Medical Image Processing Techniques

INTRODUCTION TO IMAGE PROCESSING In electrica l en gineering and computer scienc e, image proces sing is any form of signal processing for which the input is an image, such as photographs or frames of video; theoutput of image processing can be either an image or a set of characteristics or parametersrelated to the image.Most image-processing techniques involve treating the image as a two-dimensionalsignal and applying standard signal-processing techniques to it.Image processing usually refers to digital image processing, but optical and analogimage processing are also possible.

TYPICAL OPERATION Among many other image processing operations are: Euclidean geometry transformations such as enlargement, reduction, and rotation Color corrections such as brightness and contrast adjustments, quantization, or color translation to a different color space Digital compositing or optical compositing (combination of t wo or more ima ges).Used in film-making to make a "matte" Interpolation, demosaicing, and recovery of a full image from a raw image formatusing a Bayer filter pattern Image registration, the alignment of two or more images Image differencing and morphing Ima ge recognition, for example, extract the text from the image b y using opticalcharacter recognition Image segmentation High dynamic range imaging by combining multiple images Geometric hashing for 2-D object recognition with affine invariance

APPLICATIONS Further information: Imaging Computer vision Face detection Feature detection Lane departure warning system Non-photorealistic rendering Medical image processing Microscope image processing Morphological image processing Remote sensing Automated Sieving Procedures

MEDICAL IMAGING Medical imaging refers to the techniques and processes used to create images of theh u m a n b o d y ( o r p a r t s a n d f u n c t i o n t h e r e o f ) f o r c l i n i c a l p u r p o s e s o r m e d i c a l s c i e n c e (including the study of normal anatomy and physiology).A s a d i s c i p l i n e a n d i n i t s w i d e s t s e n s e , i t i s p a r t o f b i o l o g i c a l i m a g i n g a n d incorporates radio logy (in the wider s ens e), nuclear m edicine, investigative r adiologicalsciences, endoscopy, (medical) thermrorgraphy, medical photography and microscopy (e.g.for human pathological investigations). Measurement and recording techniques which are not p r i m a r i l y d e s i g n e d t o p r o d u c e i m a g e s , s u c h a s e l e c t r o e n c e p h a l o g r a p h y ( E E G ) , magnetoencephalography (MEG), Electrocardiography (ECG) and others, but which producedata susceptible to be represented as maps (i.e. containing positional information), can beseen as forms of medical imaging.

IMAGING TECHNOLOGIES Electron microscopy Radiographic Magnetic resonance imaging (MRI) Nuclear medicine Photo acoustic imaging Breast Thermography Tomography Ultrasound

CREATION OF THREE-DIMENSIONAL IMAGES Recently, techniques have been developed to enable C T , M R I a n d u l t r a s o u n d scanning software to produce 3D images for the physician. Traditionally CT and MRI scans produced 2D static output on film. To produce 3D images, man y scans are made, thencombined by computers to produce a 3D model, which can then be manipulated by the physician. 3D ultrasounds are produced using a somewhat similar technique.With the ability to vis ualize important structures in great detail, 3D visua lizationmethods are a valuable resource for the diagnosis and surgical treatment of many pathologies.It was a key resource for the famous, but ultimately unsuccessful attempt by Singaporeansurgeons to separate Iranian twins Ladan and Laleh Bijani in 2003. The 3D equipment wasused previously for similar operations with great success.Other proposed or developed techniques include: Diffuse optical tomography Elastography Electrical impedance tomography Optoacoustic imaging Ophthalmology o A-scan o B-scan o Corneal topography o

Optical coherence tomography o Scanning laser ophthalmoscopySome of these techniques are still at a research stage and not yet used in clinical routines.

NON-DIAGNOSTIC IMAGING Neuroimaging has als o been used in exp erim ental circumstances to allow p eop le(especially disabled persons) to control outside devices, acting as a brain computer interface.

