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Medical Imaging
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Textbook and Materials
Rafael C. Gonzalez, Richard E. Woods,
Techniques “Digital Image Processing”, 2nd Edition,
Pearson Education, 2003
Digital Image Processing by Jayaraman,
Veerakumar, 2012
Khandpur R.S, Handbook of Biomedical
Instrumentation, 3/e, Tata McGraw
Hill,New Delhi, 2014
Dr. K. Adalarasu
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Reference
William K. Pratt, “Digital Image Processing” ,
John Willey ,2001
Steve Webb, The physics of medical imaging,
Adam Hilger, Bristol, England, Philadelphia, Radio Isotope
USA, 1988
Jain A.K., “Fundamentals of Digital Image
Imaging
Processing”, PHI, 1995.
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Radio Isotopes in Medical Diagnosis Radio Isotopes in Medical Diagnosis
Used in medicine both for therapeutic as well as Detector
diagnostic applications Amount of radioactivity can be measured within parts of
organs as well as within the whole organ
Diagnostic practice
Small amounts of radioactive chemicals, called ‘tracers’ (or Measurement of the uptake of radioactive iodine by
radio-pharmaceuticals), the thyroid gland
Injected into an arm vein or administered through ingestion or Rate of uptake of iodine by the thyroid
inhalation
Greatly increased in patients with disease characterized
Amount of radioactivity at different points within the by increased production of thyroid hormone
patient’s body, or in body fluids (hyperthyroidism)
Then examined by radiation detectors Disease that led to nervousness, tremor, weight loss
and, in extreme cases, even death
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Radio Isotopes in Medical Diagnosis Radio Isotopes in Medical Diagnosis
Decreased iodine uptake (hypothyroidism) by the Radio-nuclide imaging depends on
thyroid Obtaining a suitable distribution of the radio-nuclide in the
Had symptoms and signs of diminished thyroid function patient
Thyroid gland continues to be the organ most Radio-nuclide is labelled to a compound
frequently examined by nuclear medicine Which will be taken up or metabolized in some way by the
Imaging of organ functions is carried out non- human tissue to be studied
invasively Patient receives the material, usually by intravenous
Nuclear medical examination approach is primarily injection
function-oriented After a suitable delay, which may be minutes or hours to
Vital processes such as blood circulation, metabolism and Allow uptake in the target tissues and clearance from the
vitality of organs and tumours can be displayed as blood, imaging can commence
functional images Each taking 2–10 minutes
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function, blood flow, clearance rates, etc Emits readily detectable gamma rays with a photon
energy of 140 keV (these 8.8 pm photons are about the
same wavelength as emitted by conventional X-ray
diagnostic equipment)
Half-life for gamma emission is 6.0058 hours
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Radio Isotopes in Medical Diagnosis
TC-99m cannot be coupled with all required
biologically active substances
So that with this radio-nuclide the spectrum of radio-
pharmaceuticals for examinations of the organ metabolism Radiation Detectors
is limited
Iodine-123 labelled substances
Which are used in many clinical examinations
Iodine-123 (123I or I-123)
Half-life is 13.22 hours
Predominant energy of 159 keV (this is the gamma
primarily used for imaging)
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Radiation Detectors Radiation Detectors
Depending upon the radiation emitted by the
radio isotope of the radiopharmaceutical Ionization chamber
A suitable detector is selected and operated under Geiger Muller Counter
optimum conditions
Proportional Counter
Radiation falls on a photographic plate
Semiconductor detectors
It would cause darkening when developed after
exposure Solid state detectors
Photographic method is useful for measuring the
total exposure to radiation of workers
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Ionization Chamber Ionization Chamber
Charged particles moving through the gas undergo Current 10–10 A or less
inelastic collisions to form ion pairs Measured by using a very high input impedance
Electrodes is sufficiently high to collect all the ion voltmetre
pairs
Chamber current will then be proportional to the
amount of radioactivity in the sample
Ionization chambers are operated
Counting mode
They respond separately to each ionizing current
Integrating mode
Collection of ionization current over a relatively long period
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Ionization Chamber
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Scintillation Detector
100,000 ion pairs produced Scintillator
Single alpha particle Crystalline substance which produces minute flashes of
Traversing approximately 1 cm in air light in the visible or near ultraviolet range
Would be around 3 x10–14 coulomb When it absorbs ionizing radiation
Average charge is made to pass through a resistance Number of fluorescent photons is proportional to the
