Medical imaging
Medical imaging is the technique and process of imaging the interior of a body for clinical analysis and medical intervention, as well as visual representation of the function of some organs or tissues (physiology). Medical imaging seeks to reveal internal structures hidden by the skin and bones, as well as to diagnose and treat disease. Medical imaging also establishes a database of normal anatomy and physiology to make it possible to identify abnormalities. Although imaging of removed organs and tissues can be performed for medical reasons, such procedures are usually considered part of pathology instead of medical imaging. Measurement and recording techniques that are not primarily designed to produce images, such as electroencephalography (EEG), magnetoencephalography (MEG), electrocardiography (ECG), and others, represent other technologies that produce data susceptible to representation as a parameter graph versus time or maps that contain data about the measurement locations. In a limited comparison, these technologies can be considered forms of medical imaging in another discipline of medical instrumentation. As of 2010, 5 billion medical imaging studies had been conducted worldwide. Radiation exposure from medical imaging in 2006 made up about 50% of total ionizing radiation exposure in the United States. Medical imaging equipment is manufactured using technology from the semiconductor industry, including CMOS integrated circuit chips, power semiconductor devices, sensors such as image sensors (particularly CMOS sensors) and biosensors, and processors such as microcontrollers, microprocessors, digital signal processors, media processors and system-on-chip devices. As of 2015, annual shipments of medical imaging chips amount to 46 million units and $1.1 billion. The term "noninvasive" is used to denote a procedure where no instrument is introduced into a patient's body, which is the case for most imaging techniques used. == History == In 1972, engineer Godfrey Hounsfield from the British company EMI invented the X-ray computed tomography device for head diagnosis, which is commonly referred to as computed tomography (CT). The CT nucleus method is based on the projecting X-rays through a section of the human head, which are then processed by computer to reconstruct the cross-sectional image, known as image reconstruction. In 1975, EMI successfully developed a CT device for the entire body, enabling the clear acquisition of tomographic images of various parts of the human body. This revolutionary diagnostic technique earned Hounsfield and physicist Allan Cormack the Nobel Prize in Physiology or Medicine in 1979. Digital image processing technology for medical applications was inducted into the Space Foundation's Space Technology Hall of Fame in 1994. By 2010, over 5 billion medical imaging studies had been conducted worldwide. Radiation exposure from medical imaging in 2006 accounted for about 50% of total ionizing radiation exposure in the United States. Medical imaging equipment is manufactured using technology from the semiconductor industry, including CMOS integrated circuit chips, power semiconductor devices, sensors such as image sensors (particularly CMOS sensors) and biosensors, as well as processors like microcontrollers, microprocessors, digital signal processors, media processors and system-on-chip devices. As of 2015, annual shipments of medical imaging chips reached 46 million units, generating a market value of $1.1 billion. == Types == In the clinical context, "invisible light" medical imaging is generally equated to radiology or "clinical imaging". "Visible light" medical imaging involves digital video or still pictures that can be seen without special equipment. Dermatology and wound care are two modalities that use visible light imagery. Interpretation of medical images is generally undertaken by a physician specialising in radiology known as a radiologist; however, this may be undertaken by any healthcare professional who is trained and certified in radiological clinical evaluation. Increasingly interpretation is being undertaken by non-physicians, for example radiographers frequently train in interpretation as part of expanded practice. Diagnostic radiography designates the technical aspects of medical imaging and in particular the acquisition of medical images. The radiographer (also known as a radiologic technologist) is usually responsible for acquiring medical images of diagnostic quality; although other professionals may train in this area, notably some radiological interventions performed by radiologists are done so without a radiographer. As a field of scientific investigation, medical imaging constitutes a sub-discipline of biomedical engineering, medical physics or medicine depending on the context: Research and development in the area of instrumentation, image acquisition (e.g., radiography), modeling and quantification are usually the preserve of biomedical engineering, medical physics, and computer science; Research into the application and interpretation of medical images is usually the preserve of radiology and the medical sub-discipline relevant to medical condition or area of medical science (neuroscience, cardiology, psychiatry, psychology, etc.) under investigation. Many of the techniques developed for medical imaging also have scientific and industrial applications. === Radiography === Two forms of radiographic images are in use in medical imaging. Projection radiography and fluoroscopy, with the latter being useful for catheter guidance. These 2D techniques are still in wide use despite the advance of 3D tomography due to the low cost, high resolution, and depending on the application, lower radiation dosages with 2D technique. This imaging modality uses a wide beam of X-rays for image acquisition and is the first imaging technique available in modern medicine. Fluoroscopy produces real-time images of internal structures of the body in a similar fashion to radiography, but employs a constant input of X-rays, at a lower dose rate. Contrast media, such as barium, iodine, and air are used to visualize internal organs as they work. Fluoroscopy is also used in image-guided procedures when constant feedback during a procedure is required. An image receptor is required to convert the radiation into an image after it has passed through the area of interest. Early on, this was a fluorescing screen, which gave way to an Image Amplifier (IA) which was a large vacuum tube that had the receiving end coated with cesium iodide, and a mirror at the opposite end. Eventually the mirror was replaced with a TV camera. Projectional radiographs, more commonly known as X-rays, are often used to determine the type and extent of a fracture as well as for detecting pathological changes in the lungs. With the use of radio-opaque contrast media, such as barium, they can also be used to visualize the structure of the stomach and intestines – this can help diagnose ulcers or certain types of colon cancer. === Magnetic resonance imaging === A magnetic resonance imaging instrument (MRI scanner), or "nuclear magnetic resonance (NMR) imaging" scanner as it was originally known, uses powerful magnets to polarize and excite hydrogen nuclei (i.e., single protons) of water molecules in human tissue, producing a detectable signal that is spatially encoded, resulting in images of the body. The MRI machine emits a radio frequency (RF) pulse at the resonant frequency of the hydrogen atoms on water molecules. Radio frequency antennas ("RF coils") send the pulse to the area of the body to be examined. The RF pulse is absorbed by protons, causing their direction with respect to the primary magnetic field to change. When the RF pulse is turned off, the protons "relax" back to alignment with the primary magnet and emit radio waves in the process. This radio-frequency emission from the hydrogen atoms on water is what is detected and reconstructed into an image. The resonant frequency of a spinning magnetic dipole (of which protons are one example) is called the Larmor frequency and is determined by the strength of the main magnetic field and the chemical environment of the nuclei of interest. MRI uses three electromagnetic fields: a very strong (typically 1.5 to 3 teslas) static magnetic field to polarize the hydrogen nuclei, called the primary field; gradient fields that can be modified to vary in space and time (on the order of 1 kHz) for spatial encoding, often simply called gradients; and a spatially homogeneous radio-frequency (RF) field for manipulation of the hydrogen nuclei to produce measurable signals, collected through an RF antenna. Like CT, MRI traditionally creates a two-dimensional image of a thin "slice" of the body and is therefore considered a tomographic imaging technique. Modern MRI instruments are capable of producing images in the form of 3D blocks, which may be considered a generalization of the single-slice
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