Cinematic Rendering: Principles, Applications, and Observations in CT

Cinematic Rendering (CR)

Cinematic Vs. Volume Rendering

Cinematic Vs. Volume Rendering

Cinematic Rendering: Strikingly Different from other 3D Methods

Clinical Utility of Cinematic Rendering has not Been Established

Clinical Examples of Cinematic Rendering

Calvarial, Skull Base, and Maxillofacial Normal Anatomy

VR vs. CR: normal skull anatomy

Calvarial, Skull Base, and Maxillofacial Normal Anatomy

Calvarial, Skull Base, and Maxillofacial Normal Anatomy

Photorealistic images such as these cinematic renders may prove invaluable in trainee education

Calvarial, Skull Base, and Maxillofacial Normal Anatomy

Forearm and Hand Anatomy with Varying Window Widths and Levels

Cinematic Rendering of Forearm and Hand

The potential for CR to replace MRI for soft tissue and tendon evaluation in certain situations should be extensively investigated

Cinematic Rendering of Forearm and Hand

Changes in widow width, window setting, and transparency can allow for almost any tissue or combination of tissues to be displayed in the visualizations

Cinematic Rendering of Forearm and Hand

Viewing the volume from different virtual points of view will ensure that key findings are not missed because of the realistic shadowing effects/obscuration of the light source that are intrinsic to the method

Normal Fetal and Placental Anatomy can be Well-Evaluated

Note the shadowing that occurs between the pubic symphysis and the fetal skull in the last two images (red arrowheads) that allows for a definitive understanding of the relative locations of those objects



Rowe SP, Fishman EK. Radiol Case Rep. 2017; Ahead of print.

Highly Detailed Head and Neck Soft Tissue Anatomy can be Rendered

Highly Detailed Head and Neck Soft Tissue Anatomy can be Rendered

Highly Detailed Head and Neck Soft Tissue Anatomy can be Rendered

Highly Detailed Head and Neck Soft Tissue Anatomy can be Rendered

Small structures, such as the submandibular glands (red arrows) are delineated on CR images, and aspects of the textures of the glands can be appreciated.

Normal Stomach Anatomy

The level of surface detail that can be achieved with CR allows the texture of the folds of the stomach to be depicted in the second of these panels

Destructive Facial Squamous Cell Carcinoma

CR of facial squamous cell carcinoma – appropriate window settings allow one to “move through” the layers of soft tissue to display more of the underlying bone structure

Squamous Cell Carcinoma Invading the Calvarium

Note the excellent display of the vascular map of the lesion on the CR images as well as the photorealistic appearance of the body calvarium

Calvarial, Skull Base, and Maxillofacial Anatomy and Pathology

Posterior calvarial osteoma: note the shadowing around the interface between the osteoma and the overlying skull, indicating that this lesion arises from a bony stalk

Cinematic Rendering of Pancreas Serous Cystadenoma

Pancreatic Lipoma

Adencarcinoma of the Tail of the Pancreas

Note the excellent delineation of the duodenal invasaion (red arrows) on the CR images

Pancreatic Adenocarcinoma with Vascular Invasion

Note the ability of CR to display the abdominal vasculature including the collateral vessels in a photorealistic manner.

Pancreatic Adenocarcinoma with Upstream Atrophy

Note the texture change that is visible between normal pancreas, the tumor (red arrows) and the atrophied pancreatic tail on the CR images.

Pancreatic Neuroendocrine Tumor with Extensive Neovascularity

Pancreatic Neuroendocrine Tumor with Extensive Neovascularity

Note the effective depiction of the “nest” of tumor neovascularity that surrounds the tumor in the bottom panels.

Large, Highly-Vascular Gastro-Intestinal Stromal Tumor

Large, Highly-Vascular Gastro-Intestinal Stromal Tumor

Large, Highly-Vascular Gastro-Intestinal Stromal Tumor

Large, Highly-Vascular Gastro-Intestinal Stromal Tumor

For a large, hyper-vascular tumor such as this GIST lesion, the combination of accurate vascular maps and high levels of soft tissue detail that can be provided by CR may prove very beneficial for pre-operative planning

Right Lower Pole Clear Cell Renal Cell Carcinoma

Left Lower Pole Clear Cell Renal Cell Carcinoma

The texture of the tumor and the extensive neovascularity are shown to good advantage by the CR images (red arrows in the bottom row of figures. Pre-operative planning in such complex cases may prove to be a valuable application for this 3D visualization technique

5 mm Clear Cell Renal Cell Carcinoma Detected Incidentally

Infiltrating Right Kidney Renal Cell Carcinoma

Left Kidney Transitional Cell Carcinoma

Careful scrutiny of the 2D and VR images demonstrates a lesion (red arrows) in the left renal collecting system.

Left Kidney Transitional Cell Carcinoma

Left Kidney Transitional Cell Carcinoma

Another Example of Left Kidney Transitional Cell Carcinoma

Another Example of Left Kidney Transitional Cell Carcinoma

Depending on the contrast phase and the widow width and settings used, a transitional cell carcinoma (red arrows) can appear as either a mass lesion or a defect within an excreted contrast column

Colorectal Metastasis to the Liver

Renal Cell Carcinoma Adrenal Metastases

Although the 2D and VR images demonstrate heterogeneity in these renal cell carcinoma metastases, the texture of that heterogeneity is much more apparent in the CR panels on the bottom

Metastatic Carcinoid Tumor

This example of metastatic carcinoid tumor (red arrows) to the mesentery has the typical calcifications and vascular tethering, with the effects on the vasculature well displayed on these CR images

Small Bowel Gastrointestinal Stromal Tumor

Small Bowel Gastrointestinal Stromal Tumor

Small Bowel Obstruction Secondary to Cecal Adenocarcinoma

Treated Gastrointestinal Stromal Tumor Liver Metastasis

Liver Hemangioma

Carcinoid Liver Metastases

Gallbladder Adenocarcinoma