Diagnosis of Brain Tumor Using Area Detector CT

Diagnosis of Brain Tumor Using Area Detector CT

Diagnosis of Cerebral
Aneurysm Using Area
Detector CT
Kazuhiro Katada
Department of Radiology
Fujita Health University, School of Medicine
[email protected]
10th Stanford MDCT Symposium 2008, Las Vegas
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Disclosure
Kazuhiro Katada is consultant of
Toshiba Medical Systems Japan.
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Area Detector CT
• Single rotation scan
1. Dose reduction
2. Shorter scanning time
3. Geometrical accuracy
4. Isophasic imaging
5. Functional imaging
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Basilar-Top Aneurysm: 3D-CTA: 320
Single Rotation Scan
Total Scanning
Time
0.5 sec.
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Case: 0.5 x 160mm, 0.5 sec./rot., 125 kV/ 300mA, 1 rot.
MCA Aneurysm: 3D-CT DSA: VR 320
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Case 005: 0.5 x 160mm, 0.5 sec./rot., 125 kV/ 300mA, 1 rot.
Acom Aneurysm: 3D-CTA
320
Software Subtraction
Case 020: 0.5 mm x 320, 0.75 s/rot., 135 kV/ 200 mA, 1 rot.
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Acom Aneurysm: MPR
320
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Case 020: 0.5 mm x 320, 0.75 s/rot., 135 kV/ 200 mA, 1 rot.
Acom Aneurysm: MPR
320
Imaging Time 0.75 sec.
pcom
ant.chor.
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Case 020: 0.5 mm x 320, 0.75 s/rot., 135 kV/ 200 mA, 1 rot.
IC Large Aneurysm
Case: 0.5 x 320mm, 1 sec./rot., 120 kV/ 270, 2 rot.
320
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IC Large Aneurysm
320
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Case: 0.5 x 320mm, 1 sec./rot., 120 kV/ 270, 2 rot.
IC Large Aneurysm
320
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Case: 0.5 x 320mm, 1 sec./rot., 120 kV/ 270, 2 rot.
IC Large Aneurysm
Case: 0.5 x 320mm, 1 sec./rot., 120 kV/ 270, 2 rot.
320
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IC Aneurysm Post-Op:
320
MPR/3D-CTA
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Case 0.5 x 160mm, 0.5 sec./rot., 120 kV/135 mA, 1 rot., 2.4 mSv
IC Aneurysm Post-Op: 3D-CTA
320
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Case 0.5 x 160mm, 0.5 sec./rot., 120 kV/135 mA, 1 rot., 2.4 mSv
Lt IC Aneurysm Post-Op:
320
3D-CT DSA
Case 0.5 x 160mm, 0.5 sec./rot., 120 kV/135 mA, 1 rot., 2.4 mSv
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IC Aneurysm Post.-Op: Subtraction320
Case: 0.5 x 240 mm, 0.75 sec./rot., 120 kV/ 270 mA
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IC Aneurysm Post.-Op: Subtraction320
Case: 0.5 x 240 mm, 0.75 sec./rot., 120 kV/ 270 mA
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IC Aneurysm Post. Coil Embolization:320
Subtraction
Case: 0.5 x 240 mm, 0.75 sec./rot., 120 kV/ 270 mA
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Acom Aneurysm Post-Op.: Vasospasm
Case: 0.5 x 320 mm, 0.5 sec./rot., 9 sec., 120 kV/50-150 mA, 7.79 mSv
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Acom Aneurysm Post-Op.: Vasospasm
Case: 0.5 x 320 mm, 0.5 sec./rot., 9 sec., 120 kV/50-150 mA, 7.79 mSv
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Acom Aneurysm Post-Op.: Vasospasm
CBF
CBV
MTT
TTP
Case: 0.5 x 320 mm, 0.5 sec./rot., 9 sec., 120 kV/50-150 mA, 7.79 mSv
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MCA Aneurysm: 3D-CT DSA: VR 320
Case: 0.5 x 320, 160mm, 1.0 sec./rot., 125 kV/ 30-40mA, 3.9 mSv
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32-row Helical CT:
Aneurysm Pulsation
Hayakawa M, Katada K, et.al. AJNR 26:1366-1369, June/July 2005
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Basilar Top Aneurysm: Pulsation 320
Case: 0.5 x 240 mm, 0.375 sec./rot., 3.75 sec., 120 kV/ 270 mA, 4.93 mSv
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Basilar Top Aneurysm: Pulsation 320
Case: 0.5 x 240 mm, 0.375 sec./rot., 3.75 sec., 120 kV/ 270 mA, 4.93 mSv
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Basilar Top Aneurysm: Pulsation 320
Case: 0.5 x 240 mm, 0.375 sec./rot., 3.75 sec., 120 kV/ 270 mA, 4.93 mSv
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Applications of ADCT:
Aneurysm
• 3D-CTA: Detection of Aneurysm
• Subtraction: Skull base lesions/
Post-surgical follow up
• Dynamic MPR/3D-CTA: Flow
dynamics, Aneurysm pulsation
• CTP: Cerebral Vasospasm
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AVM・AVF
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320
AVM: High Temporal Resolution CT-DSA
Case 008: 0.5 x 280mm, 1 sec./rot., 80 kV/ 80 (int.) or 120 (cont.) mA, 27 rot.
