Volume Rendering versus Maximum Intensity Projection in CT Angiography: What Works Best, When, and Why

Published Online:https://doi.org/10.1148/rg.263055186

The introduction and widespread availability of 16-section multi–detector row computed tomographic (CT) technology and, more recently, 64-section scanners, has greatly advanced the role of CT angiography in clinical practice. CT angiography has become a key component of state-of-the-art imaging, with applications ranging from oncology (eg, staging of pancreatic or renal cancer) to classic vascular imaging (eg, evaluation of aortic aneurysms and renal artery stenoses) as well as newer techniques such as coronary artery imaging and peripheral runoff studies. With an average of 400–1000 images in each volume data set, three-dimensional postprocessing is crucial to volume visualization. Radiologists now have workstations that provide capabilities for evaluation of these data sets by using a range of software programs and processing tools. Although different systems have unique capabilities and functionality, all provide the options of volume rendering and maximum intensity projection for image display and analysis. These two postprocessing techniques have different advantages and disadvantages when used in clinical practice, and it is important that radiologists understand when and how each technique should be used.

© RSNA, 2006


  • 1 HeathDG, Soyer PA, Kuszyk BS, et al. Three-dimensional spiral CT during arterial portography: comparison of three rendering techniques. RadioGraphics1995; 15: 1001–1011. LinkGoogle Scholar
  • 2 CalhounPS, Kuszyk BS, Heath DG, Carley JC, Fishman EK. Three-dimensional volume rendering of spiral CT data: theory and method. RadioGraphics1999; 19: 745–764. LinkGoogle Scholar
  • 3 Van OoijenPM, Ho KY, Dorgelo J, Oudkerk M. Coronary artery imaging with multidetector CT: visualization issues. RadioGraphics2003; 23: e16. LinkGoogle Scholar
  • 4 DrebinRA, Magid D, Robertson DD, Fishman EK. Fidelity of three-dimensional CT imaging for detecting fracture gaps. J Comput Assist Tomogr1989; 13: 487–489. Crossref, MedlineGoogle Scholar
  • 5 KuszykBS, Heath DG, Bliss DF, Fishman EK. Skeletal 3-D CT: advantages of volume rendering over surface rendering. Skeletal Radiol1996; 25: 207–214. Crossref, MedlineGoogle Scholar
  • 6 CodyDD. AAPM/RSNA physics tutorial for residents: topics in CT. Image processing in CT. RadioGraphics2002; 22: 1255–1268. LinkGoogle Scholar
  • 7 HalpernEJ, Wechsler RJ, DiCampli D. Threshold selection for CT angiography shaded surface display of the renal arteries. J Digit Imaging1995; 8: 142–147. Crossref, MedlineGoogle Scholar
  • 8 LeClercX, Godefroy O, Pruvo JP, Leys D. Computed tomographic angiography for the evaluation of carotid artery stenosis. Stroke1995; 26: 1577–1581. Crossref, MedlineGoogle Scholar
  • 9 LuB, Dai RP, Jiang SL, et al. Effects of window and threshold levels on the accuracy of three-dimensional rendering techniques in coronary artery electron-beam CT angiography. Acad Radiol2001; 8: 754–761. Crossref, MedlineGoogle Scholar
  • 10 FishmanEK, Drebin B, Magid D, et al. Volumetric rendering techniques: applications for three-dimensional imaging of the hip. Radiology1987; 163: 737–738. LinkGoogle Scholar
  • 11 JohnsonPT, Halpern EJ, Kuszyk BS, et al. Renal artery stenosis: CT angiography—comparison of real-time volume rendering and maximum intensity projection algorithms. Radiology1999; 211: 337–343. LinkGoogle Scholar
  • 12 LeclercX, Godefroy O, Lucas C, et al. Internal carotid arterial stenosis: CT angiography with volume rendering. Radiology1999; 210: 673–682. LinkGoogle Scholar
  • 13 VerhoekG, Costello P, Khoo EW, Wu R, Kat E, Fitridge RA. Carotid bifurcation CT angiography: assessment of interactive volume rendering. J Comput Assist Tomogr1999; 23: 590–596. Crossref, MedlineGoogle Scholar
  • 14 SmithPA, Marshall FF, Urban BA, Heath DG, Fishman EK. Three-dimensional CT stereoscopic visualization of renal masses: impact on diagnosis and patient treatment. AJR Am J Roentgenol1997; 169: 1331–1334. Crossref, MedlineGoogle Scholar
  • 15 CollDM, Uzzo RG, Herts BR, Davros WJ, Wirth SL, Novick AC. 3-dimensional volume rendered computerized tomography for preoperative evaluation and intraoperative treatment of patients undergoing nephron sparing surgery. J Urol1999; 161: 1097–1102. Crossref, MedlineGoogle Scholar
  • 16 El FettouhHA, Herts BR, Nimeh T, et al. Prospective comparison of 3-dimensional volume rendered computerized tomography and conventional renal arteriography for surgical planning in patients undergoing laparoscopic donor nephrectomy. J Urol2003; 170: 57–60. Crossref, MedlineGoogle Scholar
