactic Body
Radiation Therapy. Boca
Raton: CRC Press. pp. 156
159.
15. Jump up^ Khan, FR;
Henderson, JM (2013). "Deep
Brain Stimulation Surgical
Techniques". In Lozano, AM;
Hallet, M. Brain Stimulation:
Handbook of Clinical
Neurology. 116. Amsterdam:
Elsevier. pp. 2830.
16. Jump up^ Arle, J (2009).
"Development of a Classic:
the Todd-Wells Apparatus, the
BRW, and the CRW
Stereotactic Frames". In
Lozano, AM; Gildenberg, PL;
Tasker, RR.Textbook of
Stereotactic and Functional
Neurosurgery. Berlin:
Springer-Verlag. pp. 456461.
17. Jump up^ Brown RA, Nelson
JA (June 2012). "Invention of
the N-localizer for stereotactic
neurosurgery and its use in
the Brown-Roberts-Wells

stereotactic
frame".Neurosurgery. 70 (2
Supplement Operative): 173
176.doi:10.1227/NEU.0b013e
318246a4f7. PMID 22186842.
18. ^ Jump up to:a b c American
Headache
Society (September
2013), "Five Things
Physicians and Patients
Should Question", Choosing
Wisely, American Headache
Society, retrieved 10
December 2013, which cites

"Neuroimaging for the

evaluation of chronic
headaches: An evidencebased analysis". Ontario
health technology
assessment
series. 10 (26): 157.
2010. PMC 3377587 . PM
ID 23074404.

Evans RW (2009).
"Diagnostic Testing for
Migraine and Other
Primary
Headaches". Neurologic
Clinics. 27 (2): 393
415.doi:10.1016/j.ncl.2008
.11.009. PMID 19289222.

Semelka RC, Armao DM,

Elias J, Huda W (2007).
"Imaging strategies to
reduce the risk of radiation
in CT studies, including
selective substitution with
MRI". Journal of Magnetic
Resonance
Imaging. 25 (5): 900
909.doi:10.1002/jmri.2089
5. PMID 17457809.

Brenner DJ, Hall EJ

(2007). "Computed
Tomography an
Increasing Source of
Radiation Exposure". New
England Journal of
Medicine. 357 (22): 2277
2284. doi:10.1056/NEJMr
a072149. PMID 18046031
.

19. Jump up^ American College

of Emergency
Physicians, "Five Things
Physicians and Patients
Should Question", Choosing
Wisely, American College of
Emergency Physicians,
retrieved January 24, 2014,
which cites

Jagoda AS, Bazarian JJ,

Bruns JJ, Cantrill SV,
Gean AD, Howard PK,
Ghajar J, Riggio S, Wright
DW, Wears RL, Bakshy A,
Burgess P, Wald MM,
Whitson RR (2008).
"Clinical policy:
neuroimaging and
decisionmaking in adult
mild traumatic brain injury
in the acute setting". Ann
Emerg Med. 52 (6): 714
48. doi:10.1016/j.annemer
gmed.2008.08.021. PMID
19027497.

Stiell IG, Clement CM,

Rowe BH, Schull MJ,
Brison R, Cass D,
Eisenhauer MA, McKnight
RD, Bandiera G, Holroyd
B, Lee JS, Dreyer J,
Worthington JR, Reardon
M, Greenberg G, Lesiuk

H, MacPhail I, Wells GA
(2005). "Comparison of
the Canadian CT Head
Rule and the New Orleans
Criteria in patients with
minor head
injury". JAMA. 294 (12):
1511
8.doi:10.1001/jama.294.12
.1511. PMID 16189364.

Haydel MJ, Preston CA,

Mills TJ, Luber S,
Blaudeau E, DeBlieux PM
(2000). "Indications for
computed tomography in
patients with minor head
injury". N. Engl. J.
Med. 343 (2): 100
5. doi:10.1056/NEJM2000
07133430204.PMID 1089
1517.

Smits M, Dippel DW, de

Haan GG, Dekker HM,
Vos PE, Kool DR,
Nederkoorn PJ, Hofman
PA, Twijnstra A, Tanghe
HL, Hunink MG (2005).
"External validation of the
Canadian CT Head Rule
and the New Orleans
Criteria for CT scanning in
patients with minor head
injury". JAMA. 294 (12):
151925. do
i:10.1001/jama.294.12.151
9. PMID 16189365.

