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Computed Tomography
(CT or CAT scan) Computed tomography is a diagnostic imaging technique, previously also known as computerized axial tomography (CAT), computer-assisted tomography (CAT), computerized tomographic imaging, and reconstructive tomography (RT).
A CT scan is based on the measurement of the amount of energy that a tissue absorbs as a beam of radiation passes through it from a source to a detector. As the patient table moves through the CT scanner, the CT tube rotates within the circular opening and the set of x-ray detectors rotate in synchrony. The narrow, fan-shaped x-ray beam has widths ranging from 1 to 20 mm. The large number of accurate measurements with precisely controlled geometry is transformed by mathematical procedures to image data. Corresponding to CT slices of a certain thickness, a series of two-dimensional cross-sectional images is created.
A CT is acquired in the axial plane, while coronal and sagittal images can be rendered by computer reconstruction. Although a conventional radiography provides higher resolution for bone x-rays, CT can generate much more detailed images of the soft tissues. Contrast agents are often used for enhanced delineation of anatomy and allow additional 3D reconstructions of arteries and veins.
CT scans use a relatively high amount of ionizing radiation compared to conventional x-ray imaging procedures. Due to widespread use of CT imaging in medicine, the exposure to radiation from CT scans is an important issue. To put this into perspective, the FDA considers the risk of absorbed x-rays from CT scans to be very small. Even so, the FDA recommends avoiding unnecessary exposure to radiation during diagnostic imaging procedures, especially for children.
CT is also used in other than medical fields, such as nondestructive testing of materials including rock, bone, ceramic, metal and soft tissue.

See also Contrast Enhanced Computed Tomography.
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Computed Tomography Dose Index
(CTDI) The computed tomography dose index is most commonly used dose descriptor, which represents the dose to a location (e.g., depth) in a scanned volume.
This index describes the dose from a single rotation of a CT scanner. CTDI must be corrected for pitch or couch increment to receive the dose for a series of slices. The CTDI100 is measured using a 100 mm long ionization chamber. The CTDIair is the value of CTDI determined free-in-air.
Different definitions of CTDI exist and are used in different applications.
Computed Tomography Enterography
(CTE) Computed tomography enterography is an imaging procedure to evaluate diseases affecting the mucosa and bowel wall of the small intestine. CTE uses oral contrast agents to improve bowel wall visualization. Several studies established that small bowel distention using negative oral contrast agent increases diagnostic performance of some abdomen CT studies.
The multi-detector row CT (MDCT) improves temporal and spatial resolution and 3D imaging processes offer a full examination of the small bowel with surrounding structures, depicting the small bowel inflammation associated with Crohn's disease by displaying mural hyperenhancement, stratification, and thickening.
CT enterography versus capsule endoscopy provides a non invasive study with comparable sensitivity, high specificity and overall accuracy.

See also Colonoscopy and Virtual Colonoscopy.
Contrast Enhanced Computed Tomography
(CECT) Contrast agents are used during contrast enhanced computed (or computerized) tomography examinations to highlight specific tissues and parts of the body. Bones can be clearly seen on x-ray images, the visualization of some other organs and soft tissues is more difficult. Sufficient contrast is important in perceiving a difference in the density between areas of a CT image. The identification of a disease may be challenging due to very low contrast between pathological tissues (for example tumors, metastases and abscesses), normal organ structures and surrounding tissues.
Contrast agents are used in CT angiography (CTA) to delineate vessels, in multiphasic CT studies to provide dynamic information of blood supply (e.g., liver CT) and in CECT studies of various body parts to achieve opacification of tissue of interest (e.g., kidney CT) in relation to the background tissue. Contrast enhanced multi-detector row CT (MDCT) replaces several conventional diagnostic imaging methods such as intravenous urography, cholangiography, or catheter angiography, due to advanced CT studies with fast examination times, high contrast enhancement, perfusion measurement and multiplanar reformatting capabilities.
See also Contrast Media Injector, Single-Head CT Power Injector, Multi-Head Contrast Media Injector, Syringeless CT Power Injector, CT Power Injector.
Diagnostic Imaging
Imaging refers to the visual representation of an object. Today, diagnostic imaging uses radiology and other techniques, mostly noninvasive, to create pictures of the human body. Diagnostic radiography studies the anatomy and physiology to diagnose an array of medical conditions. The history of medical diagnostic imaging is in many ways the history of radiology. Many imaging techniques also have scientific and industrial applications. Diagnostic imaging in its widest sense is part of biological science and may include medical photography, microscopy and techniques which are not primarily designed to produce images (e.g., electroencephalography and magnetoencephalography).
Brief overview about important developments:
Imaging used for medical purposes, began after the discovery of x-rays by Konrad Roentgen 1896. The first fifty years of radiological imaging, pictures have been created by focusing x-rays on the examined body part and direct depiction onto a single piece of film inside a special cassette.
In the 1950s, first nuclear medicine studies showed the up-take of very low-level radioactive chemicals in organs, using special gamma cameras. This diagnostic imaging technology allows information of biologic processes in vivo. Today, single photon emission computed tomography (SPECT) and positron emission tomography (PET) play an important role in both clinical research and diagnosis of biochemical and physiologic processes.
In the 1960s, the principals of sonar were applied to diagnostic imaging. Ultrasound has been imported into practically every area of medicine as an important diagnostic tool, and there are great opportunities for its further development. Looking into the future, the grand challenges include targeted contrast imaging, real-time 3D or 4D ultrasound, and molecular imaging. The earliest use of ultrasound contrast agents (USCA) was in 1968.
The introduction of computed tomography (CT/CAT) in the 1970s revolutionized medical imaging with cross sectional images of the human body and high contrast between different types of soft tissues. These developments were made possible by analog to digital converters and computers. First, spiral CT (also called helical), then multislice CT (or multi-detector row CT) technology expanded the clinical applications dramatically.
The first magnetic resonance imaging (MRI) devices were tested on clinical patients in 1980. With technological improvements including higher field strength, more open MRI magnets, faster gradient systems, and novel data-acquisition techniques, MRI is a real-time interactive imaging modality that provides both detailed structural and functional information of the body.

Today, imaging in medicine has been developed to a stage that was inconceivable a century ago, with growing modalities:
x-ray projection imaging, including conventional radiography and digital radiography;
scintigraphy;
single photon emission computed tomography;
positron emission tomography.

All these types of scans are an integral part of modern healthcare. Usually, a radiologist interprets the images. Most clinical studies are acquired by a radiographer or radiologic technologist. In filmless, digital radiology departments all images are acquired and stored on computers. Because of the rapid development of digital imaging modalities, the increasing need for an efficient management leads to the widening of radiology information systems (RIS) and archival of images in digital form in a picture archiving and communication system (PACS). In telemedicine, medical images of MRI scans, x-ray examinations, CT scans and ultrasound pictures are transmitted in real time.

See also Interventional Radiology, Image Quality and CT Scanner.
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