OPEN SOURCE SOFTWARE Several open source software packages are available for performing analysis of medicalimages: ImageJ ITK DICOMWORKS GemIdent

PROPRIETARY SOFTWARE MIMViewer SureVistaVision Universal PACS Simpleware ScanIP

AN INNOVATIVE MEDICAL IMAGING ARCHITECTURE Fig: Medical Imaging Technology Architecture

omputed tomography (CT) is a medical imaging method employing tomographycreated b y computer proc essing. Di gital geomet ry processing is used to generate a three-dimensional image of the inside of an object from a large series of two-dimensional X-rayimages taken around a single axis of rotation.CT produces a volume of data which can be manipulated, through a process known as"windowing", in order to demonstrate various bodily structures based on their ability to block the X-ra y/R ntgen beam. Although historically the images gen erat ed were in the axial or transverse plane, orthogonal to the long axis of the body, modern scanners allow this volumeof data to be reformatted in various planes or even as volumet ric (3D) repres entations of structures. Although most comm on in medicine, CT is also us ed in other fi elds, such asnondestructive materials testing. Another example is the DigiMorph project at the Universityo f T e x a s a t A u s t i n w h i c h u s e s a C T s c a n n e r t o s t u d y b i o l o g i c a l a n d p a l e o n t o l o g i c a l specimens.

TERMINOLOGY The word "tom ography" is deri ved from th e Greek tomos (slice) and graphein (towrite). Computed tomography was originally known as the "EMI scan" as it was developed ata research branch of EMI, a company best known today for its music and recording business.It was lat er known as computed axial tomography (C AT or C T scan) and body sectionroentgenography .

Alth ough the t erm "computed tomograph y" c ould b e u s e d t o d e s c r i b e p o s i t r o n emis sion tomograph y and single photon emission computed tom ography, in practice itusually refers to t he computation of tomograph y from X-ra y images , especially in old er medical literature and smaller medical facilities.In MeS H, "computed axial tomograph y" was us ed from 1977-79, but the currentindexing explicitly includes "X-ray" in the title.

HISTORY In the early 1900s, the Italian radiologist Alessandro Vallebona proposed a method torepresent a single s lice of the bod y on the radiographic film. This method was known ast o m o g r a p h y . T h e i d e a i s b a s e d o n s i m p l e p r i n c i p l e s o f p r o j e c t i v e g e o m e t r y : m o v i n g synchronously and in opposite directions the X-ray tube and the film, which are connectedtogether by a rod whose pivot point is the focus; the image created by the points on the focal plane appears sharper, while the images of the other points annihilate as noise. This is onlymarginally effective, as blurring occurs only in the "x" plane. There are also more complexdevices which can move in more than one plane and perform more effective blurring.Tomography had been one of the pillars of radiologic diagnostics until the late 1970s,when the availability of minicomputers and of the transverse axial scanning method, this lastdue to the work of Godfrey Hounsfield and South African born Allan Mc Leod Cormack,gradually supplanted it as the modality of CT.The first commercially viable CT scanner was invented by Sir Godfrey Hounsfield inHayes, United Kingdom at EMI Central Research Laboratories using X-rays. Hounsfieldconceived his idea in 1967, and it was publicly announced in 1972. Allan McLeod Cormack of Tufts Universit y in Massachusetts independently invented a similar process, and bothHounsfield and Cormack shared the 1979 Nobel Prize in Medicine.

The original 1971 prototype took 160 parallel readings through 180 angles, each 1apart, with each scan taking a little over five minutes. The images from these scans took 2.5hours to be proc ess ed b y algebraic reconstruction techni ques on a large c omputer. Thescanner had a single photomultiplier detector, and operated on the Translate/Rotate principle.It h a s b e e n c l a i m e d t h a t t h a n k s t o t h e s u c c e s s o f T h e B e a t l e s , E M I c o u l d f u n d research and build early models for medical use. The first production X-ray CT machine (infact called the "EMI-Scanner") was limited to making tomographic sections of the brain, buta c q u i r e d t h e i m a g e d a t a i n a b o u t 4 m i n u t e s ( s c a n n i n g t w o a d j a c e n t s l i c e s ) , a n d t h e computation time was about 7 minutes per picture. This scanner required the use of a water-fi lled Perspex tank with a pre-shaped rubber "h eadcap" at the front, which enclos ed the patient's head. The watertank was used to reduce the dynamic range of the radiation reachingthe detectors. The images were relatively low resolution, being composed of a matrix of only8 0 x 8 0 p i x e l s . T h e f i r s t E M I Scanner was insta lled in Atkinson Morley Hospital in Wimbledon, England, and the first patient brain-scan was made with it in 1972In the U.S., the first installation was at the Mayo Clinic. As a tribute to the impact of this s yst em on m edical imaging the Mayo Clinic has an EM I sc anner on displa y in theRadiology Department.The first CT s yst em that could make images of an y part of the bod y and did notrequire the "water tank" was the ACTA (Automatic Computerized Transverse Axial) scanner d e s i g n e d b y R o b e r t S . L e d l e y , D D S a t G e o r g e t o w n U n i v e r s i t y . T h i s m a c h i n e h a d 3 0 photomultiplier

