Contributing Editor Greg Freiherr offers an overview of computed tomography (CT) advances at the Radiological Society of North America (RSNA) 2015. The video includes Freiherr during his booth tours with some of the key vendors who were featuring new technology.
Computed Tomography (CT)
United Imaging has installed its first transportable CT Scanner at Maimonides Medical Center in New York City to help expand its capacity for imaging during the fight against coronavirus in the U.S. As the hospital scales its operations to meet the needs of an expected influx of coronavirus patients, doubling its capacity to 1,400 beds, United Imaging’s scanner will help expand its capacity for imaging studies to support diagnosis and treatment.
The first of three clinical scenarios presented to the panel with final recommendations. Mild features refer to absence of significant pulmonary dysfunction or damage. Pre-test probability is based upon background prevalence of disease and may be further modified by individual’s exposure risk. The absence of resource constraints corresponds to sufficient availability of personnel, personal protective equipment, COVID-19 testing, hospital beds, and/or ventilators with the need to rapidly triage patients. Contextual detail and considerations for imaging with CXR (chest radiography) versus CT (computed tomography) are presented in the text. (Pos=positive, Neg=negative, Mod=moderate). [Although not covered by this scenario and not shown in the figure, in the presence of significant resources constraints, there is no role for imaging of patients with mild features of COVID-19.] Image courtesy of the journal Radiology
An example of Philips’ TrueVue technology, which offers photo-realistic rendering and the ability to change the location of the lighting source on 3-D ultrasound images. In this example of two Amplazer transcatheter septal occluder devices in the heart, the operator demonstrating the product was able to push the lighting source behind the devices into the other chamber of the heart. This illuminated a hole that was still present that the occluders did not seal. Photo by Dave Fornell
CT scoring criteria were applied to images from sequential chest CT examinations. A, Initial chest CT image obtained 2 days after onset of symptoms shows small region of subpleural ground-glass opacities in right lower lobe, for CT score of 1. B, Chest CT image obtained on day 3 of treatment shows slightly enlarged region of subpleural ground-glass opacities with partial crazy-paving pattern and consolidation, for CT score of 3. C, Chest CT image obtained on day 5 of treatment shows partial resolution of consolidation, for CT score of 2. D, Chest CT image obtained on day 14 of treatment shows continued resolution of consolidation with minimal residual ground-glass opacities, for CT score of 1. Image courtesy of American Journal of Roentgenology (AJR)
Fig 1. A sample scoring on CT images of a 63-year-old woman from mortality group demonstrated a total score of 63. It was calculated as: for upper zone (A), 3 (consolidation) × 3 (50–75% distribution) × 2 (both right and left lungs) + 2 (ground glass opacity) ×1 (< 25% distribution) × 2 (both right and left lungs); for middle zone (B), 3 (consolidation) × 2 (25–50% distribution) × 2 (both right and left lungs) + 2 (ground glass opacity) × 2 (25–50% distribution) × 2 (both right and left lungs); for lower zone (C), 3 (consolidation) × (2 (25–50% distribution of the right lung) + 3 (50–75% distribution of the left lung)) + 2 (ground glass opacity) × (2 (25–50% distribution of the right lung) + 1 (< 25% distribution of the left lung)) Yuan et al, 2020 (CC BY 4.0)
A, Image from noncontrast head CT demonstrates symmetric hypoattenuation within the bilateral medial thalami (arrows). B, Axial CT venogram demonstrates patency of the cerebral venous vasculature, including the internal cerebral veins (arrows). C, Coronal reformat of aCT angiogram demonstrates normal appearance of the basilar artery and proximal posterior cerebral arteries. Image courtesy of the Radiological Society of North America (RSNA)