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Medical imaging is the technique and process of
imaging Imaging is the representation or reproduction of an object's form; especially a visual representation (i.e., the formation of an image). Imaging technology is the application of materials and methods to create, preserve, or duplicate images. ...
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 Physiology (; ) is the science, scientific study of function (biology), functions and mechanism (biology), mechanisms in a life, living system. As a branches of science, subdiscipline of biology, physiology focuses on how organisms, organ syst ...
). Medical imaging seeks to reveal internal structures hidden by the skin and bones, as well as to diagnose and treat
disease A disease is a particular abnormal condition that adversely affects the structure or function (biology), function of all or part of an organism and is not immediately due to any external injury. Diseases are often known to be medical condi ...
. Medical imaging also establishes a database of normal
anatomy Anatomy () is the branch of morphology concerned with the study of the internal structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old scien ...
and
physiology Physiology (; ) is the science, scientific study of function (biology), functions and mechanism (biology), mechanisms in a life, living system. As a branches of science, subdiscipline of biology, physiology focuses on how organisms, organ syst ...
to make it possible to identify abnormalities. Although imaging of removed
organs In a multicellular organism, an organ is a collection of tissues joined in a structural unit to serve a common function. In the hierarchy of life, an organ lies between tissue and an organ system. Tissues are formed from same type cells to a ...
and tissues can be performed for medical reasons, such procedures are usually considered part of
pathology Pathology is the study of disease. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in the context of modern medical treatme ...
instead of medical imaging. Measurement and recording techniques that are not primarily designed to produce
image An image or picture is a visual representation. An image can be Two-dimensional space, two-dimensional, such as a drawing, painting, or photograph, or Three-dimensional space, three-dimensional, such as a carving or sculpture. Images may be di ...
s, such as
electroencephalography Electroencephalography (EEG) is a method to record an electrogram of the spontaneous electrical activity of the brain. The biosignal, bio signals detected by EEG have been shown to represent the postsynaptic potentials of pyramidal neurons in ...
(EEG),
magnetoencephalography Magnetoencephalography (MEG) is a functional neuroimaging technique for mapping brain activity by recording magnetic fields produced by electric current, electrical currents occurring naturally in the human brain, brain, using very sensitive magn ...
(MEG),
electrocardiography Electrocardiography is the process of producing an electrocardiogram (ECG or EKG), a recording of the heart's electrical activity through repeated cardiac cycles. It is an electrogram of the heart which is a graph of voltage versus time of t ...
(ECG), and others, represent other technologies that produce data susceptible to representation as a parameter graph versus time or
map A map is a symbolic depiction of interrelationships, commonly spatial, between things within a space. A map may be annotated with text and graphics. Like any graphic, a map may be fixed to paper or other durable media, or may be displayed on ...
s 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 The semiconductor industry is the aggregate of companies engaged in the design and fabrication of semiconductors and semiconductor devices, such as transistors and integrated circuits. Its roots can be traced to the invention of the transistor ...
, including
CMOS Complementary metal–oxide–semiconductor (CMOS, pronounced "sea-moss ", , ) is a type of MOSFET, metal–oxide–semiconductor field-effect transistor (MOSFET) semiconductor device fabrication, fabrication process that uses complementary an ...
integrated circuit An integrated circuit (IC), also known as a microchip or simply chip, is a set of electronic circuits, consisting of various electronic components (such as transistors, resistors, and capacitors) and their interconnections. These components a ...
chips,
power semiconductor device A power semiconductor device is a semiconductor device used as a switch or rectifier in power electronics (for example in a switch-mode power supply). Such a device is also called a power device or, when used in an integrated circuit, a power IC ...
s,
sensors A sensor is often defined as a device that receives and responds to a signal or stimulus. The stimulus is the quantity, property, or condition that is sensed and converted into electrical signal. In the broadest definition, a sensor is a devi ...
such as
image sensors An image sensor or imager is a sensor that detects and conveys information used to form an image. It does so by converting the variable attenuation of light waves (as they pass through or reflect off objects) into signals, small bursts of curren ...
(particularly
CMOS sensor An active-pixel sensor (APS) is an image sensor, which was invented by Peter J.W. Noble in 1968, where each pixel sensor unit cell has a photodetector (typically a pinned photodiode) and one or more active transistors. In a metal–oxide–semic ...
s) and
biosensors A biosensor is an analytical device, used for the detection of a chemical substance, that combines a biological component with a physicochemical detector. The ''sensitive biological element'', e.g. tissue, microorganisms, organelles, cell rece ...
, and processors such as
microcontrollers A microcontroller (MC, uC, or μC) or microcontroller unit (MCU) is a small computer on a single integrated circuit. A microcontroller contains one or more CPUs (processor cores) along with memory and programmable input/output peripherals. Pro ...
,
microprocessors A microprocessor is a computer processor for which the data processing logic and control is included on a single integrated circuit (IC), or a small number of ICs. The microprocessor contains the arithmetic, logic, and control circuitry r ...
,
digital signal processors A digital signal processor (DSP) is a specialized microprocessor chip, with its architecture optimized for the operational needs of digital signal processing. DSPs are fabricated on metal–oxide–semiconductor (MOS) integrated circuit chips. ...
,
media processor A media processor, mostly used as an image/ video processor, is a microprocessor-based system-on-a-chip which is designed to deal with digital streaming data in real-time (e.g. display refresh) rates. These devices can also be considered a class ...
s and
system-on-chip A system on a chip (SoC) is an integrated circuit that combines most or all key components of a computer or electronic system onto a single microchip. Typically, an SoC includes a central processing unit (CPU) with memory, input/output, and da ...
devices. , annual shipments of medical imaging chips amount to 46million units and . The term "
noninvasive Minimally invasive procedures (also known as minimally invasive surgeries) encompass surgical techniques that limit the size of incisions needed, thereby reducing wound healing time, associated pain, and risk of infection. Surgery by definition ...
" 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 (CT) device for head diagnosis, which is commonly referred to as CT (computed tomography). 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 The Space Foundation is an American nonprofit organization, the mission of which is to advocate for all sectors of the global space industry through space awareness activities, educational programs, and major industry events. It was founded in ...
'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 The semiconductor industry is the aggregate of companies engaged in the design and fabrication of semiconductors and semiconductor devices, such as transistors and integrated circuits. Its roots can be traced to the invention of the transistor ...
, including
CMOS Complementary metal–oxide–semiconductor (CMOS, pronounced "sea-moss ", , ) is a type of MOSFET, metal–oxide–semiconductor field-effect transistor (MOSFET) semiconductor device fabrication, fabrication process that uses complementary an ...
integrated circuit An integrated circuit (IC), also known as a microchip or simply chip, is a set of electronic circuits, consisting of various electronic components (such as transistors, resistors, and capacitors) and their interconnections. These components a ...
chips,
power semiconductor device A power semiconductor device is a semiconductor device used as a switch or rectifier in power electronics (for example in a switch-mode power supply). Such a device is also called a power device or, when used in an integrated circuit, a power IC ...
s,
sensors A sensor is often defined as a device that receives and responds to a signal or stimulus. The stimulus is the quantity, property, or condition that is sensed and converted into electrical signal. In the broadest definition, a sensor is a devi ...
such as
image sensors An image sensor or imager is a sensor that detects and conveys information used to form an image. It does so by converting the variable attenuation of light waves (as they pass through or reflect off objects) into signals, small bursts of curren ...
(particularly
CMOS sensor An active-pixel sensor (APS) is an image sensor, which was invented by Peter J.W. Noble in 1968, where each pixel sensor unit cell has a photodetector (typically a pinned photodiode) and one or more active transistors. In a metal–oxide–semic ...
s) and
biosensors A biosensor is an analytical device, used for the detection of a chemical substance, that combines a biological component with a physicochemical detector. The ''sensitive biological element'', e.g. tissue, microorganisms, organelles, cell rece ...
, as well as processors like
microcontrollers A microcontroller (MC, uC, or μC) or microcontroller unit (MCU) is a small computer on a single integrated circuit. A microcontroller contains one or more CPUs (processor cores) along with memory and programmable input/output peripherals. Pro ...
,
microprocessors A microprocessor is a computer processor for which the data processing logic and control is included on a single integrated circuit (IC), or a small number of ICs. The microprocessor contains the arithmetic, logic, and control circuitry r ...
,
digital signal processors A digital signal processor (DSP) is a specialized microprocessor chip, with its architecture optimized for the operational needs of digital signal processing. DSPs are fabricated on metal–oxide–semiconductor (MOS) integrated circuit chips. ...
,
media processor A media processor, mostly used as an image/ video processor, is a microprocessor-based system-on-a-chip which is designed to deal with digital streaming data in real-time (e.g. display refresh) rates. These devices can also be considered a class ...
s and
system-on-chip A system on a chip (SoC) is an integrated circuit that combines most or all key components of a computer or electronic system onto a single microchip. Typically, an SoC includes a central processing unit (CPU) with memory, input/output, and da ...
devices. , annual shipments of medical imaging chips reached 46 million units, generating a market value of .