tubes as detectors and complet ed a scan in only 9 translate/rotate c yc les,much faster than the EMI-scanner. It used a DEC PDP11/34 minicomputer both to operatethe servomechanisms and to acquire and proces s the images. The Pfizer drug compan yacquired the prototype from the university, along with rights to manufacture it. Pfizer then began making copies of the prototype, calling it the "200FS" (FS meaning Fast Scan), whichwere selling as fast as they could make them. This unit produced images in a 256x256 matrix,with much better definition than the EMI-Scanner's 80x80

TOMOGRAPHY A form of tomography can be performed by moving the X-ray source and detector during an exposure. Anatomy at the target level remains sharp, while structures at differentlevels are blurred. By varyin g the ext ent and path of motion, a variet y of effects can beobtained, with variable d epth of fi eld and different degrees of blurring of ' out of plan e'structures.Although largely obsolete, conventional tomography is still used in specific situationssuch as dental imaging (orthopantomography) or in intravenous urography.

TOMOSYNTHESIS Digital tom os ynthesis combines digital image capture and proces sing with simpletube/detector motion as used in conventional radiographic tomography. Although there aresom e similarities to C T, it is a separate technique. In CT, the source/d etector makes acomplete 360-degree rotation about the subject obtaining a complete set of data from whichimages may be reconstructed. In digital tomosynthesis, only a small rotation angle (e.g., 40degrees) with a small number of discrete exposures (e.g., 10) are used. This incomplete set of data can be digitally processed to yield images similar to conventional tomography with a limited depth of field. However, because the image processing is digital, a series of slices atd i f f e r e n t d e p t h s a n d w i t h d i f f e r e n t t h i c k n e s s e s c a n b e r e c o n s t r u c t e d f r o m t h e s a m e acquisition, saving both time and radiation exposure.B e c a u s e t h e d a t a a c q u i r e d i s i n c o m p l e t e , t o m o s y n t h e s i s i s u n a b l e t o o f f e r t h e extremely narrow slice widths that CT offers. However, higher resolution detectors can beused, allowing very-high in-plane res olution, even if the Z-a xis res olution is poor. The primary interest in tomosynthesis is in breast imaging, as an extension to mammography,where it may offer better detection rates with little extra increase in radiation exposure.R e c o n s t r u c t i o n a l g o r i t h m s f o r t o m o s y n t h e s i s a r e s i g n i f i c a n t l y d i f f e r e n t f r o m conventional CT, becaus e the conventional filt ered back projection algorithm require s acomplete s et of data. It erative a lgorithms based upon exp ectation maximization are mostcomm only used, but are extrem ely computationally int ensive. S ome manufacturers have produced practical systems using off-the-shelf GPUs to perform the reconstruction.

WORKING OF COMPUTED TOMOGRAPHY Computed Tomography is a powerful nondestructive evaluation (NDE) technique for p r o d u c i n g 2 - D a n d 3 - D c r o s s sectional images of an object from flat Xr a y i m a g e s . Characteristics of the internal structure of an object such as dimensions, shape, internaldefects, and density are readily available from CT images. Shown below is a schematic of aCT system.

The test component is placed on a turntable stage that is between a radiation sourceand an imaging system. The turntable and the imaging system are connected to a computer sothat x-ray images collected can be correlated to the position of the test component. Theimaging system produces a 2-dimensional shadowgraph image of the specimen just like afilm radiograph. Specialized computer software makes it possible to produce cross-sectionalimages of the test component as if it was being sliced.

