1. Applications of Diagnostic Imaging Computed Tomography
Gerald R. Aben, MD FACR
Department of Radiology
College of Osteopathic Medicine
In this short presentation, I would like to present an overview of the applications of Computed Tomography.
9/16/2018
Department of Radiology

2. Department of Radiology
Computed Tomography
Ionizing radiation
Requires concern and careful utilization
Excellent discrimination between subtle tissue density differences
Moderately expensive
Readily available
Growing spectrum of applications across a broad spectrum of diseases and body parts
Computed tomography is also a modality utilizing ionizing radiation and this requires our concern and careful utilization. Through the years it has become much easier and quicker to obtain a CT scan which has lead to dose creep and increased exposure to our patients, so we have to be careful to make sure we appropriately utilize this resource. CT scanning tends to discriminate very well between subtle soft tissue density differences allowing us in many cases to detect abnormalities within solid organs without the utilization or addition of contrast agents. CT scanning is moderately expensive but is readily available in the community. There is a growing spectrum of applications across a broad spectrum of diseases and body parts where it is applicable.
9/16/2018
Department of Radiology

3. Department of Radiology
Computed Tomography
Primary applications:
First line evaluation in suspected cerebral vascular events – hemorrhagic vs. ischemic
First line evaluation in soft-tissue and skeletal trauma
First line evaluation in suspected pulmonary embolism
First line evaluation in suspected urinary calculi
CT scanning has among its primary applications a first line evaluation in suspected cerebrovascular events in attempt to discriminate between hemorrhagic and ischemic events which have totally different treatment protocols. CT also provides a first line evaluation and soft tissue and skeletal trauma in the cases. It is also one of our first line tools used in suspected pulmonary embolism and is a now a first line evaluation in suspected urinary tract calculi
9/16/2018
Department of Radiology

4. Department of Radiology
Computed Tomography
Primary applications:
Head & Neck
CVA evaluation
Carotid and intra-cerebral vascular evaluation
Head-neck trauma – evaluation for subdural and epidural hematoma – evaluation for cervical fracture
Neoplasm staging
Thorax
Lung- mediastinum nodule/ mass evaluation,
Cardiac, coronary, pulmonary and great vessel vascular evaluation
Airway evaluation
Primary applications of CT scanning include in the head and neck cerebrovascular accident evaluation, carotid and intracerebral vascular evaluation utilizing CT angiography. In head and neck trauma evaluation for subdural and epidural hematomas as well as parenchymal hemorrhage and the evaluation for cervical fractures. There is value in neoplasm staging. In the thorax CT is useful in lung and mediastinum nodule or mass evaluation. For the evaluation of cardiac, coronary, pulmonary and great vessel vascular structures utilizing CT angiography. The airway can be evaluated for its patency and its caliber and neoplastic staging can be performed with CT scanning.
9/16/2018
Department of Radiology

5. Department of Radiology
Computed Tomography
Primary applications:
Abdomen/ Pelvis
Solid organ evaluation
Urinary tract evaluation for calcification
CT angiography
CT colonography
CT urography
Lumbar spine evaluation (pacemakers, stimulators)
Neoplasm Staging
Primary applications in the abdominal and pelvic region include evaluation for solid organ abnormalities. Looking at urinary tract for calcification. CT angiography utilized for evaluating the vascular structures of the aorta and its branches. CT colonography a minimally invasive way to evaluate the colon for polyps. CT urography replacing intravenous urography for evaluating of the kidneys, renal pelvis, ureters and bladder. Evaluation of lumbar spine in patient's precluded from MRI imaging because the presence of pacemakers, neural stimulators and other implanted devices and finally neoplasm staging.
9/16/2018
Department of Radiology

6. Department of Radiology
Computed Tomography
Primary applications:
Bones & Joints
3-D joint reconstructed images
Evaluation of fracture union
Evaluation of neoplasm / extent
Secondary applications:
Evaluation of patients with a contraindication to MRI imaging
Bone mineral density analysis
Other primary applications for CT scanning include bone and joint evaluation, looking at 3-D joint reconstructed images can assist the orthopedic surgeon in reconstructing damaged joint. We can evaluate for the successful union of a fracture. We can evaluate the presence of neoplasm and the extent of neoplasm involving bone. Secondary applications can include evaluation of patients with contraindication to MR imaging and for bone mineral density analysis.
9/16/2018
Department of Radiology