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Everything you need to know about Computed Tomography (CT) & CT Scanning

Kidney: Cinematic Rendering Imaging Pearls - Educational Tools | CT Scanning | CT Imaging | CT Scan Protocols - CTisus
Imaging Pearls ❯ Kidney ❯ Cinematic Rendering

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  • “In this pictorial essay, we provide demonstrations of the appearance of a number of renal pathologies as visualized with CR. While this will not be a comprehensive review of all possible renal pathologic conditions, it will serve to demonstrate the potential utility of CR in evaluating the kidney—potential that must still be borne out in prospective studies evaluating the technique.”
    3D CT of renal pathology: initial experience with cinematic rendering
    Steven P. Rowe, Alexa R. Meyer, Michael A. Gorin, Pamela T. Johnson, and Elliot K. Fishman
    Abdom Radiol (2018) 43:3445–3455
  • “VR has demonstrated accuracy in identifying accessary renal arteries and variant renal venous anatomy in the pre- operative setting, and may be of particular value in patients with complex underlying anatomy. While a study outlining the utility of CR for evaluation of renal vascular anatomy has not yet been reported, the highly detailed vascular maps produced by the CR technique may provide similar information to that obtained from VR but with a more photorealistic appearance.”
    3D CT of renal pathology: initial experience with cinematic rendering
    Steven P. Rowe, Alexa R. Meyer, Michael A. Gorin, Pamela T. Johnson, and Elliot K. Fishman
    Abdom Radiol (2018) 43:3445–3455
  • “While older 3D CT methods have previously been successfully applied to identify the cause of obstruction and appropriately guide surgical intervention, the added anatomic detail and realistic shadowing effects of CR may be particularly helpful in preoperative planning prior to treatment of UPJ obstruction.”
    3D CT of renal pathology: initial experience with cinematic rendering
    Steven P. Rowe, Alexa R. Meyer, Michael A. Gorin, Pamela T. Johnson, and Elliot K. Fishman
    Abdom Radiol (2018) 43:3445–3455
  • “Both the arterial and venous vasculature of the kidneys are susceptible to a number of pathologic conditions. On the arterial side, any number of pathologic conditions such as atherosclerosis, dissection, transection, and aneurysms can be encountered in the renal arteries just as they can be in other arterial systems. 3D CT angiography can play a role in the evaluation of all of these entities. In addition, 3D visualizations of volumetric CT data can be utilized to evaluate for fibromuscular dysplasia, an uncommon cause of renovascular hypertension, but one that is amenable to treatment with antihypertensives and/or angioplasty.”
    3D CT of renal pathology: initial experience with cinematic rendering
    Steven P. Rowe, Alexa R. Meyer, Michael A. Gorin, Pamela T. Johnson, and Elliot K. Fishman
    Abdom Radiol (2018) 43:3445–3455
  • “Although CR as a means to visualize fibromuscular dysplasia has not been studied, the highly detailed vascular anatomy that can be displayed with this technique is likely to readily allow for the identification of patients with this condition.”
    3D CT of renal pathology: initial experience with cinematic rendering
    Steven P. Rowe, Alexa R. Meyer, Michael A. Gorin, Pamela T. Johnson, and Elliot K. Fishman
    Abdom Radiol (2018) 43:3445–3455
  • “Potential advantages of CR in this context include improved preoperative planning via better understanding of the relative positions of anatomic objects within the imaged volume and facilitation of patient engagement and education as these images may be more intuitive for those without a formal medical background.”
    3D CT of renal pathology: initial experience with cinematic rendering
    Steven P. Rowe, Alexa R. Meyer, Michael A. Gorin, Pamela T. Johnson, and Elliot K. Fishman
    Abdom Radiol (2018) 43:3445–3455
  • “Additionally, the anatomic detail provided in CR images may allow for the perception of tumoral textures that are otherwise not appreciated, which could lead to more accurate differentiation of benign from malignant tumors without the need for complex statistical textural analysis.”
    3D CT of renal pathology: initial experience with cinematic rendering
    Steven P. Rowe, Alexa R. Meyer, Michael A. Gorin, Pamela T. Johnson, and Elliot K. Fishman
    Abdom Radiol (2018) 43:3445–3455
  • “Similar to traditional 3D methodologies, CR may prove to be a useful adjunct to 2D imaging in the evaluation of the upper urinary tract. Indeed, the ability of CR to accentuate textural features could provide added diagnostic yield for the detection of subtle and/or infiltrative tumors. Again, the ultimate utility of CR in this context will need to be explored in dedicated studies.”