Types

In the clinical context, "invisible light" medical imaging is generally equated to
radiology Radiology ( ) is the medical specialty that uses medical imaging to diagnose diseases and guide treatment within the bodies of humans and other animals. It began with radiography (which is why its name has a root referring to radiation), but tod ...
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 Radiology ( ) is the medical specialty that uses medical imaging to diagnose diseases and guide treatment within the bodies of humans and other animals. It began with radiography (which is why its name has a root referring to radiation), but tod ...
''; 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
radiographer Radiographers, also known as radiology technologists, radiologic technologists, diagnostic radiographers and medical radiation technologists, are healthcare professionals who specialise in the imaging of human anatomy for the diagnosis and tr ...
s frequently train in interpretation as part of expanded practice. Diagnostic
radiography Radiography is an imaging technology, imaging technique using X-rays, gamma rays, or similar ionizing radiation and non-ionizing radiation to view the internal form of an object. Applications of radiography include medical ("diagnostic" radiog ...
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 Biomedical engineering (BME) or medical engineering is the application of engineering principles and design concepts to medicine and biology for healthcare applications (e.g., diagnostic or therapeutic purposes). BME also integrates the logica ...
,
medical physics Medical physics deals with the application of the concepts and methods of physics to the prevention, diagnosis and treatment of human diseases with a specific goal of improving human health and well-being. Since 2008, medical physics has been incl ...
or
medicine Medicine is the science and Praxis (process), practice of caring for patients, managing the Medical diagnosis, diagnosis, prognosis, Preventive medicine, prevention, therapy, treatment, Palliative care, palliation of their injury or disease, ...
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 Computer science is the study of computation, information, and automation. Computer science spans Theoretical computer science, theoretical disciplines (such as algorithms, theory of computation, and information theory) to Applied 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 Neuroscience is the scientific study of the nervous system (the brain, spinal cord, and peripheral nervous system), its functions, and its disorders. It is a multidisciplinary science that combines physiology, anatomy, molecular biology, ...
,
cardiology Cardiology () is the study of the heart. Cardiology is a branch of medicine that deals with disorders of the heart and the cardiovascular system. The field includes medical diagnosis and treatment of congenital heart defects, coronary artery di ...
,
psychiatry Psychiatry is the medical specialty devoted to the diagnosis, treatment, and prevention of deleterious mental disorder, mental conditions. These include matters related to cognition, perceptions, Mood (psychology), mood, emotion, and behavior. ...
,
psychology Psychology is the scientific study of mind and behavior. Its subject matter includes the behavior of humans and nonhumans, both consciousness, conscious and Unconscious mind, unconscious phenomena, and mental processes such as thoughts, feel ...
, etc.) under investigation. Many of the techniques developed for medical imaging also have
scientific Science is a systematic discipline that builds and organises knowledge in the form of testable hypotheses and predictions about the universe. Modern science is typically divided into twoor threemajor branches: the natural sciences, which stu ...
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 An X-ray (also known in many languages as Röntgen radiation) is a form of high-energy electromagnetic radiation with a wavelength shorter than those of ultraviolet rays and longer than those of gamma rays. Roughly, X-rays have a wavelength ran ...
for image acquisition and is the first imaging technique available in modern medicine. * ''
Fluoroscopy Fluoroscopy (), informally referred to as "fluoro", is an imaging technique that uses X-rays to obtain real-time moving images of the interior of an object. In its primary application of medical imaging, a fluoroscope () allows a surgeon to see t ...
'' produces real-time images of internal structures of the body in a similar fashion to
radiography Radiography is an imaging technology, imaging technique using X-rays, gamma rays, or similar ionizing radiation and non-ionizing radiation to view the internal form of an object. Applications of radiography include medical ("diagnostic" radiog ...
, but employs a constant input of X-rays, at a lower dose rate.
Contrast media A contrast agent (or contrast medium) is a substance used to increase the contrast of structures or fluids within the body in medical imaging. Contrast agents absorb or alter external electromagnetism or ultrasound, which is different from radio ...
, 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 Barium is a chemical element; it has symbol Ba and atomic number 56. It is the fifth element in group 2 and is a soft, silvery alkaline earth metal. Because of its high chemical reactivity, barium is never found in nature as a free element. Th ...
, 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 Colorectal cancer (CRC), also known as bowel cancer, colon cancer, or rectal cancer, is the development of cancer from the colon or rectum (parts of the large intestine). Signs and symptoms may include blood in the stool, a change in bowel ...
.


