CT SCANNING – TECHNIQUES AND APPLICATIONS Edited by K. Subburaj CT Scanning – Techniques and Applications Edited by K. Subburaj Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2011 InTech All chapters are Open Access articles distributed under the Creative Commons Non Commercial Share Alike Attribution 3.0 license, which permits to copy, distribute, transmit, and adapt the work in any medium, so long as the original work is properly cited. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published articles. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Davor Vidic Technical Editor Teodora Smiljanic Cover Designer Jan Hyrat Image Copyright Losevsky Pavel, 2010. Used under license from Shutterstock.com First published September, 2011 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechweb.org CT Scanning – Techniques and Applications, Edited by K. Subburaj p. cm. ISBN 978-953-307-943-1 free online editions of InTech Books and Journals can be found at www.intechopen.com Contents Preface IX Part 1 Imaging 1 Chapter 1 State-of-the-Art Multi-Detector CT Angiography in Acute Pulmonary Embolism: Technique, Interpretation and Future Perspectives 3 IJC Hartmann, PJ Abrahams-van Doorn and C Schaefer-Prokop Chapter 2 Application of Optical CT Scanning in Three-Dimensional Radiation Dosimetry 37 Andy Y. Xu and C. S. Wuu Chapter 3 PET/CT 53 Joshua D. Schaefferkoetter, Eric R. Carlson and Amy K. LeBlanc Chapter 4 CT Scan of Pediatric Liver Tumors 69 Qian Dong and Jingjing Chen Chapter 5 Cone-Beam Volumetric Imaging in Craniofacial Medicine 89 Corega Claudia, Avram Adrian, Nocini Pier Francesco and Bertossi Dario Chapter 6 Medical CT Image Classification 105 Hongmei Xie Part 2 Diagnosis 119 Chapter 7 Distraction Osteogenesis of the Maxillofacial Skeleton: Clinical and Radiological Evaluation 121 Mehmet Cemal Akay Chapter 8 Efficacy of Preoperative CT Imaging in Posterior Cervical Spine Surgery 147 Shiro Imagama and Naoki Ishiguro VI Contents Chapter 9 CT Scanning in Minor Head Injury 161 Saeed Shoar and Soheil Saadat Chapter 10 Routine CT- Chest in Primary Evaluation of the Major Blunt Trauma Patients; Pros and Cons 177 Abdel-Mohsen M. Hamad Part 3 3D Modelling 185 Chapter 11 Influence of End-Plates on Biomechanical Response of the Human Lumbosacral Segment 187 Vincenzo Moramarco, Claudia Macchia, Carmine Pappalettere and Amaya Pérez del Palomar Chapter 12 Computer-Assisted Visualization of Central Lung Tumours Based on 3-Dimensional Reconstruction 205 S. Limmer, C. Stöcker, V. Dicken, S. Kraß, H. Wolken and P. Kujath Chapter 13 CT Scanning and Dental Implant 229 Yeon-Jo Choi, Sang-Ho Jun, Young-Dae Song, Myoung-Woo Chang and Jong-Jin Kwon Chapter 14 Three-Dimensional CT Analysis of Congenital Scoliosis and Kyphosis: A New Classification 251 Shiro Imagama, Noriaki Kawakami and Naoki Ishiguro Part 4 Treatment Planning 273 Chapter 15 Computed Tomography of Osteolysis Related to Total Ankle Replacement 275 Ia Kohonen, Helka Koivu, Kimmo Mattilaand Hannu Tiusanen Chapter 16 Cardiac Rhythm Management Device Infections: Imaging Examinations to Direct Replacement Timing 289 Michela Casella, Francesco Perna, Antonio Dello Russo, Gemma Pelargonio, Stefano Bartoletti, Lucia Leccisotti, Ghaliah Al-Mohani, Pasquale Santangeli, Luigi Di Biase, Andrea Natale, Fulvio Bellocci and Claudio Tondo Chapter 17 Comparison of Patient Localization Accuracy Between Stereotactic X-Ray Based Setup and Cone Beam CT Based Setup on Intensity Modulated Radiation Therapy 299 Naoki Hayashi, Hitoshi Takagi, Shinichi Hashinokuchi, Hiroshi Fujiwara, Hidetoshi Kobayashi, Fumitaka Itoh, Yumi Oie and Hideki Kato Contents VII Part 5 Applications 309 Chapter 18 CT-Scanning in Forensic Medicine 311 Peter Mygind Leth Chapter 19 Use of X-Ray Computed Tomography (CT) in UK Sheep Production and Breeding 329 L. Bünger, J.M. Macfarlane, N. R. Lambe, J. Conington, K. A. McLean, K. Moore, C.A. Glasbey and G. Simm Preface Since its introduction in 1972, X-ray computed tomography (CT) has evolved into an essential diagnostic imaging tool for a continually increasing variety of clinical applications. The original systems were dedicated to head imaging only, but “whole body” systems with larger patient openings became available in the late 1970’s. Technical advancements in developing high-power x-ray tubes and computing technologies led to two major evolutionary leaps in CT imaging during the past decade. The first of these occurred in the early 1990’s with the introduction of CT scanners with simultaneous patient translation and data acquisition (“spiral” or “helical”). The second leap occurred mid-decade, with the introduction of multiple row detectors capable of multiple slices per x-ray tube rotation. These advances improved volume coverage and/or longitudinal spatial resolution, and creating new applications that could not have been attempted before, such as CT angiography, virtual endoscopy, CT-guided surgery/radiation therapy, and computer integrated surgery. The goal of this book was not simply to summarize currently available CT imaging techniques but also to provide clinical perspectives, advances in hybrid technologies, new applications other than medicine and an outlook on future developments. Major experts in this growing field contributed to this book, which is geared to radiologists, orthopedic surgeons, engineers, and clinical and basic researchers. Each of us has written different part of this book, obviously depending on our areas of expertise. We believe that CT scanning is an effective and essential tools in treatment planning, basic understanding of physiology, and and tackling the ever-increasing challenge of diagnosis in our society. I would finally like to acknowledge our publishing process manager Davor Vidic’s hard work and support during the preparation of this book. K. Subburaj, PhD Department of Radiology and Biomedical Imaging University of California, San Francisco USA [...]