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Spie Press Book

Computed Tomography: Principles, Design, Artifacts, and Recent Advances, Third Edition
Author(s): Jiang Hsieh
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Book Description

X-ray computed tomography (CT) has experienced an explosion of technological development for a quarter century. Six years after the second edition of Computed Tomography, this third edition captures the most recent advances in technology and clinical applications. New to this edition are descriptions of iterative reconstruction, statistical reconstruction, methodologies used to model the CT systems, and the searching methodologies for optimal solutions. A new section on 3D printing introduces approaches by early adopters in the area. Also added is a description and discussion of the size-specific dose estimate, an index that attempts to more accurately reflect the dose absorption of specific-sized patients. The coverage of dual-energy CT has been significantly expanded to include its background, theoretical development, and clinical applications.

"This is a new edition of the reputable book on the principles and designs of CT, which I believe is the best CT textbook available. The new materials appropriately cover the emerging field with sufficient depth, further increasing the value of the book."
--Katsuyuki (Ken) Taguchi, Ph.D., Johns Hopkins University School of Medicine

Want a more thorough understanding? Use this book along with the author's online course: Principles and Advancements in X-ray Computed Tomography: SC471

Book Details

Date Published: 21 October 2015
Pages: 666
ISBN: 9781628418255
Volume: PM259

Table of Contents
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Table of Contents


Nomenclature and Abbreviations

1 Transmission, Absorption, and Reflection Measurements
1.1 Conventional X-ray Tomography
1.2 History of Computed Tomography
1.3 Different Generations of CT Scanners
1.4 Problems

2 Preliminaries
2.1 Mathematics Fundamentals
     2.1.1 Fourier transform and convolution
     2.1.2 Random variables
     2.1.3 Linear algebra
2.2 Fundamentals of X-ray Physics
     2.2.1 Production of x rays
     2.2.2 Interaction of x rays with matter
2.3 Measurement of Line Integrals and Data Conditioning
2.4 Sampling Geometry and Sinogram
2.5 Problems

3 Image Reconstruction
3.1 Introduction
3.2 Several Approaches to Image Reconstruction
3.3 The Fourier Slice Theorem
3.4 The Filtered Backprojection Algorithm
     3.4.1 Derivation of the filtered back-projection formula
     3.4.2 Computer implementation
     3.4.3 Targeted reconstruction
3.5 Fan-Beam Reconstruction
     3.5.1 Reconstruction formula for equiangular sampling
     3.5.2 Reconstruction formula for equal-spaced sampling
     3.5.3 Fan-beam to parallel-beam rebinning
3.6 Iterative Reconstruction
     3.6.1 Mathematics verses reality
     3.6.2 The general approach to iterative reconstruction
     3.6.3 Algebraic reconstruction
     3.6.4 System modeling pro
     3.6.5 Optimization algorithms
     3.6.6 Reconstruction speedup
3.7 Problems

4 Image Presentation
4.1 Setup of a Static Luminescence Spectrophotometer
4.2 Volume Visualization
     4.2.1 Multiplanar reformation
     4.2.2 MIP, minMIP, and volume rendering
     4.2.3 Surface rendering
     4.2.4 3D printing
4.3 Impact of Visualization Tools
4.4 Problems

5 Key Performance Parameters of the CT Scanner
5.1 High-Contrast Spatial Resolution
     5.1.1 In-plane resolution
     5.1.2 Slice sensitivity profile
5.2 Low-Contrast Resolution
5.3 Temporal Resolution
5.4 CT Number Accuracy and Noise
5.5 Impact of Iterative Reconstruction on Performance Measurement
     5.5.1 Performance-metric-based approach
     5.5.2 Task-based approach
5.6 Performance of the Scanogram
5.7 Problems

6 Major Components of the CT Scanner
6.1 System Overview
6.2 The X-ray Tube and High-Voltage Generator
6.3 The X-ray Detector and Data-Acquisition Electronics
6.4 The Gantry and Slip Ring
6.5 Collimation and Filtration
6.6 The Reconstruction Engine
6.7 The Patient Table
6.8 Problems