HOW A C.T SYSTEM WORKS The ima ging s yst em provides a shadowgraph of an object, with the 3-D structurec ompres sed onto a 2-D plan e. Th e density data along one horizon tal line of the image isuncompressed and stretched out over an area. This information by itself is not very useful, but when the test component is rotated and similar data for the same linear slice is collectedand overlaid, an image of the cross-sectional density of the component begins to develop. Tohelp comprehend how this works, look at the animation below.In the animation, a single line of density data was collected when a component was atthe starting position and then when it was rotated 90 degrees. Use the pullring to stretch outthe density data in the vertical direction. It can be seen that the lighter area is stretched acrossthe whole region. This lighter area would indicate an area of less density in the component because imaging s ys tems t ypically glow bri ghter wh en they are struck with an increas edamount of radiation. When the information from the second line of data is stretched acrossand averaged with the first set of stretched data, it becomes apparent that there is a less densearea in the upper right quadrant of the component's cross-section. Data collected at moreangles of rotation and merged together will further define this feature. In the movie below, aC T i m a g e o f a casting is produced. It can be seen that the crosss e c t i o n o f t h e c a s t i n g becomes more defined as the casting is rotated, X-rayed and the stretched density informationis added to the image.In the image below left is a set of cast aluminum tensile specimens. A radiographicimage of several of these specimens is shown below right CT slices through several locations of a specimen are shown in the set of images below.A number of slices through the object can be reconstructed to provide a 3-D view of i n t e r n a l a n d e x t e r n a l s t r u c t u r a l d e t a i l s . A s s h o w n b e l o w , t h e 3 - D i m a g e c a n t h e n b e manipulated and sliced in various ways to provide thorough understanding of the structure.

Since its introduction in the 1970s, CT has become an important tool in medicali m a g i n g t o s u p p l e m e n t X ra ys and medica l ult ras onograph y. Althou gh it is sti ll q u i t e expensive, it is the gold standard in the diagnosis of a large number of different diseas eentities. It has more recently begun to also be used for preventive medicine or screening for disease, for example CT colonography for patients with a high risk of colon cancer. Althougha number of institutions offer fullbody scans for the general population.

HEAD CT scanning of the head is typically used to detect:1.bleeding, brain injury and skull fractures2.bleeding due to a ruptured/leaking aneurysm in a patient with a sudden severeheadache3.a blood clot or bleeding within the brain shortly after a patient exhibits symptoms of astroke4 . a s t r o k e 5 . b r a i n t u m o r s 6.enlarged brain cavities in patients with hydrocephalus7.diseas es/malformations of the skull8.diagn ose diseases of the temporal bone on the side of the skull, which may be causinghearing problems9.plan radiation therapy for cancer of the brain or other tissues10.guide the passage of a needle used to obtain a tissue sample (biopsy) from the brain

CHEST CT can be used for detecting both acute and chronic changes in the internals of thelungs. It is particularly relevant here because normal two dimensional x-rays do not showsuch defects. For evaluation of chronic interstitial processes thin sections with high spatialfrequenc y reconstru ctions are used oft en scans are perform ed

both in inspiration andexpiration. This special technique is called High Resolution CT (HRCT). HRCT is normally done with thin section with skipped areas between the thin sections. Therefore it produces asampling of the lung and not continuous images. Continuous images are provid ed in astandard CT of the chest.For d etec tion of airspace diseas e (such as pneumonia) or cancer, relatively thick s e c t i o n s a n d g e n e r a l p u r p o s e i m a g e r e c o n s t r u c t i o n t e c h n i q u e s m a y b e a d e q u a t e . C T angiograph y of the chest is also b ecoming the pri mary m ethod for det ecting pulmonaryembolism (PE) and aortic dissection, and require s accurately tim ed rapid injections of contrast (Bolus Tracking) and high-speed helical scanners. Cardiac CTA is now being used todiagnose coronary artery disease.

PULMONARY ANGIOGRAM CT pulmonary angiogram (CTP A) is a m edical diagnostic test used to diagnose pulmonary embolism (PE). It employs computed tomograph y to obtain an image of the pulmonary arteries.MDCT (multi detector CT) scanners give the optimum resolution and image qualityfor this test. Ima ges are usually taken on a 0.625 mm slice thickness, although 2 mm iss u f f i c i e n t . 5 0 100 mls of contrast is given to the patient at a ra t e o f 4 m l / s . T h e tracker/locator is placed at the level of the Pulmonary Arteries, which sit roughly at the levelof the carina This is done using bolus tracking. Example of a CTPA, demonstrating a saddle embolus (dark horizontal line) occluding the pulmonaryarteries (bright white triangle)

