Applied Radiology

Stuart E. Mirvis, MD, FACR
Professor of Radiology in the Diagnostic Imaging Department,
University of Maryland Medical Center, Baltimore, MD
and Editor-in-Chief of Applied Radiology

The introduction and increasing availability of multidetector computed tomography (MDCT) has brought about some wonderful improvements in the overall quality of CT images and has expanded the application of CT to new areas, particularly vascular imaging. With the improvement in technology comes the inevitable alteration in scanning techniques needed to maximize the benefit of the new imaging capabilities. So the tried-and-true approaches to single-slice helical scanning must make way for a new set of parameters tailored to multidetector scanners. Given the shorter scanning times permitted by MDCT, the appropriate timing of contrast injection becomes more exacting than it was in the single-slice era. The period when the intravenous contrast bolus is where it is needed is short; injection rates, contrast volumes, and contrast concentration must be adjusted to optimize the target window.

This supplement to Applied Radiology presents the views of a group of true experts in the field of MDCT imaging and contrast utilization who were brought together as a panel to address the use of high-concentration contrast in MDCT. Drs. Dennis Foley and Paul Silverman reviewed general concepts of MDCT technology with a focus on CT angiography. Dr. Rendon Nelson discussed MDCT of hepatic imaging, Dr. Lawrence Tanenbaum considered neurologic imaging, Dr. William Stanford reviewed progress in cardiac applications, and Dr. Sergio Ginaldi presented a summary of contrast safety.

Following these presentations, all of the participants discussed their views of and experiences with contrast-enhanced CT scanning, particularly the use of high-concentration contrast for MDCT applications. As moderator of this discussion, I sought to foster as open (no-holds-barred) a discussion as possible to find out where consensus and differences of opinion lay and to discover the real day-to-day experiences of the panelists rather than just their formal "for-the-record" positions. I hope that the reader will find that the formal presentations and the follow-up freewheeling discussion offer valuable, useful information on how to perform optimal MDCT imaging studies for a variety of applications.