Advanced Imaging Techniques
Advanced Imaging Techniques
Advanced Imaging Techniques
Ultrasonography
Nuclear medicine.
COMPUTED TOMOGRAPHY
In 1972 Godfrey hounfield,an engineer,announced the invention of revolutionary imaging techniques that used image reconstruction mathamatics developed by Alan cormade in 1950s & 1960s.
CT scanner consists of an xray tube that emits a finely collimated,fan shaped x-ray directed through a patient to a series of scintillation detectors or ionization chambers.These detectors measure the no of photons that exit the patient.
The intensity of the x-ray beam exiting the body is determined by:
TECHNIQUE
Patient would lie on a stationary table while the x-ray source rotates one cycle around them.The table would move 1-5mm for the next scan.
CT scan that uses this type of step & shootmovement for image acquisition are called incremental scanners.
The final image set consists of series of overlapping axial images,made up of right angles to the long axis of the patients body.
In 1989 CT scanners were introduced that acquire image data in helical fashion. In helical CT scanners,Pitch refers to the amount of patient movement compared with the width of the image acquired.
MDCT,multislice ct,multirow CT.With this method anywhere from 4-64 adjacent detectors arrays are used in conjunction with helical CT.
The time for the x-ray tube to make a full cycle around the patients has been reduced to as little as 0.35sec.
ELECTRON BEAM CT
An electron gun generates an electron beam that is focused electrostatically on a fixed tungstan target circling halfway around the patient. Because there are no moving parts an image may be acquired in less than 100microsec.This technique is primarily used for cardiac imaging to stop heart motion.
CT TOMOGRAPHIC SCANNER COMPUTED ASSEMBLY The basic components of CT are: 1.Gantry 2.Patient supporting couch 3.Computer
GANTRY
The gantry is made up of detector array,patient supporting couch & the xray tube or source. The gantry can be tilted up to 30degree. The facility to tilt helps in excluding structure from the scan that may degrade the final image(eg metallic dental restoration). Components of gantry are:
X-ray detectors
Detector array
X-ray tube
CT scanners use x-ray tubes with rotating anodes.These tubes a high heat capicity 8 million heat units. Operate at-120-140(kvp)
DETECTORS
X-ray beam exiting the patient is captured by an array of detectors.
The detectors are usually gas filled or solid state. Gas filled ion chamber detectors are usually made of high pressure xenon. Gas filled ion chamber respond quickly but only capture about 50% of photons. Solid state detectors are commonly used they are made up of cadmium tungstate
IMAGE RECONSTRUCTION
Computer algorithms use these photons counts to construct one or more often,many digital crossectional images.The ct image is recorded and displayed as a matrix of individual blocks called voxels(volume elements).Each square of the image matrix is a pixel.
Next an interpolator algorithm is used to correct for the helical motion of the scanner and to construct planer crossectional from the helical information.
The patient support couch helps in stabilising the position of the patient during ct scan.The couch must be made of low molecular weight material such as carbon filter to ensure that the path of the x ray beam is not altered before or after it transverse the patient.
COMPUTER
The rapidly of capturing the image,acquring data,and larger matrix size(512 *512) necessitates the use of high speed computers.
CONTROL CONSOLE
The control console allows the operator to select the parameters of the ct scan and view the image as they are been generated. Image is stored in the computer so that it can be manipulated in no. of ways(eg. Magnetic tapes or discs).
The no. is propotional to the degree to which the material with in the voxel has attenuated the xray beam.
Ct no. also called as hounsfield units range from -1000 to +1000. An image optimised for viewing bone-a bone window,may have a range of 700 units and mean of 5000units.
TYPICAL HOUNSFIELD UNITS FOR AIR AND TISSUES TISSUE BONE SOFT TISSUE WATER FAT LUNG AIR HOUNSFIELD UNITS +400-+1000 +40-+80 0 -60_-100 -400_-600 -1000
ARTIFACTS
Different types of artifacts may degrade CT images. Some are: Partial volume artifacts
Metal artifacts
CONTRAST AGENTS
Are the substances used to improve visualization of structure. CT imaging frequency uses iodine,administered i/v to enhance soft tissue and vascular image details.
ADVANTAGES
Multiplaner images.
Greater geometric projections. Manipulation of acquired images. Soft tissue imaging.
DISADVANTAGES
Production of artifacts.
Expensive.
USES IN DENTISTRY Evaluation of presence & extent of clinically suspected pathology in the head & neck. Detection of extention of disease process into the paranasal sinus,base of skull& orbit.
Determination of location,extent & displacement of maxillofacial skeletal fractures,including direction of subdural & epidural haematomas.
Salivary gland imaging.
Virtual surgeries.
NUCLEAR MEDICINE
Radionuclide imaging uses radioactive atoms or molecules that emit gamma rays.
Radionuclides allow measurement of tissue funtions in vivo & provide early marker of disease through measurement of biochemical changes.
After the radionuclides are administered in the body they distribute according to there chemical properties.
RADIONUCLITIDES
The ideal radionuclide has a short half life,emits gamma rays and is capable of binding to a variety of pharmaceuticals.Although many gamma emitting isotopes are used in imaging,including iodine,gallium,selenium.The most commonly used is Technetium. Technetium has a half life of 6hr and emits primarily 140 kiloelectron volt photon.As Tc is injected i/v it gets concentrated in thyroid gland and gastric mucosa.
TO IMAGE A BONE
Tc is typically bound to methylene diphosphonate and a dose of 20 to 30mlci is injected i/v.immediately after injection the tracer distributes intravascularly. Images made during this flow phase,the first 60-90sec are called as radionuclide angiography. In the second,or blood pool phase,the tracer moves quickly into the extracellular spaces. The third or bone scintigraphy phase,is made 2-3hrs after injection show most of the tracer activity in skelton,kidney,and bladder.
These camera capture photon and convert them to light and then to voltage signal.
Gamma sclintillation camera also called as anger camera are most common means of forming an image.
These signal is constructed to a planer image that shows the distribution of the radionuclide in the patient.
In this technique either a single or multiple gamma camera is rotated 360degree about the patient.
APPLICATIONS
Investigate abnormal metabolic bone activity.helps in assessing growth activity in case of condylar hyperplasia and presence of metabolic lesions.
USES
The PET/CT combination has been helpful in staging and treatment of squamous cell carcinoma in head and neck.
PRESENTED BY
ROLL NO:75
SAKEENA ASSAD