8/26/2012

MEDICAL IMAGING
BMEN 420 500

MW 04:10PM-05:25PM ETB 1020

INSTRUCTOR:

MARY PRESTON MCDOUGALL

5026 ETB
mpmcdougall@tamu.edu

OBLIGATORY FUNNY INTRODUCTION

Possible Syllabus:

Your Syllabus:

Office hours
Prereqs
Required text
Grading and exam dates
Email and distribution of papers

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COURSE OUTLINE
1. Signals and Systems

Signals
Systems
Fourier Transform
Sampling theory

2. Image Quality

Contrast-to-noise ratio
Signal-to-noise ration
Image resolution
Artifacts and distortion

3. Radiographic imaging
Physics, instrumentation,
image formation

4. Nuclear Medicine imaging

Physics, instrumentation,
image formation

5. Ultrasound imaging
-

Physics, instrumentation,
image formation

6. MRI
-

Physics, instrumentation,
image formation

INTRODUCTION - TERMS
Imaging MODALITY = imaging technique, method, system

Magnetic Resonance Imaging (MRI)

Ultrasound
Projection radiography (x-ray)
Computed Tomography (CT)
Nuclear Medicine (PET, SPECT)

risk free
noninvasive

Projection vs. Tomographic

Static vs. Dynamic
Functional vs. Anatomic or
Structural

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INTRODUCTION
Signal originates from
bodys physical parameters physical measurements:
Z  h ^
>   -ray intensities (CT)
Hydrogen proton density radiofrequency waves (MRI)

Four main [medical imaging] signals:

X-ray transmission
Gamma ray emission
Ultrasound echoes
Nuclear magnetic resonance induction

HISTORY OF MEDICAL IMAGING

First published medical image,
December 1895, Wrtzburg, Germany
Wilhelm Conrad Rntgen
a new kind of rays exposed film even
when optically shielded
X-ray used pre-surgically January,
1896
Nobel Prize in Physics, 1901, for
discovery and use of x-rays

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HISTORY OF MEDICAL IMAGING

1896: discovery of radioactivity. Initially used in
cancer therapy only.
1923: Father of Nuclear Medicine, George de
Hevesy, introduces ideas of using radioactive
TRACERS to study physiology
1952: the modern Anger scintillation camera was
developed by Hal Anger at UC Berkeley for nuclear
imaging.
1952: Bloch and Purcell receive Nobel Prize for
discovery of phenomenon of nuclear magnetic
resonance.

HISTORY OF MEDICAL IMAGING

1961: first use in medicine of nuclear imaging
1960s: simple A-mode and B-mode ultrasound
scanning develops from WWII sonar technology
1971: Raymond Damadian publishes paper
suggesting use of NMR in medical imaging
1972: Godfrey Hounsfield produced first true CT
scanner for cross-sectional imaging with x-rays using
image reconstruction technique of Cormack

Early CT image

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HISTORY OF MEDICAL IMAGING

1973: Paul Lauterbur published paper showing first
localized magnetic resonance images
1979: Hounsfield and Cormack share Nobel Prize in
Medicine
1991: Nobel Prize to Richard Ernst for work in
localizing NMR signal
2003: Nobel Prize to Paul Lauterbur and Peter
Mansfield for invention of MRI
Modern: PET/CT & PET/MR

MODALITIES: BASIC CHARACTERISTICS AND COMPARISON

Projection radiography uses the fact that the bodys
tissues selectively attenuate x-ray intensity

Routine diagnostic radiography

Digital radiography
Neuroradiology
Mobile x-ray systems
Angiography

Computed tomography (CT) uses the fact that the

bodys tissues selectively attenuate
x-ray intensity
Standard, single slice
Helical
Multislice

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MODALITIES: BASIC CHARACTERISTICS AND COMPARISON

Nuclear Medicine images using radioactive sources
that emit radiation from within the body =>
*** a FUNCTIONAL imaging method ***
Conventional radionuclide imaging, scintigraphy
Single-photon emission computed tomography (SPECT)
Positron emission tomography

MODALITIES: BASIC CHARACTERISTICS AND COMPARISON

Ultrasound Imaging fires high frequency sound into
the obdy and receives the echoes retruning from
structures within the body.

A-mode imaging
B-mode imaging
M-mode imaging
Doppler imaging

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MODALITIES: BASIC CHARACTERISTICS AND COMPARISON

Magnetic Resonance Imaging (MRI) uses a
combination of a high-strength magnetic field and
radio waves to image properties of the proton
nucleus of the hydrogen atom.

