Oral Radiology - CT Basics

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Questions and Answers

What is a disadvantage of fourth-generation CT scanners?

  • They are unable to detect scatter radiation.
  • They require a lower acceptance angle for radiation.
  • They produce lower quality images.
  • Only 1/4th of detectors are in use at a single time. (correct)

How do incremental scanners acquire images?

  • Using a stationary detector that moves during exposure.
  • By keeping the patient stationary while the CT rotates.
  • By continuously rotating the x-ray tube around the patient.
  • With a stepping motion of the patient table for slice positioning. (correct)

What technological advancement eliminated the need for wired connections in helical CT imaging?

  • Magnetic resonance coupling.
  • Slip-ring technology. (correct)
  • Infrared wireless communication.
  • Digital signal processing.

What primary issue did Single-Slice CT (SSCT) encounter?

<p>Excess stress on the x-ray tube due to heating. (C)</p> Signup and view all the answers

What does the 'z-axis' in Multi-Slice CT indicate?

<p>The slice thickness direction. (B)</p> Signup and view all the answers

What is the significant feature of Multi-Detector CT (MDCT) scanners?

<p>They typically utilize an array of 64 to 128 detector rows. (A)</p> Signup and view all the answers

What advantage does MSCT provide over SSCT?

<p>Increased z-axis coverage to minimize rotations. (B)</p> Signup and view all the answers

How does the design of the fourth-generation CT scanner differ from third-generation scanners?

<p>It has a circular array of fixed detectors. (B)</p> Signup and view all the answers

What is one major limitation of plain radiography compared to cross-sectional imaging?

<p>Plain radiography cannot demonstrate soft tissue. (D)</p> Signup and view all the answers

What does CT technology primarily utilize to create images?

<p>X-rays and computer processing. (D)</p> Signup and view all the answers

What distinguishes Multislice CT from conventional CT?

<p>It can acquire multiple sections simultaneously. (A)</p> Signup and view all the answers

Which component of a CT scanner is responsible for controlling data acquisition?

<p>Computer. (B)</p> Signup and view all the answers

What is a primary disadvantage of first-generation CT scanners?

<p>It requires a linear movement of the x-ray tube. (C)</p> Signup and view all the answers

What scanning method is utilized in fifth-generation CT scanners?

<p>Steering of electrons magnetically. (B)</p> Signup and view all the answers

What advancement in CT imaging technology allows for higher spatial resolution?

<p>Micro-CT. (D)</p> Signup and view all the answers

What is the primary purpose of collimating the beam before it enters the patient?

<p>To minimize patient exposure (C)</p> Signup and view all the answers

What improvement did third-generation CT scanners provide over the second generation?

<p>Higher number of detectors and larger fan beam. (D)</p> Signup and view all the answers

In a CT scanner, what purpose does the gantry serve?

<p>To house the X-ray tube and detectors. (B)</p> Signup and view all the answers

Which generation of CT scanners was specifically designed for cardiac scanning?

<p>Fifth generation. (A)</p> Signup and view all the answers

Which of the following detectors is known to produce light when exposed to ionizing radiation?

<p>Scintillation Crystals (A)</p> Signup and view all the answers

What is the primary function of the rotation in a CT scanner?

<p>To scan one section at a time. (D)</p> Signup and view all the answers

Which of the following is NOT a feature of MDCT technology?

<p>It is capable of producing exclusively 2D images. (C)</p> Signup and view all the answers

What is a characteristic of Xenon Gas Ionization Chambers?

<p>They cannot be used in rotate-rotate scanners (B)</p> Signup and view all the answers

What main technological feature do second-generation CT scanners utilize for image acquisition?

<p>Narrow fan beam with multiple detectors. (A)</p> Signup and view all the answers

What was a limitation of the fifth-generation CT scanners?

<p>They operate at low x-ray flux. (C)</p> Signup and view all the answers

Which generation of CT scanners used a pencil beam to acquire images?

<p>First Generation (D)</p> Signup and view all the answers

What was one reason why the First Generation of CT scanners became obsolete?

<p>They were too slow, taking about 5 minutes (A)</p> Signup and view all the answers

Which of the following statements correctly describes the imaging process in first-generation CT scanners?

<p>The x-ray beam is collimated at the source. (C)</p> Signup and view all the answers

How did the introduction of larger arrays of detectors in third-generation CT scanners benefit imaging?

<p>It improved resolution and decreased scatter radiation. (A)</p> Signup and view all the answers

Which detector type has largely replaced previous scintillation designs due to lower afterglow?

