Radiologie up2date 2010; 10(4): 351-364
DOI: 10.1055/s-0030-1255900
Gerätetechniken/Neuentwicklungen/Digitale Radiologie

© Georg Thieme Verlag KG Stuttgart · New York

Neue Entwicklungen in der MSCT

New developments in MSCTH.  Shin
Further Information

Publication History

Publication Date:
16 December 2010 (online)

Zusammenfassung

Im Fokus der Weiterentwicklung in der MSCT stehen aktuell neue Anwendungen und die Softwareentwicklung. Ein wichtiges Thema ist dabei die Multispektrenbildgebung, die unter Verwendung von mindestens 2 verschiedenen Energiestufen eine Gewebedifferenzierung erlaubt. Neben der Differenzierung von Kalk und Jod für die CT-Angiografie und für onkologische Fragestellungen findet sie zunehmendes Interesse auch in anderen Anwendungsfeldern. Durch die ultraschnelle Bildgebung werden Atem- und Pulsationsartefakte weitgehend eliminiert, sodass eine Untersuchung auch bei mangelnder Compliance des Patienten meist ohne Sedierung oder Narkose möglich wird. Perfusionsuntersuchungen können durch große Detektorbreiten oder durch die sog. Shuffle-Technik auf ganze Körperregionen ausgedehnt werden. Neue Softwareentwicklungen umfassen iterative Rekonstruktionsalgorithmen und die organspezifische Dosismodulation für die Dosisreduktion.

Abstract

Progress in MSCT is focused on new applications and software development. A hot topic is multispectral imaging which allows for tissue differentiation using at least two energy-levels. Besides differentiation of calcification and jodine in CT-angiography and oncologic imaging, there is also increasing interest in other application fields. Ultrafast imaging nearly eliminates breathing and pulsation artifacts allowing examination of non-compliant patients without sedation or anesthesia. Perfusion can now be extended to large body regions using large detectors or applying shuffle-techniques. New software developments include iterative reconstruction and organ specific dose modulation allowing for dose reduction and for protection of radiosensitive organs.

Kernaussagen

  • In der MSCT liegt der Fokus der Weiterentwicklungen auf neuen Anwendungen und der Softwareentwickung – weniger auf der weiteren Zunahme der Zeilenzahl.

  • Die Multispektrenbildgebung (Dual Energy) erlaubt die Analyse von Gewebezusammensetzungen.

  • Durch die ultraschnelle Bildgebung werden auch bei mangelnder Compliance des Patienten Untersuchungen ohne Sedierung oder Intubation möglich.

  • Die iterativen Rekonstruktionsalgorithmen und die organspezifische Dosismodulation haben das Potenzial, die Dosis zu reduzieren bzw. strahlensensible Organe zu schonen.

