Clinical Utility of Multiplanar Reformation in Pulmonary CT Angiography

Espinosa, Leandro; Kelly, Aine Marie; Hawley, Colleen; Inampudi, Radha; Chughtai, Aamer; Agarwal, Prachi P.; Khalatbari, Shokoufeh; Myles, James D.; Kazerooni, Ella A.

doi:10.2214/ajr.09.2380

Cited by 15 publications

(11 citation statements)

References 18 publications

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“…MPR has two-dimensional axial, coronal, sagittal and oblique images with centering on trachea and main bronchus tumors, can reflect different density tissues by using different attenuation scales with high density resolution and not obvious artifact, clearly display lumen and longitudinal involvements of tumors and adjacent structures[ 7 , 13 – 15 ]. Our results demonstrated that combination of axial, coronal, sagittal and oblique MPR images could not only display the locations, morphologies, internal features and extramural invasions of primary trachea and main bronchus tumors, morphologies and extents of luminal stenoses, but also measure their longitudinal involvements, distances between main bronchus tumors and trachea carinas; however, its images could not have three-dimensional effect due to two-dimensional images.…”

Section: Discussionmentioning

confidence: 99%

“…MPR images[ 11 , 13 – 15 ]: axial, coronal, sagittal, and oblique images were acquired section by section with centering on trachea and main bronchus tumors by using MPR software, and to display the walls, lumina, and adjacent structures of trachea and main bronchus tumors. VR images[ 16 – 18 ]: firstly, image reconstruction of trachea and main bronchus area was performed by making use of VR software; secondly, unnecessary parts were cut off with Scalpel program, and interested trachea and main bronchus images were obtained; thirdly, images were magnified and rotated locally to display trachea and main bronchus tumors as clear as possible.…”

Section: Methodsmentioning

confidence: 99%

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Diagnostic Value of Multidetector CT and Its Multiplanar Reformation, Volume Rendering and Virtual Bronchoscopy Postprocessing Techniques for Primary Trachea and Main Bronchus Tumors

et al. 2015

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PurposeTo evaluate the diagnostic value of multidetector CT (MDCT) and its multiplanar reformation (MPR), volume rendering (VR) and virtual bronchoscopy (VB) postprocessing techniques for primary trachea and main bronchus tumors.MethodsDetection results of 31 primary trachea and main bronchus tumors with MDCT and its MPR, VR and VB postprocessing techniques, were analyzed retrospectively with regard to tumor locations, tumor morphologies, extramural invasions of tumors, longitudinal involvements of tumors, morphologies and extents of luminal stenoses, distances between main bronchus tumors and trachea carinae, and internal features of tumors. The detection results were compared with that of surgery and pathology.ResultsDetection results with MDCT and its MPR, VR and VB were consistent with that of surgery and pathology, included tumor locations (tracheae, n = 19; right main bronchi, n = 6; left main bronchi, n = 6), tumor morphologies (endoluminal nodes with narrow bases, n = 2; endoluminal nodes with wide bases, n = 13; both intraluminal and extraluminal masses, n = 16), extramural invasions of tumors (brokethrough only serous membrane, n = 1; 4.0 mm—56.0 mm, n = 14; no clear border with right atelectasis, n = 1), longitudinal involvements of tumors (3.0 mm, n = 1; 5.0 mm—68.0 mm, n = 29; whole right main bronchus wall and trachea carina, n = 1), morphologies of luminal stenoses (irregular, n = 26; circular, n = 3; eccentric, n = 1; conical, n = 1) and extents (mild, n = 5; moderate, n = 7; severe, n = 19), distances between main bronchus tumors and trachea carinae (16.0 mm, n = 1; invaded trachea carina, n = 1; >20.0 mm, n = 10), and internal features of tumors (fairly homogeneous densities with rather obvious enhancements, n = 26; homogeneous density with obvious enhancement, n = 1; homogeneous density without obvious enhancement, n = 1; not enough homogeneous density with obvious enhancement, n = 1; punctate calcification with obvious enhancement, n = 1; low density without obvious enhancement, n = 1).ConclusionMDCT and its MPR, VR and VB images have respective advantages and disadvantages. Their combination could complement to each other to accurately detect locations, natures (benignancy, malignancy or low malignancy), and quantities (extramural invasions, longitudinal involvements, extents of luminal stenoses, distances between main bronchus tumors and trachea carinae) of primary trachea and main bronchus tumors with crucial information for surgical treatment, are highly useful diagnostic methods for primary trachea and main bronchus tumors.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Diagnostic Value of Multidetector CT and Its Multiplanar Reformation, Volume Rendering and Virtual Bronchoscopy Postprocessing Techniques for Primary Trachea and Main Bronchus Tumors

