CT Image Post Processing - TRANSCRIPT
Modality CT
Course Title CT Image Post-Procesing
Welcome to our module on post processing. We hope you will enjoy this module and learn or review information to
enhance your CT knowledge.
Objectives
After completion of this module, the participant will be able to:
• Understand the concept of post processing
• Explain volume rendering
• Compare maximum intensity projection (MIP) and minimum intensity projection (MinIP)
• Discuss image fusion
Please keep these in mind as you progress through this module.
Outline
Post-processing
• Rendering mode
• M.I.P. (maximum intensity projection)
• Min.I.P. (minimum intensity projection)
• Average
• Curved
• Stenosis measurement
• Endoprosthesis planning
• Volume rendering
• Volumetric reconstruction
• Endoscopy
• Image fusion
• Emphysema measurement
Informatics is a branch of information engineering. It involves the practice of information processing and the
engineering of information systems, and as an academic field it is an applied form of information science.
Informatics is the science of how to use data, information and knowledge to improve human health and the delivery
of health care services.
We will be breaking this unit down into 8 main parts. This will allow students the opportunity to understand the
integration of images from acquisition to interpretation and beyond. Let’s begin with defining Informatics.
Rendering Mode
Three main methods will be explained in detail, minimum intensity projection, average intensity projection and
maximum intensity projection. Maximum intensity projection consists of projecting the voxel with the highest
attenuation value on every view throughout the volume onto a 2D image.
An image that displays the maximum intensity for each pixel point on a thickened reformat plane
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CT Image Post Processing - TRANSCRIPT
MIP (maximum intensity projection)
Vascular
This slide shows an example of when maximum intensity projection is used to search for vascular diseases or
anomalies.
Searching for vascular diseases or anomalies.
Renal Artery
This image shows us a dysplastic renal artery stenosis. Notice the contour of the renal artery.
Searching for vascular diseases
Nodules
This slide shows where maximum intensity projection is used to search for parenchyma solid nodule lesions. Notice
the many metastatic lesions shown in both lung fields.
Searching for parenchyma solid nodular lesions.
Pulmonary Nodules
This slide shows where maximum intensity projection is used to search for parenchyma solid nodular lesions. Notice
the pulmonary lesion in the lung field.
Searching for solid nodular parenchyma lesions.
Lithiasis
You can see on this image an example of maximum intensity projection used to search for ureter stenosis caused by
a prevesical lithiasis.
Minimum Intensity Projection
Minimum intensity projection is a data visualization method that enables detection of low-density structures in a
given volume. MinIP is a data visualization method that enables detection of low-density structures in a given
volume.
Chest
Both of these images show how minimum intensity projection technique is used for the diagnosis of emphysema.
Notice the bullae in the image on the left and the pneumothorax in the left lung on the image on the right.
Inner Ear
On this slide we can see an example of how minimum intensity projection is used in diagnosis of the semicircular
canal. Abnormalities such as cholesteatomas can be easily seen.
Heart
The minimum intensity algorithm is particularly useful in highlighting hypo or low-density regions within the heart.
Heart: highlighting regions with hypodensities.
Biliary Tract
This example shows us a presence of air in the biliary tract known as pneumobilia. Notice the white arrows pointing
out the air. Pneumobilia: Presence of air in the biliary tract
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CT Image Post Processing - TRANSCRIPT
Average
In the average intensity algorithm (AIP), the visualization is averaged. The AIP technique is an algorithm that is
intended to create a thick MPR image by using the average of an attenuation through the tissues of interest to
calculate pixels viewed on the computer.
The visualization is averaged.
Images
In the image on the left we see polycystic disease of both kidneys while the image on the left shows the presence of
ascites in the abdomen.
Multi Planar Reconstructions
In this slide, both images show the presence of nodes in the Barety lodge, or Baréty's box (or right pre-tracheal
space). It is an anatomical space located in the middle mediastinum of the human thorax which is formed of cellulo-
lymphatic tissue running along the trachea.
Summary
This video shows how contrast in the acquired images varies when changing the post processing algorithm. Play the
video and observe the impact of the changes.
Curved
Multi-planer
A curved multiplanar axis allows the draw of a central axis inside a structure independently from its origin.
