Abstract
Although humans spend most of their daily lives in an upright position, very few imaging methods can be used to analyze the anatomical structures and pathophysiology of the whole human body while in a standing or sitting position. In 2014, we initiated a project to develop an upright CT device that would enable the visualization and quantitative evaluation of the effects of gravity on the whole human anatomical structures and pathologic conditions. In 2017, the development of the first ever upright CT with 320-detector row CT scanner was completed and introduced at our hospital. Although achieving a high-speed, high-precision vertical rotation while minimizing vibration was challenging, we confirmed spatial resolution, noise, or CT number of the upright CT was comparable to those of a conventional 320-detector row CT scanner. Furthermore, differences in the anatomical structure of a normal volunteer were observed when images were taken in an upright versus supine position, suggesting potential advantages of using upright CT over conventional CT for the evaluation of certain diseases.
Highlights
The first images of the human body’s interior date back to 1895, when Roentgen discovered X-rays (Röntgen 1896)
The scanning time has improved with the development of single-helical scans in 1990 (Kalender et al 1990) and a four-row detector computed tomography (CT) in 1999 (Hu 1999), and the scanning time was drastically improved by the development of a 64-detector CT in 2004
X-ray examinations using contrast material (CM) have been replaced by 3D CT, simple X-ray examinations remain widely used for two reasons
Summary
The first images of the human body’s interior date back to 1895, when Roentgen discovered X-rays (Röntgen 1896). An X-ray of his wife’s hand provided the first image of a human internal structure. The contrast produced by X-rays was not sufficient to visualize internal organs, such as the liver, spleen, kidney, or urinary bladder (Fig. 27.1). To compensate for the weakness of low-contrast X-rays, a contrast material was developed in 1896, 1 year after the discovery of X-rays (Haschek 1896). Thereafter, iodinated contrast material (CM) was developed and has been widely used ever since (Brooks 1924; Wallingford 1953). CM enables the visualization of the vascular system, urinary tract system, biliary tract system and alimentary tract system during projection imaging using X-rays (Fig. 27.2)
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