RSNA 2017: Poster Alert: Evolution of 3D imaging in radiology

It’s impossible to describe in print, but readers of this newsletter attending RSNA 2017 or who have online access to its virtual posters, should check out “3D Imaging in Radiology: What a Long Strange Trip It’s Been” (IN118-ED-X). The poster is an informative 35-slide romp through the evolution and adoption of the technology. The lead author of this poster, Elliot K. Fishman, MD, professor of radiology at Johns Hopkins Hospital, is an expert in the field for his pioneering research and adoption of 3D medical visualization technology. He has authored or co-authored over 100 peer-review journal articles to date on the subject.

“3D medical imaging has always been closely aligned with 3D imaging or visualization in other domains. Whether the developments were in the world of the movies (LucasFilm, Pixar, Disney), video games (Microsoft, Nvidia) or technology (NASA), we shared a common need for ‘visualization’ of ever increasing size and complex data sets,” the authors write.

They describe and illustrate what has changed and what hasn’t over the past 22 years. They start with the “big picture” role of 3D imaging, explaining that its role is segmented into specific uses. These include the ability to optimize the detection of pathology on CT scans and to define the extent of disease processes including accurate staging of disease. 3D imaging can hep plan better patient management and triage, and better select optical treatment planning for both radiologists and referring physician. It also can help minimize medical error by providing a deeper understanding through unique methods of display.

What has changed the landscape in terms of the increasing mainstream utilization and technological breakthroughs of 3D medical imaging are the large data sets of CT scans, increasing from a typical 60 slice set to up to 2,500 slice sets. Post-processing speeds have increased by a factor of  1000,X and hardware costs have decreased by a factor of 50X. Reconstruction algorithms have proliferated.

The poster displays fascinating images, including the first 3D images of a hip showing bone, muscle and soft tissue, created with Pixar technology in 1985 by LucasFilm. “Image quality and speed on the Pixar computer produced some impressive images considering the datasets were 4 mm thick and reconstructed with a 3 mm overlap,” the authors said, explaining that this was the point at which 3D imaging began to play a critical role in orthopedic surgery.

Fast forward, past many interesting images representing technological breakthroughs: 3D medical imaging is now a foundation technology for 3D of printing complex anatomy. 3D printing technology for medical applications is at its infancy, just as 3D medical imaging was more than two decades ago.

“The journey we are on changes every day, and we look forward to new opportunities for improving the role of 3D in medical imaging.....We are optimistic that the best is yet to come,” conclude Dr. Fishman and co-author Pamela T Johnson, MD, associate professor of radiology and radiological science.

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