of 3 x 1010 Ω in 1s energy of the radioactive particle
Difference of approximately 1 mV potential would develop Flashes occur
across the high resistance Due to the recombination and de-excitation of ions
Voltage is a function of the rate of ionization in the Excited atoms produced along the path of the radiation
chamber Light flashes are of very short duration
Portable ionization chambers are also used to Detected by using a photo-multiplier tube
monitor personnel radiation doses
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Scintillation Detector Scintillation Detector
Which produces a pulse for each particle Scintillating material which is generally used as
Scintillation counter gamma ray detector
Scintillator along with the photo-multiplier tube A crystal of sodium iodide activated with about 0.5%
Gamma radiations cannot be detected directly in a of thallium iodide
scintillating material Counting beta particles
Because gamma rays possess no charge or mass Scintillator crystals of anthracene are employed
Gamma ray energy must be converted into kinetic Detector must be able to absorb a high proportion of
energy of electrons present in the scintillating the incident radiation
material Convert this energy rapidly into suitable electronic signals
Conversion power will be proportional to the number of Thallium-activated sodium-iodide NaI(TI)
electrons (electron density) available for interaction with the
gamma rays
scintillation crystal is used in all commercial
cameras
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Semiconductor Detectors Solid State Detectors
Advantage
Miniature form and can be utilized as in-vivo probes
Low energy (3 to 3.5 eV) required to produce an for clinical and experimental applications in medicine
electron-hole pair relative to that of a gas (30 to 35
Silicon and cadmium telluride detectors (1 mm
eV to produce one ion pair)
diameter)
Or scintillation detector (200 to 300 eV to produce one
Which can be encapsulated
photoelectron)
Used as catheter tubes for studying blood circulation and
Operate lithium-drifted silicon or germanium regional pulmonary functions
detectors at a low temperature (at the liquid
Detectors are highly sensitive to gamma rays
nitrogen boiling point of 77°K) in order to reduce
because of the high atomic number of cadmium (48)
the leakage current
and telluride (52)
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Pulse Height Analyser
Radioactivity measurements
Individual particles are detected as single electrical
impulses in the detector
Pulse Height Analyser Measurement of pulse height is thus a useful tool for
energy determination
To sort out the pulses of different amplitudes and to
count them
Electronic circuits are employed
Instrument which accomplishes this is called a ‘pulse
height analyser
Analysers are either single or multiple-channel instruments
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Pulse Height Analyser Pulse Height Analyser
Output pulses from the photo-multiplier are amplified
in a high input impedance low-noise pre-amplifier
Amplified pulses are fed into a linear amplifier of
sufficient gain to produce output pulses in the
amplitude range of 0–100 V
Pulses are then given to two discriminator circuits
Schmitt trigger circuit
Which can be set to reject any signal below a certain voltage
Required for excluding scattered radiation and
amplifier noise
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Pulse Height Analyser Pulse Height Analyser
Upper discriminator circuit Anti-coincidence circuit
Rejects all but signal 3 Output pulse when there is an impulse in only one of the
Lower discriminator circuit input channels
Rejects signal 1 only Cancels all the pulses which trigger both the Schmitt
triggers
Transmits signals 2 and 3
Only signal reaching the counter is the one lying in
Two discriminator circuits give out pulses of
the window of the pulse height analyser
constant amplitude
Window can be manually or automatically adjusted to
Pulses with amplitudes between the two triggering
cover the entire voltage range with a width of 5–10 V
levels are counted
Difference in two levels is called the window width, the
Scaler and counter
channel width or the acceptance slit Scaling unit counts down the pulses from the analyser
So that they are digitally displayed
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Uptake Monitoring Equipment Uptake Monitoring Equipment
Medical investigations depends Fraction of the chemical present in the organ at any
On obtaining a suitable distribution of the radio-nuclide in time
the patient Would indicate the functional status or what is called
Achieved by administering a suitable chemical the uptake of the organ
substance tagged with a radio-nuclide Gamma energy range for uptake monitoring studies
Emitting gamma radiations is from 100 keV to 500 keV
Gamma ray gets transmitted through the body NaI (TI) scintillation crystal for detection of gamma
tissues rays
An external monitoring system can be used to detect Photo-multiplier which converts the scintillations into an
them electrical signal
Provide the measurement of the chemical substance