... resulting in a dataset obtained within 1 s and without disturbing breathing artifacts, even in very dyspnoeic patients 4 CT Scanning – Techniques and Applications The development of faster CT scanning techniques has resulted in a substantial decrease of the percentage of non-interpretable scans (overall from 10% using SDCT techniques to up to 6% for multi-detector CT (MDCT)) (2, 3) However, the very fast... reconstruction further improves image quality 10 CT Scanning – Techniques and Applications by reducing artefacts, i.e., spiral artefacts and beam hardening artefacts, the latter might be especially advantageous in the assessment of use of dual-energy CT (DECT) perfusion images (see below under ‘Dual-source CT ) So far, these techniques were not used in CT as the algorithm requires significant computational... conversion factor is the same for men and women, although the individually received dose is higher for women because of radiation to the breasts The CTDIvol is given on the scanner console after each examination As a rule of 6 CT Scanning – Techniques and Applications thumb it can be said that for a total CTPA with a scan length of 30 cm the effective dose amounts to about 40% of the CTDIvol for men and to... axial reconstruction performed using a single-source CT scanner (A, white arrow) and at additional coronal thin MIP reconstructions (B and C, detail) A fused color-coded and virtual 120 kV axial image demonstrates decreased perfusion in the left lower lobe (D, black area) 24 CT Scanning – Techniques and Applications A B C D Fig 11 Forty-year-old female patient with chronic thrombo-embolic PH CTPA shows... image acquisition for a CTPA during breathhold and in inspiration 12 CT Scanning – Techniques and Applications Breathing artefacts and a Valsalva maneuver by the patient hampering contrast-inflow are still major causes for sub-optimal scan quality A careful patient instruction by the technologist is therefore very important: it should include an appropriate explanation of the effects of fast contrast-inflow... for a multi-detector CTA The magnitude of the dataset is determined by the slice thickness and the reconstruction index and not by the number of CT detectors Therefore, the number of images does not necessarily increase with the use of CT systems with more detectors Scrolling through the dataset is helpful to identify and follow the pulmonary arteries, to identify pulmonary emboli and to differentiate... arteries and other pulmonary structures Thorough knowledge of the anatomy of the pulmonary arterial tree and the hilar structures and a systematic approach are essential for optimal interpretation One possible and in our view useful and practical approach is to start with the pulmonary trunk and follow per lobe every artery from its origin to the periphery 3.4 Multiplanar and curved reformats With MDCT isotropic... Interpretation and Future Perspectives 17 MPR’s represent the simplest and most frequently used processing technique To obtain a good quality MPR, the slice thickness is usually 2 mm MPR’s can be reconstructed in any direction and the optimal direction is dependent on the patient’s vascular anatomy and the individual findings and therefore should be done individually and not in a standardized way Some... evaluation 18 CT Scanning – Techniques and Applications whether CAD may be used more efficiently as “concurrent reader” meaning that already the initial reading process is supported by CAD candidates In the future the automatic detection of vascular emboli may be also used for the quantification of thrombus load (57) A True positive candidate B False positive candidate Fig 5 Automatic detection of pulmonary... Healthcare, the Netherlands): (A) example of true positive candidates, and (B) false positive candidates in badly opacified pulmonary arteries 4 Imaging characteristics of PE For correct interpretation of a CTPA study, every single artery from the main PA to the subsegmental branches has to be examined for signs of acute or chronic PE Not only knowledge of the direct and indirect imaging characteristics of . CT SCANNING – TECHNIQUES AND APPLICATIONS Edited by K. Subburaj CT Scanning – Techniques and Applications Edited by K. Subburaj. obtained within 1 s and without disturbing breathing artifacts, even in very dyspnoeic patients. CT Scanning – Techniques and Applications 4 The development of faster CT scanning techniques has. CT Scanning – Techniques and Applications 6 thumb it can be said that for a total CTPA with a scan length of 30 cm the effective dose amounts to about 40% of the CTDI vol for men and