<p>Silicon Photodiodes (D)</p> Signup and view all the answers

What scanning movement did the Third Generation of CT scanners implement?

<p>Rotation-Rotation (C)</p> Signup and view all the answers

What is a notable feature of the Fourth Generation CT scanners?

<p>Entire detector ring for remnant radiation (A)</p> Signup and view all the answers

What is a primary advantage of using Third Generation Multidetector Helical CT compared to single-slice scanners?

<p>Less motion artifact (D)</p> Signup and view all the answers

Which of the following components is housed in the circular gantry of a CT scanner?

<p>X-ray tube-head and detectors (D)</p> Signup and view all the answers

What effect does smaller pixel size have on image quality in CT scans?

<p>Improves image resolution (D)</p> Signup and view all the answers

Which statement accurately describes a voxel in computed tomography?

<p>The depth or volume of pixels (A)</p> Signup and view all the answers

What is a disadvantage of Third Generation Multidetector Helical CT scanners?

<p>Higher radiation exposure (D)</p> Signup and view all the answers

How is the attenuation profile produced during a CT scan?

<p>From the interaction of X-rays with tissue (B)</p> Signup and view all the answers

In CT imaging, what does a Hounsfield unit represent?

<p>The level of absorption in tissue (B)</p> Signup and view all the answers

What feature helps to reduce motion artifacts in CT scans?

<p>Quicker scan times (B)</p> Signup and view all the answers

What causes ring artifacts in CT imaging?

<p>Miscalibration of detector elements (B)</p> Signup and view all the answers

Which type of artifact occurs due to a voxel representing tissues of differing densities?

<p>Partial Volume Artifact (D)</p> Signup and view all the answers

How does Dual Energy CT (DECT) enhance imaging of blood vessels?

<p>By selectively increasing the effects of iodine (C)</p> Signup and view all the answers

What advantage does Dual Energy CT provide for patients with kidney stones?

<p>It helps detect the type of stone present (B)</p> Signup and view all the answers

What benefit does metal artifact reduction software (MARS) provide in Dual Energy CT scans?

<p>It significantly improves image quality near metal objects (D)</p> Signup and view all the answers

Flashcards

Fourth-generation CT scanner

A CT scanner where the x-ray tube rotates around the patient, and a fixed circular array detects the remnant beam.

Detector drift

A problem in CT scanners where detectors gradually shift in their position or sensitivity, leading to ring-like artifacts in the images.

Ring artifact

An image artifact appearing as a ring-like structure in CT scans due to detector drift or other issues.

Incremental scanner

A CT scanner that acquires images by sequentially scanning thin slices (using the "step and shoot" method).

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Helical (Spiral) CT

A CT imaging technique where the patient moves continuously through the gantry while the x-ray source moves around the patient in a circle.

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Slip-ring technology

A technique that eliminates the need for directed wired connections to the x-ray tube and detector on moving parts of CT equipment.

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Single-slice helical CT (SSCT)

A helical CT scanner using a single-row detector array.

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Multislice CT (MSCT)

A CT scanner that uses multiple detector rows to improve acquisition speed and reduce strain on the X-ray tube.

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Multi-detector CT (MDCT)

Another name for Multislice CT, indicating Multiple detector rows are used to create images.

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Collimated fan beam

A focused x-ray beam used in CT scanning, shaped like a fan.

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Collimation

The process of limiting or shaping the x-ray beam to a specific area.

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Scattered photons

X-ray photons that change direction after interacting with the patient.

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Detector

Device that receives the radiation and converts it into an electrical signal.

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Scintillation Detector

A solid-state detector that produces light when exposed to ionizing radiation. Converts the light into an electrical signal.

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Ionization Detector

Gas-based detector that detects radiation by measuring the ions it creates.

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First-Generation CT Scanner

Earliest CT scanner type, used translation-rotation geometry, slow image acquisition.

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Second-Generation CT Scanner

Improved speed over first generation with multiple detectors.

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Third-Generation CT Scanner

Faster method using rotate-rotate geometry for complete anatomical coverage

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Fourth-Generation CT Scanner

Uses a complete ring of detectors, further improving image speed.

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Plain Radiography

A two-dimensional (2D) imaging technique used to view a three-dimensional (3D) object. Images made with this process can have overlapping structures, and only hard tissues are seen well.

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Cross-Sectional Imaging (CT)

A method of imaging that produces a detailed visual representation of a body slice, allowing visibility of soft tissues.

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Tomography

A technique producing images showing only a specific slice of a patient. This helps overcome overlapping structures in imaging.