Magnetic resonance imaging

A magnetic resonance imaging instrument ( MRI scanner), or "nuclear magnetic resonance (
NMR Nuclear magnetic resonance (NMR) is a physical phenomenon in which atomic nucleus, nuclei in a strong constant magnetic field are disturbed by a weak oscillating magnetic field (in the near and far field, near field) and respond by producing ...
) imaging" scanner as it was originally known, uses powerful magnets to polarize and excite
hydrogen Hydrogen is a chemical element; it has chemical symbol, symbol H and atomic number 1. It is the lightest and abundance of the chemical elements, most abundant chemical element in the universe, constituting about 75% of all baryon, normal matter ...
nuclei (i.e., single
proton A proton is a stable subatomic particle, symbol , Hydron (chemistry), H+, or 1H+ with a positive electric charge of +1 ''e'' (elementary charge). Its mass is slightly less than the mass of a neutron and approximately times the mass of an e ...
s) of water molecules in human tissue, producing a detectable signal which 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 Sir Joseph Larmor (; 11 July 1857 – 19 May 1942) was an Irish mathematician and physicist who made breakthroughs in the understanding of electricity, dynamics, thermodynamics, and the electron theory of matter. His most influential work was ...
and is determined by the strength of the main magnetic field and the chemical environment of the nuclei of interest. MRI uses three
electromagnetic field An electromagnetic field (also EM field) is a physical field, varying in space and time, that represents the electric and magnetic influences generated by and acting upon electric charges. The field at any point in space and time can be regarde ...
s: 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 Radio frequency (RF) is the oscillation rate of an alternating electric current or voltage or of a magnetic, electric or electromagnetic field or mechanical system in the frequency range from around to around . This is roughly between the ...
(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, tomographic, concept. Unlike CT, MRI does not involve the use of
ionizing radiation Ionizing (ionising) radiation, including Radioactive decay, nuclear radiation, consists of subatomic particles or electromagnetic waves that have enough energy per individual photon or particle to ionization, ionize atoms or molecules by detaching ...
and is therefore not associated with the same health hazards. For example, because MRI has only been in use since the early 1980s, there are no known long-term effects of exposure to strong static fields (this is the subject of some debate; see 'Safety' in
MRI Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to generate pictures of the anatomy and the physiological processes inside the body. MRI scanners use strong magnetic fields, magnetic field gradients, and rad ...
) and therefore there is no limit to the number of scans to which an individual can be subjected, in contrast with
X-ray An X-ray (also known in many languages as Röntgen radiation) is a form of high-energy electromagnetic radiation with a wavelength shorter than those of ultraviolet rays and longer than those of gamma rays. Roughly, X-rays have a wavelength ran ...
and CT. However, there are well-identified health risks associated with tissue heating from exposure to the RF field and the presence of implanted devices in the body, such as pacemakers. These risks are strictly controlled as part of the design of the instrument and the scanning protocols used. Because CT and MRI are sensitive to different tissue properties, the appearances of the images obtained with the two techniques differ markedly. In CT, X-rays must be blocked by some form of dense tissue to create an image, so the image quality when looking at soft tissues will be poor. In MRI, while any nucleus with a net nuclear spin can be used, the proton of the hydrogen atom remains the most widely used, especially in the clinical setting, because it is so ubiquitous and returns a large signal. This nucleus, present in water molecules, allows the excellent soft-tissue contrast achievable with MRI. A number of different pulse sequences can be used for specific MRI diagnostic imaging (multiparametric MRI or mpMRI). It is possible to differentiate tissue characteristics by combining two or more of the following imaging sequences, depending on the information being sought: T1-weighted (T1-MRI), T2-weighted (T2-MRI), diffusion weighted imaging (DWI-MRI), dynamic contrast enhancement (DCE-MRI), and spectroscopy (MRI-S). For example, imaging of prostate tumors is better accomplished using T2-MRI and DWI-MRI than T2-weighted imaging alone. The number of applications of mpMRI for detecting disease in various organs continues to expand, including
liver The liver is a major metabolic organ (anatomy), organ exclusively found in vertebrates, which performs many essential biological Function (biology), functions such as detoxification of the organism, and the Protein biosynthesis, synthesis of var ...
studies, breast tumors, pancreatic tumors, and assessing the effects of
vascular Vascular can refer to: * blood vessels, the vascular system in animals * vascular tissue Vascular tissue is a complex transporting tissue, formed of more than one cell type, found in vascular plants. The primary components of vascular tissue ...
disruption agents on cancer tumors.


Nuclear medicine

Nuclear medicine encompasses both diagnostic imaging and treatment of disease, and may also be referred to as molecular medicine or molecular imaging and therapeutics. Nuclear medicine uses certain properties of isotopes and the energetic particles emitted from radioactive material to diagnose or treat various pathology. Different from the typical concept of anatomic radiology, nuclear medicine enables assessment of physiology. This function-based approach to medical evaluation has useful applications in most subspecialties, notably oncology, neurology, and cardiology. ''
Gamma camera A gamma camera (γ-camera), also called a scintillation camera or Anger camera, is a device used to image gamma radiation emitting radioisotopes, a technique known as scintigraphy. The applications of scintigraphy include early drug development ...
s'' and '' PET scanners'' are used in e.g. scintigraphy, SPECT and PET to detect regions of biologic activity that may be associated with a disease. Relatively short-lived
isotope Isotopes are distinct nuclear species (or ''nuclides'') of the same chemical element. They have the same atomic number (number of protons in their Atomic nucleus, nuclei) and position in the periodic table (and hence belong to the same chemica ...
, such as 99mTc is administered to the patient. Isotopes are often preferentially absorbed by biologically active tissue in the body, and can be used to identify tumors or
fracture Fracture is the appearance of a crack or complete separation of an object or material into two or more pieces under the action of stress (mechanics), stress. The fracture of a solid usually occurs due to the development of certain displacemen ...
points in bone. Images are acquired after collimated photons are detected by a crystal that gives off a light signal, which is in turn amplified and converted into count data. * ''
Scintigraphy Scintigraphy (from Latin ''scintilla'', "spark"), also known as a gamma scan, is a diagnostic test in nuclear medicine, where radioisotopes attached to drugs that travel to a specific organ or tissue (radiopharmaceuticals) are taken internally a ...
'' ("scint") is a form of diagnostic test wherein
radioisotope A radionuclide (radioactive nuclide, radioisotope or radioactive isotope) is a nuclide that has excess numbers of either neutrons or protons, giving it excess nuclear energy, and making it unstable. This excess energy can be used in one of three ...
s are taken internally, for example, intravenously or orally. Then, gamma cameras capture and form two-dimensional images from the radiation emitted by the radiopharmaceuticals. * ''
SPECT Single-photon emission computed tomography (SPECT, or less commonly, SPET) is a nuclear medicine tomographic imaging technique using gamma rays. It is very similar to conventional nuclear medicine planar imaging using a gamma camera (that is, ...
'' is a 3D tomographic technique that uses gamma camera data from many projections and can be reconstructed in different planes. A dual detector head gamma camera combined with a CT scanner, which provides localization of functional SPECT data, is termed a SPECT-CT camera, and has shown utility in advancing the field of molecular imaging. In most other medical imaging modalities, energy is passed through the body and the reaction or result is read by detectors. In SPECT imaging, the patient is injected with a radioisotope, most commonly Thallium 201TI, Technetium 99mTC, Iodine 123I, and Gallium 67Ga. The radioactive gamma rays are emitted through the body as the natural decaying process of these isotopes takes place. The emissions of the gamma rays are captured by detectors that surround the body. This essentially means that the human is now the source of the radioactivity, rather than the medical imaging devices such as X-ray or CT. * ''
Positron emission tomography Positron emission tomography (PET) is a functional imaging technique that uses radioactive substances known as radiotracers to visualize and measure changes in metabolic processes, and in other physiological activities including blood flow, r ...
'' (PET) uses coincidence detection to image functional processes. Short-lived positron emitting isotope, such as 18F, is incorporated with an organic substance such as
glucose Glucose is a sugar with the Chemical formula#Molecular formula, molecular formula , which is often abbreviated as Glc. It is overall the most abundant monosaccharide, a subcategory of carbohydrates. It is mainly made by plants and most algae d ...
, creating F18-fluorodeoxyglucose, which can be used as a marker of metabolic utilization. Images of activity distribution throughout the body can show rapidly growing tissue, like tumor, metastasis, or infection. PET images can be viewed in comparison to
computed tomography A computed tomography scan (CT scan), formerly called computed axial tomography scan (CAT scan), is a medical imaging technique used to obtain detailed internal images of the body. The personnel that perform CT scans are called radiographers or ...
scans to determine an anatomic correlate. Modern scanners may integrate PET, allowing PET-CT, or PET-MRI to optimize the image reconstruction involved with positron imaging. This is performed on the same equipment without physically moving the patient off of the gantry. The resultant hybrid of functional and anatomic imaging information is a useful tool in non-invasive diagnosis and patient management. Fiduciary markers are used in a wide range of medical imaging applications. Images of the same subject produced with two different imaging systems may be correlated (called image registration) by placing a fiduciary marker in the area imaged by both systems. In this case, a marker which is visible in the images produced by both imaging modalities must be used. By this method, functional information from
SPECT Single-photon emission computed tomography (SPECT, or less commonly, SPET) is a nuclear medicine tomographic imaging technique using gamma rays. It is very similar to conventional nuclear medicine planar imaging using a gamma camera (that is, ...
or
positron emission tomography Positron emission tomography (PET) is a functional imaging technique that uses radioactive substances known as radiotracers to visualize and measure changes in metabolic processes, and in other physiological activities including blood flow, r ...
can be related to anatomical information provided by
magnetic resonance imaging Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to generate pictures of the anatomy and the physiological processes inside the body. MRI scanners use strong magnetic fields, magnetic field gradients, and ...
(MRI). Similarly, fiducial points established during MRI can be correlated with brain images generated by
magnetoencephalography Magnetoencephalography (MEG) is a functional neuroimaging technique for mapping brain activity by recording magnetic fields produced by electric current, electrical currents occurring naturally in the human brain, brain, using very sensitive magn ...
to localize the source of brain activity.


