Wide field of view CT: clinical impact in medical imaging

Although Computer Tomography (CT) has been widely used for medical imaging over the previous thirty years, recent advances in the superior to inferior coverage of multidetector systems have contributed to the introduction of wide field of view CT units. The immediate clinical benefit of wide field of view is the ability to apply the scan to a region of interest with a view to avoiding table motion, should the coverage with one gantry rotation be adequate. We considered investigating wide field of view CT and determining other potential benefits, which may not be readily visible. Areas of interest include myocardial tissue and the ability to assess density of the entire heart at the same point in time, brain perfusion and joint motion assessment. We determined that certain absolute parameters for imaging the heart with regard to temporal resolution no longer need to be met, and establishment of baseline myocardial density values were of importance considering the significant impact of volumetric imaging in the setting of myocardial perfusion and both rest and stress assessment. Baseline measurements for previously poorly assessed and poorly understood joints were determined, including the acromioclavicular and wrist joints. A significant benefit of investigating abnormal wrist motion was the discovery of a clinical entity which has previously not been appreciated, that of trigger lunate syndrome. We propose that wide field of view CT, and in particular 4D CT, have a significant benefit in clinical imaging, and that 4D CT may be considered a new imaging technique allowing us to visualize and examine motion and perfusion disorders which have previously either been not possible or significantly limited.