CARDIAC With the advent of sub second rotation combined with multi-slice CT (up to 64-slice),high resolution and high speed can be obtained at the same time, allowing excellent imagingof the coronary arteri es (ca rdiac CT angiograp hy). Images with an even higher temp ora lresolution can be formed using retrospective ECG gating. In this technique, each portion of the heart is imaged more than once while an ECG trace is recorded. The ECG is then used tocorrelat e the CT data with their corresponding phases of cardiac contraction. Once

thiscorrelation is complete, all data that were recorded while the heart was in motion (systole)can be ignored and images can be made from the remaining data that happened to be acquiredw h i l e t h e heart was at rest (diast ole). In this wa y, individual f r a m e s i n a c a r d i a c C T investigation have a better temporal resolution than the shortest tube rotation time.Methods are available to decreas e this exposure, however, such as prospectivelyd ecreasing radiation output based on the concurrently acquired ECG. Th is can result in asignificant decrease in radiation exposure, at the risk of compromising image quality if thereis any arrhythmia during the acquisition. The significance of radiation doses in the diagnosticimaging range has not been proven, although the possibility of inducing an increased cancer r i s k a c r o s s a p o p u l a t i o n i s a s o u r c e o f s i g n i f i c a n t c o n c e r n . T h i s p o t e n t i a l r i s k m u s t b e weighed against the competing risk of not performing a test and potentially not diagnosing asignificant health problem such as coronary artery disease.Dual Source CT scanners, introduced in 2005, allow higher temporal resolution byacquiring a full CT slice in only half a rotation, thus reducing motion blurring at high heartrates and potentially allowing for shorter breath-hold time. This is particularly useful for ill patients who have difficulty holding their breath or who are unable to take heart-rate loweringmedication.

ABDOMINAL AND PELVIC CT is a sensitive method for diagnosis of abdominal diseases. It is used frequently todetermine stage of cancer and to follow progress. It is also a useful test to investigate acuteabdominal pain,Renal stones, appendicitis, pancreatitis, diverticulitis, abdominal aorticaneurysm, and bowel obstruction are conditions that are readily diagnosed and assessed withCT. CT is also the first line for detecting solid organ injury after trauma

EXTREMITIES CT is often used to image complex fractures, especially ones around joints, because of itsability to reconstruct the area of interest in multiple planes. Fractures, ligamentous injuriesand dislocations can easily be recognised with a 0.2 mm resolution.

ADVANTAGES AND HAZARDS ADVANTAGES OVER TRADITIONAL RADIOGRAPHY There are several advantages that CT has over traditional 2D medical radiography.CT complet ely elimi nates the superimposition of images of st ructures outside the area of interest. Because of the inherent high-contrast resolution of CT, differences between tissuesthat differ in physical density by less than 1% can be distinguished.Data from a single CT imaging proc edure consisting of either multiple c ontiguous or onehelical scan can be viewed as images in the axial, coronal, or sagittal planes, depending onthe diagnostic task. This is referred to as multiplanar reformatted imaging.CT is regarded as a moderate to high radiation diagnostic technique. While technicaladvances have improved radiation efficiency, there has been simultaneous pressure to obtainhigher-res olution imaging and use more comp lex scan techniques, both of which requirehigher doses of radiation. The improved resolution of CT has permitted the development of new investigations, which may have advantages; compared to conventional angiography for example, CT angiography avoids the invasive insertion of an arterial catheter and guidewire;CT colonography (also known as virtual colonoscopy or VC for short) may be as useful as a b a r i u m enema for detection of tumors, but may use a lower r a d i a t i o n d o s e . C T V C i s increasingly being used in the UK

as a diagnostic test for bowel cancer and can negate theneed for a colonoscopy.The greatly increas ed availability of C T, together with its va lue for an increasingnumber of conditions, has been responsible for a large rise in popularity. So large has beenthis rise that, in the most rec ent compreh ensive survey in the United Kingdom, CT scansconstituted 7% of all radiologic examinations, but contributed 47% of the total collectivedose from medical X-ray examinations in 2000/2001.T h e r a d i a t i o n d o s e f o r a p a r t i c u l a r s t u d y d e p e n d s o n m u l t i p l e f a c t o r s : v o l u m e scanned, patient build, number and type of scan sequences, and desired resolution and imagequality. Additionally, two helical CT scanning parameters that can be adjusted easily and thathave a profound effect on radiation dose are tube current and pitch.Safety Concerns. Th e increased use of CT scans has been the greatest i n t w o f i e l d s : s c r e e n i n g o f a d u l t s (screening CT of the lung in smokers, virtual colonoscopy, CT cardiac screening and whole- body CT in asymptomatic patients) and CT imaging of children. Shortening of the scanningtime to around one second, eliminating the strict need for subject to remain still or be sedated,is one of the main reasons for large increase in the pediatric population (especially for thediagnosis of appendicitis). CT scans of children have been estimated to produce non-negligible increases in the probability of lifetime cancer mortality leading to calls for the useof reduced current settings for C T scans of children. Th es e calculations are based on theassumption of a lin ear relationship between radiation dose and cancer risk; this claim iscontroversial, as some but not all evid ence shows that smaller ra diation doses are lessharmful. Estimated lifetime cancer mortality risks attributable to the radiation exposure froma CT in a 1-year-

