Computed Tomography III

Reconstruction
Image quality
Artifacts

Simple backprojection
Starts with an empty image matrix, and the
value from each ray in all views is added
to each pixel in a line through the image
corresponding to the rays path
A characteristic 1/r blurring is a byproduct
A filtering step is therefore added to correct
this blurring

Filtered backprojection
The raw view data are mathematically
filtered before being backprojected onto the
image matrix
Involves convolving the projection data
with a convolution kernel
Different kernels are used for varying
clinical applications such as soft tissue
imaging or bone imaging

Convolution filters
Lak filter increases amplitude linearly as a
function of frequency; works well when there is no
noise in the data
Shepp-Logan filter incorporates some roll-off at
higher frequencies, reducing high-frequency noise
in the final CT image
Hamming filter has even more pronounced highfrequency roll-off, with better high-frequency
noise suppression

Bone kernels and soft tissue

kernels
Bone kernels have less high-frequency roll-off and
hence accentuate higher frequencies in the image at
the expense of increased noise
For clinical applications in which high spatial
resolution is less important than high contrast
resolution for example, in scanning for metastatic
disease in the liver soft tissue kernels are used
More roll-off at higher frequencies and therefore produce
images with reduced noise but lower spatial resolution

CT numbers or Hounsfield units

The number CT(x,y) in each pixel, (x,y), of the
image is:
( x, y ) water
CT ( x, y ) 1,000
water
CT numbers range from about 1,000 to +3,000
where 1,000 corresponds to air, soft tissues range
from 300 to 100, water is 0, and dense bone and
areas filled with contrast agent range up to +3,000

CT numbers (cont.)
CT numbers are quantitative
CT scanners measure bone density with
good accuracy
Can be used to assess fracture risk

CT is also quantitative in terms of linear

dimensions
Can be used to accurately assess tumor volume
or lesion diameter

Digital image display

Window and level adjustments can be made
as with other forms of digital images
Reformatting of existing image data may
allow display of sagittal or coronal slices,
albeit with reduced spatial resolution
compared with the axial views
Volume contouring and surface rendering
allow sophisticated 3D volume viewing

Image quality
Compared with x-ray radiography, CT has
significantly worse spatial resolution and
significantly better contrast resolution
Limiting spatial resolution for screen-film
radiography is about 7 lp/mm; for CT it is about 1
lp/mm
Contrast resolution of screen-film radiography is
about 5%; for CT it is about 0.5%

Image quality (cont.)

Contrast resolution is tied to the SNR, which is related to
the number of x-ray quanta used per pixel in the image
There is a compromise between spatial resolution and
contrast resolution
Well-established relationship among SNR, pixel
dimensions (), slice thickness (T), and radiation dose (D):

SNR
D 3
T

Factors affecting spatial

resolution
Detector pitch (center-to-center spacing)
For 3rd generation scanners, detector pitch determines
ray spacing; for 4th generation scanners, it determines
view sampling

Detector aperture (width of active element)

Use of smaller detectors improves spatial resolution

Number of views
Too few views results in view aliasing, most noticeable
toward the periphery of the image

Factors affecting spatial

resolution (cont.)
Number of rays
For a fixed FOV, the number of rays increases as
detector pitch decreases

Focal spot size

Larger focal spots cause more geometric unsharpness
and reduce spatial resolution

Object magnification
Increased magnification amplifies the blurring of the
focal spot

Factors affecting spatial

resolution (cont.)
Slice thickness
Large slice thicknesses reduce spatial resolution in the
cranial-caudal axis; they also reduce sharpness of edges
of structures in the transaxial image

Slice sensitivity profile

A more accurate descriptor of slice thickness

Helical pitch
Greater pitches reduce resolution. A larger pitch
increases the slice sensitivity profile

Factors affecting spatial

resolution (cont.)
Reconstruction kernel
Bone filters have the best spatial resolution, and soft
tissue filters have lower spatial resolution

Pixel matrix
Patient motion
Involuntary motion or motion resulting from patient
noncompliance will blur the CT image proportional to
the distance of motion during scan

Field of view
Influences the physical dimensions of each pixel

Factors affecting contrast

resolution
mAs
Directly influences the number of x-ray photons used to
produce the CT image, thereby influencing the SNR
and the contrast resolution

Dose
Dose increases linearly with mAs per scan

Pixel size (FOV)

If patient size and all other scan parameters are fixed,
as FOV increases, pixel dimensions increase, and the
number of x-rays passing through each pixel increases

Factors affecting contrast

resolution (cont.)
Slice thickness
Thicker slices uses more photons and have better SNR

Reconstruction filter
Bone filters produce lower contrast resolution, and soft
tissue filters improve contrast resolution

Patient size
For the same technique, larger patients attenuate more
x-rays, resulting in detection of fewer x-rays. Reduces
SNR and therefore the contrast resolution

Factors affecting contrast

resolution (cont.)
Gantry rotation speed
Most CT systems have an upper limit on mA, and for a
fixed pitch and a fixed mA, faster gantry rotations
result in reduced mAs used to produce each CT image,
reducing contrast resolution

Beam hardening
Like all medical x-ray beams, CT uses a
polyenergetic x-ray spectrum
X-ray attenuation coefficients are energy
dependent
After passing through a given thickness of patient,
lower-energy x-rays are attenuated to a greater extent
than higher-energy x-rays are

As the x-ray beam propagates through a thickness

of tissue and bones, the shape of the spectrum
becomes skewed toward higher energies

Beam hardening (cont.)

The average energy of the x-ray beam
becomes greater (harder) as it passes
through tissue
Because the attenuation of bone is greater
than that of soft tissue, bone causes more
beam hardening than an equivalent
thickness of soft tissue

Beam hardening (cont.)

The beam-hardening phenomenon induces artifacts in CT
because rays from some projection angles are hardened to
a differing extent than rays from other angles, confusing
the reconstruction algorithm
Most scanners include a simple beam-hardening correction
algorithm, based on the relative attenuation of each ray
More sophisticated two-pass algorithms determine the path
length that each ray transits through bone and soft tissue,
and then compensates each ray for beam hardening for the
second pass

Motion artifacts
Motion artifacts arise when the patient
moves during the acquisition
Small motions cause image blurring
Larger physical displacements produce
artifacts that appear as double images or
image ghosting

Partial volume averaging

Some voxels in the image contain a mixture
of different tissue types
When this occurs, the is not representative
of a single tissue but instead is a weighted
average of the different values
Most pronounced for softly rounded
structures that are almost parallel to the CT
slice

Partial volume averaging (cont.)

Occasionally a partial volume artifact can
mimic pathological conditions
Several approaches to reducing partial
volume artifacts
Obvious approach is to use thinner CT slices
When a suspected partial volume artifact occurs
with a helical study and the raw scan data is
still available, additional CT images may be
reconstructed at different positions