By

Deepashree D
INTRODUCTION
RADIOGRAPHY
FLUOROSCOPY
ANGIOGRAPHY
MAMMOGRAPHY
COMPUTED TOMOGRAPHY
CONCLUSION
Medical imaging is the process by which
physicians evaluate an area of the
subject's body that is not normally visible.

This process could be clinical or research

motivated and can also have scientific and
industrial applications.
X-rays can be described in 2 ways
1. Electromagnetic wave with
v= f*λ
λ=wavelength
f = frequency and
V=velocity
2. Particle or photon with Energy proportional to
frequency
E=h*f
h = Planck's constant = (4.13 e-18) [KeVsec]
1 eV= 1.6 e-19 [Joule]
Electromagnetic (EM) Spectrum
X-ray Radiography
Fluoroscopy
Angiography
Subtraction & DSA
Mammography
CT
Radiography is the creation of radiographs,
photographs made by exposing a photographic film or other
image receptor to X-rays.

Since X-rays penetrate solid objects, but are slightly

attenuated by them, the picture resulting from the exposure
reveals the internal structure of the object.

The most common use of radiography is in the medical field

(where it is known as medical imaging).
X-ray radiography remains the most commonly used clinical
procedure today.

The rays produced by the generator are filtered .

Immediately behind the patient are positioned the grid for removing
the scattered radiation and the screen-film combination for recording
the image, which is a map of the transmitted X ray intensity .

X ray attenuation in a tissue is proportional to mass density of the

tissue, the Xray intensity that has traversed a region of lower density
will be greater than that which has traversed a region of higher
density.

Lower density region is darker

Conventional X-ray Radiography
Uses an imaging plate system that consists of an imaging plate
and a scanning mechanism.

The recorded image on the plate is extracted by scanning, usually

by a He-Ne laser beam.

The emitted light is collected by a lens and detected by a

photomultiplier tube whose o/p is then digitized.

The imaging plate can be reused after erasing the stored image by
flooding the plate with light.

Advantages: Image information is available in digital format that

allows easy implementation of image processing algorithms on
the image such as spatial filtering, signal compression, fast image
storage and transmission.
Digital X-ray image acquisition systems for
Digital Radiography.
DIGITAL RADIOGRAPH
Fluoroscopy is an imaging technique
commonly used by physicians to obtain
real-time images of the internal structures
of a patient through the use of a
fluoroscope.

In its simplest form, a fluoroscope consists

of an x-ray source and fluorescent
screen(Calcium Tungstate) between which a
patient is placed .
Modern fluoroscopes couple the screen to an x-ray image
intensifier and CCD video camera allowing the images to be
layed and recorded on a monitor.

In a typical fluoroscopic procedure for examining the

digestive tract, a contrast medium like barium sulphate that is
nontoxic is either taken orally by the patient or by enema
depending on which part of the GI tract is being examined.

The radiation dose received by the patient can be very high.

camera enabled viewing of the image on a monitor, allowing a

radiologist to view the images in a separate room away from
the risk of radiation exposure
FLUOROSCOPY
The X ray image captured directly by an image intensifier as
in Fluoroscopy, and the image on the o/p screen of the image
intensifier is focussed and scanned by a video camera.

The video signal from the camera is digitized. The centre of

the system is a computer that controls the firing of the X ray
tube, imaging acquisition via the camera, and imaging
processing such as subtraction.
Remains the golden standard for diagnosing a no. of clinical
disorders. (Coronary stenosis, Pancreatic disease, venous
thrombosis,etc.

is a procedure involving radiographic visualization of blood vessels

by injecting a nontoxic substance such as water soluble organic
compounds of iodine into the blood stream.

Useful for demonstrating vessel constrictions and vascular tumors.

A bolus of contrast medium is injected into the artery or vein,

usually through catheterization.

The medium is then rapidly diluted in the blood circulation.

A series of images are taken immediately after the injection.

Angiography System
Angiograms of cerebral circulation
Angiographic
Imaging:Blood vessels
in
kidney.
Is a procedure that is used to suppress background information
on an image and enhance the image of the object of interest.

Here the image before the injection of a contrast medium is

subtracted from the image obtained shortly following the
injection.

Disadv: The patient has to be motionless between exposures .

DSA Example
The same procedure performed digitally.

The components of a DSA system are similar to those of a

digital fluoroscopy system with the exception that the video
signal from the video camera is typically logarithmically
amplified before digitizing.

Allows signal processing algorithms such as contrast

enhancement through windowing and filtering.
Advantages
Better signal to noise ratio, larger signal amplification.
better sensitivity.
the injection can be performed with a smaller catheter, lessening
the risk associated with puncturing an artery.
DSA may be performed as an outpatient procedure.
The problem caused by patient motion is reduced.
It is less costly .
speed and efficiency.

Disadvantages:
It suffers from poorer resolution
smaller field of view .
not possible to produce multiple views simultaneously.
 It is the radiographic examination of the breast performed
with or without the injection of contrast medium.

The requirements for mammography are different from

ordinary X ray examination in the following reasons:
i)Low energy X rays in the order of 20keV.
ii)Needs spatial resolution better than 0.1mm
iii)Exposure time should be short to avoid artifact due to
patient motion.
MAMMOGRAM
A mammography unit is a rectangular box that houses the tube in
which x-rays are produced.

The unit is a dedicated equipment because it is used exclusively

for x-ray exam of the breast, with special accessories that allow
only the breast to be exposed to the x-rays.

Attached to the unit is a device that holds and compresses the

breast and positions it so images can be obtained at different
angles.

The image of the breast is produced as a result of some of the x-

rays being absorbed (attenuation) while others pass through the
breast to expose either a film (conventional mammography) or
digital image receptor (digital mammography).
A mammography unit
(CT), also known as computed axial tomography or
computer-assisted tomography (CAT) and body
section roentgenography, is medical imaging
method employing tomography where digital
processing is used to generate a three-dimensional
image of the internals of an object from a large
series of two-dimensional X-ray images taken
around a single axis of rotation.

The word "tomography" is derived from the Greek

tomos (slice) and graphia (describing).
It is based on the principle that an image of an unknown object can be
obtained if one has an infinite number of projections through the object.

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.

Many data scans are progressively taken as the object is gradually

passed through the gantry.

They are combined together by the mathematical procedure known as

tomographic reconstruction.
 Principle of CT

X-ray tube

Patient Computer

Ray Beam

Detector
system
Schematic Representation
Principle of CT Cont…
1st GENERATION 2nd GENERATION

3rd GENERATION 4th GENERATION

Principle of spiral CT
CT Scanner
CT SCANNER Cont…
 Computed Tomography contd…

Normal CT scan of the head Chest CT horizontal section

With the discovery of X- rays we are able to learn more about
ourselves by looking within.

Medical Imaging by X-rays clearly illustrates the impact of

radiology on our everyday lives.

It is a great tool in medical field when strict protocol of its use

is applied not only because it has several invaluable potential
advantages but also its technology has been improving and
many ancillary appealing features, along with its core
development, are under intense investigations.