Parathyroid 4D CT is an imaging technique for preoperative localization of parathyroid adenomas that involves multidetector CT image acquisition during two or more contrast enhancement phases.
In an article in the January issue of Radiology (RSNA.org/Radiology), Jenny K. Hoang, M.B.B.S., of Duke University Medical Center, Durham, N.C., and colleagues describe the 4D CT technique, provide a practical guide to the radiologist for imaging interpretation and discuss the rationale for imaging, the approach to interpretation, and imaging findings and pitfalls. Awareness of several technical and patient factors can increase the success of performing 4D CT, according to the authors.
“Interpretation of 4D CT images is challenging because of ectopic lesions, multiglandular disease, and lesion mimics such as thyroid nodules and lymph nodes,” the authors write. “The radiologist’s ability to detect a candidate lesion and differentiate it from mimics can be increased with appreciation of the typical contrast enhancement characteristics and morphologic features of parathyroid adenomas.”
Recent advances in CT scanning techniques have allowed CT radiation dose reduction while maintaining diagnostic image quality. Radiologists need to understand the latest dose optimization strategies and should incorporate them into clinical practice by collaborating with physicists and CT technologists
In an article in the January-February issue of RadioGraphics (RSNA.org/RadioGraphics), Ravi K. Kaza, M.D., University of Michigan Hospitals, Ann Arbor, and colleagues discuss the use of emerging techniques for the development of optimal imaging protocols aimed at achieving the desired image quality at a reduced dose. Specifically, the authors discuss:
Optimization of scanning technique based on imaging task and patient habitus, in conjunction with use of iterative image reconstruction, allows significant radiation dose reduction without compromising image quality, according to the authors.
“The optimization of scanning protocols requires a collaborative effort between radiologists, medical physicists, and CT technologists, and a full recognition of the potential decrease in image quality when radiation dose is reduced,” the authors write.
This article is accompanied by an Invited Commentary by Mahadevappa Mahesh, M.S., Ph.D., Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine Baltimore.
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