Fundamentals of Medical Imaging, 2nd ed

264 Pages·2009·18.38 MB·English

by  Paul Suetens

FundamentalsofMedicalImaging
SecondEdition

Fundamentals of
Medical Imaging
Second Edition
PaulSuetens
KatholiekeUniversiteitLeuven
CAMBRIDGEUNIVERSITYPRESS
Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore,
São Paulo, Delhi, Dubai, Tokyo
Cambridge University Press
The Edinburgh Building, Cambridge CB2 8RU, UK
Published in the United States of America by Cambridge University Press, New York
www.cambridge.org
Information on this title: www.cambridge.org/9780521519151
© First edition © Cambridge University Press 2002
Second edition © P. Suetens 2009
This publication is in copyright. Subject to statutory exception and to the
provision of relevant collective licensing agreements, no reproduction of any part
may take place without the written permission of Cambridge University Press.
First published in print format 2009
ISBN-13 978-0-511-59640-7 eBook (NetLibrary)
ISBN-13 978-0-521-51915-1 Hardback
Cambridge University Press has no responsibility for the persistence or accuracy
of urls for external or third-party internet websites referred to in this publication,
and does not guarantee that any content on such websites is, or will remain,
accurate or appropriate.
Every effort has been made in preparing this publication to provide accurate and
up-to-date information which is in accord with accepted standards and practice at
the time of publication. Although case histories are drawn from actual cases, every
effort has been made to disguise the identities of the individuals involved.
Nevertheless, the authors, editors and publishers can make no
warranties that the information contained herein is totally free from error, not least
because clinical standards are constantly changing through research and
regulation. The authors, editors and publishers therefore disclaim all liability for
direct or consequential damages resulting from the use of material contained in
this publication. Readers are strongly advised to pay careful attention to
information provided by the manufacturer of any drugs or equipment that they
plan to use.
Contents
Preface pagevii Imagequality 90
Acknowledgments ix Equipment 95
Clinicaluse 98
Biologiceffectsandsafety 102
1 Introductiontodigitalimage
Futureexpectations 104
processing 1
Digitalimages 1 5 Nuclearmedicineimaging 105
Imagequality 2
Introduction 105
Basicimageoperations 4
Radionuclides 105
Interactionofγ-photonsandparticles
2 Radiography 14
withmatter 108
Introduction 14
Dataacquisition 108
X-rays 14
Imaging 111
Interactionwithmatter 16
Imagequality 116
X-raydetectors 17
Equipment 117
Dual-energyimaging 21
Clinicaluse 122
Imagequality 23
Biologiceffectsandsafety 124
Equipment 24
Futureexpectations 125
Clinicaluse 25
Biologiceffectsandsafety 27
6 Ultrasoundimaging 128
Futureexpectations 32
Introduction 128
3 X-raycomputedtomography 33 Physicsofacousticwaves 128
Generationanddetectionof
Introduction 33
ultrasound 137
X-raydetectorsinCT 34
Grayscaleimaging 138
Imaging 35
Dopplerimaging 141
CardiacCT 46
Imagequality 145
Dual-energyCT 48
Imagequality 49 Equipment 149
Equipment 53 Clinicaluse 152
Clinicaluse 58 Biologiceffectsandsafety 155
Biologiceffectsandsafety 59 Futureexpectations 156
Futureexpectations 63
7 Medicalimageanalysis 159
4 Magneticresonanceimaging 64 Introduction 159
Introduction 64 Manualanalysis 160
Physicsofthetransmittedsignal 64 Automatedanalysis 160
Interactionwithtissue 68 Computationalstrategiesforautomated
Signaldetectionanddetector 71 medicalimageanalysis 163
Imaging 72 Pixelclassification 166
Contents
Geometricmodelmatchingusinga Virtualreality 205
transformationmatrix 170 Userinteraction 207
Flexiblegeometricmodelmatching 175 Intraoperativenavigation 208
Validation 186 Augmentedreality 214
Futureexpectations 189 Futureexpectations 218
8 Visualizationfordiagnosis
AppendixA:Linearsystemtheory 219
andtherapy 190
AppendixB:Exercises 232
Introduction 190
2Dvisualization 192 Bibliography 246
3Drendering 192 Index 248
vi
Preface
This book explains the applied mathematical and the stronger student to read around the subject and
physicalprinciplesofmedicalimagingandimagepro- alsomakesthebookausefulpurchaseforthosegoing
cessing. It gives a complete survey, accompanied by ontodoresearch.
more than 300 illustrations in color, of how medical InChapter1,anintroductiontodigitalimagepro-
images are obtained and how they can be used for cessing is given. It summarizes the jargon used by
diagnosis,therapy,andsurgery. thedigitalimagecommunity, thecomponentsdefin-
Ithasbeenwrittenprincipallyasacoursetexton ing image quality, and basic image operations used
medicalimagingintendedforgraduateandfinal-year to process digital images. The theory of linear sys-
undergraduatestudentswithabackgroundinphysics, tems, described in Chapter 2 of the first edition, has
mathematics, or engineering. However, I have made been moved to an appendix. It is too high-level for
anefforttomakethetextbookreadableforbiomedical themedicalreaderandasignificantpartoftheengi-
scientists and medical practitioners as well by delet- neering readers of the previous edition considered it
ingunnecessarymathematicaldetails,withoutgiving asredundant. However, manystudentsinphysicsor
up the depth needed for physicists and engineers. engineeringarenotfamiliarwithlinearsystemtheory
Mathematicalproofsarehighlightedinseparatepara- andwillwelcomethisappendix.
graphsandcanbeskippedwithouthamperingafluent Chapters 2–6 explain how medical images are
readingofthetext. obtained. The most important imaging modalities
Although a large proportion of the book covers todayarediscussed:radiography,computedtomogra-
