Multiplanar and three-dimensional imaging of the thorax

Progressive improvements in helical CT scanners over the past few years have greatly revolutionized the performance of thoracic CT studies. As multi-detector capabilities have increased from dual-slice to 16-slice imaging, thinner sections can be acquired faster and with greater Z-axis coverage. Multidimensional imaging with near isotropic voxels and fewer artifacts is possible with these new scanners. Computer hardware has similarly improved such that a three-dimensional image that once took an hour to create can be performed at the touch of a button. This allows for more precise vascular imaging and can provide surgeons exquisite anatomic data for surgical planning. The possibility of noninvasive coronary artery imaging with CT is closer to reality than ever. Within the lung, the tracheobronchial tree can be mapped, pulmonary nodules can be detected and categorized more readily, and lung volumes can be measured precisely. The demand for such images will likely increase in the foreseeable future. This article discusses practical clinical applications of multidimensional imaging within the thorax.