20. Jump up^ Wiener RS, Gould

MK, Woloshin S, Schwartz
LM, Clark JA (2012). ""What
do you mean, a spot?": A
qualitative analysis of patients'
reactions to discussions with
their doctors about pulmonary

nodules". CHEST
Journal. 143 (3): 672
677. doi:10.1378/chest.121095. PMC 3590883 . PMID
22814873.
21. ^ Jump up to:a b c American
College of Chest
Physicians; American
Thoracic Society(September
2013), "Five Things
Physicians and Patients
Should Question",Choosing
Wisely, American College of
Chest Physicians and
American Thoracic Society,
retrieved 6 January 2013,
which cites

MacMahon H, Austin JH,

Gamsu G, Herold CJ, Jett
JR, Naidich DP, Patz EF,
Swensen SJ (2005).
"Guidelines for
Management of Small
Pulmonary Nodules
Detected on CT Scans: A
Statement from the
Fleischner
Society1".Radiology. 237 (
2): 395
400. doi:10.1148/radiol.23
72041887.PMID 1624424
7.

Gould MK, Fletcher J,

Iannettoni MD, Lynch WR,
Midthun DE, Naidich DP,
Ost DE (2007).
"Evaluation of Patients
with Pulmonary Nodules:
When is It Lung Cancer?
*". CHEST
Journal. 132 (3_suppl):
108S

130S.doi:10.1378/chest.07
-1353. PMID 17873164.

Smith-Bindman R, Lipson
J, Marcus R, Kim KP,
Mahesh M, Gould R,
Berrington de Gonzlez A,
Miglioretti DL (2009).
"Radiation Dose
Associated with Common
Computed Tomography
Examinations and the
Associated Lifetime
Attributable Risk of
Cancer". Archives of
Internal
Medicine. 169 (22): 2078
2086. doi:10.1001/archinte
rnmed.2009.427. PMID 20
008690.

Wiener RS, Gould MK,

Woloshin S, Schwartz LM,
Clark JA (2012). ""What do
you mean, a spot?": A
qualitative analysis of
patients' reactions to
discussions with their
doctors about pulmonary
nodules". CHEST
Journal.143 (3): 672
677. doi:10.1378/chest.121095. PMC 3590883
.PMID 22814873.

22. Jump up^ "Ankle

Fractures". orthoinfo.aaos.org.
American Association of
Orthopedic Surgeons.
Retrieved 2010-05-30.
23. Jump up^ Buckwalter,
Kenneth A.; et al. (11
September
2000). "Musculoskeletal
Imaging with Multislice

CT". ajronline.org. American

Journal of Roentgenology.
Retrieved2010-05-22.
24. Jump up^ abi S, Wang Q,
Morton T, Brown KM (March
2013). "A low dose simulation
tool for CT systems with
energy integrating
detectors". Medical
physics. 40 (3).Bibcode:2013
MedPh..40c1102Z. doi:10.111
8/1.4789628.
25. Jump up^ Brian R. Subach
M.D., F.A.C.S et al."Reliability
and accuracy of fine-cut
computed tomography scans
to determine the status of
anterior interbody fusions with
metallic cages"
26. ^ Jump up to:a b c d Redberg,
Rita F., and Smith-Bindman,
Rebecca. "We Are Giving
Ourselves Cancer", New York
Times, Jan. 30, 2014
27. Jump up^ Mathews, J. D.;
Forsythe, A. V.; Brady, Z.;
Butler, M. W.; Goergen, S. K.;
Byrnes, G. B.; Giles, G. G.;
Wallace, A. B.; Anderson, P.
R.; Guiver, T. A.; McGale, P.;
Cain, T. M.; Dowty, J. G.;
Bickerstaffe, A. C.; Darby, S.
C. (2013)."Cancer risk in 680
000 people exposed to
computed tomography scans
in childhood or adolescence:
data linkage study of 11
million
Australians". BMJ.346 (may21
1): f2360
f2360. doi:10.1136/bmj.f2360.

