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when was CT first introduced?
in the 1970s
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who received the Nobel Peace Prize for inventing CT and when?
- G.N. Hounsfield and A.M. Cormack
- 1979
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_____________ demonstrated the first CT scanner in _______. He was using ______________'s mathematic formulas that were developed in __________.
- Godfrey Housfield
- the early 1970s
- Alan Cormack
- the 1960s
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who first demonstrated that images could be created through mathematical projections and when?
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the movable frame of the CT unit that contains the x-ray tube and detectors:
the gantry
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the part of the CT unit that delivers x-ray around the patient:
x-ray tube
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the part of the CT unit that receives the x-rays that are attenuated by the patient to acquire data to be sent to the CPU:
detectors
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name seven main parts that make up the modern CT unit:
- gantry
- table
- x-ray tube
- detectors
- computer
- display console
- image storage units
-
the part of the CT unit that processes data received at the detectors:
computer
-
the part of the CT unit that shows post processed data:
display console
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the part of the CT units that can store massive amounts of data to be used to visualize images through various dimensions:
image storage units
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what is the size range of the gantry aperture in CT?
50-85cm
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describe the first generation CT unit:
- capable of scanning only the head
- a water bag was utilized to eliminate air interferences
- used a pencil slit x-ray beam
- had only two detectors
- used sodium iodide scintillation crystals and photomultiplier tubes
- capable of 180° rotation and 10-12 sections
- scans took 25-35 minutes to acquire
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describe the second generation CT unit:
- scan time greatly reduced from 1st generation
- had a fan beam and 30 detectors
- but it increased the amount of scatter present in images
- (lead mask)
-
describe the third generation CT unit:
- had a wider fan beam and a curved array of 250-750 detectors
- capable of 360° rotation
- scan time became even faster (compared to 1st and 2nd gen)
- utilized dynamic imaging
- prone to ring artifacts (due to single detector array)
-
describe the fourth generation CT unit:
- had 600-2000 stationary detectors in a 360° array
- needed decreased calibration requirements
- AS&E funded by NIH
- was limited by its computer processing time
-
describe the fifth generation CT unit:
- utilized electron beam tomography (EBT) or cardiac cine (CT)
- used contrast injections synchronized to pt's ECG
- introduced a dedicated cardiac unit with a surrounding rotating electron beam with an electron gun and anode ring
- the electron gun shot down into the gantry
-
describe the sixth generation CT unit:
- called a helical or spiral CT, a type of 3D CT
- also called "Cone Beam Computed Tomography" (CBCT)
- used slip ring technology
- the patient was continually advanced through the bore
- it lowered the dose of contrast media required
- it could be acquired through a single breath hold
-
describe the seventh generation CT unit:
- a multiple section CT, with multiple detector arrays
- utilizes multiple bands of detectors as opposed to just one band
- allows for a reduction in section thickness
- improved resolution (determined by width of detector)
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what generation CT unit does each image represent?
- A. 2nd generation
- B. 4th generation
- C. 6th generation
- D. 7th generation
- E. 1st generation
- F. 3rd generation
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if you increase the pitch, what happens to the amount of tissue being scanned?
it increases
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if you increase the pitch, what happens to the scan time?
it decreases
-
if you increase the pitch, what happens to slice thickness?
it stays the same
-
smaller fields yield ___________ resolution.
better
-
give the typical scan field sizes for head & spine, small bodies, and large bodies:
- head and spine: typically 25 cm
- small bodies: typically 35 cm
- large bodies: typically 48 cm
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what two things help determine the resolution on a helical multi section CT?
- the image matrix (in x and y planes)
- helical pitch
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give all the versions of the name of the seventh generation CT unit:
- multi-section CT (best)
- multi-slice CT
- multi-detector CT
- multiple detector array scanners
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what type of CT unit can be found at Holy Cross Hospital in Fort Lauderdale, Florida?
256 slice CT unit
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what type of CT unit can be found at Le Bonheur in Memphis, Tennessee?
320 slice CT unit
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what type of CT unit can be found at John Hopkins?
