Road to RSNA 2010: CT Preview By Eric Barnes, AuntMinnie.com staff writer
November 11, 2010
CT in 2010 is lightning-fast, technically dazzling, and more popular than Miley Cyrus at a tween slumber party. It's invaluable for trauma and stroke patients presenting to emergency departments, and for ruling out worry in patients with chest pain.
At this year's RSNA conference, technical innovation leading to speed and image sharpness continues to make the modality popular with radiologists and bean counters alike.
Radiation issues remain, but they are being addressed aggressively with carefully crafted guidelines and innovations such as prospective electrocardiogram gating and iterative reconstruction. High-pitch scanning is generating clear images of the entire thorax at low doses. New technologies have moved the research bar far beyond yesterday's attempts to cut dose by seeing how much image noise would render the results unreadable.
Functional imaging of the brain and heart are going low-dose and high-output. Mayo Clinic researchers, for example, are experimenting with brain perfusion images acquired at the dose of a normal head scan. In the heart, one group is finding success with dynamic myocardial stress CT perfusion, getting favorable results versus MRI. In another experiment, investigators are hoping to replace an expensive biomarker test with CT scans that were being done anyway.
Meanwhile, tumor perfusion imaging is being applied to different kinds of cancers -- for example, treatment monitoring in soft-tissue sarcomas, or malignant lung nodule detection by Japanese researchers. And of course, the use of dual-energy CT to separate scanned materials, such as renal stone types, is becoming increasingly sophisticated. Computer-aided detection is growing faster and delivering fewer false positives, while other researchers are using CT to quantify emphysema and air trapping.
For juggling the complex world of multimodality digital media and design, we recommend an RSNA/American Association of Physicists in Medicine (AAPM) plenary session, PS50, titled "Slicing Through Complexity in Medical Imaging," being held on Thursday, December 2, from 1:50 p.m. to 2:45 p.m. in the Arie Crown Theater.
Below you'll find a smattering of some of the innovative CT scientific presentations you might consider attending. You'll definitely want to visit the RSNA meeting program website as well to round out your conference schedule. Have a great meeting!
Scientific and Educational Presentations
Individualized contrast injection keeps up with triple-rule-out CTSunday, November 28 | 10:55 a.m.-11:05 a.m. | SSA04-02 | Room S404CD Outrunning the contrast bolus can be a real problem with state-of-the art CT equipment that scans the thorax in less than a second. But J. Michael Barraza and colleagues from the Medical University of South Carolina in Charleston found excellent results with a contrast injector equipped with an individualized patient-based contrast media injection algorithm.
|
CT unnecessary in most blunt trauma admissionsSunday, November 28 | 11:05 a.m.-11:15 a.m. | SSA05-03 | Room N227 Blunt trauma patients admitted to emergency departments are routinely scanned with CT of the chest, abdomen, and pelvis. But are all those scans really necessary in the absence of serious signs of injury? No, say Noam Millo, MD, and colleagues from the University of Alberta in Edmonton.
|
CT perfusion gauges sarcoma treatment responseSunday, November 28 | 11:25 a.m.-11:35 a.m. | SSA13-05 | Room E451B In this scientific presentation, researchers from Massachusetts General Hospital in Boston will discuss their successful use of CT perfusion imaging to monitor the response to sarcoma treatment. Both tumor size and density differences were visible after antiangiogenic therapy for soft-tissue sarcomas.
|
Automated tool speeds clot burden assessment in PE patientsSunday, November 28 | 11:35 a.m.-11:45 a.m. | SSA04-06 | Room S404CD Gauging the clot burden in pulmonary embolism (PE) patients at CT pulmonary angiography is important for management and treatment. For most but not all patients, assessment can be performed faster using an automated clot burden assessment tool, researchers will report in this Sunday session.
|
Triple-rule-out plus CAD gets the nodules radiologists missSunday, November 28 | 12:30 p.m.-1:00 p.m. | LL-ERS-SU2A | Lakeside Learning Center Triple-rule-out scans are often read by emergency department radiologists with concern about their patients' chest pain, but who often have no subspecialty training in thoracic radiology. Lung nodules will be missed. Fortunately, computer-aided detection (CAD) might help find them.
|
Pulmonary CTA accurately predicts right ventricular dysfunctionSunday, November 28 | 1:00 p.m.-1:30 p.m. | LL-ERS-SU2B | Lakeside Learning Center Pulmonary CT angiography (CTA) could potentially replace a biomarker used to assess right ventricular dysfunction, according to a novel study to be presented on Sunday by researchers from the Medical University of South Carolina in Charleston.
|
CT drives imaging growth in emergency departmentsMonday, November 29 | 9:05 a.m.-9:15 a.m. | VE21-02 | Room N227 Imaging utilization in emergency departments has grown every year from 2000 to 2008 -- but CT is far and away the biggest driver of imaging utilization, according to Vijay Rao, MD, and colleagues from Thomas Jefferson University in Philadelphia. And it's mostly radiologists doing it.
