MEDI 421
Fatimah B. Ayete Labi
ifatiwill@[Link]
Learning objectives
At the end of this section, students should be able to
understand and explain;
• Post-processing operations
• Multiplanar Reformation (MPR)
• Curved Planar Reformation (CPR)
• Maximum Intensity Projection (MIP)
• Volume-rendered Technique (VRT)
• Surface Rendering [Shaded Surface
Display (SSD)]
• Advantages of 3-D reconstruction
POST-PROCESSING OPERATIONS
• Modern scanners allow many opportunities to manipulate both
raw data and image data after scanning has taken place.
• Collectively, these techniques are referred to as post-processing.
• The term “reconstruction” is used when raw data are
manipulated to create pixels that are then used to create an
image.
• The term “reformation” is used when image data are assembled
to produce images in different planes, or to produce three-
dimensional (3D) images.
POST-PROCESSING OPERATIONS
• Reconstructing raw data to create new images (image data) can
only be done from the operator’s console.
• Even though many parameters can be changed retrospectively,
the images that result are always in the same plane (i.e.,
coronal, axial) and the same orientation as were the original
images.
• Parameters like Display field of view (DFOV), image center, and
reconstruction algorithm can be changed on both axial and
helical data retrospectively.
• Reformatted images are used to better display anatomic
relationships and can be of either a 2D or 3D in nature.
POST-PROCESSING OPERATIONS
• To successfully reformat a CT study all the source images must
have an identical DFOV, image center (i.e., the xy coordinates
must be the same), and gantry tilt, and they must be contiguous
(i.e., no nonimaged spaces between slices).
• Because lining up the images exactly is vital in reformation,
even a small amount of patient motion seriously degrades the
nature.
• In general, the thinner the original slice, the better the
reformatted image
• Image reformation uses only image data to generate images in a
plane or orientation different from the prospective image.
POST-PROCESSING OPERATIONS
Below are the post-processing techniques performed
on the data.
• Multiplanar Reformation (MPR)
• Curved Planar Reformation (CPR)
• Maximum Intensity Projection (MIP)
• Volume-rendered Technique (VRT)
• Surface Rendering [Shaded Surface
Display (SSD)]
MULTIPLANAR REFORMATION
• MPR is the postprocessing technique used most commonly
used and represents a simple reordering of the image voxels.
• MPRs show anatomy in various planes and are 2D in nature.
• MPRs can typically be created either at the operator’s console
or at a separate workstation.
• A known limitation of MPR is that visualized structures must
be in a same plane.
• Because most structures of interest are not within a single
plane, a MPR cannot be created that demonstrates an entire
structure.
• As structures course in and out of the MPR, pseudostenoses
are created.
MULTIPLANAR REFORMATION
MULTIPLANAR REFORMATION
MULTIPLANAR REFORMATION
MULTIPLANAR REFORMATION
CURVED PLANAR REFORMATIONS
• Curved planar reformations (CPR) are used to solve the
MPR limitation.
• CPR have a single voxel –thick tomogram, but it is capable
of demonstrating an uninterrupted longitudinal cross-
section as the display plane curves along the structure of
interest
• CPR images can be obtained manually by drawing a line
over a structure of interest or it can be produced
automatically or semiautomatically by dedicated software.
CURVED PLANAR REFORMATION
CURVED PLANAR REFORMATIONS
• CPR provide the most useful
luminal assessment (such as of
blood vessels, airways, and
bowel) and are useful in
improving the visualization of
vessels of small diameter or
tortuous anatomy.
• CPR have an important
limitation in that they are
highly dependent on the
accuracy of the curve
MAXIMUM INTENSITY PROJECTION
• MIP displays the maximum voxel intensity along a line of
viewer projection in a given volume.
• High-density structures, such as contrast-filled vessels
and the collecting system, are demonstrated nicely in
images, such as angiograms or urograms.
• The main disadvantage of MIP is that it obscures the area
of interest by high-density material, such as bone,
calcium, and oral contrast medium.
• With the MIP technique, a 3-D effect can be obtained
with rotational viewing of multiple projections, but it
lacks depth orientation
MAXIMUM INTENSITY PROJECTION
VOLUME-RENDERED TECHNIQUE
• With this technique, all attenuation values within a voxel
are used to obtain the final image (that each voxel
contributes brightness, color, and opacity to the final
image).
• Anatomic structures with different levels of opacity (eg,
renal parenchyma, renal veins and arteries, and the
collecting system) can be demonstrated simultaneously.
• VRT is an excellent 3-D technique for presentation that
provides a roadmap for surgery and summary picture for
the referring physician.
VOLUME-RENDERED TECHNIQUE
• The most important
limitation of VRT is its need
for more powerful
computers and costly
workstations.
• Using editing techniques,
structures overlying the
area of interest can be
removed for better
visualization and desired
orientation
SURFACE RENDERING [SHADED SURFACE
DISPLAY (SSD)]
• Shaded surface displays enable accurate 3-D
representations of anatomy, relying on the gray scale to
encode surface reflections from an imaginary source of
illumination
• SSD images are limited by their dependence on user-
selected threshold settings
• The 12-bit CT data is reduced to binary data, each pixel
either within or outside of the threshold range
• Because of this, it can overestimate or underestimate
stenosis.
AN IMAGE SHOWING SSD
ADVANTAGES OF 3-D
RECONSTRUCTION
Reconstructed 3-D data offers several advantages:
1. It enhances viewing of pathology
2. It equips radiologists to deal with the large data sets that
are available with the new multi-detector CT scanners
and to more easily compare current and previous exams.
3. It improves service to referring physicians, since selected
3-D images can be attached to the radiology report.
4. 3-D images illustrate the diagnosis and may even be
shown to patients while discussing the condition and
recommended treatment.
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