ISSN 1756-1833.PMC 36606

19 . PMID 23694687.
28. Jump up^ Sasieni, P D;
Shelton, J; Ormiston-Smith,
N; Thomson, C S; Silcocks, P
B (2011). "What is the lifetime
risk of developing cancer?:
the effect of adjusting for
multiple primaries". British
Journal of Cancer. 105 (3):
460
465.doi:10.1038/bjc.2011.250.
ISSN 0007-0920.
29. ^ Jump up
to:a b c d e f g h i j k l m n o p Furlo
w B (MayJun
2010). "Radiation dose in
computed
tomography." (PDF). Radiolog
ic technology. 81 (5): 437
50.PMID 20445138.[dead link]
30. ^ Jump up to:a b c d e Davies,
H. E.; Wathen, C. G.;
Gleeson, F. V. (25 February
2011). "The risks of radiation
exposure related to diagnostic
imaging and how to minimise
them". BMJ. 342 (feb25 1):
d947d947. do
i:10.1136/bmj.d947.
31. Jump up^ Baysson H, Etard
C, Brisse HJ, Bernier MO
(January 2012). "[Diagnostic
radiation exposure in children
and cancer risk: current
knowledge and
perspectives].". Archives de
Pdiatrie. 19 (1): 64
73.doi:10.1016/j.arcped.2011.
10.023. PMID 22130615.

32. ^ Jump up to:a b c d Semelka

RC, Armao DM, Elias J, Huda
W (May 2007). "Imaging
strategies to reduce the risk of
radiation in CT studies,
including selective substitution
with MRI.". J Magn Reson
Imaging. 25 (5): 900
9.doi:10.1002/jmri.20895. PMI
D 17457809.
33. Jump up^ Larson DB, Rader
SB, Forman HP, Fenton LZ
(August 2007). "Informing
parents about CT radiation
exposure in children: it's OK
to tell them". Am J
Roentgenol. 189 (2): 271
5. doi:10.2214/AJR.07.2248.
PMID 17646450.
34. ^ Jump up
to:a b Namasivayam S, Kalra
MK, Torres WE, Small WC
(Jul 2006). "Adverse reactions
to intravenous iodinated
contrast media: a primer for
radiologists.".Emergency
radiology. 12 (5): 210
5. doi:10.1007/s10140-0060488-6.PMID 16688432.
35. ^ Jump up to:a b c Christiansen
C (2005-04-15). "X-ray
contrast media an
overview.".Toxicology. 209 (2):
1857. do
i:10.1016/j.tox.2004.12.020. P
MID 15767033.
36. ^ Jump up to:a b Wang H,
Wang HS, Liu ZP (October
2011). "Agents that induce
pseudo-allergic
reaction". Drug Discov
Ther. 5 (5): 211

9.doi:10.5582/ddt.2011.v5.5.2
11. PMID 22466368.
37. Jump up^ Drain KL, Volcheck
GW (2001). "Preventing and
managing drug-induced
anaphylaxis.". Drug
Safety. 24 (11): 843
53. doi:10.2165/00002018200124110-00005. PMID 116
65871.
38. Jump up^ editor, Mariana C.
Castells,. Anaphylaxis and
hypersensitivity reactions.
New York: Humana Press.
p. 187. ISBN 9781603279505.
39. ^ Jump up to:a b c Cuttler JM,
Pollycove M (2009). "Nuclear
energy and health: and the
benefits of low-dose radiation
hormesis". Dose
Response. 7 (1): 52
89.doi:10.2203/doseresponse.08-024.Cuttler. PM
C 2664640 . PMID 19343116.
40. ^ Jump up to:a b "What are the
Radiation Risks from
CT?". Food and Drug
Administration. 2009.
41. ^ Jump up to:a b c d e f Hall EJ,
Brenner DJ (May 2008).
"Cancer risks from diagnostic
radiology.". The British journal
of radiology. 81 (965): 362
78.doi:10.1259/bjr/01948454.
PMID 18440940.
42. ^ Jump up
to:a b c d e Shrimpton, P.C;
Miller, H.C; Lewis, M.A; Dunn,
M. Doses from Computed
Tomography (CT)

