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Computed Tomography: Image Manipulation

Computed Tomography: Image Manipulation

Below, we explain some of the most widely used techniques for capturing images in computed tomography, which allow for more detailed visualization of patients' internal structures for more accurate diagnoses. Some of these include MPR, MIP/MinIP, and the Hounsfield scale.

By Eden Experts

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Imaging studies have become the most important tool for assessing patients' conditions and making more reliable diagnoses, which can be reviewed with other specialists through teleradiology. For these results to be of high quality, however, image manipulation techniques also play a role, for example, in computed tomography (CT).

In tomography, images can be sectioned into parts using computer systems to obtain an image with a broader scope of analysis. These manipulations are image acquisition techniques. Below, we will look at some of them to provide patients with more accurate answers.

Preliminary Considerations for Quality Tomography

To begin using a scanner, certain steps must be followed, such as turning on the CT equipment, then connecting the Gantry console, which houses the X-ray tubes, the information panels, the radiation detection devices, and which activates the structure. The tubes must also be warmed up according to the manufacturer's manual, and finally, calibration must be performed.

This calibration is performed daily or monthly according to the provider's specifications. In this way, the software avoids errors to achieve quality, optimized images, as established by various image quality standards. This allows specialists to verify that the parameters and slices are correctly configured.

Additionally, to access image manipulation tools, it is necessary to have a PACS system whose DICOM viewer includes them.

Techniques for Image Manipulation in CT

Below, we will review some of the most widely used image manipulation techniques in interpreting CT scans. All of these techniques are made possible by the advanced tools of the DICOM viewers found in the best PACS systems.

Recall that image manipulation techniques are the techniques or processes that modify a radiological image to improve the visibility of useful information, while reducing information that is not useful for diagnosis, sometimes known as noise.

Multiplanar Reconstruction (MPR)

First, we will discuss multiplanar reconstruction (MPR), one of the most widely used techniques and one that offers the greatest benefits for accurate diagnoses. 

This technique makes it possible to go from a two-dimensional (2D) image to a three-dimensional (3D) plane in order to view cross-sections of the body area in question in axial, sagittal, and coronal planes.

The dimensional change in MPR is built from a single series or image acquisition, and there are no alterations in its quality. In effect, to be able to use this technique, the healthcare facility must have a cutting-edge technological architecture, like the DICOM viewers of the most sophisticated PACS systems.

Maximum or Minimum Intensity Projection (Mip/Minip)

Another manipulation technique is maximum or minimum intensity projection (Mip/Minip), which is useful for zooming in on and highlighting very small body structures that are therefore difficult to evaluate. Examples include blood vessels, specific tissues, bronchi, and areas to which contrast was applied for more precise observation.

Some experts consider the Mip/Minip technique to be a zoom tool, but in reality, knowing how to section the part to be evaluated requires skill in order to make the necessary close-ups, especially when dealing with small body structures that are difficult to visualize.

Hounsfield Scale (Measurement Tool)

For its part, the Hounsfield scale makes it possible to highlight the outline of the body area to be evaluated and to take measurements of the region. All of this is useful for differentiating the flow of blood, water, and other substances, which can likewise be highlighted with contrast.

Being able to take measurements and adjust the scale using the Hounsfield principle depends on the temperature and pressure of the attenuation or projection of the X-ray beams. Therefore, resolution can be enhanced in areas of the body where there was greater radiation absorption.

The Relationship Between PACS Systems and CT Manipulation Techniques

As mentioned earlier, for all image manipulation techniques to be possible, healthcare facilities need to have appropriate technological infrastructure. This is where PACS systems come in, which must offer viewing and reconstruction options for these studies.

This once again reinforces the importance of digitalization in the healthcare sector for the benefit of both physicians and patients. Additionally, PACS systems offer many other benefits, such as patient clinical history, task visualization, worklists, and much more. 

It should be noted that for these PACS systems to function properly, they need to be built on a cutting-edge technological infrastructure. In other words, a platform in which images can be processed smoothly while maintaining quality across the various slices and dimensional changes.

Recall that CT studies can contain around 125 images, weighing approximately 20 MB. Hence, the PACS provider's servers must have sufficient speed and capacity so that images can be accessed and manipulated with ease. Likewise, it is best for the healthcare facility to have access to a broadband internet connection.

Contact an Eva agent for advice on the best solution for your practice.

References

  • González, C., et al. Computed Tomography and Ultrasound Techniques. Arán.
  • Zúñiga, J. (2009). Picture Archiving and Communication Systems (PACS). Mexico, Secretaría de Salud (Ministry of Health).
  • What Is Cloud Architecture?. Red Hat.