old are 0.18% (abdominal) and 0.07% (head)an order of magnitude higher than for adultsalthough those figures still represent a small increase in cancer mortalityover the background rate. In the United States, of approximately 600,000 abdominal and headCT examinations annually performed in children under the age of 15 years, a rough estimateis that 500 of these individuals might ultimately di e from cancer attributable to the CTradiation . The additional risk is still very low (0.35%) compared to the background risk of dying from cancer (23%). However, if these statistics are extrapolated to the current number of CT scans, the additional rise in cancer mortality could be 1.5 to 2%. Furthermore, certainconditions can require children to be exposed to multiple CT scans. Again, these calculationscan be problematic because the assumptions underlying them could overestimate the risk.CT scans can be performed with different settings for lower exposure in children,although these techniques are often not employed. Surveys have suggested that currently,many CT scans are performed unnecessarily. Ultrasound scanning or magnetic resonanceimaging is alternatives (for examp le, in appendicitis or brain imaging) without the risk of radiation exposure. Although CT scans come with an additional risk of cancer (it can beestimated that the radiation exposure is the same as standing 2.4km away from the WWIIatomic bomb bla sts in Japan), especially in children, the benefits that stem from th eir useoutweighs the risk in many cases. Studies support informing parents of the risks of pediatricCT scanning ADVERSE REACTIONS TO CONTRAST AGENTS

Because contrast CT scans rely on intravenously administered contrast agents in order to provide superior image quality, there is a low but non-negligible level of risk associatedwith the contrast agents themselves. Many patients report nausea and discomfort, includingwarmth in the crotch which mimics the sensation of wetting oneself. Certain patients mayexperience severe and potentially life-threatening allergic reactions to the contrast dye.The contrast agent may also induce kidney damage. The risk of this is increased with p a t i e n t s w h o h a v e p r e e x i s t i n g r e n a l i n s u f f i c i e n c y , p r e e x i s t i n g d i a b e t e s , o r r e d u c e d intravascular volume. In general, if a patient has normal kidney function, then the risks of contrast nephropathy a re n egli gible. Patients with mild k idney impairm ent are usuallyadvised to ensure full hydration for several hours before and after the injection. For moderatekidney failure, the use of iodinated contrast should be avoided; this may m ean using analternative technique instead of CT e.g. MRI. Perhaps paradoxically, patients with severerenal failure requiring dialysis do not require special precautions, as their kidneys have solittle function remaining that any further damage would not be noticeable and the dialysis willremove the contrast agent.

MAGNETIC RESONANCE IMAGING Magnetic Resonance Imaging(MRI) , or nuclear magnetic resonance imaging(NMRI), is primarily a m edical imaging technique most common ly used in radiology tovisualize the internal structure and function of the body. MRI provides much greater contrast between the different soft tissues of the body than computed tomography (CT) does, makingit especially useful in neurological (brain), musculoskeletal, cardiovascular, and oncological(cancer) imaging. Unlike CT, it uses no ionizing radiation, but uses a powerful magnetic fieldto align the nuclear magnetization of (usually) hydrogen atoms in water in the body. Radiofrequency (RF) fields are used to systematically alter the alignment of this magnetization,causing the hydrogen nuclei to produce a rotating magnetic field detectable by the scanner.This signal can be manipulated by additional magnetic fields to build up enough informationto construct an image of the body.Magnetic Resonance Imaging is a relatively new technology. The first MR image was published in 1973 and the first cross sectional image of a living mouse was published inJ a n u a r y 1 9 7 4 . T h e f i r s t s t u d i e s p e r f o r m e d o n h u mans were published in 1977. Bycomparison, the first human X-ray image was taken in 1895.Magnetic Resonance Imaging was developed from knowledge gained in the study of nuclear magn etic res onance. In its ea rly yea rs the technique was referred to as nuclear magnetic resonance imaging (NMRI). However, as the word nuclear was associated in the public mind with ionizing radiation exposure it is generally now referred to simply as MRI.Sc ientists still us e the term NMR I wh en discussing non-medical devices operating on