the physical principles of imaging modalities, the phy, magnetic resonance imaging, nuclear medicine
emphasis is always on how the image is computed. imaging, and ultrasonic imaging. Each chapter
Equipmentdesign, clinicalconsiderations, anddiag- includes (1) a short history of the imaging modality,
nosisaretreatedinlessdetail. Prematuretechniques (2)thetheoryofthephysicsofthesignalanditsinter-
ortopicsunderinvestigationhavebeenomitted. actionwithtissue, (3)theimageformationorrecon-
Presently,booksonmedicalimagingfallintotwo structionprocess,(4)adiscussionoftheimagequality,
groups, neither of which is suitable for this read- (5)thedifferenttypesofequipmentinusetoday, (6)
ership. The first group is the larger and comprises examplesoftheclinicaluseofthemodality,(7)abrief
books directed primarily at the less numerate pro- descriptionofthebiologiceffectsandsafetyissues,and
fessionssuchasphysicians, surgeons, andradiologic (8)somefutureexpectations.Theimagingmodalities
technicians.Thesebookscoverthephysicsandmathe- havemadeanimpressiveevolutioninashorttimewith
maticsofallthemajormedicalimagingmodalities,but respecttoquality, sizeandapplicability. Thispartof
mostlyinasuperficialway.Theydonotallowanyreal thebookprovidesup-to-dateinformationaboutthese
understanding of these imaging modalities. The sec- systems.
ond group comprises books suitable for professional Chapters 7 and 8 deal with image analysis and
medicalphysicistsorresearcherswithexpertiseinthe visualizationfordiagnosis, therapyandsurgeryonce
field.Althoughthesebookshaveanumerateapproach, imagesareavailable.Medicalimagescan,forexample,
they tend to cover the topics too deeply for the be analyzed to obtain quantitative data, or they can
beginnerandtohaveanarrowerscopethanthisbook. be displayed in three dimensions and actively used
ThetextreflectswhatIteachinclass,butthereis to guide a surgical intervention. Most courses sepa-
somewhatmorematerialthanIcancoverinamodule ratetheimagingtheoryfromthepostprocessing,but
of30contacthours.Thismeansthatthereisscopefor I strongly believe that they should be taken together
Preface
becausethetopicsareintegrated.Theinterestinclin- patient record, and PACS (picture archiving and
ical practice today goes beyond the production and communicationsystems).However,thisfocuswould
diagnosisoftwo-dimensionalimages, andtheobjec- put the emphasis on informatics, such as databases,
tive then is to calculate quantitative information or networking, internet technology and information
tousetheimagesduringpatienttreatment. Thefield security,whichisnotthepurposeofthisbook.
of medical image analysis is in full progress and has Newalsointhissecondeditionisanappendixwith
become more mature during the last decade. This exercises. By solving these exercises the student can
evolutionhasbeentakenintoaccountinthissecond test his or her insight into the matter of this book.
edition.Thechapteronimage-guidedinterventionsof Furthermore an ancillary website (www.cambridge.
thefirsteditionhasbeenrewrittenwithanewfocus. org/suetens) with three-dimensional animations has
The emphasis now is on three-dimensional image been produced which contains answers to the
visualization,notonlytoguideinterventions,butalso exercises.
fordiagnosticpurposes. In the bibliography, references to untreated top-
Medical imaging and image processing can also icscanbefoundaswellasmorespecializedworkson
be approached from the perspective of information aparticularsubdomainandsomeothergenerictext-
and communication and the supporting technology, booksrelatedtothefieldofmedicalimagingandimage
such as hospital information systems, the electronic processing.
viii
Acknowledgments
MycolleaguesoftheMedicalImagingResearchCen- and Dirk Vandermeulen (image analysis), Dirk
ter have directly and indirectly contributed to the Loeckx (exercises), Christophe Deroose, Steven
production of this book. This facility is quite a Dymarkowski, Guy Marchal and Luc Mortelmans
unique place where engineers, physicists, computer (clinical use). They provided me with pieces of text,
scientists, and medical doctors collaborate in an relevantclinicalimagesandimportantliterature;and
interdisciplinary team. It has a central location in Ihadindispensablediscussionswiththemconcerning
the University Hospital Leuven and is surrounded contentandstructure.
by the clinical departments of radiology, nuclear A final reading was done by Kristof Baete,
medicine, cardiology, and radiotherapy. Research Bart De Dobbelaer, An Elen, Johannes Keuster-
is focused on clinically relevant questions. This mans,FlorenceKremer,CatherineLemmens,Ronald
then explains the emphasis in this book, which Peeters, Janaki Rangarajan, Annemie Ribbens, Lies-
is on recent imaging technology used in clinical bet Roose, Kristien Smans, Dirk Smeets and Kevin
practice. Suetens.
The following colleagues and former colleagues I would like to express my gratitude to Walter
contributed to the first edition of the book: Bruno Coudyzer for his assistance in collecting radiological
DeMan,JanD’hooge,FrederikMaes,JohanMichiels, data. Special thanks are due to Dominique Delaere,
Johan Nuyts, Johan Van Cleynenbreugel and Koen the information manager of the Medical Imaging
VandeVelde. Research Center, who assisted me for both this and
This second edition came about with substan- the previous edition with the figures, illustrations
tialinputfromHildeBosmans(radiography), Bruno and animations, consistency checking, and the web-
De Man (computed tomography), Stefan Sunaert pages associated with this textbook. Thanks to his
(magneticresonanceimaging), JohanNuyts(nuclear degreeinbiomedicalengineering,healsomadeseveral
medicine), Jan D’hooge (ultrasound), Frederik Maes improvementstothecontent.