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Tomography
Tomography is imaging by sections or sectioning to obtain images of slices through objects like the human body. Tomography is derived from the Greek words 'to cut or section' (tomos) and 'to write' (graphein). A device used in tomography is called a tomograph, while the image produced is a tomogram.
The first medical applications utilized x-rays for images of tissues based on their x-ray attenuation coefficient. The mathematical basis for tomographic imaging was laid down by Johann Radon. This type of imaging is used in different medical applications as for example computed tomography, ultrasound imaging, positron emission tomography and magnetic resonance imaging (MRI) also called magnetic resonance tomography (MRT).
Conventional x-ray tomographic techniques show organ structures lying in a predetermined plane (the focal plane), while blurring the tissue structures in planes above and below by linear or complex geometrical motion of the x-ray tube and film cassette.
Basically, computed tomography is the reconstruction of an image from its projections. In the strict sense of the word, a projection at a given angle is the integral of the image in the direction specified by that angle. The CT images (slices) are created in the axial plane, while coronal and sagittal images can be rendered by computer reconstruction.

See also Zonography, Computed or Computerized Axial Tomography, Resolution Element, Radiographic Noise, Intravenous Pyelogram.
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Contrast Agents
(CA) Contrast agents are used to change the imaging characteristics, resulting in additional information about anatomy, morphology or physiology of the human body. Radiocontrast agents (also called photon-based imaging agents) are used to improve the visibility of internal body structures in x-ray and CT procedures. Contrast agents are also used to increase the contrast between different tissues in MRI (magnetic resonance imaging) and ultrasound imaging. The ideal imaging agent provides enhanced contrast with little biological interaction.
First investigations with radiopaque materials are done shortly after the discovery of x-rays. These positive contrast agents attenuate x-rays more than body soft tissues due to their high atomic weight. Iodine and barium have been identified as suitable materials with high radiodensity and are used until today in x-ray and CT contrast agents. Iodine-based contrast agents are water-soluble and the solutions are used nearly anywhere in the body. Iodinated contrast materials are most administered intravenous, but can also be introduced intraarterial, intrathecal, oral, rectal, intravesical, or installed in body cavities. Barium sulfate is only used for opacification of the gastrointestinal tract. Negative contrast agents attenuate x-rays less than body soft tissues, for example gas.

Iodinated contrast media are differentiated in;

Intravascular iodinated contrast agents are required for a large number of x-ray and CT studies to enhance vessels and organs dependent on the blood supply. Injectable contrast agents are diluted in the bloodstream and rapidly distributed throughout the extracellular fluid. The main route of excretion is through the kidneys, related to the poor binding of the agent to serum albumin. The liver (gall bladder) and small intestine provide alternate routes of elimination particularly in patients with severe renal impairment. The use of special biliary contrast agents is suitable for gallbladder CT and cholecystograms because they are concentrated by the liver to be detectable in the hepatic bile.
The introduction of fast multi-detector row CT technology, has led to the development of optimized contrast injection techniques. The amount of contrast enhancement depends on the contrast agent characteristics, such as iodine concentration, osmolality, viscosity, and the injection protocol, such as iodine flux and iodine dose. Adverse reactions are rare and have decreased with the introduction of nonionic contrast agents.
See also Contrast Enhanced Computed Tomography, Abdomen CT, Contrast Media Injector, Single-Head CT Power Injector, Multi-Head Contrast Media Injector, Syringeless CT Power Injector, CT Power Injector.
CT Angiography
(CTA) A computed tomographic angiography or computerized tomography angiogram is a diagnostic imaging test that combines conventional CT technique with that of traditional angiography to create images of the blood vessels in the body - from brain vessels to arteries of the lungs, kidneys, arms and legs.
High resolution CT scans with thin slices and intravenous injection of iodinated contrast material provide detailed images of vascular anatomy and the adjacent bony structures. CTA requires rapid scanning as the imaging data are typically acquired during the first pass of a bolus of contrast medium. The selection of acquisition timing is important to optimize the contrast enhancement, which is dependent on contrast injection methods, imaging techniques and patient variations in weight, age and health. CT angiography is less invasive compared to conventional angiography and the data can be rendered in three dimensions.

CTA techniques are commonly used to:
Detect pulmonary embolism with computed tomography pulmonary angiography;
rule out coronary artery disease with coronary CT angiography;
evaluate heart disease with cardiac CT;
identify aneurysms, dissections, narrowing, obstruction and other vessel disease in the aorta or major blood vessels;

See also Cardiovascular Imaging, Magnetic Resonance Angiography MRA, Coronary Angiogram, Computed Tomography Dose Index and Computed or Computerized Axial Tomography.
Biopsy
A biopsy is a procedure in which tissue samples are collected. This can be done with a needle, which is inserted into the abnormal area.
An example is the needle breast biopsy. Needle biopsies are usually guided by different imaging techniques like ultrasound, computed tomography, or magnetic resonance imaging. Stereotactic-assisted breast biopsies use computer maps to guide the needle. The location of the breast lump is provided from digital mammograms taken from two angles.
The cells can be removed and examined under a microscope to determine whether the abnormality is cancerous.

See also CT Guided Biopsy.
Breast Imaging
Breast imaging methods include mammography (mammogram), ultrasound, breast MRI, positron emission tomography, xeromammography, diaphanography and thermography.
Mammography is widely used as a screening method and diagnostic tool for breast cancer detection or evaluation of breast disease. Digital mammography takes multiple thin digital image 'slices' through the breast, which provides higher potential to see a small mass within dense tissue. The mammography quality standards act guarantees a high image quality.
Breast ultrasound (also called ultrasonography) should only be used as an additional imaging modality to evaluate specific breast abnormalities, especially to differentiate cystic from solid masses. Ultrasound is also used to guide needle breast biopsies.
Magnetic resonance imaging (MRI) is useful for breast MRI screening in cases of high cancer risk. In addition, multifocal breast cancer can be missed by standard practice mammography and can be early detected with breast MRI.
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