examinations in the UK
2003 Review
43. Jump up^ Poston, edited by
Michael T. Ryan, John W.
(2005). A half century of
health physics. Baltimore,
Md.: Lippincott Williams &
Wilkins.
p. 164.ISBN 9780781769341.
44. Jump up^ Polo SE, Jackson
SP (March 2011). "Dynamics
of DNA damage response
proteins at DNA breaks: a
focus on protein
modifications". Genes
Dev. 25 (5): 409
33. doi:10.1101/gad.2021311.
PMC 3049283 . PMID 21363
960.
45. Jump up^ The Measurement,
Reporting, and Management
of Radiation Dose in CT "It is
a single dose parameter that
reflects the risk of a
nonuniform exposure in terms
of an equivalent whole-body
exposure."
46. Jump up^ Hill B, Venning AJ,
Baldock C, 2005. A
preliminary study of the novel
application of normoxic
polymer gel dosimeters for the
measurement of CTDI on
diagnostic X-ray CT scanners.
Medical Physics. 32 1589
1597
47. Jump up^ Wintermark M, Lev
MH (January 2010). "FDA
investigates the safety of
brain perfusion CT". AJNR Am
J Neuroradiol. 31 (1): 2

3. doi:10.3174/ajnr.A1967.PMI
D 19892810.
48. Jump up^ "Image Gently".
The Alliance for Radiation
Safety in Pediatric Imaging.
Retrieved 19 July 2013.
49. Jump up^ "Image Wisely".
Joint Task Force on Adult
Radiation Protection.
Retrieved19 July 2013.
50. Jump up^ "Optimal levels of
radiation for patients". World
Health Organization.
Retrieved19 July 2013.
51. Jump up^ "Global Initiative
on Radiation Safety in
Healthcare Settings" (PDF).
World Health Organization.
Retrieved 19 July 2013.
52. Jump up^ Andrew Skelly
(Aug 3, 2010). "CT ordering
all over the map". The Medical
Post.
53. Jump up^ Korley FK, Pham
JC, Kirsch TD (October 2010).
"Use of advanced radiology
during visits to US emergency
departments for injury-related
conditions, 1998
2007". JAMA. 304 (13): 1465
71. doi:10.1001/jama.2010.14
08.PMID 20924012.
54. ^ Jump up to:a b Barkan, O;
Weill, J; Averbuch, A; Dekel,
S. "Adaptive Compressed
Tomography Sensing". In
Proceedings of the IEEE
Conference on Computer
Vision and Pattern

Recognition 2013 (pp. 21952202).

55. Jump up^ Contrast agent for
radiotherapy CT (computed
tomography) scans. Patient
Information Series No. 11 at
University College London
Hospitals NHS Foundation
Trust. Last reviewed: October
2009
56. Jump up^ Dahlman P,
Semenas E, Brekkan E,
Bergman A, Magnusson A
(2000). "Detection and
Characterisation of Renal
Lesions by Multiphasic Helical
Ct". Acta Radiologica. 41 (4):
361366. do
i:10.1080/0284185001273454
79.PMID 10937759.
57. Jump up^ Computerized
Tomography
chapter at University of
Connecticut Health Center.
58. Jump up^ Udupa, J.K. and
Herman, G. T., 3D Imaging in
Medicine, 2nd Edition, CRC
Press, 2000
59. Jump up^ Bhowmik, Ujjal
Kumar; Zafar Iqbal, M.;
Adhami, Reza R. (28 May
2012). "Mitigating motion
artifacts in FDK based 3D
Cone-beam Brain Imaging
System using
markers". Central European
Journal of Engineering. 2 (3):
369
382.Bibcode:2012CEJE....2..3
69B. doi:10.2478/s13531-0120011-7.

60. ^ Jump up to:a b P. Jin; C. A.

Bouman; K. D. Sauer
(2013). "A Method for
Simultaneous Image
Reconstruction and Beam
Hardening
Correction" (PDF). IEEE
Nuclear Science Symp. &
Medical Imaging Conf., Seoul,
Korea, 2013.
61. Jump up^ Boas FE,
Fleischmann D
(2011). "Evaluation of Two
Iterative Techniques for
Reducing Metal Artifacts in
Computed
Tomography". Radiology. 259
(3): 894
902. doi:10.1148/radiol.11101
782. PMID 21357521.
62. Jump up^ Mouton, A.;
Megherbi, N.; Van
Slambrouck, K.; Nuyts, J.;
Breckon, T.P. (2013). "An
Experimental Survey of Metal
Artefact Reduction in
Computed
Tomography" (PDF). Journal
of X-Ray Science and
Technology.doi:10.3233/XST130372.
63. Jump up^ Pessis, Eric;
Campagna, Raphal; Sverzut,
Jean-Michel; Bach, Fabienne;
Rodallec, Mathieu; Guerini,
Henri; Feydy, Antoine; Drap,
Jean-Luc (2013). "Virtual
Monochromatic Spectral
Imaging with Fast Kilovoltage
Switching: Reduction of Metal
Artifacts at
CT". RadioGraphics. 33 (2):
573

