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About Computer Tomography (CT)

Image: A view through the CT tube
The patient goes into the CT tube | © Dmytro Zinkevych /

Computer tomography, also called CT scan, is a medical procedure in which X-Ray images of the anatomy of the body are taken with the aid of a computer. The CT procedure, which was revolutionized in the 1970s, has undergone enormous development and is one of the leading applications in radiology.

A computer tomograph is a large device with a round opening in the middle. During the examination, the patient lies down on a bed which moves into the CT tube. Meanwhile, the X-ray tube rotates continuously around the person's longitudinal axis. The required X-ray image is captured within one second, the entire examination usually takes only a few minutes up to half an hour.

There are different types of CT machines, which differ in functionality and quality. The conventional form of CT equipment is the incremental CT. The CT machine is driven along the patient for several measurements. The patient is not allowed to move during the CT examination due to the machine's high sensitivity. The further the CT scanner travels, the more layers of the body it examines.

Difference to Magnetic Resonance Imaging (MRI)

There is no general answer to the question of which examination procedure - CT or MRI - is better. Both MRI and CT have their advantages and disadvantages. The MRI machine works with magnetic fields that are free of radiation. CT devices, on the other hand, work with X-rays.

An MRI is particularly suitable for the imaging of soft tissue, the CT for the imaging of bony structures. Which type of examination actually makes more sense is decided individually. Frequently, the economic aspect also plays a major role in determining which device is used.

Image: Our tips in purchasing new medical equipment

A CT examination is usually much cheaper and takes place faster than an MRI examination. If both procedures are available, the use of a CT machine is often preferred.

Areas of Application and Costs

Image: A patient is advised by a doctor about the CT device
The CT machine to diagnose diseases | © LStockStudio /

Computer tomography is mainly performed in hospitals, clinics and by specialized doctors, for example radiologists. In CT, radiopaque material containing iodine are often used to amplify the image signals. These are injected intravenously. Therefore, the compatibility should be clarified beforehand.

There are different types of CT machines which differ in functionality and quality. The conventional form is an incremental CT scanner. Today's best computer tomographs are the advanced, faster working spiral CT machines. An extension of the CT machine is the multi-line spiral CT, which uses special detectors to achieve even higher efficiency, accuracy and speed in CT examinations.

Even more innovative is the so-called volume CT machine, which can absorb an extremely high number of layers per rotation, so that even one rotation reveals important inner body layers. The latest and most innovative type of CT machine is the dual-source CT invented by Siemens. It offers detailed analysis and sharper images of the smallest regions of the body. The price range for a new CT device is between 300,000 and 900,000 euros net. Used equipment are significantly cheaper.

CT Machine Field of Application Features
Incremental CT Chest and diffusing lung diseases Standard device, which moves the patient's couch forward a little bit for each individual exposure
Pulmonary fibrosis and emphysema The patient must lie still during the admissions
Spiral CT Tumors and diseases become clear through the visualization of the blood supply The patient is not examined step by step, but is pushed continuously and in a few seconds through the device
Analysis of urinary tract blockage, tumors, scar tissue, etc. Examination of individual body areas takes only a few seconds
Multi-line Spiral CT Detection of the formation of calcium in the coronary arteries and analysis of constrictions, so-called stenoses Further development of the Spiral CT
Examination of the functioning of bypass vessels and analysis of changes within the heart, e.g. tumours or blood clots Better contrast medium distribution, as a large number of detectors are in a row
Volume CT Cardiac diagnostics and coronary artery disease Very high quality images, even at unstable heart rates
Unclear chest pain, cardiac arrhythmia and congenital heart defect Entire heart can be seen at a glance
PET CT Oncology and Neurology Technology not yet very widespread but trending
Early detection of Alzheimer's disease and cardiology Combination of positron emission tomography and computed tomography
Dual Source CT Diagnosis analysis for blood circulation, suspected stroke and emergency patients Dual Source system combines two X-ray tubes in one unit
For acute chest and abdominal pain Higher speed than ordinary CT devices

Incremental CT

During the examination, a CT machine moves once around the patient and carries out the measurements of the desired body region. The images are then transmitted to a computer and combined to form a sectional image with different contrasts. The machine is pushed piece by piece over the patient and the desired area is scanned.

