Escolar Documentos
Profissional Documentos
Cultura Documentos
Digital Radiography
CR: Computed
Radiography with
photostimulable
phosphor plates
Digital Radiography
CR: Computed
Radiography with
photostimulable
phosphor plates
DR: Digital
Radiography with
direct-readout detectors
Digital Radiography
Image quality
- Dynamic range
- Processing
Interactive
- Window/Level
- Zoom
Image access
-Local
- PACS
University of Chicago
Chest Section 2006
2nd CR plate
X Ray
Source
Patient
Single exposure ES
uses two detectors
separated by a filter
2nd CR plate
X Ray
Source
Patient
Single exposure ES
uses two detectors
separated by a filter
2nd CR plate
X Ray
Source
Patient
Single exposure ES
uses two detectors
separated by a filter
2nd CR plate
X Ray
Source
Patient
Single exposure ES
uses two detectors
separated by a filter
Lung Carcinoma
Conventional CXR
Conventional CXR
Clinical Advantages of ES
Radiography
Improved detection of pulmonary
nodules
Calcified granuloma
Clinical Advantages of ES
Radiography
Improved detection of pulmonary
nodules
Improved rejection of false positives
Clinical Advantages of ES
Radiography
Improved detection of pulmonary
nodules
Improved rejection of false positives
Improved detection/characterization of
calcified pleural plaques
Improved detection of bone metastases
Current CXR
1-21-03
Current CXR
Current CXR
1-21-03
Previous CXR
7-18-00
Previous and
D
Current CXRs
Iterative
Warping of
Previous CXR
Subtraction
Current CXR
Current CXR
Temporal Subtraction
Benefits
Improved detection for pulmonary, pleural,
mediastinal disease
Status
Used clinically in Japan, under investigation in the
USA
Enhancement
Energy
Subtraction
Detection
Nodules
Interstitial Dis
Bone subtraction
Cardiomegaly
Imaging
Pneumothorax
Temporal
Subtraction
Tomosynthesis
1.0
True Positive
Fraction
0.8
0.6
0.4
0.2
P = 0.005
0.0
0.0
0.2
0.6
False0.4
Positive
0.8
1.0
Fraction
Advances in CT Technology
Advances in CT Technology
Single slice
4 Slice
8 Slice
16 Slice
40 Slice
64 Slice
256 Slice
??
1MM
3MM
8-01
12-02
4-03
1-04
Isotropic Voxels
0.5 mm
0.5 mm
0.5 mm
5 mm
10 mm
0.5 mm
Body
Thorax
MIP theory
3mm
3mm
1mm
3mm
1mm
MIP
Standard CXR
Coronal
3mm axial
3mm3mm
axialaxial
MIP
MIP
Slab
minIP
3D Nodule Analysis
Malignant
Benign
Malignant
Trial
ELCAP Mayo
Subjects 1000
1520
Nodules 23%
51%
Moffet
1150
32%
% Malignant
1--9
10--19
20--29
>30
Nodule Size in mm
Natural History and Evaluation of Prevalence Nodules
Midthun, Swensen, Jett et al ( Unpublished Data )
Cardiac CT
Conclusions
Energy Subtraction is a powerful tool for
nodule detection on CXRs
Nodule detection CAD is available for CXRs
and is improving steadily
MDCT provides routine off-axis recons with
improved depiction of pathology
CT Nodule detection/comparison has great
potential to improve accuracy & productivity