583.doi:10.1148/rg.33212512
4. ISSN 0271-5333.
64. ^ Jump up to:a b Jha, Diwaker
(2014). "Adaptive center
determination for effective
suppression of ring artifacts in
tomography images". Applied
Physics
Letters (105).Bibcode:2014Ap
PhL.105n3107J. doi:10.1063/
1.4897441. Retrieved19
January 2015.
65. Jump up^ Sijbers J, Postnov
A (2004). "Reduction of ring
artefacts in high resolution
micro-CT
reconstructions". Phys Med
Biol. (49(14)).
66. Jump up^ J. Nemirovsky; A.
Lifshitz; I. Beerya (May
2011). "Tomographic
reconstruction of
incompressible flow". AIP Rev.
Sci.
Instrum. 82 (5).Bibcode:2011
RScI...82e5115N. doi:10.1063
/1.3590934.
67. Jump up^ Van de Casteele
E, Van Dyck D, Sijbers J,
Raman E (2004). "A modelbased correction method for
beam hardening artefacts in
X-ray
microtomography"(PDF). Jour
nal of X-ray Science and
Technology. 12 (1): 4357.
68. Jump up^ Van Gompel G,
Van Slambrouck K, Defrise M,
Batenburg KJ, Sijbers J,
Nuyts J (2011). "Iterative
correction of beam hardening

artifacts in CT". Medical

Physics.38 (1): 36
49. Bibcode:2011MedPh..38S.
.36V. doi:10.1118/1.3577758.
69. Jump up^ R. A. Crowther; D.
J. DeRosier; A. Klug (1970).
"The Reconstruction of a
Three-Dimensional Structure
from Projections and its
Application to Electron
Microscopy". Proc. Roc. Soc.
Lond. A. 317.
70. Jump up^ Simpson, Graham
(2009). "Thoracic computed
tomography: principles and
practice" (PDF). Australian
Prescriber, 32:4. Retrieved
September 25, 2009.
71. Jump up^ Evans, Ll. M.;
Margetts, L.; Casalegno, V.;
Lever, L. M.; Bushell, J.;
Lowe, T.; Wallwork, A.; Young,
P.; Lindemann, A. (2015-0528). "Transient thermal finite
element analysis of CFCCu
ITER monoblock using X-ray
tomography data".Fusion
Engineering and Design. 100:
100
111.doi:10.1016/j.fusengdes.2
015.04.048.
72. Jump up^ Payne, Emma
Marie (2012). "Imaging
Techniques in
Conservation". Journal of
Conservation and Museum
Studies. Ubiquity Press: 17
29.doi:10.5334/jcms.1021201.
73. Jump up^ P. Jin; E. Haneda;
K. D. Sauer; C. A. Bouman
(June 2012). "A model-based

3D multi-slice helical CT
reconstruction algorithm for
transportation security
application". Second
International Conference on
Image Formation in X-Ray
Computed
Tomography (PDF).
74. Jump up^ P. Jin; E. Haneda;
C. A. Bouman (November
2012). "Implicit Gibbs prior
models for tomographic
reconstruction". Signals,
Systems and Computers
(ASILOMAR), 2012
Conference Record of the
Forty Sixth Asilomar
Conference on (PDF). IEEE.
pp. 613636.
75. Jump up^ S. J. Kisner; P. Jin;
C. A. Bouman; K. D. Sauer;
W. Garms; T. Gable; S. Oh;
M. Merzbacher; S. Skatter
(October 2013). "Innovative
data weighting for iterative
reconstruction in a helical CT
security baggage
scanner". Security Technology
(ICCST), 2013 47th
International Carnahan
Conference on (PDF). IEEE.
76. Jump up^ Megherbi, N.;
Flitton, G.T.; Breckon, T.P.
(September 2010). "A
Classifier based Approach for
the Detection of Potential
Threats in CT based Baggage
Screening". Proc.
International Conference on
Image Processing (PDF).
IEEE. pp. 1833
1836. doi:10.1109/ICIP.2010.5