et al. 2015

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“…This capability enables multiplanar viewing and assessment of pulmonary vessels to subsegmental levels. All these advantages made MDCT angiography the most commonly used procedure for the diagnosis of PE (3).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of acute pulmonary embolism by sixty-four slice multidetector CT angiography: Correlation between obstruction index, right ventricular dysfunction and clinical presentation

Attia

Seifeldein

Hasan

et al. 2015

The Egyptian Journal of Radiology and Nuclear Medicine

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Introduction: MDCT pulmonary angiography is the method of choice for the detection of pulmonary embolism (PE). The severity of PE as estimated by the obstruction index (OI) and right ventricular dysfunction (RVD) can be evaluated with MDCT. Objective: To investigate the correlation between the OI, RVD and clinical presentation in patients with acute PE. Methods: Among 70 patients with suspected PE, 35 patients proved to have PE with MDCT. The CT OI and the RV/LV diameter (RVD-ratio) using the four-chamber view of the heart were calculated for PE patients. The cut-off for the OI to detect RVD was constructed using ROC curve. Results: Dyspnea and RVD (RVD-ratio >1) were significantly more common in patients with central pulmonary emboli. The mean OI (35% ± 19%) was significantly higher in patients with dyspnea, tachycardia and obesity. A positive correlation was found between the OI and both the CT pulmonary artery diameter (r = 0.66, p < 0.001) and the RVD-ratio (r = 0.628, p < 0.001). The mean OI was significantly higher in patients with RVD (p < 0.001). A CT OI > 43% identified more than 90% of patients with RVD (area under the curve on ROC analysis: 0.825; p < 0.001). Conclusion: The mean OI correlated linearly with PA diameter and RVD-ratio. OI > 43% proved to be an independent predictor of RVD.

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“…The general oncologist should bear this in mind and develop their own standard, which may include using the coronal plane to assess the mesentery and GI tract, hips and pulmonary vasculature 23 . Similar to using different window settings, this approach previously had a significant time penalty, both in image processing and reporting 24 . However in the multi-detector CT era, it has been suggested that using MPRs can actually speed up the process and reduce the need for contrast enhancement in some circumstances 25,26 .…”

Section: Failing To Spot Complications Of Cancer- "Palliative Sweep"mentioning

confidence: 99%

Minimising the impact of errors in the interpretation of CT images for surveillance and evaluation of therapy in cancer

2016

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Radiological error is inevitable and usually multifactorial. Error can be secondary to radiologist specific causes, including cognitive and perceptive errors or ambiguity of report, or system related causes, including inadequate, misleading or incorrect clinical information, poor imaging technique, excessive workload and poor working conditions.In this paper, we discuss a systematic approach to reduce errors in oncological radiology reporting, thus reducing risk to the patient. Rather than attempt to discuss all types of error we concentrate on the most important and commonly occurring errors that we have encountered over 20 years of practice, based on a weekly discrepancy reviews of our practice and independent reviews of clinical and research imaging from other institutions. This review focuses on CT scan reporting for staging, surveillance and response assessment of cancer patients, but the messages apply to all imaging modalities.

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Clinical Utility of Multiplanar Reformation in Pulmonary CT Angiography

Abstract: Use of MPR for viewing increased the reader agreement and interpretation time of cardiothoracic specialists but increased reader agreement between residents and might have decreased interpretation time. All readers had a trend toward increased confidence.

Cited by 15 publications

References 18 publications

Diagnostic Value of Multidetector CT and Its Multiplanar Reformation, Volume Rendering and Virtual Bronchoscopy Postprocessing Techniques for Primary Trachea and Main Bronchus Tumors

Diagnostic Value of Multidetector CT and Its Multiplanar Reformation, Volume Rendering and Virtual Bronchoscopy Postprocessing Techniques for Primary Trachea and Main Bronchus Tumors

Evaluation of acute pulmonary embolism by sixty-four slice multidetector CT angiography: Correlation between obstruction index, right ventricular dysfunction and clinical presentation

Minimising the impact of errors in the interpretation of CT images for surveillance and evaluation of therapy in cancer

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