CT SCAN PARAMETERS
& IMAGE QUALITY
CT SCAN PARAMETERS
CT SCAN PARAMETERS
• Many factors affect the quality of the image produced. Some of these
variables can be regulated by the operator, whereas others, such as
patient size, cannot.
• Among the factors that the operator can control are milliampere (mA)
level, scan time (s), slice thickness, field of view (FOV), reconstruction
algorithm, and kilovolt-peak (kVp).
• When using helical scan methods, the operator also has a choice of
pitch.
CT SCAN PARAMETERS
Milliampere-Second (mAs)
• The current of electrons that flow from the filament (cathode) to the
anode is measured in mA.
• Increasing the mA increases the number of electrons that will
produce x-ray photons.
• CT scan x-ray tube typically provide 2 separate filaments. A small
filament is provided for lower mA settings (typically less than 350 mA)
and a large filament for higher settings
CT SCAN PARAMETERS
Milliampere-Second (mAs)
• Scan time (s) is the time the x-ray beam is on for the collection of data
for each slice (180° or 360° rotation).
• Typical choices of scan time (s) for a full rotation range from 0.5 to 2 s.
• In CT cardiac applications, the scan time for these protocols are
shorter, in the range of 0.35 to 0.45 s.
CT SCAN PARAMETERS
Milliampere-Second (mAs)
• The quantity of x-ray photons produced is a product of mA and scan time (s).
• If a 320 mAs setting is required for a specific study of the abdomen, any
combination of mA and s can produce the similar effect (160 mA and a 2-
second scan time provides the same quantity of x-ray energy as 640 mA and a
0.5-second scan time).
• Higher mA settings allow shorter scan times (s) to be used. A short scan time is
critical in avoiding image degradation as a result of patient motion.
CT SCAN PARAMETERS
Milliampere-Second (mAs)
• As a rule, if the total mAs level can be maintained, it is preferable to use
the shortest scan time (s) available.
• However, there are exceptions to this rule. Slower scan speeds are
favored for use in radiation therapy planning when evaluating organ
movement during respiration.
CT SCAN PARAMETERS
Milliampere-Second (mAs)
• The higher the mAs setting, the longer the time between scans (interscan delay
time) while the tube cools off enough to allow another scan sequence.
• The thicker and denser the part being examined, effect the mAs level selected.
• A CT study of the lungs will require less mAs than that of the abdomen because
the chest is composed primarily of the lungs, which contain air and are less
dense than the organs of the abdomen.
CT SCAN PARAMETERS
Milliampere-Second (mAs)
• Determining the optimal mAs setting is often a matter of trial and error.
• Manufacturers often make general recommendations for the setting
required for various examination.
• Differences in mAs of less than 20% may not result in a visible change on
the image quality.
CT SCAN PARAMETERS
Tube Voltage or Kilovolt Peak (kVp)
• Most CT systems allow the operator to adjust the tube voltage (kVp).
• Compared with mA selection, choices of kVp are more limited. On some
systems, the kVp setting is fixed, typically at 120 kVp.
• In CT, kVp does not change contrast as directly as it does in film-screen
radiography.
CT SCAN PARAMETERS
Tube Voltage or Kilovolt Peak (kVp)
• Increasing the kVp setting increases the intensity of the x-ray beam and
the beam’s ability to penetrate a thick, dense anatomic part.
• Routine body CT for adult patients is performed with 120 to 140 kVp.
• Because of their smaller size, pediatric patients are often scanned with
80 kVp.
CT SCAN PARAMETERS
Tube Voltage or Kilovolt Peak (kVp)
• The appropriate selection of mAs and kVp is critical to optimize radiation
dose and image quality.
• Reducing the mAs & kVp, reduce the radiation dose to the patient.
• However, excessively lowering the kVp may result in a dramatic increase
in the amount of x-ray attenuated by patient tissue.
CT SCAN PARAMETERS
Tube Voltage or Kilovolt Peak (kVp)
• It is a more common practice to manipulate the mAs, rather than the
kVp, when modifying the radiation dose.
• mA selection is more flexible (20 – 800 mA).
• Another practical advantage of adjusting the mA instead of kVp is that its
effect on image quality is more straightforward and predictable.
CT SCAN PARAMETERS
Tube Voltage or Kilovolt Peak (kVp)
• Uncoupling Effect—using digital technology, the image quality is not
directly linked to the dose, so even when an mA or kVp setting that is too
high is used, a good image can also produce (not similar with film-screen
radiography).
• Automatic Tube Current Modulation – adapting the mAs to the patient’s
size and weight is a key factor in reducing radiation exposure from CT.
Software that automatically adjusts the tube current (mAs) to fit specific
region. Reduce 15 – 40% radiation dose.
CT SCAN PARAMETERS
Slice Thickness
• Slice thickness has a significant impact on image quality.
• In general, thinner slice thickness, produced better CT image details.
• However, thinner slice thickness also produce higher noise.