653676. Retrieved 5
November 2013.
77. Jump up^ Megherbi, N.; Han,
J.; Flitton, G.T.; Breckon, T.P.
(September 2012). "A
Comparison of Classification
Approaches for Threat
Detection in CT based
Baggage Screening". Proc.
International Conference on
Image Processing(PDF).
IEEE. pp. 3109
3112. doi:10.1109/ICIP.2012.6
467558. Retrieved5
November 2013.
78. Jump up^ Flitton, G.T.;
Breckon, T.P.; Megherbi, N.
(September 2013). "A
Comparison of 3D Interest
Point Descriptors with
Application to Airport Baggage
Object Detection in Complex
CT Imagery" (PDF). Pattern
Recognition. Elsevier. 46 (9):
24202436. do
i:10.1016/j.patcog.2013.02.00
8. Retrieved 5
November 2013.
79. ^ Jump up to:a b Littleton, J.T.
"Conventional
Tomography". A History of the
Radiological
Sciences (PDF). American
Roentgen Ray Society.
Retrieved 11 January 2014.
80. Jump up^ Radon J (1917).
"Uber die Bestimmung von
Funktionen durch ihre
Integralwerte Langs Gewisser
Mannigfaltigkeiten" [On the
determination of functions
from their integrals along

certain manifolds]. Ber.

Saechsische Akad. Wiss. 29:
262.
81. Jump up^ Radon J (1
December 1986). "On the
determination of functions
from their integral values
along certain manifolds". IEEE
Transactions on Medical
Imaging.5 (4): 170
176. doi:10.1109/TMI.1986.43
07775. PMID 18244009.
82. Jump up^ Hornich H.,
Translated by Parks PC. A
Tribute to Johann
Radon. IEEE Trans. Med.
Imaging. 1986;5(4) 1699.
83. Jump up^ Kaczmarz S
(1937). "Angenherte
Auflsung von Systemen
linearer Gleichungen". Bulletin
International de l'Acadmie
Polonaise des Sciences et
des Lettres. Classe des
Sciences Mathmatiques et
Naturelles. Srie A, Sciences
Mathmatiques. 35: 3557.
84. Jump up^ Kaczmarz S.,
"Approximate solution of
system of linear
equations. Int. J.
Control. 1993; 57-9.
85. Jump up^ Bracewell RN
(1956). "Strip Integration in
Radio Astronomy". Aust. J.
Phys. 9: 198
217. Bibcode:1956AuJPh...9..
198B. doi:10.1071/PH560198.
86. Jump up^ Oldendorf WH.
Isolated flying spot detection

of radiodensity discontinuities
displaying the internal
structural pattern of a complex
object. Ire Trans Biomed
Electron. 1961 Jan;BME8:6872.
87. Jump up^ Oldendorf WH
(1978). "The quest for an
image of brain: a brief
historical and technical review
of brain imaging
techniques". Neurology. 28 (6)
: 517
33.doi:10.1212/wnl.28.6.517.
PMID 306588.
88. Jump up^ F. Natterer, "The
Mathematics of Computerized
Tomography (Classics in
Applied Mathematics)",
Society for Industrial
Mathematics, ISBN
0898714931
89. Jump up^ F. Natterer and F.
Wbbeling "Mathematical
Methods in Image
Reconstruction (Monographs
on Mathematical Modeling
and Computation)", Society for
Industrial (2001), ISBN
0898714729
90. Jump up^ Deuflhard, P.;
Dssel, O.; Louis, A. K.;
Zachow, S. (5 March
2009). "More Mathematics
into Medicine!" (PDF). Zuse
Institute Berlin. p. 2.
91. Jump up^ Townsed CM Jr,
Beauchamp RD, Evers BM et
al. (2008). Sabiston Textbook
of Radiology: The Biological
Basis of Modern Radiological

Practice, ed 22. Saunders. pp.

