Multidetector, Multislice Spiral Computed Tomography of the Abdomen: Quo Vadis

Abstract

The traditional approach of radiology image “interpretation” involves the following steps:

• 1. Recognizing normal anatomy and normal variation

• 2. Disease detection

• 3. Disease characterization into benign or malignant categories and if possible a more specific disease diagnosis

• 4. Disease description, including disease extent, progression, and response to therapy

Traditional radiologic investigations have paralleled these approaches to “interpretation” and seek to improve the ability to detect and characterize disease. Recently, imaging investigations have attempted to determine cost effectiveness and benefit. With computed tomography (CT), such methods of improving sensitivity and specificity have included investigations into contrast media injection, both volume and dose, and methods of delivery. Technical alterations, such as changing X-ray beam collimation, pitch, and Z-axis reconstruction interval, have all attempted to improve disease detection with spiral CT. Innumerable investigations, especially in the liver, have attempted to characterize common benign neoplasms, such as a cavernous hemangioma, in an attempt to distinguish these findings from malignancy, most commonly metastatic disease.