Ultrasound

Medical ultrasound Medical ultrasound includes Medical diagnosis, diagnostic techniques (mainly medical imaging, imaging) using ultrasound, as well as therapeutic ultrasound, therapeutic applications of ultrasound. In diagnosis, it is used to create an image of ...
uses high frequency
broadband In telecommunications, broadband or high speed is the wide-bandwidth (signal processing), bandwidth data transmission that exploits signals at a wide spread of frequencies or several different simultaneous frequencies, and is used in fast Inter ...
sound waves in the
megahertz The hertz (symbol: Hz) is the unit of frequency in the International System of Units (SI), often described as being equivalent to one event (or cycle) per second. The hertz is an SI derived unit whose formal expression in terms of SI base ...
range that are reflected by tissue to varying degrees to produce (up to 3D) images. This is commonly associated with imaging the fetus in pregnant women. Uses of ultrasound are much broader, however. Other important uses include imaging the abdominal organs, heart, breast, muscles, tendons, arteries and veins. While it may provide less anatomical detail than techniques such as CT or MRI, it has several advantages which make it ideal in numerous situations, in particular that it studies the function of moving structures in real-time, emits no
ionizing radiation Ionizing (ionising) radiation, including Radioactive decay, nuclear radiation, consists of subatomic particles or electromagnetic waves that have enough energy per individual photon or particle to ionization, ionize atoms or molecules by detaching ...
, and contains speckle that can be used in elastography. Ultrasound is also used as a popular research tool for capturing raw data, that can be made available through an
ultrasound research interface An ultrasound research interface (URI) is a software tool loaded onto a diagnostic clinical ultrasound device which provides functionality beyond typical clinical modes of operation. A normal clinical ultrasound user only has access to the ultraso ...
, for the purpose of tissue characterization and implementation of new image processing techniques. The concepts of ultrasound differ from other medical imaging modalities in the fact that it is operated by the transmission and receipt of sound waves. The high frequency sound waves are sent into the tissue and depending on the composition of the different tissues; the signal will be attenuated and returned at separate intervals. A path of reflected sound waves in a multilayered structure can be defined by an input acoustic impedance (ultrasound sound wave) and the Reflection and transmission coefficients of the relative structures. It is very safe to use and does not appear to cause any adverse effects. It is also relatively inexpensive and quick to perform. Ultrasound scanners can be taken to critically ill patients in intensive care units, avoiding the danger caused while moving the patient to the radiology department. The real-time moving image obtained can be used to guide drainage and biopsy procedures. Doppler capabilities on modern scanners allow the blood flow in arteries and veins to be assessed.


Elastography

Elastography is a relatively new imaging modality that maps the elastic properties of soft tissue. This modality emerged in the last two decades. Elastography is useful in medical diagnoses, as elasticity can discern healthy from unhealthy tissue for specific organs/growths. For example, cancerous tumours will often be harder than the surrounding tissue, and diseased livers are stiffer than healthy ones. There are several elastographic techniques based on the use of ultrasound, magnetic resonance imaging and tactile imaging. The wide clinical use of ultrasound elastography is a result of the implementation of technology in clinical ultrasound machines. Main branches of ultrasound elastography include Quasistatic Elastography/Strain Imaging, Shear Wave Elasticity Imaging (SWEI), Acoustic Radiation Force Impulse imaging (ARFI), Supersonic Shear Imaging (SSI), and Transient Elastography. In the last decade, a steady increase of activities in the field of elastography is observed demonstrating successful application of the technology in various areas of medical diagnostics and treatment monitoring.


Photoacoustic imaging

Photoacoustic imaging is a recently developed hybrid biomedical imaging modality based on the photoacoustic effect. It combines the advantages of optical absorption contrast with an ultrasonic spatial resolution for deep imaging in (optical) diffusive or quasi-diffusive regime. Recent studies have shown that photoacoustic imaging can be used in vivo for tumor angiogenesis monitoring, blood oxygenation mapping, functional brain imaging, and skin melanoma detection, etc.