7 Image Artifacts: Appearances, Causes, and Corrections
7.1 What Is an Image Artifact?
7.2 Different Appearances of Image Artifacts
7.3 Artifacts Related to System Design
     7.3.1 Aliasing
     7.3.2 Partial volume
     7.3.3 Scatter
     7.3.4 Noise-induced streaks
7.4 Artifacts Related to X-ray Tubes
     7.4.1 Off-focal radiation
     7.4.2 Tube arcing
     7.4.3 Tube rotor wobble
7.5 Detector-Induced Artifacts
     7.5.1 Offset, gain, nonlinearity, and radiation damage
     7.5.2 Primary speed and afterglow
     7.5.3 Detector response uniformity
7.6 Patient-Induced Artifacts
     7.6.1 Patient motion
     7.6.2 Beam hardening
     7.6.3 Metal artifacts
     7.6.4 Incomplete projections
7.7 Operator-Induced Artifacts
7.8 Problems

8 Computer Simulation and Analysis
8.1 What Is Computer Simulation?
8.2 Simulation Overview
8.3 Simulation of Optics
8.4 Computer Simulation of Physics-Related Performance
8.5 Problems


9 Helical or Spiral CT
9.1 Introduction
     9.1.1 Clinical needs
     9.1.2 Enabling technology
9.2 Terminology and Reconstruction
     9.2.1 Helical pitch
     9.2.2 Basic reconstruction approaches
     9.2.3 Selection of the interpolation algorithm and reconstruction plane
     9.2.4 Helical fan-to-parallel rebinning
9.3 Slice Sensitivity Profile and Noise
9.4 Helically Related Image Artifacts
     9.4.1 High-pitch helical artifacts
     9.4.2 Noise-induced artifacts
     9.4.3 System-misalignment-induced artifacts
     9.4.4 Helical artifacts caused by object slope
9.5 Problems

10 Multislice and Cone-beam CT
10.1 The Need for Multislice and Cone-beam CT
10.2 Detector Configurations of Multislice and Cone-beam CT
10.3 Nonhelical Mode of Reconstruction
10.4 Helical Reconstruction
     10.4.1 Selection of interpolation samples
     10.4.2 Selection of region of reconstruction
     10.4.3 Reconstruction algorithms with 3D backprojection
10.5 Multislice and Cone-beam Artifacts
     10.5.1 General description
     10.5.2 Cone-beam effects
     10.5.3 Interpolation-related image artifacts
     10.5.4 Noise-induced multislice and cone-beam artifacts
     10.5.5 Tilt artifacts in multislice and cone-beam helical CT
     10.5.6 Distortion in step-and-shoot mode SSP
     10.5.7 Artifacts due to geometric inaccuracy
     10.5.8 Comparison of multislice and single-slice helical CT
10.6 Problems

11 X-ray Radiation and Dose-Reduction Techniques
11.1 Biological Effects of X-ray Radiation
11.2 Measurement of X-ray Dose
     11.2.1 Terminology and the measurement standard
     11.2.2 Other measurement units and methods
     11.2.3 Issues with the current CTDI
11.3 Methodologies for Dose Reduction
     11.3.1 Tube-current modulation
     11.3.2 Umbra-penumbra and overbeam issues
     11.3.3 Physiological gating
     11.3.4 Organ-specific dose reduction
     11.3.5 Protocol optimization and impact of the operator
     11.3.6 Postprocessing techniques
     11.3.7 Advanced reconstruction
11.4 Problems

12 Advanced CT Applications
12.1 Introduction
12.2 Cardiac Imaging
     12.2.1 Coronary artery calcification (CAC)
     12.2.2 Coronary artery imaging (CAI)
12.3 CT Fluoroscopy
12.4 CT Perfusion
12.5 Screening and Quantitative CT
     12.5.1 Lung cancer screening
     12.5.2 Quantitative CT
     12.5.3 CT colonography
12.6 Dual-Energy CT
     12.6.1 Intuitive explanation
     12.6.2 Theory of DECT
     12.6.3 Monochromatic image generation
     12.6.4 Multimaterial decomposition
     12.6.5 DECT data acquisition
     12.6.6 Clinical applications of DECT
12.7 Problems




X-ray computed tomography (CT) has experienced a tremendous explosion in technological development over the last quarter century, a phenomenon rarely seen in industry. Few could have predicted the speed, magnitude, and duration of the progress. The third edition of Computed Tomography captures the most recent advances in technology and clinical applications.