  • 17 KawamotoS, Montgomery RA, Lawler LP, Horton KM, Fishman EK. Multidetector CT angiography for preoperative evaluation of living laparoscopic kidney donors. AJR Am J Roentgenol2003; 180: 1633–1638. Crossref, MedlineGoogle Scholar
  • 18 KimJK, Kim JH, Bae SJ, Cho KS. CT angiography for evaluation of living renal donors: comparison of four reconstruction methods. AJR Am J Roentgenol2004; 183: 471–477. Crossref, MedlineGoogle Scholar
  • 19 HongKC, Freeny PC. Pancreaticoduodenal arcades and dorsal pancreatic artery: comparison of CT angiography with three-dimensional volume rendering, maximum intensity projection, and shaded surface display. AJR Am J Roentgenol1999; 172: 925–931. Crossref, MedlineGoogle Scholar
  • 20 AddisKA, Hopper KD, Iyriboz TA, et al. CT angiography: in vitro comparison of five reconstruction methods. AJR Am J Roentgenol2001; 177: 1171–1176. Crossref, MedlineGoogle Scholar
  • 21 SoyerP, Heath D, Bluemke DA, et al. Three-dimensional helical CT of intrahepatic venous structures: comparison of three rendering techniques. J Comput Assist Tomogr1996; 20: 122–127. Crossref, MedlineGoogle Scholar
  • 22 NakayamaY, Imuta M, Funama Y, et al. CT portography by multidetector helical CT: comparison of three rendering models. Radiat Med2002; 20: 273–279. MedlineGoogle Scholar
  • 23 ByunJH, Kim TK, Lee SS, et al. Evaluation of the hepatic artery in potential donors for living donor liver transplantation by computed tomography angiography using multidetector-row computed tomography: comparison of volume rendering and maximum intensity projection techniques. J Comput Assist Tomogr2003; 27: 125–131. Crossref, MedlineGoogle Scholar
  • 24 SavastanoS, Teso S, Corra S, Fantozzi O, Miotto D. Multislice CT angiography of the celiac and superior mesenteric arteries: comparison with arteriographic findings. Radiol Med (Torino)2002; 103: 456–463. MedlineGoogle Scholar
  • 25 KhanMF, Herzog C, Landenberger K, et al. Visualisation of non-invasive coronary bypass imaging: 4-row vs. 16-row multidetector computed tomography. Eur Radiol2005; 15: 118–126. Crossref, MedlineGoogle Scholar
  • 26 SaylisoyS, Atasoy C, Ersoz S, Karayalcin K, Akyar S. Multislice CT angiography in the evaluation of hepatic vascular anatomy in potential right lobe donors. Diagn Interv Radiol2005; 11: 51–59. MedlineGoogle Scholar
  • 27 RubinGD, Dake MD, Napel S, et al. Spiral CT of renal artery stenosis: comparison of three-dimensional rendering techniques. Radiology1994; 190: 181–189. LinkGoogle Scholar
  • 28 AchenbachS, Ropers D, Regenfus M, Muschiol G, Daniel WG, Moshage W. Contrast enhanced electron beam computed tomography to analyse the coronary arteries in patients after acute myocardial infarction. Heart2000; 84: 489–493. Crossref, MedlineGoogle Scholar
  • 29 UrbanBA, Ratner LE, Fishman EK. Three-dimensional volume-rendered CT angiography of the renal arteries and veins: normal anatomy, variants and clinical applications. RadioGraphics2001; 21: 373–386. LinkGoogle Scholar
  • 30 OferA, Nitecki SS, Linn S, et al. Multidetector CT angiography of peripheral vascular disease: a prospective comparison with intraarterial digital subtraction angiography. AJR Am J Roentgenol2003; 180: 719–724. Crossref, MedlineGoogle Scholar
  • 31 JohnsonPT, Heath DG, Kuszyk BS, Fishman EK. CT angiography with volume rendering: advantages and applications in splanchnic vascular imaging. Radiology1996; 200: 564–568. LinkGoogle Scholar
  • 32 DalrympleNC, Prasad SR, Freckleton MW, Chintapalli KN. Informatics in radiology (info-RAD): introduction to the language of three-dimensional imaging with multidetector CT. RadioGraphics2005; 25: 1409–1428. LinkGoogle Scholar
  • 33 SchreinerS, Paschal CB, Galloway RL. Comparison of projection algorithms used for the construction of maximum intensity projection images. J Comput Assist Tomogr1996; 20: 56–67. Crossref, MedlineGoogle Scholar
  • 34 NapelS, Marks MP, Rubin GD, et al. CT angiography with spiral CT and maximum intensity projection. Radiology1992; 185: 607–610. LinkGoogle Scholar
  • 35 CollDM, Herts BR, Davros WJ, Uzzo RG, Novick AC. Preoperative use of 3D volume rendering to demonstrate renal tumors and renal anatomy. RadioGraphics2000; 20: 431–438. LinkGoogle Scholar
  • 36 KuszykBS, Heath DG, Johnson PT, Eng J, Fishman EK. CT angiography with volume rendering for quantifying vascular stenoses: in vitro validation of accuracy. AJR Am J Roentgenol1999; 173: 449–455. Crossref, MedlineGoogle Scholar
  • 37 BaekSY, Sheafor DH, Keogan MT, DeLong DM, Nelson RC. Two-dimensional multiplanar and three-dimensional volume-rendered vascular CT in pancreatic carcinoma: interobserver agreement and comparison with standard helical techniques. AJR Am J Roentgenol2001; 176: 1467–1473. Crossref, MedlineGoogle Scholar

Article History

Published in print: May 2006