A CT scan of the abdomen and pelvis can contain over a thousand individual image slices. A CT of the cervical spine may have several hundred. Getting from that raw DICOM study to a usable, organized image set for litigation is not a simple task — and the volume of data is only part of the challenge. Here is what attorneys need to know about CT scan printing for litigation use.
What Makes CT Different From MRI
CT scans and MRI studies are both stored as DICOM files, but they differ significantly in how the data is organized and how it is used in litigation. CT studies typically produce a much larger number of image slices — often hundreds to over a thousand — organized into series based on acquisition parameters, contrast phases, and reconstruction algorithms.
For litigation use, this volume means that image selection and organization are particularly important. Printing every slice from a CT study is neither practical nor useful. The relevant images need to be identified — typically by the expert witness — and organized into a coherent set.
The Role of the Expert in CT Image Selection
Because CT studies contain so many slices, the expert witness typically plays a central role in identifying which images are relevant for litigation use. The expert reviews the full DICOM study, identifies the key sequences and slices that support their opinion, and provides instructions for the image set.
This is why the workflow for CT imaging often involves sending the full DICOM study to the expert first, getting their input on image selection, and then producing the litigation image set based on those instructions.
Windowing and Display Parameters
CT images are displayed using windowing parameters — window width and window level — that determine which tissue densities are visible in the image. The same CT slice displayed with bone window settings looks completely different from the same slice displayed with soft tissue window settings.
For litigation use, the appropriate windowing depends on what the image is intended to show. This is another reason why expert input on image preparation matters — the expert can specify the display parameters that best present the relevant findings.
Formats for CT Litigation Sets
CT litigation image sets are produced in the same formats as other imaging studies: physical prints, PDF files, high-resolution JPEG or TIFF files, and large-format exhibit prints. The appropriate format depends on how the images will be used — expert review, deposition, mediation, or trial.
For complex CT studies with multiple series and phases, digital files organized by series can be particularly useful for expert review and report preparation.
Timing Considerations for CT Orders
CT studies with large slice counts take longer to process than smaller studies. When ordering CT image sets, provide as much lead time as possible. If your expert has not yet reviewed the study and identified the relevant images, build that review time into your timeline before placing the imaging order.
Lightning Medical provides medical image reproduction and litigation-support services. Lightning Medical does not provide medical diagnoses, radiological interpretations, medical opinions, or legal advice.