This third edition provides significant additions in several areas. The first area of major enhancement is on the topic of iterative reconstruction. With the heightened awareness of radiation dose in CT in recent years, iterative reconstruction has evolved from a topic in academic research to the mainstream of CT reconstruction for all commercially available scanners. Chapter 3 describes the fundamental concept of iterative reconstruction, the idea of statistical reconstruction, methodologies used to model CT systems, and searching methodologies for optimal solutions. Given the clinical demands on workflow, a brief discussion on the reconstruction speedup effort is also provided.

One complexity brought by the iterative reconstruction technology is performance evaluation. Unlike the filtered backprojection reconstruction algorithm, in general, iterative reconstruction performance is nonlinear. Although some of the existing measurement approaches are still useful, they are inadequate to fully assess the performance of iteratively reconstructed images. Chapter 5 has an added section that discusses the impact and various measurement methodologies of iterative reconstruction.

Historically, the presentation of the CT outcome has been limited to computer monitors, either at scanner consoles, workstations, or PACS monitors. With the recent advancements in 3D printing, however, physical models can be quickly prototyped to convey CT information. Therefore, a section was added in Chapter 4 to introduce approaches by the early adopters in the area.

In terms of radiation dose, the topic of a size-specific dose estimate (SSDE) has been added. During the last few years, significant attention has been paid to the radiation impact on human health by academic researchers, radiologists, the general public, and the news media. Although awareness on the subject has been increasing, dose measurement methodology was developed more than a decade ago. The updated Chapter 11 briefly describes the recent proposal of a dose measurement index, SSDE, in an attempt to more accurately reflect the dose absorption rates of specific-sized patients, and proposed modifications to the dose measurement for scanners with large z coverage.

When the second edition of this book was published, true cone-beam CT had just been introduced commercially. Nowadays, scanners capable of single-organ coverage in a rotation are widely available commercially and have significantly impacted clinical practices. Chapter 10 has been expanded to discuss the technological challenges associated with wide-cone step-and-shoot reconstruction and the additional challenges with cardiac imaging.

Dual-energy CT was predominately in the hands of a few researchers at the time of the second edition publication. The situation has significantly changed since then, as dual-energy CT is now utilized in routine clinical applications to aid in disease diagnosis. A significant expansion to Chapter 12 has been written to provide the technology background, theoretical development, and clinical applications of dual-energy CT.

To enhance readers' understanding of the material and to inspire creative thinking about the topics presented, more problems have been added at the end of each chapter. Many problems are open-ended and may not have uniquely correct solutions.

At the time of the publication of the second edition, the world was experiencing an unprecedented financial crisis that some called a financial "tsunami." Although we predicted that "CT technology is unlikely to remain stagnant," nobody was certain about the true impact the crisis would have on CT development. Recent advances in CT have shown that the entire industry remains healthy, and the demand for advanced CT technologies has expanded beyond the developed counties. The future of CT remains bright.


Many of the ideas, principles, results, and examples that appear in this book stem from thoughts provoked by other books and research papers, and the author would like to take this opportunity to acknowledge those sources. The author would like to express his appreciation to Prof. Jeffrey A. Fessler of the University of Michigan for his review of this text. His expert critical opinions have significantly strengthened and enhanced the manuscript. The author owes a debt to two people for supplying materials for all editions of this book: Dr. Ting-Yim Lee of the Robarts Research Institute for providing reference materials on CT perfusion, and Mr. Nick Keat of the ImPACT group in London for supplying historical pictures on early CT development. The author would also like to thank Dr. T. S. Pan of the M.D. Anderson Cancer Research Center for providing some of the positron emission computed tomography images, Dr. P. Kinahan of the University of Washington for providing research results on patient motion artifacts, and Dr. G.-H. Chen for supplying pictures from his research in iterative reconstruction performance. The valuable suggestions and comments made by Dr. N. Pelc from Stanford University are gratefully acknowledged. The author would like to thank many current and former colleagues at GE Healthcare Technologies and the GE Global Research Center for useful discussions, joint research projects, inspiration, and many beautiful images. Finally, the most significant acknowledgment of all goes to the author's spouse, Lily J. Gong, and his children, Christopher and Matthew, for their unconditional support of the project.

Jiang Hsieh
July 2015

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