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Computed Tomography (CT)

Uses X-rays and a computer to create 3D images from 2D slices to give detailed view of internal structures. It builds on tomography.

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CT Scanner Components

A CT scanner has key components; computer, gantry, table, and operator's console, enabling data acquisition, image reconstruction, storage, and display.

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Gantry (CT)

The circular structure of a CT scanner that houses the X-ray tube, detectors, and other crucial components for image acquisition.

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X-ray Tube (CT)

Part of the CT scanner that produces X-rays. High-powered for quick scanning.

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Multislice CT

A type of CT that can acquire multiple slices simultaneously, enhancing image acquisition speed.

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Dual-energy CT

A type of CT that uses two different X-ray energies (energies in X-ray) to provide more detailed information on various tissues.

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Spectral CT

A type of CT using multiple energy levels of X-rays to better differentiate tissues, like different compositions of bone.

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1st Gen CT Scanners

Early CT scanners that used a pencil beam and required linear translation and rotation of the X-ray tube and detectors to acquire each slice of the body.

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2nd Gen CT Scanners

CT scanners improving on 1st generation by using a narrow fan beam and a linear array of detectors. This allowed for faster scans than first-generation but still required translation/rotation.

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3rd Gen CT Scanners

CT scanners that use a fan beam and a rotating assembly of the X-ray tube and detectors around the patient for a faster and more efficient acquisition of slices.

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4th Gen CT Scanners

CT scanners with the x-ray tube and stationary detectors. Improves efficiency for some uses.

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5th Gen CT Scanners

CT scanners that use fast cardiac scanning by magnetically steering the x-ray tube (scanning x-ray tube) rather than physically moving it. Allows for quick acquisitions, but limited coverage

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Fan Beam

A wider beam of X-rays used in CT scanners compared to a pencil beam, allowing for faster image acquisition.

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Cardiac CT

A CT scan specialized for imaging the heart and its structures.

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Multidetector Helical CT

A CT scanning technique with multiple detector rows, allowing for faster scans and reduced motion artifacts.

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Detector Array

A group of detectors in the CT scanner that measure X-ray absorption.

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Scan Time

The time it takes to acquire a CT scan.

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Motion Artifact

Distortion in a CT image caused by patient movement during the scan.

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Gantry

The circular structure of a CT scanner that holds the X-ray tube and detectors.

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Matrix

An array of numbers representing the image data in a CT scan.

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Pixel

A single square or picture element within the matrix.

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Voxel

The volume of tissue represented by a single pixel.

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CT Number (Hounsfield Unit)

A numerical value assigned to each voxel representing its X-ray absorption.

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Image Resolution

Clarity and detail of the image.

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Ring Artifacts (CT)

Optical artifacts in CT scans appearing as rings, caused by problems with detector elements, insufficient radiation, or contrast contamination.

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Partial Volume Artifact (CT)

An image artifact in CT scans when a voxel (pixel) represents tissues of different densities, resulting in an inaccurate intermediate value.

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Beam-Hardening Artifact

Dark streaks in CT images between very dense structures (e.g., bone, implants), caused by differences in x-ray absorption.

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Dual Energy CT (DECT)

A CT scanning technique using two X-ray beams with different energies, offering enhanced image detail and substance identification.

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DECT and Contrast Agents

DECT can highlight specific substances in the body (like iodine in X-ray contrast agents), improving the clarity of blood vessels or other areas.

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DECT and Single Examination

DECT allows obtaining images with and without contrast agents in a single scan, avoiding the need for separate procedures.

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DECT and Stone Analysis

DECT can help identify the type of kidney stones, aiding in deciding the right treatment.

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Metal Artifact Reduction (MARS)

Software in DECT that reduces image distortion from metal objects in the scanned area, providing clearer images.

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Study Notes

Oral Radiology - Computed Tomography (CT)