Tomography

Tomography Tomography is imaging by sections or sectioning that uses any kind of penetrating wave. The method is used in radiology, archaeology, biology, atmospheric science, geophysics, oceanography, plasma physics, materials science, cosmochemistry, ast ...
is the imaging by sections or sectioning. The main such methods in medical imaging are: *
X-ray computed tomography An X-ray (also known in many languages as Röntgen radiation) is a form of high-energy electromagnetic radiation with a wavelength shorter than those of ultraviolet rays and longer than those of gamma rays. Roughly, X-rays have a wavelength ran ...
(CT), or Computed Axial Tomography (CAT) scan, is a helical tomography technique (latest generation), which traditionally produces a 2D image of the structures in a thin section of the body. In CT, a beam of X-rays spins around an object being examined and is picked up by sensitive radiation detectors after having penetrated the object from multiple angles. A computer then analyses the information received from the scanner's detectors and constructs a detailed image of the object and its contents using the mathematical principles laid out in the Radon transform. It has a greater
ionizing radiation Ionizing (ionising) radiation, including Radioactive decay, nuclear radiation, consists of subatomic particles or electromagnetic waves that have enough energy per individual photon or particle to ionization, ionize atoms or molecules by detaching ...
dose burden than projection radiography; repeated scans must be limited to avoid health effects. CT is based on the same principles as X-ray projections but in this case, the patient is enclosed in a surrounding ring of detectors assigned with 500–1000 scintillation detectors (fourth-generation X-ray CT scanner geometry). Previously in older generation scanners, the X-ray beam was paired by a translating source and detector. Computed tomography has almost completely replaced focal plane tomography in X-ray tomography imaging. *
Positron emission tomography Positron emission tomography (PET) is a functional imaging technique that uses radioactive substances known as radiotracers to visualize and measure changes in metabolic processes, and in other physiological activities including blood flow, r ...
(PET) also used in conjunction with computed tomography, PET-CT, and magnetic resonance imaging PET-MRI. *
Magnetic resonance imaging Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to generate pictures of the anatomy and the physiological processes inside the body. MRI scanners use strong magnetic fields, magnetic field gradients, and ...
(MRI) commonly produces tomographic images of cross-sections of the body. (See separate MRI section in this article.)


Echocardiography

When ultrasound is used to image the heart it is referred to as an
echocardiogram Echocardiography, also known as cardiac ultrasound, is the use of ultrasound to examine the heart. It is a type of medical imaging, using standard ultrasound or Doppler ultrasound. The visual image formed using this technique is called an echo ...
. Echocardiography allows detailed structures of the heart, including chamber size, heart function, the valves of the heart, as well as the pericardium (the sac around the heart) to be seen. Echocardiography uses 2D, 3D, and Doppler imaging to create pictures of the heart and visualize the blood flowing through each of the four heart valves. Echocardiography is widely used in an array of patients ranging from those experiencing symptoms, such as shortness of breath or chest pain, to those undergoing cancer treatments. Transthoracic ultrasound has been proven to be safe for patients of all ages, from infants to the elderly, without risk of harmful side effects or radiation, differentiating it from other imaging modalities. Echocardiography is one of the most commonly used imaging modalities in the world due to its portability and use in a variety of applications. In emergency situations, echocardiography is quick, easily accessible, and able to be performed at the bedside, making it the modality of choice for many physicians.


Functional near-infrared spectroscopy

FNIR Is a relatively new non-invasive imaging technique. NIRS (near infrared spectroscopy) is used for the purpose of
functional neuroimaging Functional neuroimaging is the use of neuroimaging technology to measure an aspect of brain function, often with a view to understanding the relationship between activity in certain brain areas and specific mental functions. It is primarily used a ...
and has been widely accepted as a
brain imaging Neuroimaging is the use of quantitative (computational) techniques to study the structure and function of the central nervous system, developed as an objective way of scientifically studying the healthy human brain in a non-invasive manner. Incre ...
technique.


Magnetic particle imaging

Using superparamagnetic iron oxide nanoparticles, magnetic particle imaging (
MPI MPI or Mpi may refer to: Science and technology Biology and medicine * Magnetic particle imaging, a tomographic technique * Myocardial perfusion imaging, a medical procedure that illustrates heart function * Mannose phosphate isomerase, an enzyme ...
) is a developing diagnostic imaging technique used for tracking
superparamagnetic Superparamagnetism is a form of magnetism which appears in small ferromagnetic or ferrimagnetic nanoparticles. In sufficiently small nanoparticles, magnetization can randomly flip direction under the influence of temperature. The typical time betw ...
iron oxide An iron oxide is a chemical compound composed of iron and oxygen. Several iron oxides are recognized. Often they are non-stoichiometric. Ferric oxyhydroxides are a related class of compounds, perhaps the best known of which is rust. Iron ...
nanoparticle A nanoparticle or ultrafine particle is a particle of matter 1 to 100 nanometres (nm) in diameter. The term is sometimes used for larger particles, up to 500 nm, or fibers and tubes that are less than 100 nm in only two directions. At ...
s. The primary advantage is the high
sensitivity and specificity In medicine and statistics, sensitivity and specificity mathematically describe the accuracy of a test that reports the presence or absence of a medical condition. If individuals who have the condition are considered "positive" and those who do ...
, along with the lack of signal decrease with tissue depth. MPI has been used in medical research to image
cardiovascular In vertebrates, the circulatory system is a system of organs that includes the heart, blood vessels, and blood which is circulated throughout the body. It includes the cardiovascular system, or vascular system, that consists of the heart a ...
performance, neuroperfusion, and cell tracking.


In pregnancy

Medical imaging may be
indicated In medicine, an indication is a valid reason to use a certain test, medication, procedure, or surgery. There can be multiple indications to use a procedure or medication. An indication can commonly be confused with the term diagnosis. A diagnosis ...
in
pregnancy Pregnancy is the time during which one or more offspring gestation, gestates inside a woman's uterus. A multiple birth, multiple pregnancy involves more than one offspring, such as with twins. Conception (biology), Conception usually occurs ...
because of pregnancy complications, a pre-existing disease or an acquired disease in pregnancy, or routine
prenatal care Prenatal care, also known as antenatal care, is a type of preventive healthcare for pregnant individuals. It is provided in the form of medical checkups and healthy lifestyle recommendations for the pregnant person. Antenatal care also consists of ...
.
Magnetic resonance imaging Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to generate pictures of the anatomy and the physiological processes inside the body. MRI scanners use strong magnetic fields, magnetic field gradients, and ...
(MRI) without
MRI contrast agent MRI contrast agents are contrast agents used to improve the visibility of internal body structures in magnetic resonance imaging (MRI). The most commonly used compounds for contrast enhancement are gadolinium-based contrast agents (GBCAs). Suc ...
s as well as
obstetric ultrasonography Obstetric ultrasonography, or prenatal ultrasound, is the use of medical ultrasonography in pregnancy, in which sound waves are used to create real-time visual images of the developing embryo or fetus in the uterus (womb). The procedure is a stand ...
are not associated with any risk for the mother or the fetus, and are the imaging techniques of choice for pregnant women. February 2016
Projectional radiography Projectional radiography, also known as conventional radiography, is a form of radiography and medical imaging that produces two-dimensional images by X-ray radiation. The image acquisition is generally performed by radiographers, and the images a ...
,
CT scan A computed tomography scan (CT scan), formerly called computed axial tomography scan (CAT scan), is a medical imaging technique used to obtain detailed internal images of the body. The personnel that perform CT scans are called radiographers or ...
and
nuclear medicine Nuclear medicine (nuclear radiology, nucleology), is a medical specialty involving the application of radioactivity, radioactive substances in the diagnosis and treatment of disease. Nuclear imaging is, in a sense, ''radiology done inside out'', ...
imaging result some degree of
ionizing radiation Ionizing (ionising) radiation, including Radioactive decay, nuclear radiation, consists of subatomic particles or electromagnetic waves that have enough energy per individual photon or particle to ionization, ionize atoms or molecules by detaching ...
exposure, but have with a few exceptions much lower
absorbed dose Absorbed dose is a dose quantity which represents the specific energy (energy per unit mass) deposited by ionizing radiation in living matter. Absorbed dose is used in the calculation of dose uptake in living tissue in both radiation protecti ...
s than what are associated with fetal harm. At higher dosages, effects can include
miscarriage Miscarriage, also known in medical terms as a spontaneous abortion, is an end to pregnancy resulting in the loss and expulsion of an embryo or fetus from the womb before it can fetal viability, survive independently. Miscarriage before 6 weeks ...
,
birth defect A birth defect is an abnormal condition that is present at birth, regardless of its cause. Birth defects may result in disabilities that may be physical, intellectual, or developmental. The disabilities can range from mild to severe. Birth de ...
s and
intellectual disability Intellectual disability (ID), also known as general learning disability (in the United Kingdom), and formerly mental retardation (in the United States), Rosa's Law, Pub. L. 111-256124 Stat. 2643(2010).Archive is a generalized neurodevelopmental ...
.