- 320 slice
- with viewing sizes less than 16 cm
- takes less than one second
-
describe the shape and composition of the CT table:
- flat or curved
- made of carbon graphite fiber (low attenuation, radioluscent)
- a motor drive provides exact section interval positioning
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with the x-ray tube, rapid sequential loading requires a design with:
expanded heat capacity
-
give some technical aspects to the x-ray tube of a CT unit:
- rotating, with layered alloy and cylindrical anodes
- pulsed beam (120kVp, 1-5 msec pulses, 1000 mA)
- dual energy scanning (80kVp and 140kVp)
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if taking a scan of a child or infant, would you raise or lower the kVp to reduce pt dose?
lower
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for a CT x-ray tube, ___________ exposures in a month is not uncommon. Nor is it unusual for tubes to fail after _______________.
-
double collimation controls:
voxel length
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the actual production of a CT image of a cross-sectional slice of anatomy begins with the ___________ and ends with a _______________ that represents the attenuation characteristics of the anatomy being imaged.
- x-ray tube
- matrix of CT numbers
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between the x-ray tube and the matrix of CT numbers are the (6):
- generator
- filter
- collimators
- detectors
- data acquisition system
- computer
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give some general characteristics of the CT x-ray tube:
- continuously pulsing
- lengthy exposures
- large anode that withstands large amounts of heat
- high frequency generator to supply electricity to tube
-
the high-frequency generator allows the production of an x-ray beam with ________________ energy levels, due to its ____________________.
- fairly consistant
- minimal voltage ripple
- (makes it more efficient)
-
describe the filter commonly used for a CT unit:
- typically a bow-tie filter shape
- used to filter low energy x-ray (to increase overall ave. energy)
-
name the two sets of collimators used in CT:
- prepatient collimator
- predetector collimator
-
where is the prepatient collimator located and what is its function?
- located between tube and patient
- limits the beam to a fan or cone shape
- limits patient exposure and scatter production
-
where is the predetector collimator located and what is its function?
- located before the detector array
- controls how much of the detector is exposed
- - in single slice CT, it controls the slice thickness
- - in MSCT, it controls how many rows of detectors being used
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the _______________ is the physical component consisting of multiple detectors that efficiently absorbs the ______________ and accurately converts it to _______________.
- detector array
- transmitted radiation
- an electrical signal
-
name desirable traits in detectors:
- a fast response time without lag
- high stability
- unload signal quickly
- respond consistently
- be small
- have wide dynamic range
-
name the three elements of detector dose efficiency:
- capture efficiency
- absorption efficiency
- conversion efficiency
-
what are the detectors composed of?
- scintillation crystals
- photomultiplier tubes
- xenon ionization chambers
-
absorb the transmitted radiation and produce a proportional flash of light:
scintillation crystals
-
a solid-state device that converts the light to a proportional electrical signal:
the photodiode
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A 64-slice CT Scanner has a detector array of ______ rows of _______ detectors.
-
the electrical signal produced by the detector-photodiode goes immediately to the ____________, which amplifies this weak signal, converts it to a ______________ (converts it from analog to digital data) and sends it to the _____________.
- Data Acquisition System (DAS)
- logarithmic data
- computer
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the ______________ of the measured electrical signal is critical in CT.
logarithmic conversion
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logarithmic conversion produces attenuation information from the:
- original x-ray beam intensity
- intensity of the transmitted radiation
- thickness of the part
-
a measure of the probability that the x-ray beam will interact with the material it is in while traveling in a straight path:
linear attenuation coefficient
-
name two factors that can influence the linear attenuation coefficient:
- the type of material
- the energy of the x-ray
-
the logarithmic data goes through ___________ before reaching the computer for image reconstruction.
an ADC
-
give two matrix sizes common to CT:
-
the __________________ consists of the computer analyzing raw data sent from the ________________ and reconstructing it into a digital array of ______________ based on the image matrix.
- reconstruction process
- DAS
- CT numbers (image data)
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the logarithmic data from the linear attenuation coefficient that is converted from analog to digital information by the ADC and sent to the computer:
raw data
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help the massive amounts of data and calculations needed to reconstruct the image:
array processors
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with a _____________________: using a computer or electronic filter, the computer analyzes all the data for one slice of the area being imaged to determine the _________________ which is then converted to a ____________.
