Multiplanar and three-dimensional reconstruction techniques in CT: impact on chest diseases

Abstract

The purpose of this review is to capture the current state-of-the art of the technical aspects of multiplanar and three-dimensional (3D) images and their thoracic applications. Planimetric and volumetric analysis resulting from volumetric data acquisitions obviates the limitations of segmented transverse images. Among the 3D reconstruction techniques currently available, the most recently introduced technique, i. e., volume rendering, has to be evaluated in comparison with 3D shaded surface display and maximum or minimum intensity projection. Slabs are useful in detecting and localizing micronodular or microtubular patterns and in analyzing mild forms of uneven attenuation of the lungs. Three-dimensional angiography is helpful in the pretherapeutic evaluation and posttreatment follow-up of pulmonary arteriovenous malformations, in the comprehension of the postoperative reorientation of the pulmonary vessels, in the surgical planning of pulmonary tumors, and in the diagnosis of marginated thrombi. The systemic supply to the lung and superior vena cava syndromes are also relevant to these techniques. In acquired or congenital tracheobronchial diseases including stenosis, extraluminal air and complex airway anatomy, multiplanar and 3D reformations have a complementary role to both transaxial images and endoscopy. New developments are also expected in various topics such as 3D conformal radiation therapy, planning of intraluminal bronchoscopic therapy, virtual endoscopy, and functional imaging of the bronchial tree. Miscellaneous clinical applications are promising in the analysis of diaphragmatic morphology and pathophysiology, in the volumetric quantification of the lung parenchyma, and in the vascular components of the thoracic outlet syndromes.

Characterization of Radiologists’ Search Strategies for Lung Nodule Detection: Slice-Based Versus Volumetric Displays

“…4,5 Other rendering methods exist that can be applied for particular clinical tasks, but in general they have not been shown to be acceptable for primary diagnosis. Surface rendering, for example, is a commonly used rendering method for displaying external structures and object shapes.…”

New frontiers in CT imaging of airway disease

“…The 3D surface shadowing display image (right) demonstrates the asymmetric aspect of the stenosis. b Descending virtual endoscopy view assesses the internal morphology of the stenosis malities of the tracheobronchial tree and in the diagnosis of bronchial dehiscence following lung transplantation or surgery [7]. Whereas the thickness of the displayed planar image is 0.6-0.8 mm, depending on the dimension of the field of view, multiplanar volume reconstruction (MPVR) consists of a slab with a thickness of several pixels and of a less noisy reformation [8].…”

“…Underestimation of a stenosis, however, may occur if the reformation plane is not adequately chosen. This can be avoided by a simultaneous reading of the native cross-sectional images and a selection of reformation plane from the 3D reconstructed image of the airways [7].…”

Virtual tools for imaging of the thorax

“…However, in patients with obvious micronodular pattern (46 of 81 patients) at conventional CT and in patients with normal HRCT (18 of 81 patients), MIP did not show any diagnostic superiority over HRCT. Therefore, MIP images are an additional tool used at second attention for adequate evaluation of mild forms of micronodular infiltration [8].…”