Three-dimensional volume rendering of multidetector-row CT data: applicable for emergency radiology

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Abstract

Multidetector-row computed tomography (MD-CT) not only creates new opportunities but also challenges for medical imaging. Isotropic imaging allows in-depth views into anatomy and disease but the concomitant dramatic increase of image data requires new approaches to visualize, analyze and store CT data. The common diagnostic reviewing process slice by slice becomes more and more time consuming as the number of slice increases, while on the other hand CT volume data sets could be used for three-dimensional visualization. These techniques allow for comprehensive interpretation of extent of fracture, amount of dislocation and fragmentation in a three-dimensional highly detailed setting. Further more, using minimal invasive techniques like CT angiography, new opportunities for fast emergency room patient's work up arise. But the most common application is still trauma of the muskuloskeletal system as well as face and head. The following is a brief review of recent literature on volume rendering technique and some exemplary applications for the emergency room.

Introduction

The advent of multidetector-row computed tomography (MD-CT), representing a fundamental step from a cross-sectional towards a true three-dimensional imaging modality, not only dramatically creates new opportunities but also requires changes in radiological viewing methods and data handling [1], [2], [3].

On the one hand the reduction of the collimated slice thickness, beside other significant benefits, realizes the isotropic voxel, which is the prerequisite for sophisticated three-dimensional visualization. But on the other hand the same technical innovation mentioned above is responsible for a true data explosion, thus having two major consequences: first, the isotropy of the acquired volume data enables three-dimensional visualization without the need for overwhelming further interpolation steps and, therefore, reducing erroneous interpretation of the original volume data-set. Secondly, somewhat makes conventional image interpretation slice by slice more and more difficult, as there are simply to many single images to deal with, even on state of the art computer workstations. Therefore, exact and predicative postprocessing applications are increasingly required [4].

Volume rendering of multidetector-row CT data may overcome these problems, aiming to volume reporting, thus overcoming the historical precedent to interpret volumetric CT data using planar reconstructions.

The following paragraphs will give a brief survey on technical fundamentals and current applications with a focus on emergency room usability.

Section snippets

Technical background

Johann Radon's fundamental work on line integrals not only is the cornerstone of CT, but also of virtual environments in general. Radon could demonstrate that the image of a three-dimensional object can be reconstructed from an infinite number of two-dimensional projections of this object, taken from different directions, i.e. Radon transform [5].

The idea of three-dimensional display of CT-data is not much older then CT itself. Basic work on this topic was performed by Gabor Herman and

Applications

As the first radiograph ever taken was from the musculoskeletal system, three-dimensional display of CT data from the musculoskeletal system was among the first three-dimensional visualizations, mainly to define or exclude a fracture that is equivocal on plain films and to determine the extent of a previously diagnosed fracture in order to provide guidance for therapy [21]. Due to high contrast interface between bone and adjacent tissues the musculoskeletal system is predestinate for more or

Conclusion

Three-dimensional volume rendered visualization of multidetector-row CT volume data sets produces much more then only impressive images. Volume rendering is a comprehensive contribution to standard axial and orthogonal reconstructed images, in some specific applications even more. Challenged by the data explosion evolving from multidetector-row CT, alternative visualization and analysis using volumetric tools, including 3D visualization must evolve from luxury to necessity [2]. This requires

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