- filtered back projection
- attenuation coefficient for each voxel
- CT number (hounsfield unit)
-
determined for each voxel when the computer analyzes all the data for one slice of area being imaged:
attenuation coefficient
-
begins with the x-ray tube and ends with a matrix of CT numbers:
image data production
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how is the Hounsfield Unit/CT number calculated?
by using a formula that relates the attenuation coefficient of the tissue to the attenuation coefficient of water
-
the CT number of water is set at:
0 (zero)
-
the CT number of bone is:
approximately +1000 (appearing white)
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the CT number of air is:
approximately -1000 (appearing black)
-
list items as they appear according to their CT number:
- A. air (-1000)
- B. water (0)
- C. bone (+1000)
- D. fat (-100)
- E. white matter (+25 to +30)
- F. grey matter (+35 to +45)
- G. congealed blood (+55 to +75)
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name some of the imaging controls that the technologist must use in CT:
- keyboard
- mouse
- multiple monitors
- power injector
-
name some responsibilities of the CT technologist:
- selecting the proper protocol for the requested exam
- using the power injector to deliver contrast
- manipulating the image to enhance visibility of key information
- storing the information on a temporary hard drive or long-term on large-capacity optical discs
- sending the information to PACS for interpretation by a radiologist
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be familiar with the items that the imaging controls and data storage have protocols for:
- mA
- kVp
- FSS
- slice thickness
- image matrix size
- scan field of view (SFOV)
- display field of view (DFOV)
- scan time and image display
- RPM of tube
- energy supplied to tube
- pitch and distance table travels per second
- collimation
- electronic reconstruction filters such as edge enhancement and smoothing
-
be familiar with the multiple options of post processing:
- annotation
- selection of region of interest (ROI)
- using DFOV smaller than SFOV to magnify/magnification
- image smoothing or edge enhancement filters
- multiplanar reformation (MPR)
-
name a way to magnify in post processing:
use a DFOV (display field of view) smaller than the SFOV (scan field of view)
-
reformatting differs from reconstruction in that:
the computer uses the image data that was previously reconstructed to produce additional images.
-
Multiplanar reformation (MPR) is used to display:
- coronal planes
- sagittal planes
- oblique planes
-
windowing involves using WW and WL to adjust:
how many CT numbers are visible in the image
-
in CT there is a WW of _________ and a WL of ________.
-
in post processing, CT numbers range from:
50 to 450
-
in post processing CT numbers, pixels _____________ are black and pixels ____________ are white.
- 50 and lower
- 450 and higher
-
in CT post processing, decreasing WW will:
increase contrast
-
in CT post processing, increasing WL will:
decrease brightness (opposite of digital radiography)
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name four basic things that affect image quality in CT:
- noise
- spatial resolution
- contrast resolution
- artifacts
-
an impediment of image quality that, in CT, typically results from statistical fluctuation recorded by the detectors
noise
-
affects the low contrast resolving ability of the CT unit:
noise
-
what type of relationship do noise and SNR have?
indirect
-
name four basic artifacts that affect image quality in CT:
- streak artifacts
- ring artifacts
- beam hardening artifacts
- partial-volume artifacts
-
be familiar with these artifact types:
- A. streak artifacts
- B. ring artifacts
- C. partial-volume artifacts
- D. beam hardening artifacts
-
name some routine quality control procedures:
- regular tube warm up procedures
- preventative maintenance
- testing to ensure accuracy and quality of image
- water phantoms used to calibrate CT number for water to "0"
- test objects used to monitor various areas
-
test objects are used in quality control to monitor:
- spatial resolution
- contrast resolution
- noise
- linearity
- uniformity
- accuracy of table movement
- pitch
- localization devices
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today, CT accounts for approximately ________ of the U.S. population’s radiation exposure resulting from medical procedures.
50%
-
to minimize exposure to patients the ___________ should be reduced while the _________ should be increased.
- reduce: mA and kVp
- increase: pitch
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what type of shielding is available and for what specific parts is this shielding mentioned?
- thin in-plane bismuth shields
- breasts, thyroid, and eyes
-
name some technical amounts the pulsed beam CT unit uses:
- 120 kVp
- 1-5 msec pulses
- 1000 mA
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