Allows the draw of a central axis inside
a structure independently from its origin
(vascular or other)
• Visualization of sagittal and coronal vertebrae in the same plan
Mandible
It allows the visualization of the mandibular canal as well as the visualization of the pre-implanted bony space.
• Visualization of the mandibular canal (panoramic) to observe its relationship with dental roots
• Visualization of the pre-implanted bony space
Bronchial Tree
This image shows us visualization of the bronchial lumen and its caliber. Visualization of bronchial lumen and its
caliber
Post Processing
The curved post processing algorithm allows for better visualization of a tract, better localization of a pathological
element and better measurement of distance (such as measuring stenosis).
• Better visualization of a tract
• Better localization of a pathological element
• Better distance measurement (example: Stenosis)
• This study can be done automatically through vascular HU or manually point by point
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CT Image Post Processing - TRANSCRIPT
Images
The image on the left shows us the facial nerve while the image on the right shows renal artery dysplastic stenosis.
Aneurysm
The image post processed with the curved technique shows a carotid aneurysm in the upper third of the image on
the right.
This video shows a series of CT images post processed using the curved algorithm.
Stenosis Measurement
For stenosis quantification, you have to place the reference on the curvilinear or on the stretched vessel image. Once
positioned, verify the vessel’s contour for the reference and the lesion.
Stenosis Percentages
Stenosis percentages, maximum and minimum diameter and the surface are displayed in the following table.
Endoprothesis Planning
In this step, you can choose and import the type of prosthesis you want. To do so, you have only to click on the list of
prosthesis models and select your choice.
Summary
Once the model is selected, you have to adjust the measurements as indicated on the template. For each
measurement, check the light contour automatically created by the software.
Endoprosthesis Results
Then you can display the table of results referring to the necessary measurements for a prosthesis fabrication.
This video describes in detail the endoprosthesis implantation process. Make sure to watch it until the end.
Volume Rendering
Volume rendering (VR) will allow us to use predefined protocols to adjust the amount of opacity and color applied to
the model. Then you can display the table of results referring to the necessary measurements for a prosthesis
fabrication.
Volume rendering (VR) will allow us to use predefined protocols to adjust the amount of opacity and color applied to
the model.
Density
Each density range has a very specific opacity coefficient (or transparency coefficient).
Each density range has a very specific opacity coefficient (or transparency
Volume Rendering and MIP
This video shows the difference between volume rendering and maximum intensity projection technique. Make sure
you watch the entire video.
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CT Image Post Processing - TRANSCRIPT
Volumetric MIP and ANGIO
The image on the left is post processed using volumetric maximum intensity projection technique.
Colonic Endoscopy
The lowest Hounsfield unit voxels (near air) have a maximum transparency effect. The voxels with great HU present
a significant opacity which materializes the wall of the colon.
• 3D visualization of the interior of a hollow organ.
• The lowest HU voxels (near the air) have a maximum transparency effect. The voxels with greater HU,
present a significant opacity which materializes the wall.
Endoscopy
Endoscopic Navigation
This animation shows an endoscopic visualization and navigation.
Bronchial Endoscopy
Bronchial endoscopy allows the visualization of the bronchial lumen filled with an inhaled object or invasive cancer.
3D visualization of the interior of
a hollow organ.
Allows the visualization of the bronchial lumen filled by an inhaled object or invasive cancer.
Image Fusion
After fixing three landmarks (or points) in the anatomy, the system readjusts the planes with a maximum tolerance
of 20*.
• FOV, slice thickness and identical planes. After fixing three landmarks (or points) in the anatomy, the system
readjusts the planes with a maximum tolerance of 20° .
PET CT
A PET/CT combines nuclear medicine sensitivity with the anatomical location of the CT scanner.
PET CT: Nuclear medicine sensitivity and anatomical location of the scanner
Emphysema Measurement
The automated application called “lung density” provides the physician with quantitative data on volume of
pulmonary emphysema, as well as giving us a visual representation of its diffusion.
Damaged Alveoli
This slide shows us an example of images where the damaged alveoli are highlighted in blue.
Percentage of Lung Parenchyma
In this slide we can see the percentage of lung parenchyma as a function of Hounsfield densities.
HU Measurements
This image shows the average density measurements in Hounsfield units of 25%, 50 %, 75% and 100%.
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