CT

Seeram Chapter
11:
Image Quality
 Spatial Contrast
Resolution Resolution

Image
Noise Artifacts
 Beam Subject
Characteristics Transmissivity

Slice
Dose
Thickness

Scatter

Reconstruction Display
Algorithm Resolution
Spatial Resolution
Quantifies image blurring
Ability to discriminate objects of varying
density a small distance apart against a
uniform background
Minimum separation required between two
high contrast objects for them to be
resolved as two objects
Spatial Resolution
Resolvable Object Size &
Limiting Resolution
Smallest resolvable high contrast object
Often expressed as line pairs / cm
Pair is one object + one space

One
Pair
Resolvable Object Size:
Limiting Resolution
Smallest resolvable high contrast object is
half the reciprocal of spatial frequency
Example:
Limited resolution = 15 line pairs per cm
Pair is 1/15th cm
1/15th cm
Object is half of pair
1/15th / 2

1/30th cm

.033 cm

0.33 mm

1/30th cm
Geometric Factors affecting
Spatial Resolution
Focal spot size
detector aperture width
slice thickness or
collimation
Less variation likely for
thinner slices
attenuation variations
within a voxel are
averaged
partial volume effect
Geometric Factors affecting
Spatial Resolution
focal spot - isocenter
Finite focal focal spot -
distance spot size detector
distance
Geometric Unsharpness
& CT
Decreased spatial Focal Spot
resolution if object
blurred over
several detectors Small
Object to be
Detector aperture Imaged
size
Detectors
must be < object
for object to be
resolved
Non-geometric Factors
affecting Spatial Resolution
# of projections
Display matrix size
512 X 512 pixels standard
Reconstruction algorithms
smoothing or enhancing of edges
Reconstruction Algorithm &
Spatial Resolution
Back projecting blurs image
Algorithms may be
anatomically specific
Special algorithms
edge enhancement
noise reduction
smoothing
soft tissue or bone emphasis
Hi-Resolution CT
Technique
Very small slice thicknesses
1-2 mm
High spatial frequency algorithms
increases resolution
increases noise
Noise can be offset by using higher doses

Optimized window / level settings

Small field of view (FOV)
Known as targeting
Contrast Resolution
Ability of an imaging system to
demonstrate small changes in tissue
contrast
The difference in contrast necessary to
resolve 2 large areas in image as separate
structures
CT Contrast Resolution
Significantly better than radiography
CT can demonstrate very small differences in
density and atomic #
Thisll be on your test.
I guarantee it.

Radiography CT
10% <1%
CT Contrast Resolution
Depends Upon
reconstruction algorithm
low spatial frequency algorithm smooths
image
Loss of spatial resolution
Reduces noise

enhances perceptibility of low contrast

lesions
image display
CT Contrast Resolution Depends
on Noise
CT Contrast Resolution

Contrast depends on noise

Noise depends on # photons detected

# photons detected depends on

# of Photons Detected
Depends
Upon
photon flux (x-ray technique)
slice thickness
patient size
Detector efficiency
Note:
Good contrast resolution requires that
detector sensitivity be capable of
discriminating small differences in intensity
Small Contrast Difference Harder
to Identify in Presence of Noise
CT Image Noise
Fluctuation of CT
#s in an image of
uniform material
(water)
Usually described
as standard
deviation of pixel
values
CT Image Noise
Standard deviation of pixel values

(xi - xmean)2
Noise () = -------------------
(n-1)
Xi = individual pixel value
Xmean = average of all pixel values in ROI
n =total # pixels in ROI
Noise Level

Units
CT numbers (HUs)
or
% contrast
Noise Measurement in CT

Scan water phantom

Select regions of interest
(ROI)
Take mean & standard
deviation in each region
Standard deviation
measures noise in ROI
CT Noise Levels Depend
Upon
# detected photons matrix size (pixel size)
quantum noise
slice thickness
algorithm
electronic noise
scattered radiation
object size
Photon flux to
detectors
Photon Flux to Detectors
Tube output flux (intensity) depends upon
kVp
mAs
beam filtration
Flux is combination of beam quality &
quantity
Flux to detectors modified by patient
Larger patient = less photons to detector
 Slice Thickness
Thinner slices mean
less scatter
better contrast
less active detector
area
less photons detected
More noise

To achieve equivalent
noise with thinner
slices, dose (technique
factors) must be
increased
Noise Levels in CT:
Increasing slice width = less noise
BUT
Increasing slice width degrades spatial
resolution
less uniformity inside a larger pixel
partial volume effect
 2() = kT/(td3R)

Where
is variance resulting from noise
k is a conversion factor (constant)
T is transmissivity (inverse of attenuation)
t is slice thickness
d is pixel size
R is dose
Noise Levels in CT:
When dose increases, noise decreases
dose increases # detected photons
Doubling spatial resolution (2X lp/mm)
requires an 8X increase in dose for
equivalent noise
Smaller voxels mean less radiation per voxel
 2() = kT/(td3R)
To hold noise constant