This process is repeated until the desired result is achieved. The patient must lie still and follow the instructions of the staff so that the images do not blur or become blurred. This procedure of a CT was the main influence on the early days of CT technology. Nowadays, modern CT scanners with spiral technology achieve more images per second and the examination is also more pleasant for the patient.

Spiral CT

The spiral CT is the first further development of the incremental CT. The patient is not analyzed step by step, but continuously pushed through the machine. The X-ray beam behaves like a spiral and circles permanently around the patient - hence the name Spiral CT. The images can be used for any part of the body and the examination is relatively fast.

The patient only has to hold his breath for a few seconds and the machine measures the desired part of the body during this time. The first machine with this mode was the Siemens Somatom Plus. The body areas are recorded as a whole and a smaller amount of contrast medium is required. This makes it easier for patients with impaired kidney function, for example. In general, a spiral CT is used in almost all medical areas. This applies in particular to chest examinations.

Multi-line Spiral CT

A multi-line spiral CT combines two work steps in one device. This results in clear advantages with regard to the speed of the scanning time and the reduction of the layer thickness. Compared to older CT machines, the detector system rotates around the patient twice as fast (faster than once per second) and records a total of four shifts instead of just a single shift.

With a multi-line spiral CT, there is not only a series of detectors next to each other, but also a large number of detector rows. Among other things, this leads to a better distribution of contrast medium being detected. The tomographic images are created using complex computer calculations and are primarily used for the detailed analysis of organs, blood vessels and bones.

Volume CT

The biggest difference between a conventional CT machine and a CT machine with the special volume technique lies in the number of lines. A standardized volume CT allows up to 320 lines (for comparison: a conventional CT has at least 16 lines). This significantly simplifies the examination of the heart, brain or abdominal organs etc.

The patient must lie still during the entire examination. In this way, very high-quality images can be obtained. The radiation exposure for the patient is also reduced by about 20 percent compared to a spiral CT. The manufacturer Toshiba has even developed a volume computer tomograph with 640 layers. This allows the images to be taken at lightning speed, in about 0.175 seconds - virtually within a heartbeat. In this way, complete organs and body regions can be scanned within one rotation.


The technologically advanced but not yet widely used PET CT machines combine positron emission tomography with computed tomography, which greatly simplifies the analysis of metabolic processes and the identification and localization of foreign objects. PET and CT complement each other perfectly in this procedure and thus create fast, outstanding results. The price of such a high-tech machine is currently around 2,500,000 euros net.

The state-of-the-art PET CT examination involves additional costs: the PET-CT device has to be kept in operation at high cost and requires expert personnel. The PET radiotracer specially developed for this process generates additional costs. When purchasing a PET-CT device, the costs for staff training, maintenance and the PET-Radiotracer must be taken into account.

Dual Source CT

With the Somatom Definition, the manufacturer Siemens has developed the world's first dual-source computed tomography system (DSCS). The DSC system combines two X-ray tubes in one machine. This results in two possible applications for these CT machines: On the one hand, both tubes can scan the patient simultaneously and with two different energies. On the other hand, the two tubes can examine different parts of the patient and assemble the data at the end.

The dual-source method operates at an even higher speed than the conventional CT. The availability of 128 parallel lines makes it possible to cover almost the entire heart. For example, if a patient with acute chest pain is admitted to the emergency room, fast and reliable imaging is essential to make a diagnosis. Especially for such emergency patients a fast and safe CT examination can be vital.

Advice and Tips for the Purchase

Image: A doctor examines a CT result
A CT result | © Dmytro Zinkevych /

The more modern and technologically advanced the CT machine is, the better its capabilities and functions in terms of effectiveness, reduced harm, quality and ease of use. The CT price also depends heavily on the manufacturer. The monthly costs of a CT machine, which amount to approximately 5,000 to 10,000 euros net, should also be taken into account.

The costs incurred by a CT machine in daily use include those for accessories, consumables and similar items: In concrete terms, these include spare parts and the disposal of waste products. During the entire use of the CT machine, a total cost of approx. 75,000 and 150,000 euros net for necessary accessories and possible technical repairs should be expected. Moreover, the costs for the training of specialized personnel and for the spatial conditions, which include radiation protection, should not be ignored. These cost between approx. 100,000 and 250,000 Euro net.

It is therefore important to calculate as accurately as possible the total costs incurred by a CT machine over the period of its use. In addition to the acquisition costs, the operating costs must also be taken into account. Usually the follow-up costs are three times higher than the purchase price. As a general rule, the more expensive the CT machine is to purchase, the higher the costs that are incurred during the period of use.

