Recent Advances In The Imaging World
Ultrasound has undergone dramatic changes since its inception three decades ago. Newer technologies are set to revolutionize ultrasound practice. One such technology is sonoelastography. It uses B mode USG to measure tissue stiffness. It will aid in liver fibrosis, breast lump, thyroid nodule, or lymphnode characterization and also in detection of prostate cancer.
Contrast-enhanced ultrasound
Another recent development in use of contrast agents in ultrasound. CEUS gives more sensation in detection of tumors, characterize liver lesions, allowing ultra sound into many functions currently preferred by CT/MRI. Micro bubble contrast agents and special software is needed.
Photo-acoustic imaging
Using chromophores to look for tumor vascularity.
RF ablation
Monopole radio-frequency ablation, involving application of high-frequency attenuating current to target tissue using a needle-like applicator. Small lesions can be treated early and metastatic lesions can be treated easily without open surgery.
Digital mammotomo synthesis
Cancer mass cannot be seen owing to overlapping by normal breast tissue, obscuring the presence of tumor. This section of breast is reconstructed from multiple low-dense projections acquired at different angles of the X-ray tube. New digital mammotomo synthesis machine is planned in our department in the next financial year.
Dual-energy CT
Conventional CT provides single HU of each voxel; however, there is often relapse of HU of different tissues and conventional CT is unsuitable to distinguish between them. Multispectral CT removes thin limitations by using energy dependence of HU. HU measured by CT are not absolute, and change depending upon the KVP and in image acquisition. Dural-energy CT uses this properly for minimal decomposable by acquiring the image series with ∆KVP. In characterization of renal stone, lung nodule, renal cysts, and masses myocardial iron detection, differentiating gout from pseudo joint, advanced dual energy CT is very helpful.
CT perfusion
It has become an important adjuvant along with CT angiography. It differentiates salvageable ischemic brain tissue from irreversibly damaged infarct brain. Special software and hardware requirements are necessary to combat with workload.
MR elastogram
An acquisition hardware and reconstruction application that produces images with contrast related to stiffness of soft tissue. Sound waves are generated in the body by using MRI-compatible acoustic driver. These are then imaged by special phase-contrast MRI sequences. Finally, the data generated is processed to generate elastogram. With 3T MRI, SNR is doubled with CT MRI than 1.5 MR. Special application like functional, DWI, multinuclear spectroscopy.
Diffusion tumor imaging (DTI)
DTI enables white matter tract to be studied and to decide the tumor surgery approach. This presents functional damage due to surgical removal of tumor. Special software and coils are required for the provision.
These are a few recent advances that must be present in research institutes like the MNJ Cancer Hospital. These small tweaks in software and hardware equipment will bring about drastic changes in patient management.
Since our institute is a state cancer institute with research activities, we are looking forward to upgrade the department in the near future with the latest modalities.
