Upright multidetector CT with 320-row gantry: a technical innovation providing insights into human anatomy under gravity and potential clinical implications

CT performed in the supine position has been highly effective in diagnosing organic diseases such as cancer, arteriosclerosis, and infections, significantly contributing to increased life expectancy. In an ageing society, extending healthy life expectancy becomes more critical, requiring early diagnosis of functional disorders. We have led the industry-academia collaboration in developing an upright MDCT system. Although this system maintains the same physical specifications as conventional MDCT, it differs significantly in imaging configuration—allowing supine, upright, and sitting positions—and offers improved workflow while requiring only two-thirds of the installation space. Unlike conventional MDCT, it allows for the assessment of anatomical changes under gravity. It also enables the objective diagnosis and grading of functional diseases, in which findings were not apparent on conventional CT, and enable the study of the pathogenesis of functional diseases which worsen symptoms in the upright position. Furthermore, it allows for noninvasive evaluation of dynamic functions such as swallowing and voiding, which can only be assessed in standing or sitting positions.