Cost Points Price Overview
Accessories for the CT Machine ca. 75.000 - 150.000 €
Premises ca. 100.000 - 250.000 €
Monthly Operating Costs ca. 5.000 - 10.000 €

Well-known Manufacturers of CT Systems

Image: A patient lies by the CT tube
This is how a CT scan works | © LStockStudio /

Leading companies in the medical equipment market for CT machines include Philips, Hitachi, GE Healthcare, Canon Medical and Siemens. Philips' CT devices aim for the best possible solution methods and outstanding operability, and are characterized by generally high performance and patient friendliness.

The company Hitachi focuses on the well-being of the patient and convinces through efficiency, innovation and quality. GE Healthcare focuses on healthy patient treatment with CT machines. It stands out through its wide variety of CT machines and constant progress in the healthcare industry.

Canon Medical is recognized worldwide for its reliable, high-quality image output, simplified operation and original developments that reduce stress for the patients. In this respect, the modern Aquilion ONE ViSION Edition from Canon Medical stands out. With innovative technologies, Siemens is a pioneer in the medical technology market for the manufacture of CT machines and the Somatom Emotion from Siemens is the world's best-selling CT machine.

Manufacturers Features Example CT Machine
Canon Medical Known for good image output Aquilion ONE ViSION Edition
Focused on minimum radiation dose for the patient
GE Healthcare Versatile Revolution CT
Constant further development
Hitachi Focus on patient welfare SCENARIA
Efficiency and quality
Philips Easy to operate IQon Spectral CT
High performance
Siemens Inventor of the Dual Source CT machines Somatom Emotion
Somatom Emotion is the world's best-selling CT machine

Maintenance and Service for CT devices

Image: A computer screen and a CT machine
Monitor and CT machine must be serviced regularly | © sfam_photo /

In addition to the costs for CT accessories and equipping the room, there are the running costs for the operation of the CT system, which can be limited to between approx. 5,000 and 10,000 euros net per month. These costs include energy costs, software updates, electronics, professional cleaning and technical malfunctions.

You will be confronted with a number of recurring examinations relating to the maintenance and service of CT devices. The metrological check usually has to be carried out every 12 months. It checks the accuracy of the measurement results. Just as essential is the safety check, which attempts to identify and correct risks for the patient and safety deficiencies early on.

Some manufacturers offer on-site service for their own products, while other service providers do not require you to use a specific device. A maintenance contract is often recommended for a CT system, which bundles the annual services under a total price after consultation. Additional costs may be incurred for repair and maintenance of the machine.

Maintenance Task Area
Safety Inspections Regularly recurring safety inspections by certified medical technicians
Goal: Timely detection of equipment defects and risks for patients, users and third parties
Metrological Controls It is mandatory by law in some countries
Objective: To check measurement accuracy and to compliance with permissible error limits
Accident Prevention & Operational Safety Doctors are obliged to ensure operational safety in their practice
Objective: To control the safety of patients, employees and third parties of electronic devices
Remote Service Various medical equipment manufacturers offer to connect the in-house engineers with the device at the customer's site
Goal: Reduction of overall repair time and early detection of malfunctions and system errors
Predictive Maintenance Additional service from many manufacturers to optimize service performance
Goal: Information for predictive maintenance and product optimization

CT examination: Advice for Patients

Image: The patient goes into the CT tube
Patient going into the CT tube | © Olesia Bilkei /

In order to perform a PET CT examination, certain prerequisites and preparations are required to obtain a final good image quality. 12 hours before the start of the examination, the patient should stop eating and only drink water or unsweetened tea. Sport and other physical activities should be avoided at all costs on the day before and on the day of the examination.

Since the medical personnel have to go behind a protective wall due to the X-rays, the patient is alone in the room during the examination. However, there is nothing to fear - the medical assistants or doctors always have the patient in view and can communicate or give instructions without problems. After the examination, the patient is not impaired in any way.

To illuminate diseased parts of the body on the X-ray image, patients are injected with a small amount of radioactive material via the vein. In addition, patients are often given a saline solution and a diuretic. Then patience is required, as the radioactive sugar solution first has to be distributed in the body. The waiting time is about 60 minutes, then the PET CT examination is carried out.