Use of three-dimensional CT in the abdomen: a useful preoperative planning tool

Multidetector computer tomography (CT) scanners permit large volumes of the body to be scanned during a single breath-hold. Post-processing of the acquired data permits thin-section anatomic reconstructions to be created. Software improvements also currently permit high-resolution reformations to be depicted in multiple planes, along with volume-rendered anatomic depiction and measurements, and fine detail of small vessels. For preoperative surgical planning in the abdomen, these technical advances permit the surgeon to make crucial decisions during the planning phases, by facilitating anatomic and, in particular, vascular depiction, tumor staging, and volumetric determinations of solid organs. This article describes the current state of CT scanning for performing image processing, and illustrates the spectrum of available imaging tools that can be used to facilitate surgical planning. Using the abdomen as a paradigm, practical uses of image processing are demonstrated for pancreas tumor staging, segmental liver resection planning, assessment and planning of liver transplantation, renal transplant donor, and renal cancer evaluation.