Rendering Mode

There are three main methods, the minimum intensity projection, the average intensity projection, and the maximum intensity projection.

Maximum Intensity Projection: MIP

The maximum intensity projection consists of projecting the voxel with the highest attenuation value on every view throughout the volume onto a 2D image. An image that displays the maximum intensity for each pixel point on a thickened reformat plane.

Vascular

Here an example of shows where the maximum intensity projection is used to search for vascular diseases or anomalies.

MIP Vascular: Renal Artery

This image shows us dysplastic renal artery stenosis. Notice the contour of the renal artery.

Nodules

The image shows where the maximum intensity projection is used to search for parenchyma solid nodule lesions. Notice the many metastatic lesions shown in both lung fields.

Pulmonary Nodules

The image shows where the maximum intensity projection is used to search for parenchyma solid nodular lesions. Notice the pulmonary lesion in the lung field.

Lithiasis

You can see on this image an example of maximum intensity projection which is used to search for ureter stenosis caused by perivesical lithiasis.

Minimum Intensity Projection: MinIP

The Minimum Intensity projection is a data visualization method that enables the detection of low-density structures in a given volume.

Chest

Both of these images show how the minimum intensity projection technique is used for the diagnosis of emphysema. Notice the bullae in the image on the left and the pneumothorax in the left lung on the image on the right.

Inner Ear

On these images, we can see an example of how the minimum intensity projection is used in the diagnosis of the semicircular canal. Abnormalities such as cholesteatomas can be easily seen.

Heart

The minimum intensity algorithm is particularly useful in highlighting hypo or low dense regions within the heart.

Biliary Tract

This example shows us the presence of air in the biliary tract known as pneumobilia. Notice the white arrows pointing out the air.

Average

In the average intensity algorithm (AIP), the visualization is averaged. The AIP technique is an algorithm that is intended to create a thick MPR image by using the average of the attenuation through the tissues of interest to calculate the pixel viewed on the computer.

Images

In the image on the left, we see the polycystic disease of both kidneys while the image on the left shows the presence of ascites in the abdomen.

Multi Planar Reconstructions

Both images show the presence of nodes in the Barety lodge, or Baréty’s box (or right pre-tracheal space). It is an anatomical space located in the middle mediastinum of the human thorax which is formed of a cellulo-lymphatic tissue running along the trachea.

Curved

Multiplanar

The curved multiplanar axis allows the draw of a central axis inside a structure independently from its origin. (vascular or other).Visualization of sagittal and coronal vertebrae in the same plan. Also a Visualization of the coast in the same plan.

Mandible

It allows the visualization of the mandibular canal as well as the visualization of the pre implanted bony space.

Bronchial Tree

This image shows us the visualization of the bronchial lumen and its caliber.

Post Processing

The curved post-processing algorithm allows for:

• Better visualization of a tract
• Better localization of a pathological element
• Better distance measurement (example: stenosis)
• This study can be done automatically through vascular HU or manually point by point

Images

The image on the left shows us the facial nerve while the image on the right shows renal artery dysplastic stenosis.

Aneurysm

The image post-processed with a curved technique shows a carotid aneurysm in the upper third of the image on the right.

Stenosis Measurement

For stenosis quantification, you have to place the reference on the curvilinear or the stretched vessel image. Once positioned, verify the vessel’s contour for the reference and the lesion.

Stenosis Percentages

Stenosis percentages, maximum and minimum diameter and the surface are displayed in the following table.

Endoprosthesis Planning

In this step, you can choose and import the type of prosthesis you want. To do so, you have only to click on the list of prosthesis models and select your choice.

Once the model is selected, you have to adjust the measurements as indicated on the template. For each measurement, check the light contour automatically created by the software.

Volume Rendering

Volume rendering (VR) will allow us to use predefined protocols to adjust the amount of opacity and color applied to the model. Then you can display the table of results referring to the necessary measurements for prosthesis fabrication.

Density

Each density range has a very specific opacity coefficient (or transparency coefficient).

Volume Rendering and MIP

Volumetric MIP and ANGIO

The image on the left is post-processed using a volumetric maximum intensity projection technique.

Colonic Endoscopy

The lowest Hounsfield units voxels (near air) have a maximum transparency effect. The voxels with great HU present a significant opacity which materializes the wall of the colon. This is a 3D visualization of the interior of a hollow organ.

Bronchial Endoscopy

Bronchial endoscopy allows the visualization of the bronchial lumen filled with an inhalant object or invasive cancer. This is a 3D visualization of the interior of a hollow organ.

Image Fusion

After fixing three landmarks (or points) in the anatomy, the system readjusts the plans with a maximum tolerance of 20*.

PET CT

A PET/CT combines the nuclear medicine sensitivity with the anatomical location of the CT scanner.

Emphysema Measurement

The automated application called “lung density” provides the physician with quantitative data on the volume of pulmonary emphysema, as well as gives us a visual representation of its diffusion.

Damaged Alveoli

This image shows us an example of images where the damaged alveoli are highlighted in blue.

Percentage of Lung Parenchyma

Here, we can see the percentage of lung parenchyma in function of Hounsfield densities.

HU Measurements

This image shows the average density measurements in Hounsfield Units of 25%, 50 %, 75%, and 100%.