thesame principles. The term Magnetic Resonance Tomography (MRT) is also sometimes used. HOW MRI WORKS The body is largely composed of water molecules which each contain two hydrogennuclei or protons. When a person goes inside the powerful magnetic field of the scanner, themagnetic moments of these protons align with the direction of the field.A radio frequency electromagnetic field is then briefly turned on, causing the protonsto alter their alignment relative to the field. When this field is turned off the protons return tothe original magnetization alignment. These alignment changes create a signal which can bedetected by the scanner. The frequency the protons resonate at depends on the strength of themagnetic field. The position of protons in the body can be determined by applying additionalmagnetic fields during the scan which allows an image of the body to be built up. These arecreated by turning gradients coils on and off which creates the knocking sounds heard duringan MR scan.Diseased tissue, such as tumors, can be detected becaus e the prot ons in differenttissues return to their equilibrium state at different rates. By changing the parameters on thescanner this effect is used to create contrast between different types of body tissue.Contrast agents may be injected intravenously to enhance the appearance of bloodvessels, tumors or inflammation. Contrast agents may also be directly injected into a joint inthe case of arthrograms, MR images of joints. Unlike CT, MRI uses no ionizing radiation andis generally a very safe procedure. Patients with some metal implants, cochlear implants, andcardiac pacemakers are prevented from having an MR I scan due to effects of the strongmagnetic field and powerful radio frequency pulses.M R I i s u s e d t o i m a g e e v e r y p a r t o f t h e b o d y , a n d i s p a r t i c u l a r l y u s e f u l f o r neurological conditions, for disorders of the muscles and joints, for evaluating tumors, andfor showing abnormalities in the heart and blood vessels

THREE-DIMENSIONAL (3D) IMAGE RECONSTRUCTION THE PRINCIPLE Because contemp orary MR I scanners offer is otropic, or n ea r isotropic, res olution,display of images does not need to be restricted to the conventional axial images. Instead, it is possible for a software program to build a volume by 'stacking' the individual slices one ontop of the other. The program may then display the volume in an alternative manner. 3D RENDERING TECHNIQUES SURFACE RENDERING A threshold va lue of greyscale density is chos en b y the operat or (e. g. a level thatc o r r e s p o n d s t o f a t ) . A t h r e s h o l d l e v e l i s s e t , u s i n g e d g e d e t e c t i o n i m a g e p r o c e s s i n g algorithms. From this, a 3-dimensional model can be constructed and displayed on screen.Multiple models can be constructed from vari ous different thresh olds, a llowing differentcolors to represent each anatomical component such as bone, muscle, and cartilage. However,the interior structure of each element is not visible in this mode of operation. VOLUME RENDERING Surfac e rendering is limit ed in that it will only disp la y s u r f a c e s w h i c h m e e t a threshold density, and will only display the surface that is closest to the imaginary viewer. Involume rendering, transparency and colors are used to allow a better representation of thevolum e to be sh own in a single image - e.g. the bon es of the pelvis could be displa yed assemi-transparent, so that even at an oblique angle, on e part of the image does not conc ealanother.

IMAGE SEGMENTATION Where different structures have similar threshold density, it can become impossible toseparate them simply by adjusting volume rendering parameters. The s olution is calledsegmentation, a manual or automatic procedure that can remove the unwanted structures fromthe image. COMPUTED TOMOGRAPHY VERSUS MRI A computed tomography (CT) scanner uses X-rays, a type of ionizing radiation, toacquire its images, making it a good tool for examining tissue composed of elements of ahigher atomic number than the tissue surrounding them, such as bone and calcifications(calcium based) within the body (carbon based flesh), or of structures (vessels, bowel). MRI,on the other hand, uses non-ionizing radio frequency (RF) signals to acquire its images and is best suited for non-calcified tissue, though MR images can also be acquired from bones andteeth as well as fossils.CT may be enhanced by use of contrast agents containing elements of a higher atomicnumber than the surrounding flesh such as iodine or barium. Contrast agents for MR I arethose which have paramagnetic properties, e.g. gadolinium and manganese.Both CT and MR I scanners can generat e multiple t wo-dimensional cross -s ections(slices) of tissue and three-dimensional reconstructions. Unlike CT, which uses only X-ray attenuation to generate image contrast, MRI has a long list of properties that may be used togenerate image contrast. By variation of scanning parameters, tissue contrast can be alteredand enhanced in various ways to detect different features.MRI can generate cross-sectional images in any plane (including oblique planes). Inthe past, CT was limited to acquiring images in the axial (or near axial) plane. The scans usedto be called Computed Axial

