Image Quality in CT (part 2) Flashcards

1
Q

What are the four components of CT image quality?

A

Noise
(Low) contrast resolution
High contrast (spatial) resolution
Temporal resolution

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2
Q

What is a water phantom?

A

An Acrylic cylinder with Uniform density that has an Attenuation equivalent to that of water

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3
Q

What is the HU of water?

A

0

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4
Q

T/F

If an image is created of an object that is known to be of uniform density (water phantom), then all measured points within that image should in theory be the same.

A

True

(however in reality it isn’t)

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5
Q

What two measurements appear when a Region of Interest (ROI) tool or cursor is placed over the image?

A

A mean HU measurement and standard deviation (SD) measurement is obtained.

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6
Q

T/F

The larger the SD, the higher the image noise.

A

True

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7
Q

What does the SD (standard deviation) in an image indicate?

A

The SD indicates the magnitude of random fluctuations in the CT number

These random fluctuations in the CT number of otherwise uniform materials appear as graininess on CT images.

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8
Q

Even if we image a perfectly uniform object (e.g., a water filled object) there is still a variation in the Hounsfield units about a mean. Why is this?

A

This is due to noise

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9
Q

T/F

Noise degrades the image by degrading high contrast resolution

A

False; Noise degrades the image by degrading low contrast resolution

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10
Q

What are the 3 sources of noise in CT?

A
  1. Quantum noise
  2. Electronic noise
  3. Noise introduced by the reconstruction process (e.g., filtered back projection)
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11
Q

What is the biggest enemy of low contrast resolution?

A

Noise

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12
Q

The number of photons detected will vary randomly about a mean value. What is the variation called?

A

Noise

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13
Q

Photon registration by the detectors is what type of process?

A

Photon registration by the detectors is a stochastic process.

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14
Q

What 5 technical factors (scan parameters) affects the number of photons detected?

A
  1. mA
  2. Scan (rotation time)
  3. Slice thickness
  4. Peak kVp
  5. Reconstruction algorithm
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15
Q

Describe how changes in mA can affect the noise:

A

Changing the mA value changes the beam intensity and thus, the number of x-rays — proportionally.

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16
Q

T/F

Scan (rotation) time affects the number of detected x rays proportionally

A

True

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17
Q

T/F

An increase in mA decreases the noise

A

True

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18
Q

T/F

A decreased scan time increases the signal to noise ratio (decreasing the noise)

A

True

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19
Q

T/F

As slice thickness increases, so does the noise.

A

False; as slice thickness increases, the noise decreases

For example, compared with a slice thickness of 5 mm, a thickness of 10 mm approximately doubles the number of x-rays entering each detector.

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20
Q

T/F

kVp is directly proportional to noise

A

False

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21
Q

T/F

Increasing the kilovoltage reduces image noise

A

True

(but reduces subject contrast)

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22
Q

T/F

The Reconstruction Algorithm direclty affects the number of x-rays hitting the dector, thus reducing noise.

A

False; Reconstruction Algorithm does not affect the numbers of detected x-rays. A reconstruction filter profoundly affects the appearance of noise in the image.

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23
Q

What is the purpose of the smoothing filter?

A

To soften noise

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24
Q

What is the purpose of the sharpening filter?

A

To increase noise

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25
Q

What is preffered for images of soft tissue, a smoothing or sharpening filter?

A

Smooth filter

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26
Q

What is preffered for images of structures with edges and small details, such as bone; a smooth or a sharp filter?

A

Sharp filter

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27
Q

T/F

As noise increases Low Contrast Detectability decreases

A

True

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28
Q

What is low contrast resoltion?

A

How well low-contrast test objects are seen in the presence of typical noise levels

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29
Q

What 8 factors affect low contrast resolutioin?

A
  1. mAs
  2. kVp
  3. Slice thickness
  4. Reconstruction algorithm
  5. Pixel size
  6. Patient size
  7. Inherent tissue properties
  8. Use of contrast media
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30
Q

T/F

Dose does not increase linearly with mAs

A

False; Dose increases linearly with mAs

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31
Q

As mAs increases, what happens to low contrast resolution?