    3D CT of renal pathology: initial experience with cinematic rendering
    Steven P. Rowe, Alexa R. Meyer, Michael A. Gorin, Pamela T. Johnson, and Elliot K. Fishman
    Abdom Radiol (2018) 43:3445–3455
  • “CR allows for a new level of anatomic detail with 3D CT visualization. The role of CR in renal pathology has yet to be thoroughly explored, although the potential suggested by the photorealism of the figures in this review indicates that further study would be warranted. Ultimately, studies that explore the utility of CR in a wide range of conditions and that are backed by extensive surgical and/or pathological correlation are needed to establish the potential diagnostic benefits of this new technique.”
    3D CT of renal pathology: initial experience with cinematic rendering
    Steven P. Rowe, Alexa R. Meyer, Michael A. Gorin, Pamela T. Johnson, and Elliot K. Fishman
    Abdom Radiol (2018) 43:3445–3455
  • Purpose: To assess qualitative and quantitative imaging features on enhanced CT that may differentiate pancreatic neuroendocrine tumors (PNETs) from pancreatic renal cell carcinoma (RCC) metastases.
    Conclusions: Compared to pancreatic RCC metastases, PNETs are larger, more frequently solitary, contain calcification, show MPD dilation, and are subjectively and quantitatively more heterogeneous tumors.
    Differentiation of pancreatic neuroendocrine tumors from pancreas renal cell carcinoma metastases on CT using qualitative and quantitative features
    van der Pol CB et al.
    Abdominal Radiology 2019 (in press)
  • “PNETs were larger than RCC metastases (37 ± 23 mm vs. 26 ± 21 mm, P = 0.038), more frequently solitary (P < 0.001), subjectively more heterogeneous (P = 0.033/0.144, R1/R2), and associated with calcification (P = 0.002/0.004) and MPD dilation (P = 0.025/0.006). Agreement for subjective features was moderate-to-almost perfect (K = 0.4879–0.9481). Quantitative texture analysis showed higher entropy in PNETs (6.32 ± 0.49 versus 5.96 ± 0.53; P = 0.004) with no difference in other features studied (P > 0.05). Entropy had ROC area under the curve for diagnosis of PNET of 0.77 ± 0.06, with optimal sensitivity/specificity of 71.4/79.1%.”
    Differentiation of pancreatic neuroendocrine tumors from pancreas renal cell carcinoma metastases on CT using qualitative and quantitative features
    van der Pol CB et al.
    Abdominal Radiology 2019 (in press)
  • “Renal cell carcinoma (RCC) is among the most common primary malignancies that metastasize to the pancreas and typically appears as a hypervascular pancreatic mass on CT or MRI [. RCC metastases can resemble primary pancreatic neuroendocrine tumors (PNETs), which are also commonly hypervascular masses.”
    Differentiation of pancreatic neuroendocrine tumors from pancreas renal cell carcinoma metastases on CT using qualitative and quantitative features
    van der Pol CB et al.
    Abdominal Radiology 2019 (in press)
  • “CR represents a new level of achievable anatomic detail with 3D CT visualization. The role of CR in renal pathology has yet to be extensively explored, although the figures in this pictorial review suggest an immense potential for this technique. Ultimately, studies that explore the utility of CR in a wide range of conditions and that are backed by extensive surgical and/or pathological correlation are needed to establish the potential diagnostic benefits of this new technique.” 


    3D CT of Renal Pathology: First Experience with Cinematic Rendering
Rowe SP, Gorin MA, Meyer A, Johnson PT, Fishman EK
Abdominal Imaging (in press)
  • “3D computed tomography (CT) visualizations of volumetric data have become an important aspect of diagnostic imaging and their utility in pathologic states of the kidney has been well-described. Recently, a new 3D visualization technique known as cinematic rendering (CR) has become available and provides photorealistic images derived from standard CT acquisitions by use of a complex global lighting model. Herein, we describe important imaging aspects of a number of normal variant and pathologic conditions of the kidney, known applications of traditional methods of 3D imaging in kidney pathology, present the appearance many of those conditions with CR visualizations, and comment on the potential applications of this new method for evaluation of the kidney.” 


    3D CT of Renal Pathology: First Experience with Cinematic Rendering
Rowe SP, Gorin MA, Meyer A, Johnson PT, Fishman EK
Abdominal Imaging (in press)
© 1999-2019 Elliot K. Fishman, MD, FACR. All rights reserved.