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Uptake Monitoring Equipment Uptake Monitoring Equipment
Output from the photo-multiplier is given to a
Pre-amplifier followed
By a pulse shaping circuit
A pulse height analyser
Output of the analyser drives a counter/timer
Which displays the information on a digital counter and a
strip chart recorder
Vital component in the system is the collimator
Simple collimator
Consists of a single tapered hole in a cylindrical lead block
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Radio-isotope Rectilinear Scanner Radio-isotope Rectilinear Scanner
Distribution of radioactive material within an organ or Scanner is a moving detector imaging system
part of the body is studied by using radio-isotope Heart of the system is the detector-collimator
rectilinear scanners assembly
Rectilinear scanner is a device for imaging the Detector
distribution of radioactive material within the body Three or five inch diameter NaI crystal
Situated behind a focusing collimator
Travel in a regular scanning pattern back and forth
across the area of interest
Detected and amplified signals can be plotted to
give a picture or contour map of radioactivity within
the organ
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Radio-isotope Rectilinear Scanner Radio-isotope Rectilinear Scanner
Detector-collimator assembly
Photo-multiplier
Pre-amplifier are housed in a single unit
Which is attached to a motor-driven device
Single probe scanner makes use of one detector
that scans the area of interest
Dual probe scanners that have two synchronously
moving
Axially opposite detectors with the patient between
the two detectors
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Radio-isotope Rectilinear Scanner Radio-isotope Rectilinear Scanner
Scanning can be linear or one-dimensional Photographic recorder
In the whole body counting applications Light flashes can be photographed on a film
Detector is moved continuously over the body and the Face of a cathode ray tube
counts are integrated over the entire scan
Dot recorder is most commonly used
Recording may be done either by
Photographic recorder or by dot recorders
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Radio-isotope Rectilinear Scanner Radio-isotope Rectilinear Scanner
It produces a map of the distribution of activity within
Scaling factor of 16
the area of interest by recording dots or slit-like
marks on paper Every 16 counts arriving at the input of the
scaling circuit from the pulse height analyser
Dot recording mechanism consists of an electrically
heated stylus to burn a small spot on a sheet of One dot appears on the paper
electrically conducting paper Reduction in counting rate is necessary
Each time a pulse passes through the stylus Because extremely high counting rates will drive
Pulses to the stylus are delivered from the pulse the stylus wild
height analyser Count-rate metre
After scaling down the counts by an adjustable scaling
factor from 1 to 256 Display or record the average count rate
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Radio-isotope Rectilinear Scanner
Some scanners make use of colour printing
Maximum count rate is first established
Divided into six ranges
Each being associated with a different colour print Gamma Camera
Coloured map showing the distribution of the
isotope is built up
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Gamma Camera Gamma Camera
Used to produce images of the radiation generated
by radio-pharmaceuticals within a patient’s body in Gamma camera was developed by Anger
order (1958)
To examine organ anatomy and function, and to visualize Large circular area of thin scintillation crystal
bone abnormalities An array of closely packed photo-multiplier tubes
Stationary gamma camera systems to amplify
Whole-body images (single head-to-toe skeletal profiles) Locate the gamma ray interactions in the crystal
Tomographic images (cross-sectional slices of the body
To display the scintillations instantly on a cathode
acquired at various angles around the patient and
displayed as a computer-reconstructed image) ray tube
Study the rapidly changing distribution of activity
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Gamma Camera Gamma Camera
Modern-day gamma cameras constitute extremely When a photon of the radiation leaves the patient’s
complex electronic equipment body
Detector It passes through the collimator
Collimator, crystal Interacts with a crystal
Photo-multiplier tubes Wherein its energy is converted into light
Position localization circuitry Light from the crystal is received by photo-multiplier tubes
Camera Electronics – includes Converted into an electrical signal
Correction circuitry Electrical signal passes through the position
Energy analysis circuitry localization circuitry
Counting circuit Whose output consists of X and Y positional signals, and
a Z or energy signal
Image display
Image recording device
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Gamma Camera Gamma Camera
Special correction circuits
Which compensate for errors in the detection and
localization of photon
Z or energy signal is then analysed in the pulse
height analyser circuit
To determine if the detected photon is within a user-
