www.upei.

ca/~vetrad
Cross Sectional Imaging
Nuclear Medicine
Dr. LeeAnn Pack
Dipl. ACVR
www.upei.ca/~vetrad
Computed Tomography
(CT)
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Cross Sectional Imaging
No superimposition of structures
Excellent contrast resolution can see
the difference between 2 similar tissues
For CT scan can be performed in one
plane (usually transverse) and
reformatted in the others (sag, dorsal)
CT good for bone and soft tissue
MRI better for soft tissue
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Computed Tomography
Uses X-rays, X-ray tube, detectors,
collimators very similar to radiography
in how it works.
Patient placed in gantry
Multiple samples are taken from around
the patient and then reconstruction can
occur to make a slice



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CT Generations
Generation

configuration

detectors

beam

min scan time

First

translate-rotate

1~2

pencil thin

2.5 min

Second

translate-rotate

3~52

narrow fan

10 sec

Third

Rotate-rotate

256~1000

wide fan

0.5 sec

Fourth

Rotate-fixed

600~4800

wide fan

1 sec

Fifth

electron beam

1284 detectors

wide fan electron beam

33 ms

Helical and Multislice CTs are used now
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How It Works
Scout image is made first to pick the
area to scan
Parameters set on the computer
Scan begins
Linear attenuation coefficient of tissues
Houndsfield units calculated
Shade of grey assigned to a CT number

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CT Principles
The image is divided into small areas
called pixels
Each pixel has a location
Each pixel has an attenuation value
Using this information and very complex
math formulas, the computer constructs
the image
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CT numbers
High CT number = white because of
increased attenuation
Low CT number = black because of
decreased attenuation
Houndsfield scale
Water is zero, air is 1,000 and bone is
1,000
256 shades of grey

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Windowing
Level
Center portion of the Houndsfield scale
that is being used
Should be near the tissue of interest
Width
How much of the Houndsfield scale is used
Values within the window will be various
shades of grey - rest black or white
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Level and Width
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Windowing - Use
Narrow window enhance contrast of the
tissues
Brain
Wide window area with high inherent
contrast
Lungs
Soft tissue window
Bone window
Reformatting can not be better than original
slice decreased spatial resolution
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CT Terminology
Density
Hypodense
Isodense
Hyperdense
IV Contrast can also be administered
then contrast enhancing, ring
enhancement etc can be used
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Soft Tissue Bone
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Choroid Plexus Tumor
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Fibrosarcoma Cat Back
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Multilobular
Osteochondrosarcoma
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CT images
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Bone Lysis Nasal Tumor
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Nasal Adenocarcinoma
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Retrobulbar Mass
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Pituitary Tumor
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Magnetic Resonance Imaging
(MRI)
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Magnetic Resonance Imaging
Does not involve ionizing radiation
Uses magnetic field and radiofrequency
pulses
Hydrogen proton on tissues (water)
Water = like tiny magnets
When placed into magnetic field H
protons line up along field
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MRI
Radiofrequency pulse passed through
patient
Protons flip and spin
Pulse turned off and H protons return to
normal state = relaxation
T1
T2
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Meningioma Hydrocephalus
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MRI
Tissues that have little H protons have
little signal and are black
Air, bone, moving blood
Good for soft tissue imaging though
Paramagnetic contrast agent Gad
No reformat must scan all planes
Thus much longer scan than CT
Transverse, sagittal, dorsal
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T1 vs. T2
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MRI Machines
Can vary from .3 Tesla to 3 Tesla for
routine working machines
Many are superconducting use helium
Magnet is always on and must be
contained in a Faraday cage (blocks
stray radiofrequency signals)
Open and closed magnets
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MRI Terminology
Intensity
Hyperintense
Isointense
Hypointense
Contrast enhancing with Gadolinium
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MRI Safety
Augment T waves on EKG
Light flashes Mild skin tingling
Involuntary muscle twitching
Increased body temperature
Projectile effects
Effects on surgical implants ferrous
Magnetic foreign bodies
Life support devices
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MRI Contraindications
Pacemaker
Intra-cranial implants, clips
Metallic foreign bodies
Implanted electrical pumps, mechanical
devices
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Nuclear Scintigraphy
(Nuc Med)
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The Basics
Radionuclides (radioisotopes) are used
Injected, oral, per rectal etc. administration
They undergo decay over time
Linked to a radiopharmaceutical
Determines the area of distribution
Gamma rays come from the patient
Radioactive ionizing radiation is involved
Gamma camera detects the radiation
Good for physiologic function stuff
Does not provide a good anatomical info
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The Ideal Radionuclide
Technetium
99m
Short half life = 6 hours
Binds to radiopharmaceuticals
Cheap to purchase
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The Gamma Camera
The gamma rays produce scintillations
They are converted to electrical signals
and multiplied by photomultiplier tubes
The computer records the strength and
location of the scintillation events
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Types of Scanning
Static
Images are acquired os structures at a single point
in time
Dynamic
Images are acquired of a structure over a period
of time
Provides functional activity
Time activity curves
Activity in a region is followed over time and a graph made

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Bone Scans
One of the most common scans we do
Equine
3 phases:
Vascular phase
Soft tissue phase
Bone phase
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Items to Consider
Age of the animal
Young animals physis
Older animal longer time to distribution of
radiopharmaceutical
Must scan both limbs etc even if only one is
suspected of being abnormal
Symmetry is your friend
Animals are radioactive for a time after the
scan
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Normal Equine Bone Scan
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Bone Scans
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Equine Head
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Thyroid Scintigraphy
Technetium
99m
Pertechnetate
Uptake in thyroid glands is compared to
uptake in salivary glands should be
equal
Hyperthyroid Benign adenoma
Thyroid glands exceed salivary glands
Functional thyroid tumors
Patchy irregular inconsistent pattern

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Thyroid Scintigraphy Scans
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Portosystemic Shunts
Technetium 99m is placed in the rectum
and dynamic images every 4 seconds
are acquired over 2-3 minutes
Non invasive, quick, accurate,
quantitative
Liver then heart = normal
Heart then liver = abnormal (shunt)
Time Activity Curves - important
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0
200
400
600
800
1000
0 20 40 60
Heart
Heart
Liver
Time Activity Curve Portosystemic Shunt
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Shunt vs. No Shunt
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Other Scan Types
Renal Scans
To determine GFR and ERPF
Cardiac Scans
Hepatobiliary Scans
Hepatocyte function, function of the
reticuloendothelial system, biliary function
Gastrointestinal scans
Lung Scans
Infection and tumor imaging
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Nuc Med Safety
Higher energy radiation
Especially before injection
Urine from horses
Bedding
Isolation
Lead for workers not work
Wear plastic gloves to keep off hands
Wear monitoring badges, rings
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Release Protocol
Isolation of the animals is necessary
Limited contact with the animal
Very sick animals may not be best to inject
Bedding must be monitored
Animal must be released after scanning
with Geiger counter