Basic Principles of

CT Scanning
Ilan Shelef MD , Head of Neuroradiology Unit,
Soroka Medical Center, Beer Sheva, Israel
The basics of CT
CT imaging chain
System components
Acquisition methods
Image quality
Applications
X-ray: The beginning
X-Rays founded in 1895 by
Wilhelm Conrad Roentgen

CT: The beginning
CT founded in 1970 by Sir Godfrey Hounsfield
Engineer with EMI, LTD.
first applications were in neuroradiology
CT Scanner
X-Ray modality used to the body
in cross section
Used to determine
extent of trauma
location and type of tumors
status of blood vessels
pre surgical planning
CT System
Basic CT scanner components
Gantry
X-Ray Tube
Detector
Control Console

Gantry
CT X-ray tube
High voltage generator
Detector array
Data acquistion system
Slip ring
The CT X-ray Tube
Anode heat capacity
3.5 MHU up to 28 MHU
Determines maximum mAs
Determines volume length
Dictates generator size
Detector Elements
Capture energy that has not been
attenuated by the patient
Control console
Set scan parameters
kVp, mA, scan time, reconstruction
filter, etc.
Set scan mode
Surview, Axial or Spiral
IRS (Image reconstruction
System)
Review and archive images
Post-processing
CT
CT - Computed Tomography
CAT Scan - Computerized Axial
Tomography
Scanning methods
Surview
AP,Lat
Surview, Scanogram , Topogram.
Conventional CT
Axial
Start/stop
Volumetric CT
Helical or spiral CT
Continuous acquisition
Digital Projection
X-ray tube and detector remain stationary
Patient table moves continuously
With X-rays on
Produces an image covering a range of
anatomy
Similar to a conventional X-ray image, e.g. flat
plate of the abdomen
Image used to determine scan location
Axial CT
X-ray tube and detector rotate
360
Patient table is stationary
With X-rays on
Produces one cross-sectional
image
Once this is complete patient is
moved to next position
Process starts again at the
beginning
Volume CT
X-ray tube and detector rotate 360
Patient table moves continuously
With X-rays on
Produces a helix of image information
This is reconstructed into 30 to 1000 images
Volume Scanning: Pitch
1:1 2:1
Advantages of Volume CT
More coverage in a breath-hold
Chest, Vascular studies, trauma
Reduced misregistration of slices
Improved MPR, 3D and MIP images
Potentially less IV contrast required
Gapless coverage
Arbitrary slice positioning

Fundamentals of Multislice CT
Multislice Fundamentals
Everything is better
(R)esolution
Z-axis, spatial, low contrast
(S)peed
Temporal -
bolus capture, stopped motion
(V)olume
Thin slice -
organ-specific coverage
(P)ower
Enough photons -
uncompromising image quality
Single Slice = One 10mm slice per rotation
Dual Slice = Two 5mm slices per rotation
Quad Slice = Four 2.5mm slices per rotation
Multislice Effectiveness
Everything is better
Resolution 2x 4x-8x
Speed same same
Volume same same
Power same same
Dual Quad
.
.
single detector arc dual detector arc
pre-patient collimation
post-patient collimation
x-ray tube focal spot
_ _ _
Mx8000
Dual Slice
Dual Slice Detector Optimized for
2 Slice Acquisition
Approximately 10%
more efficient than
matrix detectors
Variable Wide Area Detector
Asymmetrix
Variable detector length Fixed detector length
Quad Detector Technology
variable wide area detector
Variable slice thickness
4 x 1mm
4 x 5mm
4 x 2.5mm
2 x 0.5mm
2 x 8mm
2 x 10mm
8 Element
2-D array
4 Slices
Quad Technology
How it works
CT
CT attenuation information
CT image quality
Attenuation
X-ray beam passes through patient
Each structure attenuates X-ray beam
differently
According to individual densities
Radiation received by detector varies
according to these densities
Density information
Transferred from detector to CT computer
(A to D converter)
Reconstructed by computer into a cross-sectional image
Displayed on screen
Each pixel displayed on monitor has varying brightness
The greater the attenuation, the brighter the pixel
The less attenuation, the darker the pixel
Density information
Density values
correspond to a
range of numbers
Hounsfield scale
Window settings
Window width
Determines range of CT numbers displayed on an image
Values above this range = white
Values below this range = black
Window level
Sets the center CT number displayed on the monitor
Determines the location on the Hounsfield scale about which the
window width will be centered
CT image quality
Spatial resolution
Ability to resolve small
objects in an image
Measured in lp/cm

CT image quality
Spatial resolution
Ability to resolve small
objects in an image
Measured in lp/cm

Isotropic Imaging
True 0.5mm Isotropic imaging
CT image quality
Contrast resolution
Ability to differentiate small density differences in an image
Post Processing Options
Visualization of
vasculature in
relation to pathology
Show course of vessels
Show stent placement
Define vascular stricture
Cervical Spine
Spiral Acquisition
Rotation 0.75 sec
Coverage 160 mm
Pitch 0.875
Acq. Time 36 sec
FOV 250 mm
ST 1.0 mm
Rec. Incr. 0.6 mm
Std Res. 8 lp/cm
120 kV, 200 mAs
CTDI100w 39 mGy
CTDIFDAw 17 mGy

Thin-Slice Spiral Neck
Neuro-Angiography
Circle of Willis
Thin-Slice Spiral Lungs
MIP
4D-Angio
MasterCut
Panoramic View
Renal Arteries
Ext. Spiral Acq.
Spiral Acquisition
UltraFast 0.5 sec
Coverage 1400mm
Pitch 1.75
Acq. Time 41.5 sec
FOV 420 mm
ST 2.5 mm
Rec. Incr. 1.6 mm
Std Res. 8 lp/cm
120 kV, 96 mAs
CTDI100w 7.3 mGy
CTDIFDAw 4.9 mGy

Extended Spiral Acquisition