  • CT scanners use X-rays to produce 3D images.
  • Unlike plain radiography, CT overcomes the superimposition problem in conventional radiography.
  • CT employs tomography and computer processing to generate 3D images from 2D images.
  • CT uses very sensitive crystal or gas detectors instead of radiographic film.
  • The X-ray tube rotates around the patient, scanning one section at a time.
  • Key components of a CT system include the computer, gantry, table, and operator's console.
  • The computer controls data acquisition, reconstructs images, stores image data, and displays images.
  • The gantry is a circular device housing the data acquisition system (DAS) which includes: the X-ray tube, detectors, filters, collimators, and ADC.
  • MDCT (multi-detector CT) scanners operate at high tube voltage and tube current using x-ray tubes with rotating anodes.
  • They operate in ranges, 80 to 140 kVp and 200-800 mA.
  • X-ray beam is collimated to a thin fan beam prior to entering the patient to minimize patient exposure and scattered radiation.
  • Detectors function as image receptors for remnant radiation converting the measurement into an electrical signal proportional to radiation intensity.
  • Two main detector types: Scintillation (solid state) and lonization (xenon gas).
  • Ceramic scintillators produce light when exposed to ionizing radiation, while Xenon gas ionization chambers are less efficient and unsuitable for rotate-rotate scanners.
  • The table is an automated device linked to the computer and gantry.
  • It moves in increments based on the technologist's scan program.
  • CT scanners have evolved through different generations characterized by differences in beam configuration (pencil beam, small fan beam, large fan beam, large fan beam), detectors (one, multiple), and scanning methodologies (translation-rotation, rotation-rotation, rotate-stationary).
  • First generation CT scanners utilized a pencil beam and a single detector.
  • Second generation used a small fan beam and multiple detectors.
  • Third generation incorporated a large fan beam and multiple detectors.
  • Fourth generation used an array of detectors fixed in a ring around the patient.

CT System Advantages

  • Detailed imaging of hard and soft tissues.
  • Excellent differentiation between normal and diseased.
  • Ability to perform thin slice imaging.
  • Less exposure time and less motion artifact.
  • Highly improved image quality compared to conventional tomography.
  • Improved speed due to helical or spiral scanning.
  • The ability to obtain both axial, coronal and sagittal cuts, as well as 3D images/reconstructions.

Types of CT Scanners

  • Helical or Spiral CT Scanners: The patient is moved continuously through the gantry while the X-ray source moves continuously around the patient in a circle.
  • Multislice (Multi-Detector) CT Scanners: These have multiple rows of detectors, resulting in significantly faster scanning time, enabling better images/reconstructions. Increased speed enables scanning to be performed without needing the patient to hold their breath for extended periods.

CT Scan Disadvantages

  • High patient dose than single-slice scanners
  • Equipment is expensive.
  • Facilities are not widely available.
  • Risks related to IV contrast agents.
  • Metallic objects can produce streaking/star artifacts.
  • Ring artifacts can be caused by miscalibration or failure of detector elements, or insufficient dose.
  • Partial volume artifacts result when a single voxel represents tissues of differing densities.
  • Beam hardening artifacts appear as dark streaks between two structures, such as compact bone, dental implants, and dental restorations.

Dual Energy CT

  • Dual Energy CT (DECT) uses both normal X-rays (standard) and a less powerful x-rays (secondary beam).
  • DECT provides various additional advantages such as detecting subtle differences in structures, allowing for better images/reconstructions of blood vessels and assisting diagnoses of medical conditions like kidney stones.

Image Processing

  • Matrix: An array of numbers arranged in rows and columns.
  • Pixel: A single square or picture element within the matrix (defines the resolution of the image).
  • Voxel: The volume (depth/thickness of a pixel) represented on the image.

CT Numbers

  • Each voxel is assigned Hounsfield Units (HU) between -1000 and +1000.
  • This assignment is based on tissue absorption and forms the image's gray scale.
  • Air has a value of -1000 (blackest areas on the image/contrast).
  • Water has a value of 0.
  • Bone has a value of +1000 (whitest areas on the image/contrast).

Image Manipulation

  • In image manipulation, the Window level (WL) and Window Width (WW) are adjusted to highlight specific types of tissues or to accentuate subtle differences.
  • These modifications allow radiologists to see and differentiate various tissue types and structures.

Indications of CT

  • Intracranial disease
  • Bony fractures
  • Developmental anomalies
  • Sinuses
  • Oroantral fistula
  • Cysts (e.g., follicular cyst maxilla)
  • Benign tumours
  • Malignant tumours
  • Infection (sequestrum)
  • Salivary gland lesions.

Preoperative Assessment of Bone

  • CT is used in preoperative assessments to determine the height and thickness of the alveolar bone to guide implant placement.

CT Guided Biopsy

  • CT is employed in guiding biopsies through imaging techniques.
  • This approach facilitates accurate sample acquisition and improved diagnosis accuracy.

Advantages

  • Superior resolution
  • Detail in hard and soft tissue
  • The speed due to helical/spiral scanning means the image reconstruction can be performed much faster.

Disadvantages

  • More expensive
  • High dose radiation
  • Risks associated with IV contrast agents

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