Advances in Radiologic Imaging of GI Cancers Elliot K. Fishman M.D. - - PowerPoint PPT Presentation

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Jun 27, 2023 549 likes •871 views

Advances in Radiologic Imaging of GI Cancers Elliot K. Fishman M.D. Johns Hopkins Hospital Radiologic Oncologic Imaging 2009 MDCT MRI PET/CT Ultrasound MDCT vs MRI: Some Questions What is the clinical problem? What

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Advances in Radiologic Imaging of GI Cancers

Elliot K. Fishman M.D. Johns Hopkins Hospital

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Radiologic Oncologic Imaging 2009

MDCT MRI PET/CT Ultrasound

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MDCT vs MRI: Some Questions

 What is the clinical problem?  What information should the study

provide?

 What is the patients renal status?  What technology is available?  What is the expertiece of the interpreting

radiologist?

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CTA vs MRA

Scanner resolution Patient comfort Anatomic detail 3D mapping

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Evolution of MDCT

 1989 single slice spiral CT  1992 dual slice spiral CT  1999 four slice spiral CT  2001 eight slice spiral CT  2002 sixteen slice spiral CT  2004 sixty four slice spiral CT  2005 dual source CT  2007 128, 256 and 320 MDCT  2008 GE HRCT and Siemens Flash

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The CT Scan Journey Thru Time

year Scan speed Slice thickness Interscan spacing Total # of slices 1980 10 sec 10mm 10mm 25-30 1985 5 sec 8-10 mm 8-10 mm 30-45 1990 1 sec 3-5 mm 3-5 mm 100 1995 .75 sec 3 mm 2-3 mm 100 1999 .5 sec 1-3 mm 1-3 mm 220 2003 .4 sec .5-.75mm .5-.75 mm 400-1200 2005 .33 sec .5-.6 mm .5-.75 mm 600-4000

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What are the key advantages of 64 slice MDCT?

Spatial resolution Temporal resolution Isotrophic datasets

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What are the key advantages of 64 slice MDCT?

Spatial resolution ( < .4

mm)

Temporal resolution Isotrophic datasets

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What are the key advantages of 64 slice MDCT?

Spatial resolution Temporal resolution (160-

180 msec, 83 msec for DS)

Isotrophic datasets

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Scanning Capabilities 2009: Hardware and Software

Dual energy CT Perfusion CT CAD (computer assisted detection) Tumor volumetrics (automated

calculation of tumor response to therapy)

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FNH-Classic Enhancement Pattern

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Neuroendocrine Tumor Metastatic to Liver

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Small Pancreatic Cancer

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1 cm Islet Cell Tumor

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Hepatoma with Neovascularity

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VRT MIP

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Carcinoid Tumor in Root of Mesentery

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Gastric GIST

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conclusion

 New technology critical in GI

Oncologic Imaging

 3D mapping critical in lesion

detection, characterization and management decision making