CT SCAN PARAMETERS
Field of View (FOV)
• Two types of FOV – SFOV and DFOV.
• Scan field of view (SFOV) determines the area, within the gantry, for
which raw data are acquired.
• Display field of view (DFOV) determines how much, and what section, of
the collected raw data are used to create an image.
CT SCAN PARAMETERS
Pitch
• Pitch is the relationship between slice thickness (mm) and table travel
per rotation (mm) during a helical scan acquisition.
• Specific pitch settings available vary and depend on manufacturer and
detector row number.
• A pitch of < 1.0 results in better image quality, but a higher patient dose.
CT SCAN PARAMETERS
Reconstruction Algorithms
• Depending on the manufacturer, this feature may be called algorithm,
convolution filter, FC filter, or simply filter.
• By choosing a specific algorithm, the operator selects how the data are
filtered in the reconstruction process.
• Filter functions can only be applied to raw data (not image data).
CT SCAN IMAGE QUALITY
CT SCAN IMAGE QUALITY
• Image quality relates to how well the image represents the object
scanned.
• In CT, image quality is directly related to its usefulness in providing an
accurate diagnosis.
• Many factors influence how well a CT image represents the actual
object scanned.
CT SCAN IMAGE QUALITY
• Two main features used to measure image quality in CT scan are:
(1) Spatial Resolution
(2) Contrast Resolution
• Spatial Resolution = the ability to resolve (as separate objects) small,
high-contrast objects.
• Contrast Resolution = the ability to differentiate between objects with
very similar densities as their background.
CT SCAN IMAGE QUALITY
Spatial Resolution
• Spatial resolution can be measured using 2 methods.
• It can be measured directly using a physical line-pairs phantom (lp/cm). The
number of line pairs visible per unit length is also called spatial frequency.
• It can be calculated from analyzing the spread of information within the
system. This data analysis is known as the modulation transfer function
(MTF).
CT SCAN IMAGE QUALITY
Spatial Resolution
• Pixel size plays an important role in the in-plane spatial resolution of
the CT image.
• Smaller pixel size produce better spatial resolution.
• A large pixel size will make it more likely that multiple objects are
contained within a pixel,
CT SCAN IMAGE QUALITY
Spatial Resolution
• In general, thinner slices produce sharper images because to create an
image the system must flatten the scan thickness (a volume).
• Slice thickness plays an important role in volume averaging, thereby
affecting spatial resolution in the image.
• New CT scanners allow for very thin slice thickness; often the goal is to
produce isotropic voxels.
CT SCAN IMAGE QUALITY
Spatial Resolution
• The appropriate reconstruction algorithm depends on which parts of
the data should be enhanced or suppressed to optimize the image for
diagnosis.
• Suitable choice of reconstruction algorithm can produce good spatial
resolution.
CT SCAN IMAGE QUALITY
Spatial Resolution
• Other factor is focal spot of x-ray tube anode. Smaller focal spot
produce high spatial resolution (increase the sharpness).
• In addition, decreasing the pitch increase resolution. In practice, pitch
values from 1 to 2 are commonly used.
• Hence, shortened scan times (s), reduce motion, and may help
improve spatial resolution.
CT SCAN IMAGE QUALITY
Contrast Resolution
• The second major aspect of image quality is that of contrast resolution.
• It is the ability to differentiate a structure that varies only slightly in density
from its surrounding.
• CT is superior to all other ionizing radiation imaging modalities in its
contrast resolution.
• Contrast resolution is measured using phantoms that contain objects,
typically cylindrical, of varying sizes and with a small difference in density.
CT SCAN IMAGE QUALITY
Contrast Resolution
• The mAs selected for scanning directly influences the number of x-ray
photons used to produce the CT image, thereby affecting the SNR and
the contrast resolution.
• Doubling the mAs of the study increases the SNR by 40%.
• Therefore, doubling the mAs will improve the contrast resolution of
repeat scans. However, it also increase patient dose.
CT SCAN IMAGE QUALITY
Contrast Resolution
• Keeping all other scan parameters, the same, as pixel size decreases,
the number of detected x-ray photons per pixel will decrease.
• Fewer photons per pixel results in an increase in noise.
• This will decrease in contrast resolution.
CT SCAN IMAGE QUALITY
Contrast Resolution
• The slice thickness has a linear effect on the number of x-ray photons
available to produce the image.
• Because thicker slices allow more photons to reach the detectors,
they have a better SNR and appear less noisy.
• However, this improvement comes at the cost of spatial resolution.
CT SCAN IMAGE QUALITY
Contrast Resolution
• Patient size also effect the contrast resolution.
• For the same x-ray technique, larger patients attenuate more x-rays
photons, leaving fewer to reach the detectors.
• This reduces SNR, increases noise, and results in lower contrast
resolution.
SUMMARY
• It should be clear that there is a compromise between spatial
resolution and contrast resolution.
• In addition, image quality is closely linked to radiation dose.
• Manipulating scan parameters may improve one aspect of image
quality while decreasing another aspect.
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