Maximizing imaging procedure use

The amount of data obtained in a single MR or CT scan is very extensive. Some of the data that radiologists discard could save patients time and money, while reducing their exposure to radiation and risk of complications from invasive procedures. Another approach for making the procedures more efficient is based on utilizing additional constraints, e.g., in some medical imaging modalities one can improve the efficiency of the data acquisition by taking into account the fact the reconstructed density is positive.


Creation of three-dimensional images

Volume rendering In scientific visualization and computer graphics, volume rendering is a set of techniques used to display a 2D projection of a 3D discretely sampled data set, typically a 3D scalar field. A typical 3D data set is a group of 2D slice image ...
techniques have been developed 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 3D images, many scans are made and then combined by computers to produce a 3D model, which can then be manipulated by the physician.
3D ultrasound 3D ultrasound is a medical ultrasound technique, often used in fetal, cardiac, trans-rectal and intra-vascular applications. 3D ultrasound refers specifically to the volume rendering of ultrasound data. When involving a series of 3D volumes colle ...
s are produced using a somewhat similar technique. In diagnosing disease of the viscera of the abdomen, ultrasound is particularly sensitive on imaging of biliary tract, urinary tract and female reproductive organs (ovary, fallopian tubes). As for example, diagnosis of gallstone by dilatation of common bile duct and stone in the common bile duct. With the ability to visualize important structures in great detail, 3D visualization methods 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 Singaporean surgeons to separate Iranian twins Ladan and Laleh Bijani in 2003. The 3D equipment was used previously for similar operations with great success. Other proposed or developed techniques include: * Diffuse optical tomography * Elastography * Electrical impedance tomography * Optoacoustic imaging *
Ophthalmology Ophthalmology (, ) is the branch of medicine that deals with the diagnosis, treatment, and surgery of eye diseases and disorders. An ophthalmologist is a physician who undergoes subspecialty training in medical and surgical eye care. Following a ...
** A-scan ** B-scan **
Corneal topography Corneal topography, also known as photokeratoscopy or videokeratography, is a Non-invasive (medical), non-invasive medical imaging technique for mapping the anterior curvature of the cornea, the outer structure of the human eye, eye. Since the cor ...
**
Optical coherence tomography Optical coherence tomography (OCT) is a high-resolution imaging technique with most of its applications in medicine and biology. OCT uses coherent near-infrared light to obtain micrometer-level depth resolved images of biological tissue or oth ...
** Scanning laser ophthalmoscopy Some of these techniques are still at a research stage and not yet used in clinical routines.


Non-diagnostic imaging

Neuroimaging Neuroimaging is the use of quantitative (computational) techniques to study the neuroanatomy, structure and function of the central nervous system, developed as an objective way of scientifically studying the healthy human brain in a non-invasive ...
has also been used in experimental circumstances to allow people (especially disabled persons) to control outside devices, acting as a
brain computer interface The brain is an organ that serves as the center of the nervous system in all vertebrate and most invertebrate animals. It consists of nervous tissue and is typically located in the head ( cephalization), usually near organs for special sen ...
. Many medical imaging software applications are used for non-diagnostic imaging, specifically because they do not have an FDA approval and not allowed to use in
clinical research Clinical research is a branch of medical research that involves people and aims to determine the effectiveness (efficacy) and safety of medications, devices, diagnostic products, and treatment regimens intended for improving human health. The ...
for patient diagnosis. Note that many
clinical research Clinical research is a branch of medical research that involves people and aims to determine the effectiveness (efficacy) and safety of medications, devices, diagnostic products, and treatment regimens intended for improving human health. The ...
studies are not designed for patient diagnosis anyway.


Archiving and recording

Used primarily in
ultrasound Ultrasound is sound with frequency, frequencies greater than 20 Hertz, kilohertz. This frequency is the approximate upper audible hearing range, limit of human hearing in healthy young adults. The physical principles of acoustic waves apply ...
imaging, capturing the image produced by a medical imaging device is required for archiving and telemedicine applications. In most scenarios, a frame grabber is used in order to capture the video signal from the medical device and relay it to a computer for further processing and operations.


DICOM

The Digital Imaging and Communication in Medicine (DICOM) Standard is used globally to store, exchange, and transmit medical images. The DICOM Standard incorporates protocols for imaging techniques such as radiography, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and radiation therapy.


Compression of medical images

Medical imaging techniques produce very large amounts of data, especially from CT, MRI and PET modalities. As a result, storage and communications of electronic image data are prohibitive without the use of compression.
JPEG 2000 JPEG 2000 (JP2) is an image compression standard and coding system. It was developed from 1997 to 2000 by a Joint Photographic Experts Group committee chaired by Touradj Ebrahimi (later the JPEG president), with the intention of superseding their ...
image compression is used by the
DICOM Digital Imaging and Communications in Medicine (DICOM) is a technical standard for the digital storage and Medical image sharing, transmission of medical images and related information. It includes a file format definition, which specifies the str ...
standard for storage and transmission of medical images. The cost and feasibility of accessing large image data sets over low or various bandwidths are further addressed by use of another DICOM standard, called
JPIP JPIP (JPEG 2000 Interactive Protocol) is a compression streamlining protocol that works with JPEG 2000 to produce an image using the least bandwidth required. It can be very useful for medical and environmental awareness purposes, among others, an ...
, to enable efficient streaming of the
JPEG 2000 JPEG 2000 (JP2) is an image compression standard and coding system. It was developed from 1997 to 2000 by a Joint Photographic Experts Group committee chaired by Touradj Ebrahimi (later the JPEG president), with the intention of superseding their ...
compressed image data.