104-112.
92. Jump up^ Allen
M.Cormack: My Connection
with the Radon Transform, in:
75 Years of Radon Transform,
S. Gindikin and P. Michor,
eds., International Press
Incorporated (1994), pp. 32
35, ISBN 1-57146-008-X
93. Jump up^ Richmond,
Caroline (2004). "Obituary
Sir Godfrey
Hounsfield". BMJ. 329(7467):
687. doi:10.1136/bmj.329.746
7.687.
94. ^ Jump up to:a b Beckmann
EC (January 2006). "CT
scanning the early
days" (PDF).TheBritish
Journal of
Radiology. 79 (937): 5
8. doi:10.1259/bjr/29444122.P
MID 16421398.
95. Jump up^ "The Beatles
greatest gift... is to science".
Whittington Hospital NHS
Trust. Retrieved 2007-05-07.
96. Jump up^ Maizlin ZV, Vos
PM (2012). "Do we really
need to thank the Beatles for
the financing of the
development of the computed
tomography
scanner?". Journal of
Computer Assisted
Tomography. 36 (2): 161
164.doi:10.1097/RCT.0b013e
318249416f. PMID 22446352.

97. Jump up^ "The Nobel Prize

in Physiology or Medicine
1979 Allan M. Cormack,
Godfrey N. Hounsfield".
Nobelprize.org. Retrieved 19
July 2013.
98. Jump up^ Filler, Aaron G.
(2010). "The History,
Development and Impact of
Computed Imaging in
Neurological Diagnosis and
Neurosurgery: CT, MRI, and
DTI". The Internet Journal of
Neurosurgery. 7 (1). doi:10.55
80/23c6.
99. Jump up^ Tomography, XRay Computed at the US
National Library of
MedicineMedical Subject
Headings (MeSH)
100. Jump up^ Edholm, Paul;
Gabor, Herman (December
1987). "Linograms in Image
Reconstruction from
Projections". IEEE
Transactions on Medical
Imaging. MI6(4): 301.
101. Jump up^ Retsky,
Michael (31 July 2008).
"Electron beam computed
tomography: Challenges and
opportunities". Physics
Procedia. 1 (1): 149
154.Bibcode:2008PhPro...1..1
49R. doi:10.1016/j.phpro.2008
.07.090.
102. Jump up^ Novelline,
Robert (1997). Squire's
Fundamentals of Radiology.
5th edition. Harvard University
Press. ISBN 0-674-83339-2.

103. Jump up^ Jenkins, Ron;

Gould, R W; Gedcke, Dale
(1995).
"Instrumentation".Quantitative
x-ray spectrometry (2nd ed.).
New York: Dekker.
p. 90.ISBN 9780824795542.
104. Jump up^ Shikhaliev,
Polad M.; Xu, Tong; Molloi,
Sabee (2005). "Photon
counting computed
tomography: Concept and
initial results". Medical
Physics. 32 (2):
427.doi:10.1118/1.1854779.
105. Jump up^ Taguchi,
Katsuyuki; Iwanczyk, Jan S.
(2013). "Vision 2020: Single
photon counting x-ray
detectors in medical
imaging". Medical
Physics. 40 (10):
100901.doi:10.1118/1.482037
1.
106. Jump up^ "NIH uses
photon-counting CT scanner
in patients for the first
time". National Institutes of
Health. 24 February 2016.
Retrieved 28 July 2016.
107. Jump up^ "Photoncounting breast CT measures
up". medicalphysicsweb.
Retrieved28 July 2016.
External links[edit]
Library resources about
Computed tomography

Re
sources in your library
Wikimedia
Commons
has media
related
to Compute
d
tomography
.

Radiation Dose in X-Ray and CT

ExamsAmerican College of
Radiology and the Radiologic
Society of North America

Radiation Risk Calculator

American Society of Radiologic
Technologists

Video of patient getting a CT scan

CTisusCT scanning protocols,

images, and learning materials

CTCasesComputed
Tomography Case Studies,
images and protocols

Development of CT imaging

CT ArtefactsPPT by David
Platten

CT scanning of historic violins

Filler, Aaron (12 July 2009). "The

History, Development and Impact
of Computed Imaging in
Neurological Diagnosis and
Neurosurgery: CT, MRI, and

DTI". Nature
Precedings. doi:10.1038/npre.200
9.3267.5.
[hide]

v
t
e
Medical imaging (ICD-9-CM V3 8788, ICD-10-PCS B, CPT 7001079999)