Standard MRI
Echo-planar imaging (EPI)
MR spectroscopic imaging
Functional MRI (fMRI)

MODALITY CHARACTERISTICS AND COMPARISON

Radiography transmission
modalities
CT scanning
Nuclear medicine emission
modality
MRI

Ultrasound

use
ionizing
radiation

use electromagnetic energy

a small portion of the
spectrum is useful for
medical imaging

uses sound waves

1-20Hz
reflection modality

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MODALITY COMPARISON
non-ionizing radiation (NIR)
wave model

ionizing radiation (IR)

particle model

naturally occurring sources <50Hz

Radiofrequency (RF)
ECG (EKG)
radiometry (1011-1016)
tumor ablation
EEG
MCG
ionizing
MRI
MEG
terahertz imaging
X-ray
EOG (electro-oculography)
CT
MOG
Microwave (MW)
PET
patch clamp
tumor ablation
thermography (IR)
cancer
electric cardiac pacing
MW imaging
radiation
magnetic cardiac pacing
MW tomography
treatment
electric cardiac defibrillation
OCT
magnetic cardiac defibrillation
optical
imaging
laser (near IR)
electron [spin/paramagnetic]
electro therapy
tumor ablation
resonance (ESR, EPR)
magnetotherapy

MODALITY CHARACTERISTICS AND COMPARISON

Graph:
Medical Imaging Systems
Macovski, 1983

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MODALITY CHARACTERISTICS AND COMPARISON - CLINICAL

X-Ray/

Chest

Abdomen

Head

widely used

needs contrast

good for bone

excellent

excellent

bleeding, trauma

excellent

poor

CT
Ultrasound no, except for
heart

Nuclear

extensive use in
heart

Merge w/ CT

PET

MR

growing cardiac
applications

minor role

standard

MODALITY CHARACTERISTICS AND COMPARISON - CLINICAL

Cardiovascular
X-Ray/

Skeletal / Muscular

Excellent, with catheter-injected strong for skeletal system

contrast

CT
Ultrasound real-time
non-invasive
cheap
but, poorer images

not used
Research in elastography

Nuclear

functional information
of perfusion

functional - bone marrow

MR

getting better
High resolution
Myocardium viability

excellent

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MODALITY CHARACTERISTICS AND COMPARISON - ECONOMICS

Ultrasound: ~ $100K $250K
CT: $400K $1.5 million (helical scanner)
MR: $350K (knee) - 4.0 million (siting)
Service: Annual costs
Hospital must keep uptime
Staff:
Scans performed by technologists
Hospital Income: Competitive issues
Significant investment and return
Radiologists look for specific patterns in medical images. It is
the job of the engineers and scientists who develop medical
imaging systems to produce images that are as accurate and
useful as possible.

SUMMARY
Modality

Projection/
Tomographic

Scintigraphy Projection
Conventional
radionuclide

Anatomic/
Functional

Static/
Dynamic

Ionizing/
Nonionizing/
Other

Resolution

Cost

Functional

Static

Ionizing

Low

Medium

SPECT

Tomographic

Functional

Static

Ionizing

Low

Medium
-high

PET

Tomographic

Functional

Static

Ionizing

Medium

Medium
-high

Projection
Radiography

Projection

Anatomic

Either

Ionizing

High

Low

CT

Tomographic

Anatomic

Either

Ionizing

High

Medium
-high

Ultrasound

Other/
Direct

Anatomic

Dynamic

Other

Low

Low

MRI

Tomographic

usually
Anatomic

Static,
becoming
dynamic

Nonionizing

High

High

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WHAT MORE IS THERE?

..if only there
existed giant
machines that could
look through human
skin

EXAMINE OUR UNIVERSE20 ORDERS OF MAGNITUDE

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20 ORDERS SMALLER

ENGINEERING AT THE NANO-SCALE.

20 orders of magnitude in
each way from our world is
incomprehensible However, we can image each
Both directions are worth
studying- one we can
directly manipulate and use.
Nano-science and
engineering (dimensions <
10-9) is one of the next great
challenges.

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MEDICAL IMAGING IN CONTEXT: EVOLVING MEDICAL PRACTICE

Visit your doctor with illness

Symptom-based
diagnosis
Symptom-based
diagnosis
(In-Vitro
Diagnostics,
Imaging)
(In-Vitro
Diagnostics,
Imaging)

Here
Try This

Treatment

Recover or revisit

MEDICAL IMAGING IN CONTEXT: EVOLVING MEDICAL PRACTICE

The Future Personalized Medicine

Pinpoint
Predict

Detect

Prevent/Treat

Imaging
Gene Assay

Protein
In Vitro
(IVD)

Molecular
Diagnostics

Track and
Verify

Targeted
Chemistry

Imaging, IVD

Molecular
Imaging

Molecular
Therapeutics

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The inner life of the cell

Tools engineers have developed are allowing us to peer

inside, and even manipulate the cell.
The complexity is unimaginable, the challenges endless.

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