CT - Chapter 2 Flashcards
Describe pros/cons of iterative reconstruction
- Reduces image noise
- improved SNR
- Reduced radiation doses
- Requires longer processing (reconstruction) times than traditional FBP
- Improves image quality
- Can potentially be used with any CT system
What are advantages of sequential (prospectively triggered) scan mode compared to conventional retrospective gating?
- Reduced scan time
- may be prolonged if HR is faster
- Accommodating functional reconstructions
- Reducing the radiation dose
****** Does not improve temporal resolution
Describe the relationship between:
- image noise (quantum noise)
- exposure
Inversely proportional
- not in a one-to-one relationship
- quantum noise is inversely proportional to the square root of the exposure
- quadruple the exposure –> half the noise
- Examples:
- XR exposure that is too short (uses too little tube current) –>
- poor quality, noisy XR
What will be the result of increasing peak tube voltage on a MDCT?
- Decrease in image noise
- Higher radiation dose
- Lower contrast resolution
Describe the effects of increasing tube voltage
Decrease in image noise
- image noise is inversely related to the square root of radiation exposure
- increased peak tube voltage (exposure) –> higher energy XR’s –> decrease the noise of the image
What does the “p” stand for?
- typical XR voltage for cardiac CT is 120 kVp
“Peak”
- referring to the peak (maximum) energy of the XR spectrum
What material has a Hounsfield unit of zero?
Water
- HU scale is a linear transformation of the original linear attenuation coefficient measurement into one in which the radiodensity of distilled water at standard pressure and temperature is defined as zero HU units
How can the quality of the image be improved?

- Widening the window level
- Thin slices
- both above improve image quality
- Sharp reconstruction kernels/filters
- improve image resolution

What adjustments to acquisition or reconstruction will result in reduced image noise?
- Higher tube current or voltage
- Iterative reconstruction
What adjustments to acquisition or reconstruction will result in increased image noise?
- lower tube current or voltage
- increased pitch
- FBP reconstruction
What is the temporal resolution of the scan?
- dual-soucre CT scanner
- single-segment reconstruction
- 360 degree gantry rotation time of 280 ms
280 ms / 4 = 70 ms
- dual-source scanners use 2 XR tubes and 2 detectors, arranged at 90 degree angles to each other, to simultaneously acquire data
- 180 degrees of attenuation data that are necessary to reconstruct one image can be collected by only a qurter turn of the gantry, rather than the usual-half turn required in single source systems
- data can be gathered in one-half the time

Describe how to calculate temporal resolution
- Single-source scanner
- Dual-source scanner
- Single-source scanner
- Rotation time / 2 –> temporal resolution
- Dual-source scanner
- Rotation time / 4 –> temporal resolution

After reviewing the images of a CCTA, you decide to reconstruct the images using a smoother filter. Where can this be done?
At the scanner
- raw attenuation data are usually stored on a dedicated server attached to the scanner but separate from the CT workstation
- can be performed using raw data acquired via any acquisition mode
CCTA requires using thin detector collimation to avoid partial volume averaging, but the use of thin collimation comes at what cost?
Increased image noise
- very thin sections –> avoids partial volume averaging
- absolutely required for high-resolution coronary imaging
- comes at the cost of increased image noise
- can be overcome with:
- higher tube current
- special reconstruction algorithms for coronary arteries
What matrix size would make full use of the spatial resolution of the scanner at this field of view?
- CT scanner spatial resolution = 0.25mm
- Rows of detectors = 512
- Detector width = 0.25 mm
- Manufacturer’s protocol for CCTA = reconstructed field of view 250 mm
1024 x 1024
- main goal of image reconstruction is to properly match:
-
image pixel size = spatial resolution of scanner
- one cannot resolve something smaller than one pixel
- pixels much larger than 1/1 are essentially losing information
-
image pixel size = spatial resolution of scanner
- 250 mm (FOV) / 1024 (matrix size) = 0.243 mm pixels
- closets match to CT scanner spatial resolution = 0.25 mm
What is the utility of multi-cycle reconstruction (multi-segment reconstruction)?
Improve temporal resolution
- occurs at the expense of “averaging” data from several cardiac cycles into one single image
- requires that each slice position is scaned during several consecutive heart beats ( at least 2 )
- typically done in helical mode + low-pitch value
- “oversampling” typically occur in prospective, ECG-triggered axial scanning
What can be done to improve visualization of the proximal LAD?

Increase Peak Tube Voltage
- “burns through” the dense calcium and decrease this contrast
- calcium (partial volume averaging or “blooming” artifact) obscures the underlying contrast column within the vessel lumen –> very high photodensity gradient (contrast between the calcium and adjacent structures
- however, gain in visualization is not justified by increased radiation dose to patient.

What are the two ways in which dual-energy CT is performed?
Two raw datasets are collected for each scan –>
representing attenuation data from two different photon energies –>
differential attenuation (calcium and iodine) will allow for new differential (subtracted) images to be created
- layered detector array (which can differentiate):
- high energy photons
- low energy photons
- two XR-tubes (dual-source scanner) to scan simultaneously at two different XR energies (e.g.)
- 80 kVp
- 120 kVp
Describe the difference in regards to photons for each:
- tube voltage (kV)
- tube current (mA)
- tube voltage (kV)
- energy level of the photons coming out of the XR tube
- tube current (mA)
- quantity (output) of photons
*****Lowering both –> reduced radiation exposure
What is the definition / formula for pitch?
table feed (mm) per 360 degree gantry rotation
collimated beam width (mm) (or coverage)
What is the principle determinant of spatial resolution in CT?
Gantry rotation time
- determines how long it takes to acquire the attenuation data used to reconstruct a single axial slice
What do scintillation crystals in photodetectors convert?
X-ray photons to light photons
What is the size, in the z-dimension, of the voxels in the resultant reconstructed data set?
- Prospectively ECG-triggered, 256-slice scaner
- Detector collimation of 256 x 0.625 mm
- FOV = 250 mm
- Gantry rotation time = 270 ms
- Image matrix = 512 x 512
0.625 mm
- In prospective, axial scanning, the minimum voxel size in the z-axis dimension –>
- determined by minimum slice thickness –>
- determined by detector collimation –> 256 x 0.625 mm
What are negative aspects of utilizing high resolution setting on CT scanners?
Higher heat load to the X-ray tube
- may result in maximum heat capacity of the anode –>
- and limit the available peak tube voltage and tube current
- which may be needed in scanning obese patients
- may limit scan duration