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)
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)
Typical CT imaging features for COVID-19. Unenhanced, thin-section axial images of the lungs in a 52-year-old man with a positive RT-PCR (A-D) show bilateral, multifocal rounded (asterisks) and peripheral GGO (arrows) with superimposed interlobular septal thickening and visible intralobular lines (“crazy-paving”). Routine screening CT for diagnosis or exclusion of COVID-19 is currently not recommended by most professional organizations or the US Centers for Disease Control and Prevention. Image courtesy of RSNA
Series CT scans in 35-year-old woman with COVID-19 pneumonia. (a) Scan obtained on illness days 1 showed multiple pure ground-glass opacity (GGO) mainly in right lower lobe. (b) Scan obtained on illness days 5 showed increased extent of GGO and early consolidation. (c) Scan obtained on illness days 11 showed multiple consolidation with almost the same extent. (d) Scan obtained on illness days 15 showed a mixed pattern with a slightly smaller extent, and the perilobular consolidation might suggest the presence of organizing pneumonia. The patient was discharged on illness days 17. Image courtesy of the journal Radiology