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Abdominal Radiology

, Volume 44, Issue 12, pp 3886–3892 | Cite as

The application of cinematic rendering to CT evaluation of upper tract urothelial tumors: principles and practice

  • Steven P. RoweEmail author
  • Linda C. Chu
  • Alexa R. Meyer
  • Michael A. Gorin
  • Elliot K. Fishman
Special Section: Urothelial Disease

Abstract

Upper tract urothelial carcinoma (UTUC) is a relatively uncommon but aggressive genitourinary malignancy for which multi-phase contrast-enhanced computed tomography (CT) plays an important role in evaluation and staging. 3D imaging with maximum intensity projection (MIP) and volume-rendered (VR) images has been described as a useful means of evaluating UTUC. In this study, we describe the technique of a novel 3D methodology known as cinematic rendering (CR) and provide clinical examples of UTUC visualized with CR. CR utilizes a complex universal lighting model in order to create photorealistic images with improved detail and depth in comparison to MIP or VR images. In the case of UTUC, CR can be used in different contrast phases to show abnormally thickened and enhancing urothelium or filling defects in the renal collecting system or ureters in the excretory phase. CR images can also be manipulated in order to generate translucent views of the upper urinary tract in order to add conspicuity to intraluminal findings.

Keywords

UTUC 3D Computed tomography CR 

Notes

Funding

No funding was received by the authors in relation to writing this manuscript.

Compliance with ethical standards

Conflict of interest

EKF receives research support from Siemens and GE Healthcare and is a co-founder and stockholder in HipGraphics, Inc. The other authors have no relevant conflicts of interest to report.

Ethical approval

This manuscript does not detail a defined study and no ethical approval was necessary.

Informed consent

No patient data is included in this manuscript and informed consent was not applicable.

References

  1. 1.
    Siegel RL, Miller KD, Jemal A (2018) Cancer statistics, 2018. CA Cancer J Clin. 68(1):7-30.CrossRefGoogle Scholar
  2. 2.
    Raman JD, Messer J, Sielatycki JA, Hollenbeak CS (2011) Incidence and survival of patients with carcinoma of the ureter and renal pelvis in the USA, 1973-2005. BJU Int. 107(7):1059-1064.CrossRefGoogle Scholar
  3. 3.
    Rouprêt M, Babjuk M, Compérat E, et al. (2015) European Association of Urology guidelines on upper urinary tract urothelial cell carcinoma: 2015 update. Eur Urol. 68(5):868-879.CrossRefGoogle Scholar
  4. 4.
    Raman SP, Horton KM, Fishman EK (2012) Transitional cell carcinoma of the upper urinary tract: optimizing image interpretation with 3D reconstructions. Abdom Imaging. 37(6):1129-1140.CrossRefGoogle Scholar
  5. 5.
    Dappa E, Higashigaito K, Fornaro J, Leschka S, Wildermuth S, Alkadhi H (2016) Cinematic rendering – an alternative to volume rendering for 3D computed tomography imaging. Insights Imaging. 7(6):849-856.CrossRefGoogle Scholar
  6. 6.
    Eid M, De Cecco CN, Nance JW Jr, et al. (2017) Cinematic rendering in CT: a novel, lifelike 3D visualization technique. AJR Am J Roentgenol 209(2):370-379.CrossRefGoogle Scholar
  7. 7.
    Johnson PT, Schneider R, Lugo-Fagundo C, et al. (2017) MDCT angiography with 3D rendering: a novel cinematic rendering algorithm for enhanced anatomic detail. AJR Am J Roentgenol 209(2):309-312.CrossRefGoogle Scholar
  8. 8.
    Rowe SP, Johnson PT, Fishman EK (2018) Initial experience with cinematic rendering for chest cardiovascular imaging. Br J Radiol. 91(1082):20170558.PubMedPubMedCentralGoogle Scholar
  9. 9.
    Rowe SP, Johnson PT, Fishman EK (2018) Cinematic rendering of cardiac CT volumetric data: principles and initial observations. J Cardiovasc Comput Tomogr. 12(1):56-59.CrossRefGoogle Scholar
  10. 10.
    Rowe SP, Zinreich SJ, Fishman EK (2018) 3D cinematic rendering of the calvarium, maxillofacial structures, and skull base: preliminary observations. Br J Radiol. 91(1086):20170826.CrossRefGoogle Scholar
  11. 11.
    Rowe SP, Chu LC, Fishman EK (2018) Cinematic rendering of small bowel pathology: preliminary observations from this novel 3D CT visualization method. Abdom Radiol (NY). 43(11):2928-2937.CrossRefGoogle Scholar
  12. 12.
    Rowe SP, Meyer AR, Gorin MA, Johnson PT, Fishman EK (2018) 3D CT of renal pathology: initial experience with cinematic rendering. Abdom Radiol (NY). 43(12):3445-3455.CrossRefGoogle Scholar
  13. 13.
    Rowe SP, Fishman EK. Image processing from 2D to 3D. In: Medical Radiology. 2017. Springer, Berlin, Heidelberg.CrossRefGoogle Scholar
  14. 14.
    Mammen S, Krishna S, Quon M, et al. (2018) Diagnostic accuracy of qualitative and quantitative computed tomography analysis for diagnosis of pathological grade and stage in upper tract urothelial cell carcinoma. J Comput Assist Tomogr. 42(2):204-210.PubMedPubMedCentralGoogle Scholar
  15. 15.
    Furukawa J, Miyake H, Sakai I, Fujisawa M. (2013) Significance of ureteroscopic biopsy grade in patients with upper tract urothelial carcinoma. Curr Urol. 6(3):156-159.CrossRefGoogle Scholar
  16. 16.
    Rowe SP, Chu LC, Fishman EK (2018) Evaluation of stomach neoplasms with 3-dimensional computed tomography: focus on the potential role of cinematic rendering. J Comput Assist Tomogr. 42(5):661-666.CrossRefGoogle Scholar
  17. 17.
    Lan H, Nishitani H, Nishihara S, et al. (2011) Using the MDCT thick slab MinIP method for the follow-up of pulmonary emphysema. J Med Invest. 58(3-4):175-179.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Steven P. Rowe
    • 1
    • 2
    • 3
    Email author
  • Linda C. Chu
    • 1
  • Alexa R. Meyer
    • 2
  • Michael A. Gorin
    • 1
    • 2
  • Elliot K. Fishman
    • 1
    • 2
  1. 1.The Russell H. Morgan Department of Radiology and Radiological ScienceJohns Hopkins University School of MedicineBaltimoreUSA
  2. 2.The James Buchanan Brady Urological Institute and Department of UrologyJohns Hopkins University School of MedicineBaltimoreUSA
  3. 3.Division of Nuclear Medicine and Molecular Imaging, The Russell H. Morgan Department of Radiology and Radiological ScienceJohns Hopkins University School of MedicineBaltimoreUSA

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