Pneumoencephalography
Dental radiography
Sialography
Myelography
CXR
Bronchography

X-ray/
medical
radiography/
Industrial
radiography

AXR
KUB
DXA/DXR
Upper gastrointestinal series/Small-bowel follow-

2D

through/Lower gastrointestinal series

Cholangiography/Cholecystography
Medical:
Mammography
Pyelogram
Cystography
Arthrogram
Hysterosalpingography
Skeletal survey
Angiography
Angiocardiography
Aortography
Venography
Lymphogram

Industrial:

Radiographic testing

CT pulmonary angiogram
Computed tomography of the heart
Computed tomography of the abdomen and pelvis
Virtual colonoscopy

3D /
XCT

Medical:

CT angiography
Computed tomography of the head
Quantitative computed tomography
Spiral computed tomography
High resolution CT
Whole body imaging
Full-body CT scan
X-ray microtomography
Electron beam tomography

Industrial:

Other

MRI

Industrial computed tomography

Fluoroscopy
X-ray motion analysis

MRI of the brain

MR neurography
Cardiac MRI/Cardiac MRI perfusion
MR angiography
MR cholangiopancreatography
Breast MRI
Functional MRI
Diffusion MRI
Synthetic MRI

Echocardiography
Doppler echocardiography
TTE
TEE

Ultrasound

Intravascular
Gynecologic
Obstetric
Echoencephalography
Transcranial Doppler
Abdominal ultrasonography
Transrectal
Breast ultrasound
Transscrotal ultrasound
Carotid ultrasonography
Contrast-enhanced
3D ultrasound
Endoscopic ultrasound
Emergency ultrasound
FAST
Pre-hospital ultrasound
Duplex

Radionuclide

2D / scintigrap
hy

Cholescintigraphy
Scintimammography
Ventilation/perfusion scan
Radionuclide ventriculography
Radionuclide angiography
Radioisotope renography
Sestamibi parathyroid scintigraphy
Radioactive iodine uptake test
Bone scintigraphy
Immunoscintigraphy

Octreotide scan
Gallium 67 scan
Indium-111 WBC scan

Full body:

SPECT
gamma ray: Myocardial perfusion imaging
3D / ECT
PET (positron):

Brain PET
Cardiac PET
PET mammography
PET-CT

Optical tomography
Optical coherence tomography
Optical laser
Confocal microscopy
Endomicroscopy
non-contact thermography
contact thermography
dynamic angiothermography

Thermography
Authority
control

NDL: 00976418

Navigation menu

Not logged in

Talk

Contributions

Create account

Categories:
X-ray computed tomography
1972 introductions
Medical tests
Multidimensional signal processing

Log in

Article
Talk

Read
Edit
View history
Search
Go

Main page
Contents
Featured content
Current events
Random article
Donate to Wikipedia
Wikipedia store
Interaction
Help
About Wikipedia
Community portal
Recent changes
Contact page
Tools
What links here
Related changes
Upload file
Special pages
Permanent link
Page information
Wikidata item
Cite this page
Print/export
Create a book
Download as PDF
Printable version
In other projects
Wikimedia Commons
Languages

Azrbaycanca

Bosanski
Brezhoneg
Catal
etina
Cymraeg
Dansk
Deutsch
Eesti

Espaol
Esperanto
Euskara

Franais
Gaeilge
Galego
/Hak-k-ng

Hrvatski
Bahasa Indonesia
slenska
Italiano

Kurd
Magyar

Nederlands

Norsk bokml
Norsk nynorsk
Polski
Portugus
Ripoarisch

Scots
Simple English
Slovenina
Slovenina

/ srpski
Srpskohrvatski /
Suomi
Svenska

Trke

Ting Vit
Winaray

Edit links

Privacy policy

About Wikipedia

Disclaimers

Contact Wikipedia

Developers

Cookie statement

Mobile view

This page was last modified on 7

September 2016, at 22:26.
Text is available under the Creative
Commons Attribution-ShareAlike
License; additional terms may apply.
By using this site, you agree to
the Terms of Use and Privacy Policy.
Wikipedia is a registered trademark
of theWikimedia Foundation, Inc., a
non-profit organization.