Medical imaging in the cloud

There has been growing trend to migrate from on-premise PACS to a
cloud-based Cloud computing is "a paradigm for enabling network access to a scalable and elastic pool of shareable physical or virtual resources with self-service provisioning and administration on-demand," according to International Organization for ...
PACS. A recent article by Applied Radiology said, "As the digital-imaging realm is embraced across the healthcare enterprise, the swift transition from terabytes to petabytes of data has put radiology on the brink of
information overload Information overload (also known as infobesity, infoxication, or information anxiety) is the difficulty in understanding an issue and Decision making, effectively making decisions when one has too much information (TMI) about that issue, and is ...
. Cloud computing offers the imaging department of the future the tools to manage data much more intelligently."


Use in pharmaceutical clinical trials

Medical imaging has become a major tool in clinical trials since it enables rapid diagnosis with visualization and quantitative assessment. A typical
clinical trial Clinical trials are prospective biomedical or behavioral research studies on human subject research, human participants designed to answer specific questions about biomedical or behavioral interventions, including new treatments (such as novel v ...
goes through multiple phases and can take up to eight years. Clinical endpoints or outcomes are used to determine whether the therapy is safe and effective. Once a patient reaches the endpoint, he or she is generally excluded from further experimental interaction. Trials that rely solely on clinical endpoints are very costly as they have long durations and tend to need large numbers of patients. In contrast to clinical endpoints, surrogate endpoints have been shown to cut down the time required to confirm whether a drug has clinical benefits. Imaging
biomarkers In biomedical contexts, a biomarker, or biological marker, is a measurable indicator of some biological state or condition. Biomarkers are often measured and evaluated using blood, urine, or soft tissues to examine normal biological processes, p ...
(a characteristic that is objectively measured by an imaging technique, which is used as an indicator of pharmacological response to a therapy) and surrogate endpoints have shown to facilitate the use of small group sizes, obtaining quick results with good statistical power. Imaging is able to reveal subtle change that is indicative of the progression of therapy that may be missed out by more subjective, traditional approaches. Statistical bias is reduced as the findings are evaluated without any direct patient contact. Imaging techniques such as
positron emission tomography Positron emission tomography (PET) is a functional imaging technique that uses radioactive substances known as radiotracers to visualize and measure changes in metabolic processes, and in other physiological activities including blood flow, r ...
(PET) and
magnetic resonance imaging Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to generate pictures of the anatomy and the physiological processes inside the body. MRI scanners use strong magnetic fields, magnetic field gradients, and ...
(MRI) are routinely used in oncology and neuroscience areas. For example, measurement of
tumour A neoplasm () is a type of abnormal and excessive growth of tissue (biology), tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tiss ...
shrinkage is a commonly used surrogate endpoint in solid tumour response evaluation. This allows for faster and more objective assessment of the effects of anticancer drugs. In
Alzheimer's disease Alzheimer's disease (AD) is a neurodegenerative disease and the cause of 60–70% of cases of dementia. The most common early symptom is difficulty in remembering recent events. As the disease advances, symptoms can include problems wit ...
,
MRI Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to generate pictures of the anatomy and the physiological processes inside the body. MRI scanners use strong magnetic fields, magnetic field gradients, and rad ...
scans of the entire brain can accurately assess the rate of hippocampal atrophy, while PET scans can measure the brain's metabolic activity by measuring regional glucose metabolism, and beta-amyloid plaques using tracers such as Pittsburgh compound B (PiB). Historically less use has been made of quantitative medical imaging in other areas of
drug development Drug development is the process of bringing a new pharmaceutical drug to the market once a lead compound has been identified through the process of drug discovery. It includes preclinical research on microorganisms and animals, filing for regu ...
although interest is growing. An imaging-based trial will usually be made up of three components: # A realistic imaging protocol. The protocol is an outline that standardizes (as far as practically possible) the way in which the images are acquired using the various modalities (
PET A pet, or companion animal, is an animal kept primarily for a person's company or entertainment rather than as a working animal, livestock, or a laboratory animal. Popular pets are often considered to have attractive/ cute appearances, inte ...
,
SPECT Single-photon emission computed tomography (SPECT, or less commonly, SPET) is a nuclear medicine tomographic imaging technique using gamma rays. It is very similar to conventional nuclear medicine planar imaging using a gamma camera (that is, ...
, CT,
MRI Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to generate pictures of the anatomy and the physiological processes inside the body. MRI scanners use strong magnetic fields, magnetic field gradients, and rad ...
). It covers the specifics in which images are to be stored, processed and evaluated. # An imaging centre that is responsible for collecting the images, perform quality control and provide tools for data storage, distribution and analysis. It is important for images acquired at different time points are displayed in a standardised format to maintain the reliability of the evaluation. Certain specialised imaging contract research organizations provide end to end medical imaging services, from protocol design and site management through to data quality assurance and image analysis. # Clinical sites that recruit patients to generate the images to send back to the imaging centre.


Risks and safety issues

Medical imaging can lead to patient and healthcare provider harm through exposure to
ionizing radiation Ionizing (ionising) radiation, including Radioactive decay, nuclear radiation, consists of subatomic particles or electromagnetic waves that have enough energy per individual photon or particle to ionization, ionize atoms or molecules by detaching ...
,
iodinated contrast Iodinated contrast is a form of water-soluble, intravenous radiocontrast agent containing iodine, which enhances the visibility of vascular structures and organs during radiography, radiographic procedures. Some pathologies, such as cancer, have p ...
,
magnetic fields A magnetic field (sometimes called B-field) is a physical field that describes the magnetic influence on moving electric charges, electric currents, and magnetic materials. A moving charge in a magnetic field experiences a force perpendicular ...
, and other hazards.
Lead Lead () is a chemical element; it has Chemical symbol, symbol Pb (from Latin ) and atomic number 82. It is a Heavy metal (elements), heavy metal that is density, denser than most common materials. Lead is Mohs scale, soft and Ductility, malleabl ...
is the main material used for radiographic shielding against scattered X-rays. In
magnetic resonance imaging Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to generate pictures of the anatomy and the physiological processes inside the body. MRI scanners use strong magnetic fields, magnetic field gradients, and ...
, there is MRI RF shielding as well as
magnetic shielding In electrical engineering, electromagnetic shielding is the practice of reducing or redirecting the electromagnetic field (EMF) in a space with barriers made of conductive or magnetic materials. It is typically applied to enclosures, for isolat ...
to prevent external disturbance of image quality.


