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Thick-Section Reformatting of Thinly Collimated Helical CT for Reduction of Skull Base-Related Artifacts

Ronald A. Alberico1, Peter Loud2, Jonathan Pollina3, William Greco4, Mahesh Patel5 and Roman Klufas6

1 Department of Radiology, Neuroradiology/Head and Neck Imaging, Roswell Park Cancer Institute, Elm St. and Carlton St., Buffalo, NY 14263.
2 Department of Ultrasound, Roswell Park Cancer Institute, Buffalo, NY 14263.
3 Department of Neurosurgery, State University of New York at Buffalo, Millard Fillmore Hospital, Gates Cir., Buffalo, NY 14263.
4 Department of Cancer Prevention, Epidemiology and Biostatistics, Roswell Park Cancer Institute, Buffalo, NY 14263.
5 Department of Diagnostic Radiology, Boston Deaconess-Beth Israel Medical Center, 330 Brookline Ave., Boston, MA 02115.
6 Department of Diagnostic Radiology, Brigham and Women's Hospital, 75 Francis St., Boston, MA 02115.



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  		Fig. 1. —Graph shows mean difference scores between scanning techniques for observer confidence, image graininess, and artifacts at each anatomic location (reformatted helical CT scores versus conventional CT scores). Whiskers represent standard error of mean values. Note that confidence and graininess bars project in opposite direction from artifact bars, indicating that reformatted helical CT was associated with higher confidence and more graininess but fewer artifacts than conventional CT.

 


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  		Fig. 2A. —54-year-old man with history of non—small cell lung cancer. Conventional CT scan limited by artifacts in posterior, middle, and anterior cranial fossa.

 


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  		Fig. 2B. —54-year-old man with history of non—small cell lung cancer. Reformatted helical CT scan shows significantly fewer artifacts in all three locations.

 


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  		Fig. 3A. —72-year-old woman with breast cancer. Conventional CT scan near foramen magnum limited by artifacts that obscure medulla, lower cerebellum, and vertebral arteries.

 


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  		Fig. 3B. —72-year-old woman with breast cancer. Reformatted helical CT scan improves visibility of vertebral arteries (arrows), medulla, and lower cerebellum.

 


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  		Fig. 4A. —72-year-old woman with breast cancer. Conventional CT scan shows artifacts that obscure right cerebellar lesion.

 


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  		Fig. 4B. —72-year-old woman with breast cancer. Reformatted helical CT scan shows fewer artifacts in this patient, allowing lesion to be identified (arrow).

 


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  		Fig. 5A. —42-year-old man with malignant melanoma. Conventional CT scan shows artifacts from petrous bones that make evaluation of right pontine lesion difficult (arrow).

 


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  		Fig. 5B. —42-year-old man with malignant melanoma. Reformatted helical CT scan improves visibility of pontine lesion (long arrow) and reveals second lesion in left cerebellum (short arrow). Note decrease in artifacts in middle and anterior cranial fossa.

 


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  		Fig. 6A. —75-year-old woman with breast cancer. Conventional CT scan shows artifacts that obscure subtle right middle cranial fossa mass (arrows).

 


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  		Fig. 6B. —75-year-old woman with breast cancer. Reformatted helical CT scan reduces middle cranial fossa artifacts revealing lesion (black arrows) and associated edema (white arrows).

 


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  		Fig. 6C. —75-year-old woman with breast cancer. Fluid-attenuated inversion-recovery image from MR imaging examination performed in same patient 1 day after B confirms edema (arrow).

 


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  		Fig. 6D. —75-year-old woman with breast cancer. Gadopentetate dimeglumine (Magnevist; Berlex Laboratories, Wayne, NJ)—enhanced MR image confirms presence of enhancing mass (arrow) also identified on reformatted helical CT.

 

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