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Multiplanar Reconstruction: What Are the Advantages?

Multiplanar Reconstruction: What Are the Advantages?

Below, we discuss one of the most widely used image manipulation techniques in computed tomography: multiplanar reconstruction (MPR). This technique is highly beneficial for various areas of healthcare, as it allows physicians to view different cross-sections of a body region.

By Eden Experts

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Computed tomography scans (CT) are among the most accurate studies in radiology and medical imaging, as they allow for multiple volumetric approaches depending on the area of the body to be evaluated. The most common and efficient case is multiplanar reconstruction, known by its acronym MPR, which makes it possible to view axial, sagittal, and coronal cross-sections from the same series.

The above means that with a flat or 2D image, a slice edit can be performed to thicken the area of interest. In fact, it is practically possible to obtain a three-dimensional view starting from two coordinates. In certain studies, this technique is very useful because there are small areas that are not easily seen in the general scan.

This technological solution for reconstructing images by cross-section is truly remarkable, and its main advantage is the ability to reach more accurate diagnoses. This is achieved especially with Computed Axial Tomography (CAT), since it allows numerous planes to be generated from a single one to detail organs, tissues, and bones with greater precision. These cross-sectional views feed the coronal, oblique, sagittal planes, and 3D tools of the MPR.

It should be noted that all these reconstructions are made possible thanks to the modifications and updates that the most sophisticated PACS systems and DICOM viewers have undergone, which allow the MPR tool to be used with high quality and without any errors.

Advantages of CAT and MPR

The main advantage of CAT is that it allows multiplanar reconstructions with various types of cross-sections in a very short time. All of this without affecting the resolution of the series or image, while making room for 3D planes. This is why, for radiologists, the MPR tool becomes an indispensable ally for accurate diagnoses.

CAT results would not be as efficient and useful if multiplanar reconstruction options did not exist. 

Finally, it should be added that MPR is so efficient because of isotropic voxels, or equal slice thickness and resolution, since its results are based on the computer's spatial interpretation. 

Voxels are small three-dimensional subunits, usually measuring 200 µm or less, and they offer the ability to visualize the object under study with an accurate representation.

Planes Used in MPR

Recall that multiplanar reconstruction makes it possible to create images in different planes from a single original one, offering a clear visualization advantage over traditional CT planes, which only allow viewing one slice at a time. MPR creates isotropic images in which image quality is preserved at the same level as the original axial plane.

The planes that can be viewed with the MPR tool are:

  • Axial. This plane crosses the body from front to back and divides it into upper and lower sections.
  • Coronal. This is the plane that crosses the body from left to right and divides it into anterior and posterior sections.
  • Sagittal. In this plane, the body is crossed from front to back, dividing it into left and right sections.
  • Oblique. Finally, this plane crosses the body at axial, coronal, and sagittal angles.

How Does MPR Work?

This tool is based on the research of mathematician J.H. Radon, who proposed, at the beginning of the 20th century, a computational model for deriving three-dimensional data from two-dimensional data. Its application in medicine came much later.

Multiplanar reconstruction manages to graphically represent the characteristics of a two-dimensional layer, processing the data as a single set to ultimately create the three-dimensional image. The computer treats the object of study as being made up of equilateral rectangular prisms, called isotropic voxels (slices), which are the volume units used to form a three-dimensional matrix. 

When viewing a 3D image using the MPR tool, what is actually being observed is a reconstruction achieved through a complex calculation, which allows tissues to be analyzed from the various desired planes. This makes it possible to calculate lengths, angles, areas, and volumes with great precision, which is useful for accurate diagnoses of various conditions, something impossible with other imaging techniques.

Sophisticated software with an MPR tool will make it possible to adjust contrast and enhance desired aspects of the area of interest.

PACS Systems and MPR

All these multiplanar reconstructions derived from CT and CAT scans are made possible by the installation of a tangible and intangible technological architecture. This requires computers with cutting-edge software, such as PACS system DICOM viewers, to display imaging studies of different modalities, such as computed tomography.

When choosing a PACS system, it is important that the provider offers security and reliability in the exchange of information. For this to happen, these platforms must also operate according to imaging (DICOM) and text (HL7) standards, so that interoperability, productivity, and communication take place optimally, as is the case with Eva PACS. 

It should not be forgotten that "reconstruction speed depends on the power of the computer and also on the reconstruction algorithm used" [Rottke, Dennis]. Eva PACS offers a fast multiplanar reconstruction tool, or MPR, which will provide more faithful and accurate diagnoses, as well as help in developing an effective treatment plan.

We interviewed Dr. Benjamín Conde Castro, a physician specializing in Radiology and subspecializing in Oncological Imaging and Breast Imaging. Here is Dr. Conde's opinion on the DICOM viewer of Eva PACS, specifically regarding the multiplanar reconstruction feature:

"I think any radiologist would prefer speed over tools that might slow the system down. I always prefer speed, and I think it's the same for any radiologist. For example, I like how fast Eva's MPR tool works."

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