Privacy protection

Medical imaging are generally covered by laws of medical privacy. For example, in the United States the
Health Insurance Portability and Accountability Act The Health Insurance Portability and Accountability Act of 1996 (HIPAA or the Ted Kennedy, Kennedy–Nancy Kassebaum, Kassebaum Act) is a United States Act of Congress enacted by the 104th United States Congress and signed into law by President ...
(HIPAA) sets restrictions for health care providers on utilizing
protected health information Protected health information (PHI) under Law of the United States, U.S. law is any information about health status, provision of health care, or payment for health care that is created or collected by a Covered Entity (or a Business Associate of a ...
, which is any individually identifiable information relating to the past, present, or future physical or mental health of any individual. While there has not been any definitive legal decision in the matter, at least one study has indicated that medical imaging may contain biometric information that can uniquely identify a person, and so may qualify as PHI. The UK General Medical Council's ethical guidelines indicate that the Council does not require consent prior to making recordings of X-ray images. However, the same guidance indicates that the images and recordings need to be anonimized, and acknowledges that in deciding whether a recording is anonymised, one should bear in mind that apparently insignificant details may still be capable of identifying a patient. As such, one should be particularly careful about the anonymity of a recordings of an X-ray image before using or publishing them without consent in journals and other learning materials, whether they are printed or in an electronic format.


Industry

Organizations in the medical imaging industry include manufacturers of imaging equipment, freestanding radiology facilities, and hospitals. The global market for manufactured devices was estimated at $5 billion in 2018. Notable manufacturers as of 2012 included
Fujifilm , trading as , or simply Fuji, is a Japanese Multinational corporation, multinational Conglomerate (company), conglomerate headquartered in Tokyo, Japan, operating in the areas of photography, optics, Office supplies, office and Biomedical engine ...
, GE HealthCare, Siemens Healthineers,
Philips Koninklijke Philips N.V. (), simply branded Philips, is a Dutch multinational health technology company that was founded in Eindhoven in 1891. Since 1997, its world headquarters have been situated in Amsterdam, though the Benelux headquarter ...
, Shimadzu,
Toshiba is a Japanese multinational electronics company headquartered in Minato, Tokyo. Its diversified products and services include power, industrial and social infrastructure systems, elevators and escalators, electronic components, semiconductors ...
, Carestream Health,
Hitachi () is a Japanese Multinational corporation, multinational Conglomerate (company), conglomerate founded in 1910 and headquartered in Chiyoda, Tokyo. The company is active in various industries, including digital systems, power and renewable ener ...
, Hologic, and Esaote. In 2016, the manufacturing industry was characterized as oligopolistic and mature; new entrants included in
Samsung Samsung Group (; stylised as SΛMSUNG) is a South Korean Multinational corporation, multinational manufacturing Conglomerate (company), conglomerate headquartered in the Samsung Town office complex in Seoul. The group consists of numerous a ...
and Neusoft Medical. In the United States, as estimate as of 2015 places the US market for imaging scans at about $100b, with 60% occurring in hospitals and 40% occurring in freestanding clinics, such as the RadNet chain.


Copyright


United States

As per chapter 300 of the ''Compendium of U.S. Copyright Office Practices'', "the Office will not register works produced by a machine or mere mechanical process that operates randomly or automatically without any creative input or intervention from a human author" including "Medical imaging produced by X-rays, ultrasounds, magnetic resonance imaging, or other diagnostic equipment." This position differs from the broad copyright protections afforded to photographs. While the Copyright Compendium is an agency statutory interpretation and not legally binding, courts are likely to give deference to it if they find it reasonable. Yet, there is no U.S. federal case law directly addressing the issue of the copyrightability of X-ray images.


Derivatives

An extensive definition of the term ''derivative work'' is given by the United States Copyright Act in :
A "derivative work" is a work based upon one or more preexisting works, such as a translation... art reproduction, abridgment, condensation, or any other form in which a work may be recast, transformed, or adapted. A work consisting of editorial revisions, annotations, elaborations, or other modifications which, as a whole, represent an original work of authorship, is a "derivative work".
provides:
The copyright in a compilation or derivative work extends only to the material contributed by the author of such work, as distinguished from the preexisting material employed in the work, and does not imply any exclusive right in the preexisting material. The copyright in such work is independent of, and does not affect or enlarge the scope, duration, ownership, or subsistence of, any copyright protection in the preexisting material.


Germany

In Germany, X-ray images as well as
MRI Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to generate pictures of the anatomy and the physiological processes inside the body. MRI scanners use strong magnetic fields, magnetic field gradients, and rad ...
,
medical ultrasound Medical ultrasound includes Medical diagnosis, diagnostic techniques (mainly medical imaging, imaging) using ultrasound, as well as therapeutic ultrasound, therapeutic applications of ultrasound. In diagnosis, it is used to create an image of ...
,
PET A pet, or companion animal, is an animal kept primarily for a person's company or entertainment rather than as a working animal, livestock, or a laboratory animal. Popular pets are often considered to have attractive/ cute appearances, inte ...
and
scintigraphy Scintigraphy (from Latin ''scintilla'', "spark"), also known as a gamma scan, is a diagnostic test in nuclear medicine, where radioisotopes attached to drugs that travel to a specific organ or tissue (radiopharmaceuticals) are taken internally a ...
images are protected by (copyright-like) related rights or neighbouring rights. This protection does not require creativity (as would be necessary for ''regular'' copyright protection) and lasts only for 50 years after image creation, if not published within 50 years, or for 50 years after the first legitimate publication. The letter of the law grants this right to the "Lichtbildner", i.e. the person who created the image. The literature seems to uniformly consider the medical doctor, dentist or veterinary physician as the rights holder, which may result from the circumstance that in Germany many X-rays are performed in ambulatory settings.


United Kingdom

Medical images created in the United Kingdom will normally be protected by copyright due to "the high level of skill, labour and judgement required to produce a good quality X-ray, particularly to show contrast between bones and various soft tissues". The Society of Radiographers believe this copyright is owned by employer (unless the radiographer is self-employed—though even then their contract might require them to transfer ownership to the hospital). This copyright owner can grant certain permissions to whoever they wish, without giving up their ownership of the copyright. So the hospital and its employees will be given permission to use such radiographic images for the various purposes that they require for medical care. Physicians employed at the hospital will, in their contracts, be given the right to publish patient information in journal papers or books they write (providing they are made anonymous). Patients may also be granted permission to "do what they like with" their own images.


Sweden

The ''Cyber Law in Sweden'' states: "Pictures can be protected as photographic works or as photographic pictures. The former requires a higher level of originality; the latter ''protects all types of photographs, also the ones taken'' by amateurs, or ''within medicine'' or science. The protection requires some sort of photographic technique being used, which includes digital cameras as well as holograms created by laser technique. The difference between the two types of work is the term of protection, which amounts to seventy years after the death of the author of a photographic work as opposed to fifty years, from the year in which the photographic picture was taken." Medical imaging may possibly be included in the scope of "photography", similarly to a U.S. statement that "MRI images, CT scans, and the like are analogous to photography." (p. 296)


See also

*
Biological imaging Biological imaging may refer to any imaging technique used in biology. Typical examples include: * Bioluminescence imaging, a technique for studying laboratory animals using luminescent protein * Calcium imaging, determining the calcium status of ...
* Medical image sharing * Radiologists Without Borders * Confocal endoscopy


Explanatory notes


References


Further reading

* * *


External links

{{DEFAULTSORT:Medical Imaging Image processing Medical physics Nuclear medicine