|
Obesity no barrier to renal stone discrimination in dual-energy CTMonday, November 29 | 11:10 a.m.-11:20 a.m.| SSC14-05 | Room S403B Increased image noise seen in CT scans of obese patients does not prevent accurate discrimination of renal stone types -- provided additional filtration is used, according to a study from the Mayo Clinic in Rochester, MN, to be presented on Monday.
|
3D quantitative analysis can measure coronary plaqueMonday, November 29 | 3:30 p.m.-3:40 p.m. | SSE04-04 | Room S504AB In this paper presentation, researchers will highlight the advantages of automated 3D quantitative coronary plaque analysis.
|
VC findings in Medicare patients similar to younger populationMonday, November 29 | 3:40 p.m.-3:50 p.m. | SSE08-05 | Room E450B In this scientific session, researchers from the Mayo Clinic in Rochester, MN, will discuss the examination of more than 1,000 Medicare-aged patients with virtual colonoscopy. Their results showed the prevalence of polyps and extracolonic findings to be similar to those of younger populations.
|
Automatic kV selection tool simplifies scansTuesday, November 30 | 8:35 a.m.-8:45 a.m. | VV31-02 | Room E353A To reduce CT radiation exposure, radiologists have gotten used to adjusting kV based on body mass index and the diagnostic task at hand. But how about doing it quantitatively and automatically?
|
320-detector-row perfusion CT nabs malignant lung nodulesTuesday, November 30 | 9:15 a.m.-9:25 a.m. | VC31-04 | Room S404CD Distinguishing malignant from benign lung nodules using PET is tricky business, notably because not all lung cancers are glucose-avid. But in this Tuesday morning presentation, researchers from Kobe, Japan, will discuss how they found that perfusion CT on a 32-detector-row scanner and MRI both perform better than PET/CT for distinguishing malignant from benign nodules.
|
Quantitative CT evaluates emphysema, air trappingTuesday, November 30 | 10:40 a.m.-10:50 a.m.| SSG03-02 | Room S504AB If individualized medicine is the new mantra, emphysema evaluation is one of its most promising potential applications. Radiologists from National Jewish Health in Denver compared quantitative CT measurements of emphysema to physiologic measures of disease severity.
|
Automatic segmentation technique shows promise for CT urogramsTuesday, November 30 | 11:20 a.m.-11:30 a.m. | SSG13-06 | Room S403A In this paper, researchers from the University of Michigan in Ann Arbor will share details on their automatic bladder lesion segmentation technique for CT urograms.
|
Dynamic myocardial stress CT perfusion appears feasible and accurateWednesday, December 1 | 10:30 a.m.-10:40 a.m. | SSK03-01 | Room S503AB Cardiac MRI could potentially face some competition from adenosine-stress first-pass myocardial CT perfusion, according to an initial study from the Medical University of South Carolina in Charleston. The study won an RSNA trainee research prize for Markus Weininger, MD, who will discuss his group's initial experience with the dual-source CT technique.
|
VC CAD can be used with, without fecal taggingThursday, December 2 | 11:00 a.m.-11:10 a.m. | SSQ05-04 | Room E353C A research group will present data finding no significant performance difference with employing virtual colonoscopy CAD on patients with or without fecal tagging.
|
Using VC CAD as second reader performs bestThursday, December 2 | 11:20 a.m.-11:30 a.m. | SSQ05-06 | Room E353C In this paper presentation, researchers will share their findings from evaluating different reading methods for virtual colonoscopy CAD by experienced readers.
|
High image quality seen in high-pitch cardiac DSCTFriday, December 3 | 10:30 a.m.-10:40 a.m. | SST03-01 | Room S502AB High-pitch cardiac CT is becoming an important new method of scanning the thorax quickly and at very low doses. A group from Medical University of Vienna tried it on a 128-slice dual-source CT (DSCT) scanner and came up with excellent results versus other scanning methods.
|
Perfusion brain CT performed at normal head CT dosesFriday, December 3 | 11:10 a.m.-11:20 a.m. | SST14-05 | Room S403B In brain perfusion CT, multiple time-resolved images are needed to track the flow of contrast through the brain, leading to higher radiation doses in the range of 300-500 mGy. But researchers from the Mayo Clinic in Rochester, MN, can do it with less radiation -- down to 75 mGy -- using a gradient adaptive bilateral filter noise reduction algorithm.
|
Stroke CAD system shows promiseEducation Exhibit | LL-INE1188-WEA | Lakeside Learning Center This exhibit will present software for computer-aided detection (CAD) of stroke for automatic identification, localization, and volume estimation of ischemic infarcts in unenhanced CT images.
|
|
|
|