Abdominal/Body Imaging in the Medical College of Wisconsin Department of Radiology

Body computed tomography is a widely diversified field. Five CT scanners are utilized within Froedtert Hospital for high resolution targeted and more extensive volumetric high resolution studies on patients suffering from cancer, cardiovascular disease, focal and diffuse inflammatory disorders, diseases of the gastrointestinal and genitourinary tract, and blunt and penetrating trauma. The section has three 64-channel high resolution CT scanners and two 16-channel CT scanners, one with a relatively wide bore suitable for imaging of larger patients and in guiding interventional procedures. All scanners are operated by highly skilled technologists utilizing imaging protocols which are continuously refined to be at the cutting edge of imaging technology.

Both ultrasound and CT imaging are used for guided interventional procedures including tissue biopsy and percutaneous catheter drainage of fluid collections in the body. These highly specialized invasive procedures require cutting edge technology and experienced operators working in conjunction with referring surgical and medical services. Both sonography and CT are important imaging modalities for sick patients in intensive care units, with sonography having the additional advantage of being a portable procedure allowing the study to be performed at the patient's bedside. 

Sonography includes imaging of the upper abdomen and female pelvis, vascular imaging of the carotid and vertebral systems, abdominal visceral vasculature and the extremities, and "small pod" imaging of the superficial body structures including the thyroid and parathyroid glands, superficial musculoskeletal structures, and the external male genitalia. Seven ultrasound systems are employed with sufficient probe availability to allow high resolution targeted imaging of any specific body part.

Both ultrasound and CT imaging are used for guided interventional procedures including tissue biopsy and percutaneous catheter drainage of fluid collections in the body. These highly specialized invasive procedures require cutting edge technology and experienced operators working in conjunction with referring surgical and medical services. Both sonography and CT are important imaging modalities for sick patients in intensive care units, with sonography having the additional advantage of being a portable procedure allowing the study to be performed at the patient's bedside.

Magnetic resonance imaging utilizes state-of-the-art 1.5 and 3 tesla units to provide a full range of magnetic resonance body imaging including imaging of the solid abdominal organs and intestine, female pelvis, cardiovascular system and musculoskeletal imaging of the joints of the upper and lower extremities as well as soft tissue tumors of both the body and the extremities. Magnetic resonance imaging and CT can be utilized for similar imaging tasks and selection of the appropriate modality for each individual patient is an important aspect of the practice.

Magnetic resonance imaging employs new contrast agents in hepatobiliary imaging, optimizes 3 tesla imaging, and applies diffusion weighted imaging, more specifically for localization of difficult-to-image peritoneal tumor deposits as well as providing more accurate delineation of abdominal visceral tumors suitable for treatment with 3-dimensional conformal radiation therapy.

The imaging volume of each modality has been increasing over the past several years, reflecting the increased patient volume introduced by referral to the tertiary level medical center.

While maintaining high level clinical imaging and patient care, the Abdominal/Body Imaging section is responsible for teaching the next generation of radiologists the fundamentals of system design and operation and appropriate clinical application. In addition to the residency training program, four fellows are selected for each academic year for the Abdominal/Body Imaging Fellowship Program to pursue specialized training in body imaging. These highly trained individuals then graduate to either other academic institutions or to community practice.

The section's research activities have focused on CT and utilizing dual energy acquisition for tissue discrimination and further employing dose reduction techniques, more specifically advanced model based interactive reconstruction in providing high resolution, relatively low dose CT imaging. In ultrasound, fusion imaging employing real time ultrasound in any imaging plane to co-register with previously acquired CT or MRI data has been employed to both improve diagnostic yield as well as enable guided interventional procedure