64-slice experience bolsters head and neck expertise

June 16, 2006

With one year of 64-slice CT experience to draw upon, radiologists at Boston University Medical Center say the device has revolutionized head and neck imaging, particularly trauma cases. The 64-slice scanner’s high resolution and isotropic nature both contribute to highly valuable reconstructions, according to Dr. Alexander Norbash, radiology chair.

With one year of 64-slice CT experience to draw upon, radiologists at Boston University Medical Center say the device has revolutionized head and neck imaging, particularly trauma cases. The 64-slice scanner's high resolution and isotropic nature both contribute to highly valuable reconstructions, according to Dr. Alexander Norbash, radiology chair.

The facility leapt directly from one four-slice and two single-slice scanners to three 64-slice CT devices in April 2005. BUMC scanned its 1000th patient with 64-slice CT this past May. Installation of the new scanners has sparked an 18% increase in CT utilization at the center.

"The transition has been dramatic," Norbash said during a presentation at the Stanford Multidetector-Row CT meeting in San Francisco. "MRI has always been advantageous in the neck because of its polyplanar capability. Now we have 64-detector scanners and the ability to perform rapid reconstructions, and it has made a tremendous difference."

The medical center admits about 1600 trauma patients annually. In head and neck trauma, vessels, airways, and bony compartments are easier to evaluate with 64-slice CT, he said. Rapid rendering and various volume and surface-shaded imaging sets permit greater confidence and triage accuracy. Not only can regions be assessed tissue layer by tissue layer, but 64-slice CT also allows better understanding of differential considerations.

The speed and efficiency of image reconstructions has spurred an increase in the number of sinus CTs performed, while the volume of sinus x-rays is nearly negligible. Sinus studies currently consist of axially obtained and coronally reformatted image sets. The preoperative value is perceived as much greater than that of the prior axial scan sets, Norbash said.

Speed and resolution may have expanded the range of diagnostic options possible with CT, but the display technology is at least as important, Norbash said. He posits that radiologists need to rethink interpretation methodologies when it comes to large data sets created by 64-slice CT.

"We need to move toward an understanding of what data streams to import and of what will tangibly give us an understanding of the underlying anatomy," he said. "Some type of visualization methodology that explores the psychology of how we diagnose using these images is going to be integral to the growth of the technology."