If slice thickness goes down by 2

Dose must go up by 2
Measurements of Image
Quality
PSF = Point Spread Function
LSF = Line Spread Function
CTF = Contrast Transfer Function
MTF = Modulation Traffic Function
 Point Spread Function
PSF
Point object imaged as circle due to
blurring
Causes
finite focal spot size
finite detector size
finite matrix size
Finite separation between object and
detector
Ideally zero
Finite distance to focal spot
Ideally infinite
Quantifying Blurring
Object point becomes image circle
Difficult to quantify total image circle size
difficult to identify beginning & end of object

Intensity

?
Quantifying Blurring
Full Width at Half Maximum (FWHM)
width of point spread
function at half its
maximum value
Maximum value easy
to identify
Half maximum value
easy to identify
Maximum
Easy to quantify width
at half maximum
Half
Maximum

FWHM
Line Spread Function
LSF
Line object image blurred
Image width larger than object width

Intensity

?
Contrast Response Function
CTF or CRF
Measures contrast response of imaging
system as function of spatial frequency

Lower Higher
Frequency Frequency

Loss of contrast between light and dark areas as bars &

spaces get narrower. Bars & spaces blur into one another.
Contrast Response Function
CTF or CRF
Blurring causes loss of contrast
darks get lighter
lights get darker

Lower Higher
Frequency Frequency

Higher Lower
Contrast Contrast
 CT Phantoms
Available from Measure
CT manufacturer
noise
private phantom
manufacturers spatial resolution
American Association contrast resolution
of Physicists in
Medicine
slice thickness
AAPM dose
CT Spatial vs. Contrast
Resolution
Spatial & contrast resolution interact
High contrast objects are easier to resolve
Omprove one at the expense of the other
Can only improve both by increasing dose

Increasing
object size

Increasing contrast
 Contrast & Detail
Larger objects easy to see even at low
contrast

Increasing
object size

Increasing contrast
 Contrast & Detail
Small objects only visible at high contrast

Increasing
object size

Increasing contrast
 Contrast Detail
Contrast vs. object diameter
Relationship
less contrast means object must be larger to resolve

Visibility
Increasing
object size
Difference
in CT #

Object Diameter Increasing contrast

 Modulation Transfer
Function
Fraction of contrast reproduced as a function
MTF
of frequency

Freq. =
line pairs / cm
1

MTF
50%
Recorded
Contrast provided Contrast
0 to film (reduced by blur)
frequency
MTF
Can be derived from
point spread function
line spread function
MTF = 1 means
all contrast reproduced at this frequency
MTF = 0 means
no contrast reproduced at this frequency
MTF
If MTF = 1
all contrast reproduced at this frequency

Contrast provided Recorded

to film Contrast
MTF
If MTF = 0.5
half of contrast reproduced at this
frequency

Contrast provided Recorded

to film Contrast
MTF
If MTF = 0
no contrast reproduced at this frequency

Contrast provided Recorded

to film Contrast
CT Number
Calculated from reconstructed pixel
attenuation coefficient

t - W)
CT # = 1000 X ------------
W

Where:
ut = linear attenuation coefficient for tissue in pixel
uW = linear attenuation coefficient for water
 Linearity
Linear relationship of CT #s to
object linear attenuation coefficients
Checked with phantom of several
known materials
average CT # of each material
obtained from ROI analysis
Compare CT #s with known
coefficients 77 -100
325
50 -44
Cross-Field Uniformity
Use uniform phantom (water)
CT pixel values should be uniform
anyplace in image
Take 5 ROI
1 center ROI
4 corners ROIs
Compare standard deviation between
ROIs
CT Artifacts
Distortion
Areas where image not
faithful to subject
Sources
patient
image process
equipment
CT Artifacts
Distortion
Phantoms with evenly distributed objects
Preview!
CT Artifacts: Causes
motion
metal & high-contrast
sharp edges
beam hardening
partial volume averaging
sampling
detectors
Motion Artifacts
Causes streaks in image
Algorithms have trouble coping because of
inconsistent data
Artifacts:
Abrupt High Contrast
Examples:
Changes
prostheses
dental fillings
surgical clips
Electrodes
bone
Metal absorbs all
radiation in ray
causes star-shaped artifact
Can be reduced by
software
CT Artifacts:
Beam Hardening
Increase in mean energy of polychromatic
beam as it passes through patient
Can cause broad dark bands or streaks
cupping artifact
Reduced by beam hardening correction
algorithms
CT Artifacts:
Partial Volume Effect
CT #s based on linear attenuation coefficient for
tissue voxels
If voxel non-uniform (contains several materials),
detection process will average
Partial Volume Effect
Can appear as
incorrect densities
streaks
bands
Minimizing
Use thinner slices
Image Artifacts:
Ring Artifact in 3rd
Causes
Generation
1 or more bad detectors
small offset or gain difference
of 1 detector compared to
neighbors
detector calibration required
Reason: rays measured by a
given detector are all tangent
to same circle
Quality Control in CT
Performance tested at prescribed intervals

Image Quality Tests

spatial resolution kVp waveform

contrast average & standard
resolution deviation of water
noise phantom CT #
slice width scatter & leakage