AVM: CT-DSA: VR
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320
Case 008: 0.5 x 280mm, 1 sec./rot., 80 kV/ 80 (int.) or 120 (cont.) mA, 27 rot.
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320
CBF
AVM: Whole-Brain CT Perfusion
CBV
MTT
Case 008: 0.5 x 280mm, 1 sec./rot., 80 kV/ 80 (int.) or 120 (cont.) mA, 27 rot.
Dural AVF: 3D-CT DSA: MIP
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320
Case 019: 0.5 x 320mm, 1 sec./rot., 80 kV/ 80 (int.) or 120 (cont.) mA, 24 rot.
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Ophthalmic Arteries & Branches 320
Ant. Ethm. A
Lacrimal artery
OA-3
OA-2
OA-1
Case 019: 0.5 x 320mm, 1 sec./rot., 80 kV/ 80 (int.) or 120 (cont.) mA, 24 rot.
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320-row ADCT
-improve patient throughput
-provides new applications
-improves diagnosis and management
of cerebral aneurysm, AVM and AVF.
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320-Raw ADCT:
How to Change Clinical Practice?
• Improve throughput
• Improve pediatric & emergency exam.
• Further replacement of conventional
DSA
• Replace SPECT
• First choice for acute ischemic diseases
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Future Challenge
• Handling of large amount of data
• Further improvement of workflow
• Development of the applications
• Cost
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64-row Helical vs.
320-row Non-Helical
20% Dose Reduction
64-row
ADCT
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Meningioma of the Anterior Clinoid Process
Dynamic MPR
Lateral Mainstem Artery
Case: 0.5 x 320mm, 0.5 sec./rot., 120 kV/ 150 (int.) or 120 (int.) mA, 13 rot.
AVM: CT-DSA
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320
Case 008: 0.5 x 280mm, 1 sec./rot., 80 kV/ 80 (int.) or 120 (cont.) mA, 27 rot.
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AVM: CT-DSA
320
Case 008: 0.5 x 280mm, 1 sec./rot., 80 kV/ 80 (int.) or 120 (cont.) mA, 27 rot.
AVM: CT-DSA: VR
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320
Case 008: 0.5 x 280mm, 1 sec./rot., 80 kV/ 80 (int.) or 120 (cont.) mA, 27 rot.
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Time Sequential Averaging
averaging
averaging
averaging
80 kV, 100 mA, 1.0 s/rot., 20 rot., 0.5 mmX256, range: 128mm, 5 ml/s, Total: 35ml
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320-Raw ADCT : Advantages
• Short exam. time: 0.35 sec.
• Volume subtraction
• Sequential volume scan
• Step & Shoot scan
• Advanced data-filing system
• Large volume storage & network
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Acknowledgments
• Noriyuki Moriyama MD, Dept. of Radiology, National Cancer Center
• Teruichi Mochizuki MD, Dept. of Radiology, Ehime University
• Masahiro Endo MD, Syuzi Tanada MD, Shinichiro Mori RT, Dept. of Radiology,
National Institute of Radiological Sciences
• Hirofumi Anno MD, Ryoivhi Kato MD, Masato Nakane MD, Naoko Fujii
MD, Yoshihiro Ida RT, Toshihiro Nakai RT, Yumi Kataoka RT, Satoshi
Yoshimi RT, Dept. of Radiology, School of Medicine, FHU
• Motoharu Hayakawa MD, Dept. of Neurosurgery, School of Medicine, FHU
• Tetsushi Yoshioka MD, Dept. of Otology, School of Medicine, FHU
• Takeshi Kondo MD, Dept. of Cardiology, School of Medicine, FHU
• Shoichi Suzuki RT, School of Health Sciences, FHU
• Akira Taniguchi RT, Shinsuke Tsukagoshi, Masahiro Kazama, Shintaro
Funabasama, Tokukazu Yamada, Masatoshi Kanou, Jeff Hall，Kazuhiro
Anami RT, Toshihiro Rifu, Miwa Okumura, Hiroshi Aradate, CT Clinical
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