How 3D & 4D Technology Is Changing Medical Imaging

Once linked with wearing special glasses at the movies, multidimensional images — 3D and 4D — have become incredibly important to medical care. After decades of looking at two-dimensional images, clinicians now have the benefit of additional dimensions that provide depth and detail.

“3D and 4D technology adds new complexities and requires new skills and training for technologists,” said Greg Crutcher, spokesman for the American Society of Radiologic Technologists. 

Sara Baker, MEd, RDMS, RVT, RMSKS, RT(R), a board member of the Society of Diagnostic Medical Sonography, reported 3D technology can provide additional information but has been slow to take off.

“It’s not widely utilized in all of the disciplines yet,” Baker said. “As people are using it and realizing its potential, I think it has a lot to offer.”

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Research began in the 1970s developing 3D imaging scanners. By 2005, 3D imaging allowed structures to be viewed, but they still did not show soft tissue. Technology continues to evolve, creating more and more opportunities for advanced imaging. 

3D and 4D imaging in CTs, X-rays and MRIs

Multidetector computed tomography (CT) is being used to provide clinicians with images of children’s lungs, replacing the need for invasive procedures and anesthesia. The image provides nearly all of the same information as a bronchoscopy. 3D virtual dissection produces a 3D model of the colon and then virtually opens it up and lays it flat, similar to a pathology specimen. 

3D CTs help in assessing developmental deformities and bone fragment displacement in trauma cases. 3D imaging also can be used to study trauma to the spine, shoulder and knee.  

A 4D flow MRI lets clinicians measure and see arterial blood flow, and evaluate the cardiovascular system. The test can be used to understand the patient’s hemodynamics and monitor treatment success. 

Millions of women are receiving breast tomosynthesis to screen for breast cancer. Tomosynthesis provides an image of the entire breast and combines multiple digital X-rays to deliver a clear, 3D image. Clinicians can see through overlapping breast tissue to confirm whether suspicious breast abnormalities are cancerous, according to the Medical Imaging & Technology Alliance. 

Additionally, stereoscopic 3D mammography allows clinicians to find more cancerous lesions than standard mammography. The accuracy of 3D mammography results in tumors being found sooner. 

3D and 4D ultrasound

3D imaging also can be helpful during breast ultrasounds to visualize if the mass has extended into the ductile tissue, indicating an infiltration into the ductal system.

Obstetricians and new parents can watch 4D images of the new baby sucking his or her thumb and other real-time movements, which helps with parent bonding, Baker said. Clinicians can determine if any abnormal behavior in the fetus might be related to neurological problems; congenital defects, such as a cleft lip or palate; or extremity abnormalities, such as a club foot. 

“We use it a lot in our GYN practice,” Baker said. “We use it for looking at the endometrial stripe, the inner lining of the uterus.”

3D ultrasound can help in diagnosing a fibroid or polyp, a congenital abnormality and placement of an IUD.

“With volume sweeping, it can reduce the time, theoretically, a sonographer has to be in the ultrasound room to scan,” Baker said. The images are reconstructed later. However, she cautioned that sonographers often worry with volume sweeping about not taking traditional 2D images and, possibly, missing something. 

In the emergency department, 4D ultrasound can help the physician determine the cause of sudden right upper quadrant pain. Fly-through ultrasounds, used during endoscopic procedures, allow the provider to see a colon polyp and figure out its depth. The same technology can scan the inside of the aorta. 

Training in 3D and 4D imaging 

All of this new technology requires radiology technicians and sonographers to stay abreast of the changes and how to operate the new machinery. Crutcher indicated that in day-to-day practice, the training to acquire these new skills is often provided by the manufacturer of the machine and provided when a facility purchases the new equipment. Baker said the same holds true for new ultrasound equipment. 

Radiologic technologists and sonographers do not need additional certification to use 3D and 4D technology, reported Crutcher and Kelly G. Stafford, MPA, CAE, at the Society of Diagnostic Medical Sonography. 

Radiology technologists (including CT techs and other specialists) and sonographers can learn new techniques and equipment with every new allied travel job.

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