Tomography scans (CAT scans). However, the development of multi-detector CT scanners with near-isotropic resolution, allows the CT scanner to producedata that can be retrosp ectively reconstructed i n any plane with minimal loss of imagequality.For purpos es of tumor d etection and identification in the brain, MRI is genera llys u p e r i o r . However, in the case of solid tumors of the abdomen a n d c h e s t , C T i s o f t e n preferred due to less moti on artifact. Furthermore, C T usually is m ore widely available,fast er, much less exp ensive, and may be less likely t o require the pers on to be sedated or anesthetized.MRI is also best suited for cases when a patient is to undergo the exam several timessuccessively i n the short term, becaus e, unlike CT, it does not expose t he patient to thehazards of ionizing radiation. ECONOMICS OF MRI MR I equipment is exp ensive. 1.5 tesla scanners oft en cost bet ween $1 million and$1.5 million USD. 3.0 tesla scanners often cost between $2 million and $2.3 million USD.Construction of MR I suites can cost up to $500,000 USD, or m ore, depending on proj ectscope. SAFETY Death and injuries have occurred from proj ectiles creat ed by the ma gnetic field,although few c ompared to the milli ons of examinations administered. MR I makes use of powerful ma gnetic fi elds which, though they have not been dem onstrated to cause direct biological damage, can interfere with metallic and electromechanical devices. Additional(small) risks are presented by the radio frequency systems, components or elements of the

MRI system's operation, elements of the scanning procedure and medications that may beadministered to facilitate MRI imaging.There are many steps that the MRI patient and referring physician can take to help reduce theremaining risks, including providing a full, accurate and thorough medical history to the MRI provider. EXPERIMENTAL EXAMPLE FOR C T COMPUTED TOMOGRAPHY,HEAD Computed axial tomograph y (C AT), computerassisted tomograph y, computedtomography, CT, or body section roentgenography is the process of using digital processingto generate a three-dimensional image of the internals of an object from a large series of two-d i m e n s i o n a l x ray images taken around a single axis of rotation. So m e t i m e s c o n t r a s t materials such as barium (administered orally or rectally) or intravenous iodinated contrastare used.

INDIVIDUAL IMAGES OF CT A volume rendering of this volume clearly shows the high density bones. Fig.,Bone reconstructed in 3D After using a segmentation tool to remove the bone, the previously concealed vessels cannow be demonstrated. Medical Image Processing TechniquesFig.,Brain vessels reconstructed in 3D after bone has been removed by segmentation

CONCLUSION Image processing is any form of signal processing for which the input is an image andthe output of image processing can be either an image or a set of characteristics or parametersrelated to the image.Most imageprocessing techniques involve treating the image as a twodimensionalsignal and applying standard signal-processing techniques. Recently, techniques have beendeveloped to enable CT, MRI and ultrasound scanning software to produce 3D images for the physician.Traditionally CT and MRI scans produced 2D static output on film. To produce 3Dimages, man y scans are made, and then combined by c omputers t o produce a 3D model, which can then be manipulated by the physician. 3D ultrasounds are produced using asomewhat similar technique.Computer tomography is a medical imaging method employing tomography created by computer processing. Digital geometry processing is used to generate a threedimensionalimage of the inside of an object from a large series of two-dimensional X-ray images taken around a single axis of rotation. (CT) is a powerful nondestructive evaluation (NDE) technique for producing 2-D and 3-D cross-sectional images of an object from flat X-ray images. The Italian radiologist Alessandro Vallebona proposed a method to represent a singleslice of the body on the radiographic film. This method was known as tomography. The firstcommercially viable CT scanner was invented by Sir Godfrey Hounsfield in Hayes, UnitedKingdom at EMI Central Research Laboratories using X-rays.MRI can generate cross-sectional images in any plane (including oblique planes). Inthe past, CT was limited to acquiring images in the axial (or near axial) plane. The scans usedto be called Computed Axial Tomography scans (CAT scans). However, the development of multi-detector CT scanners with near-isotropic resolution,

allows the CT scanner to producedata that can be retrosp ectively reconstructed i n any plane with minimal loss of imagequality.

REFERENCES 1.http://www.ndted.org/EducationResources/Radiography/Advanced Techniques 2.http://www.picturen ews letter.c om/index 3.http://wikipedia.com/ Ima geproces sing/ 4.http://en.wikipedia.org/ wiki /MRI 5.http://www.orchid-tech.com/ 6.http://www. medicalimaging. org/ 7.http://en.wikipedia.org/wiki/Magnetic_resonance_imaging/