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MDCT Adaptations for HRCT Imaging MDCT
Johnny Vlahos, MD: Adaptations for HRCT imaging May 15, 2008- 9:10 AM MDCT HRCT –When and where? • Routine MDCT studies MDCT Adaptations for HRCT Imaging Johnny Vlahos Assistant Prof. Radiology - NYU Medical Center Consultant – St. George’s Hospital London SCHOOL OF MEDICINE – Reconstructed at 3-5mm collimation – Additional reconstruction of 1q 10mm data set for every patient – Evaluation for incidentally detected emphysema, fibrosis, bronchiectasis etc. • “HRCT” indication – Step and shoot MDCT HRCT – Volumetric acquisition and retrospective 1mm HRCT recon NEW YORK UNIVERSITY Volumetric MDCT HRCT Advantages • Speed → ↓Motion Artifacts • Comprehensive study Volumetric MDCT HRCT – Motion Effect Disadvantages • Dose – Anatomic Evaluation – Clinician Understanding – Children – Multiple M lti l repeatt studies t di • Volumetric HRCT – Contiguous axial HRCT – MPR, 3-D tools – Quantitative imaging Volumetric MDCT HRCT – Motion Effect Volumetric HRCT – Image quality • Step and shoot non-contiguous (NC) HRCT – MDCT equivalent to SDCT • Retrospective recon of MDCT data v NC HRCT “Ground Ground Glass Glass” Micronodular Sarcoid Stanford Radiology 10th Annual Multidetector CT Symposium –R Reduced d d motion ti artifacts tif t – For early generation MDCT anatomic visualization better on NC HRCT – Equivalent at 16-detector – Likely equivalent or better for 64-detector MDCT HRCT Vikgren. Acta Radiologica 2007; 48:956-61 Sumikawa Rad Medicine 2005; 23:539-44 Studler AJR 2005; 185:602-7 1 Johnny Vlahos, MD: Adaptations for HRCT imaging Volumetric HRCT – Contiguous Data May 15, 2008- 9:10 AM Volumetric HRCT – Contiguous Data Volumetric HRCT – Contiguous Data Volumetric HRCT – Contiguous Data Volumetric HRCT - Bronchiectasis Advantages • Avoids missing bronchiectasis due to sampling • Better appreciation of non-tapering • Focal mucoid impaction not interpreted as nodules • Less motion artifacts Remy-Jardin. Eur Radiol 2003;13:1165 Sung. J Comput Assist Tomogr 2003;27:490 Chooi. Br J Radiol 2003;76:536 Stanford Radiology 10th Annual Multidetector CT Symposium 2 Johnny Vlahos, MD: Adaptations for HRCT imaging Volumetric HRCT - Bronchiectasis May 15, 2008- 9:10 AM Coronal Evaluation - Bronchiectasis Detection • Volumetric 1mm axial MDCT vs NC HRCT • 61 patients with bronchiectasis – 7 MDCT only • Of 479 lobes – 25 lobes cylindrical, 11 varicose and 4 cystic detected only by volumetric MDCT HRCT Dodd AJR 2006 187(2):414-20 Coronal Evaluation - Bronchiectasis MPRs ↑ Detection of bronchiectasis Observer agreement Distribution agreement Particularly mild cylindrical Remy-Jardin. Eur Radiol 2003;13:1165 Sung. J Comput Assist Tomogr 2003;27:490 Chooi. Br J Radiol 2003;76:536 Coronal Evaluation - Bronchiectasis Volumetric HRCT – Coronal Evaluation Sarcoidosis Coronal MPRs in Diffuse Disease •Additional info compared to axial in 22% •Lesion conspicuity/distribution •Equivalent to axial in 72% Arakawa. J Thorac Imaging 2004; 19:24-31 Stanford Radiology 10th Annual Multidetector CT Symposium 3 Johnny Vlahos, MD: Adaptations for HRCT imaging May 15, 2008- 9:10 AM Volumetric HRCT – Coronal Evaluation UIP-IPF Volumetric HRCT – Coronal Evaluation Ground Glass--Edema Histiocytosis X Alveolar Proteinosis Coronal Evaluation – Tree in Bud “Lateral” “PA” Sarcoidosis Pulmonary MIPs– Nodule Characterization 1mm 1mm MPR 3mm MIP 5mm 1mm MPR Stanford Radiology 10th Annual Multidetector CT Symposium 5mm MIP 15mm MIP 4 Johnny Vlahos, MD: Adaptations for HRCT imaging Pulmonary MIPs – Tree-in Bud TB 1mm HRCT 5mm MIP MDCT HCRT – Emphysema Evaluation May 15, 2008- 9:10 AM Thick section Pitfall – Miliary TB 7mm axial 1mm HRCT MDCT HCRT – Emphysema Evaluation Quantitative Emphysema Evaluation Stanford Radiology 10th Annual Multidetector CT Symposium 5 Johnny Vlahos, MD: Adaptations for HRCT imaging May 15, 2008- 9:10 AM MDCT Adaptations for HRCT Imaging Thank You SCHOOL OF MEDICINE NEW YORK UNIVERSITY Stanford Radiology 10th Annual Multidetector CT Symposium 6