A

It increases

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32
Q

As kV increases, what happens to low contrast resolution?

A

It decreases

Although the use of a higher tube voltage (kV) results in improved x-ray photon statistics (↑SNR), the quality of the x-ray beam is somewhat compromised because the visibility of low-contrast objects depends on the presence of low-energy photons, which are disproportionally less for the higher tube voltage

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33
Q

What is the downside of increasig Slice Thickness?

A

It decreases spatial resolution in the z axis

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34
Q

T/F

Slice thickness has a linear effect on the number of x-ray photons available to produce the image

A

True

5mm slice will have twice the number of photons as a 2.5mm slice.

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35
Q

Although slice thickness can increase SNR, what factor can get in the way and decrease the visiblity of smaller objects?

A

Volume averaging can reduce the visibility of smaller objects.

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36
Q

What produces better low contrast resolution; smoothening filters or sharpening filters?

A

Smoothening filters improve low contrast resolution

(at the cost of SR)

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37
Q

T/F

As noise increases, low contrast resolution decreases

A

True

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38
Q

As Pixel Size decreases, what happens to low contrast resolution? Why?

A

-Contrast resolution decreases
-As pixel size decreases, the number of detected photons per pixel will decrease.Fewer photons per pixel results in a subsequent decrease in contrast resolution.

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39
Q

As patient size increases, what happens to low contrast resolution?

A

It decreases

-For the same technique, larger patients attenuate more x-ray photons, leaving fewer to reach the detectors.
-This reduces SNR, increases noise, and results in lower contrast resolution.

40
Q

How do inherent tissue properties affect low contrast resolution?

A

The difference in the linear attenuation coefficient of adjacent imaged objects will determine the contrast between those objects

41
Q

What is this describing?

The scanner’s ability to resolve closely placed objects that are significantly different from their background.

A

Spatial resolution of a CT scanner

42
Q

In what two dimensions can the spatial resolution of a CT image be described?

A
  1. in-plane (transaxial) resolution.
  2. cross-plane (longitudinal) resolution or z axis sensitivity
43
Q

What is cross-plane (longitudinal) resolution or z axis sensitivity?

A

Resolution in the z direction

44
Q

What is in-plane (transaxial) resolution?

A

Resolution in the x-y direction

45
Q

What are the 7 factors that affect the In-Plane Resolution?

A
  1. Focal Spot Size
  2. Detector Size
  3. Scanner Geometry
  4. Field of View
  5. Sampling Theorem
  6. Reconstruction Algorithm
  7. Patient Motion
46
Q

T/F

Smaller focal spots give higher resolution

47
Q

What are the sizes of the focal spots in CT?

A

Fine = 0.7 mm
Broad = 1.2 mm

48
Q

What is the relationship between Detector Size (Width) and detail?

A

Detector Size (Width) Inversely related to detail

Increased detail requires decreased size or space between detector elements.

49
Q

T/F

Detector size or spacing is dependent on the model of CT scanner

50
Q

Increased detail requires what; an increased tube arc or a decreased tube arc?

A

increased tube arc

51
Q

T/F

By taking two matching (mirror) samples taken 180° apart, the image is ussually improved.

52
Q

T/F

Partial 180° scans are inferior to standard 360° scans. Why or why not?

A

True; Only half of the otherwise available data are available to reconstruct the image with partial scans

53
Q

What is one benefit of partial 180 degree scans?

A

Decreased dose

54
Q

What is an overscan?

A

400° tube arc scan

55
Q

What makes up the 400° scan?

A

360° (full scan) + 40° (overscan) = 400° scan.

56
Q

T/F

Changing the DFOV will NOT alter the size of the image on the screen

A

False; Changing the DFOV will alter the size of the image on the screen

57
Q

How does the image matrix divide data with DFOV?

A

The matrix divides data into squares with an x and y dimension.

58
Q

By increasing by increasing the DFOV, what happens to the size of each pixel in the image?

A

Increasing the DFOV, increases the size of each pixel in the image.

59
Q

T/F

The larger pixel will include more patient data

60
Q

T/F

If an object is larger than a pixel, its density will be averaged with the density of other tissues contained in the pixel, creating a more accurate representation of the object.