specified energy range
If it is registered in the counter
X and Y signals are then sent to an image recording
device
Where they are used to position the beam of a cathode ray
tube
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Gamma Camera Gamma Camera
Z pulse then turns the beam on Collimator
Causing a bright dot to appear at a location on the face of Heavy metal absorber such as lead, with some
the CRT corresponding to the location in the crystal
where the photon deposited its energy
tungsten or platinum parts
Hundreds of thousands of photons leave the Basic types of collimators used in conventional
patient’s body and strike crystal gamma camera imaging
Each causing a black spot to be formed on the film Pinhole
Collimator is used to selectively absorb unwanted Parallel-hole
radiation Diverging
Only photons traveling along the desired path are allowed
to pass through to the detector
Converging
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Gamma Camera
Crystal of up to 500 mm diameter
Typically 6.4 mm or 9.6 mm thick with an array of
61, 75 or 93 photo-multiplier tubes
Number of gamma rays received by any region
Multicrystal Gamma
of the crystal is directly proportional to the
amount of nuclide located directly below the Camera
region
Polaroid camera is mounted on the
oscilloscope for photographing the build-up of
about 50,000 dots on the screen
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Multicrystal Gamma Camera Multicrystal Gamma Camera
Major limitation in using a scintillation camera for Z-pulse analyser accepts only those events which
rapid dynamic studies is the counting losses that fall within the selected window
occur at the high count rates Two pulses occurring within a short span of each
Actual count rate is always greater than the other are piled up and the resulting summation
registered count rate that passes the window of the pulse is rejected
analyser Because its amplitude exceeds the upper window level
Scintillation Results in the loss of two valid pulses
Output of all photomultipliers is summed to give a Z-signal With subsequent total count loss
Proportional to the total amount of light emitted during the Principle of operation differs slightly for multi-crystal
scintillation cameras
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Multicrystal Gamma Camera Multicrystal Gamma Camera
Rectangular array of many small crystal detectors If two or more events interact at the same time
Each surrounded by reflective or shielding material to in different crystals
minimize scattering
Both events are discarded
Modified parallel-hole collimator
This is not possible with a mono-crystal
Bisecting lead septa within the hole of each detector
Used to increase sensitivity while maintaining overall
system
spatial resolution Computerized multi-crystal gamma camera
Multi-crystal data accumulation matrix system can accumulate high count rates
Every gamma event coming from the patient and (200,000 Hz)
interacting in any crystal
At rapid time intervals (20 s) making possible both
Detected as a separate event at a unique location
clinical and research applications
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Multicrystal Gamma Camera Multicrystal Gamma Camera
Detector system of this camera consists of 294
discrete crystals arranged in 14 rows and 21 columns
Each column and row is optically coupled by a lucite
light guide to a photo-multiplier tube
35 photo-multiplier tubes
Pulses from 35 pre-amplifiers and amplifiers serving
photo-multiplier tubes pass to 35 low-discriminators
Which eliminate events observed simultaneously in
adjacent crystals
Row and column photo-tube are uniquely identified
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Multicrystal Gamma Camera Multicrystal Gamma Camera
Scintillations occur in the front part of the detector Movable bed which performs a scanning motion is
Thin crystals provide better resolution by bringing the light used
flashes closer to the PMTs
To improve spatial resolution in static imaging
Crystals of such units are 9.5 mm thick and 28 to 61 measurements
cm in diameter Bed motion permits each detector crystal to scan a
Rectangular crystals are of similar thickness and range from square area within 1.11 cm sides in 16 programmed
20 X 20 cm to 46 X 66 cm
movements of 2.78 mm each
Random-access, solid-state buffer memory
Bed motion cannot be used during a dynamic study
Valid events are stored
Spatial resolution may be somewhat less in these studies
Information representing data from the entire detector
assembly passes into the memory of the computer
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Multicrystal Gamma Camera Multicrystal Gamma Camera
System ensures that only events that occur in one
and only one detector at the correct energy range
will be stored in the memory
Modern gamma camera employs a crystal of up to
500 mm diameter
Typically 6.4 mm or 9.6 mm thick
With an array of 61,75 or 93 photo-multiplier tubes
Prime general purpose instrument for radio-nuclide
imaging in routine nuclear medicine investigations
2 X 2 crystal array
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