Literatur

  • 1 Vetter J R, Perman W H, Kalender W A. et al . Evaluation of a prototype dual-energy computed tomographic apparatus. II. Determination of vertebral bone mineral content.  Med Phys. 1986;  13 340-343
  • 2 Johnson T R. et al . Material differentiation by dual energy CT: initial experience.  Eur Radiol. 2007;  17 1510-1517
  • 3 Lell M M, Kramer M, Klotz E. et al . Carotid computed tomography angiography with automated bone suppression: a comparative study between dual energy and bone subtraction techniques.  Invest Radiol. 2009;  44 322-328
  • 4 Meyer B C. et al . Dual energy CT of peripheral arteries: effect of automatic bone and plaque removal on image quality and grading of stenoses.  Eur J Radiol. 2008;  68 414-422
  • 5 Morhard D. et al . Cervical and cranial computed tomographic angiography with automated bone removal: dual energy computed tomography versus standard computed tomography.  Invest Radiol. 2009;  44 293-297
  • 6 Sommer W H. et al . The value of dual-energy bone removal in maximum intensity projections of lower extremity computed tomography angiography.  Invest Radiol. 2009;  44 285-292
  • 7 Thomas C. et al . Automatic lumen segmentation in calcified plaques: dual-energy CT versus standard reconstructions in comparison with digital subtraction angiography.  Am J Roentgenol. 2010;  194 1590-1595
  • 8 Remy-Jardin M. et al . Thoracic applications of dual energy.  Radiol Clin North Am. 2010;  48 193-205
  • 9 Graser A, Johnson T R, Chandarana H, Macari M. Dual energy CT: preliminary observations and potential clinical applications in the abdomen.  Eur Radiol. 2009;  19 13-23
  • 10 Graser A. et al . Dual-energy CT in patients suspected of having renal masses: can virtual nonenhanced images replace true nonenhanced images?.  Radiology. 2009;  252 433-440
  • 11 Stolzmann P. et al . Endoleaks after endovascular abdominal aortic aneurysm repair: detection with dual-energy dual-source CT.  Radiology. 2008;  249 682-691
  • 12 Chandarana H. et al . Abdominal aorta: evaluation with dual-source dual-energy multidetector CT after endovascular repair of aneurysms – initial observations.  Radiology. 2008;  249 692-700
  • 13 Bauer R W, Schulz J R, Zedler B, Graf T G, Vogl T J. Compound analysis of gallstones using dual energy computed tomography-Results in a phantom model.  Eur J Radiol. 2010;  75 e74-80
  • 14 Boll D T. et al . Renal stone assessment with dual-energy multidetector CT and advanced postprocessing techniques: improved characterization of renal stone composition – pilot study.  Radiology. 2009;  250 813-820
  • 15 Stolzmann P. et al . Dual-energy computed tomography for the differentiation of uric acid stones: ex vivo performance evaluation.  Urol Res. 2008;  36 133-138
  • 16 Thomas C. et al . Dual-energy CT for the characterization of urinary calculi: In vitro and in vivo evaluation of a low-dose scanning protocol.  Eur Radiol. 2009;  19 1553-1559
  • 17 Artmann A, Ratzenbock M, Noszian I, Trieb K. Dual energy CT–a new perspective in the diagnosis of gout.  Rofo. 2010;  182 261-266
  • 18 Nicolaou S. et al . Dual-energy CT as a potential new diagnostic tool in the management of gout in the acute setting.  AJR Am J Roentgenol. 2010;  194 1072-1078
  • 19 Deng K, Sun C, Liu C, Ma R. Initial experience with visualizing hand and foot tendons by dual-energy computed tomography.  Clin Imaging. 2009;  33 384-389
  • 20 Holmes D R. et al . Evaluation of non-linear blending in dual-energy computed tomography.  Eur J Radiol. 2008;  68 409-413
  • 21 Yu L, Primak A N, Liu X, McCollough C H. Image quality optimization and evaluation of linearly mixed images in dual-source, dual-energy CT.  Med Phys. 2009;  36 1019-1024
  • 22 Kim K S. et al . Image fusion in dual energy computed tomography for detection of hypervascular liver hepatocellular carcinoma: phantom and preliminary studies.  Invest Radiol. 2010;  45 149-157
  • 23 Marin D. et al . Hypervascular liver tumors: low tube voltage, high tube current multidetector CT during late hepatic arterial phase for detection – initial clinical experience.  Radiology. 2009;  251 771-779
  • 24 Yeh B M. et al . Dual-energy and low-kVp CT in the abdomen.  AJR Am J Roentgenol. 2009;  193 47-54
  • 25 Flohr T G. et al . Dual-source spiral CT with pitch up to 3.2 and 75 ms temporal resolution: image reconstruction and assessment of image quality.  Med Phys. 2009;  36 5641-5653
  • 26 Lell M. et al . Prospectively ECG-triggered high-pitch spiral acquisition for coronary CT angiography using dual source CT: technique and initial experience.  Eur Radiol. 2009;  19 2576-2583
  • 27 Leschka S. et al . Diagnostic accuracy of high-pitch dual-source CT for the assessment of coronary stenoses: first experience.  Eur Radiol. 2009;  19 2896-2903
  • 28 Pflederer T. et al . Radiation exposure and image quality in staged low-dose protocols for coronary dual-source CT angiography: a randomized comparison.  Eur Radiol. 2010;  20 1197-1206
  • 29 Schwarz F. et al . Dual-energy CT of the heart-principles and protocols.  Eur J Radiol. 2008;  68 423-433
  • 30 Stolzmann P. et al . Prospective and retrospective ECG-gating for CT coronary angiography perform similarly accurate at low heart rates.  Eur J Radiol. 2010;  [Epub ahead of print]
  • 31 Flohr T G. et al . Pushing the envelope: new computed tomography techniques for cardiothoracic imaging.  J Thorac Imaging. 2010;  25 100-111
  • 32 Nieman K. et al . Reperfused myocardial infarction: contrast-enhanced 64-Section CT in comparison to MR imaging.  Radiology. 2008;  247 49-56
  • 33 Konig M, Klotz E, Heuser L. Cerebral perfusion CT: theoretical aspects, methodical implementation and clinical experience in the diagnosis of ischemic cerebral infarction.  Rofo. 2000;  172 210-218
  • 34 Konig M. Brain perfusion CT in acute stroke: current status.  Eur J Radiol. 2003;  45 (Suppl. 1) S11-S22
  • 35 Kandel S. et al . Whole-organ perfusion of the pancreas using dynamic volume CT in patients with primary pancreas carcinoma: acquisition technique, post-processing and initial results.  Eur Radiol. 2009;  19 2641-2646
  • 36 Silva A C, Lawder H J, Hara A. et al . Innovations in CT dose reduction strategy: application of the adaptive statistical iterative reconstruction algorithm.  AJR Am J Roentgenol. 2010;  194 191-199
  • 37 Hara A K. et al . Iterative reconstruction technique for reducing body radiation dose at CT: feasibility study.  AJR Am J Roentgenol. 2009;  193 764-771
  • 38 Marin D. et al . Low-tube-voltage, high-tube-current multidetector abdominal CT: improved image quality and decreased radiation dose with adaptive statistical iterative reconstruction algorithm – initial clinical experience.  Radiology. 2010;  254 145-153

Priv.-Doz. Dr. med. Hoen-oh Shin

Medizinische Hochschule Hannover
Institut für Radiologie

Carl-Neuberg-Straße 1
30625 Hannover

Phone: 0511 532-3421

Fax: 0511 532-3885

Email: shin.hoen-oh@mh-hannover.de

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