A

If an object is smaller than a pixel, its density will be averaged with the density of other tissues contained in the pixel, creating a less accurate representation of the object.

61
Q

T/F

Having smaller pixels decreases the volume averaging, thus increasing spatial resolution

62
Q

T/F

The Technologist directly controls DFOV but cannot change pixel size

63
Q

What does the Nyquist Sampling Theorem state?

A

The pixel dimension should be half the size of the object to increase the likelihood of that object being resolved

64
Q

T/F

Reconstruction algorithm is indirectly related to spatial resolution.

A

False; Reconstruction algorithm is directly related to spatial resolution.

65
Q

T/F

As the spatial frequency of a filter increases the detail increases.

66
Q

What does Z-sensitivity refer to?

A

Z-sensitivity refers to the effective imaged slice width.

67
Q

T/F

The wider (in the z-axis) the detector row, the lower the resolution.

68
Q

T/F

The greater the z axis, the more flattening (volume averaging) is necessary.

69
Q

What is the relationship between slice thickness and spatial resolution?

A

Inversely related to spatial resolution.

70
Q

T/F

The thicker the slice, the less volume averaging needed

A

False; The thicker the slice, the more volume averaging

71
Q

What reduces cross-plane resolution?

A

Slice Thickness

72
Q

What is the smallest slice thickness that scanners allow today?

73
Q

T/F

Two 0.5mm slices added together to display a single 1.0mm slice will retain the spatial resolution of the original 0.5mm slices

74
Q

What is an Isotropic voxel?

A

A voxel where the x, y & z axis dimensions are equal.

75
Q

What is the benefit of Isotropic voxels?

A

There is no loss of information when data are reformatted in a different plane (i.e. coronal or sagittal images).

76
Q

What anatomy benefits the most from isotropic voxels?

A

small vascular tortuous structures

77
Q

What is the disadvantage of thinner slices?

A

Increased noise

78
Q

What is Slice Sensitivity Profile (SSP)?

A

SSP describes the effective slice thickness of an image and to what extent anatomy within that slice contributes to the image.

79
Q

What pitch results in a broader SSP?

A

Pitch 2 results in a broader SSP

80
Q

T/F

Z axis spatial resolution is traditionally described by the slice sensitivity profile (SSP).

81
Q

T/F

Increasing pitch increases the effective slice thickness.

82
Q

T/F

↓ volume averaging = ↓ spatial resolution

A

False; ↑ volume averaging = ↓ spatial resolution

Increasing the pitch uses data farther from the actual slice position, thus degrading the slice sensitivity profile

83
Q

T/F

↓ Pitch = ↑ spatial resolution

84
Q

As pitch decreases, what happens to noise?

A

Noise decreases

85
Q

If all other parameters are constant, what is the realtionship between dose and pitch?

A

Dose is inversely proportional to the pitch (if all other parameters are constant).

86
Q

As pitch increases, what happens to noise?

A

Noise increases

87
Q

What is the scanners goal when imaging a patient?

A

Scanner’s goal is to maintain image quality

88
Q

When you increase the pitch, the mA is increased. Why is this?

A

To keep the effective mAs constant

Thus, the dose and image noise remain constant.

89
Q

T/F

Increasing pitch increases dose

A

False; Increasing pitch does NOT increase dose

DEPENDS IF ITS THE ONLY FACTOR CHANGED

90
Q

T/F

Dose is affected by the AEC system selection

91
Q

What is temporal resolution?

A

The temporal resolution of a system refers to how rapidly data is accquired and the ability to freeze motion of the scanned object

92
Q

What is the best way to elimate motion impact?

A

Increase the scan speed

93
Q

What is the fastest speed that third generation MDCT scanners are capable of rotating?

A

Less than 0.3 seconds per gantry rotation

94
Q

What is the half scan algorithm?

A

The projection dataset in the view range of 180 degrees plus fan angle (total 220 degrees) are used

95
Q

How is cardiac motion reduced in a CT scan?

A

ECG gated acquisition; synchronizing the data acquisition and reconstruction with an ECG signal