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Published online before print March 16, 2006, 10.1148/radiol.2392050483
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Polyp Detection with CT Colonography: Primary 3D Endoluminal Analysis versus Primary 2D Transverse Analysis with Computer-assisted Reader Software1

Stuart A. Taylor, BSc, MD, MRCP, FRCR, Steve Halligan, MD, FRCP, FRCR2, Andrew Slater, MRCP, FRCR, Vicky Goh, MRCP, FRCR3, David N. Burling, MRCP, FRCR, Mary E. Roddie, MRCP, FRCR, Leslie Honeyfield, DCR(R), Justine McQuillan, DCR(R), Hamdan Amin, PhD and Jamshid Dehmeshki, PhD

1 From the Department of Intestinal Imaging, St Mark's Hospital, Northwick Park, Harrow, United Kingdom (S.A.T., S.H., A.S., V.G., D.N.B.); Charing Cross Hospital, London, United Kingdom (M.E.R.); and Medicsight, London, United Kingdom (M.E.R., L.H., J.M., H.A., J.D.). Received March 22, 2005; revision requested May 17; revision received May 24; accepted June 21; final version accepted July 18. Supported by Medicsight, London, United Kingdom. Address correspondence to S.A.T., Department of Specialist X-Ray, Level 2 Podium, University College Hospital, 235 Euston Rd, London NW1 2BU, UK (e-mail: csytaylor{at}yahoo.co.uk).


Figure 1
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  		Figure 1: Transverse CT colonographic image demonstrates method of polyp annotation, with hand-drawn region of interest around 10-mm rectal polyp.

 

Figure 2
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  		Figure 2: Transverse CT colonographic image demonstrates method used by CAR software to highlight potential polyps. Polyp is circled as shown (same polyp as in Fig 1).

 

Figure 3
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  		Figure 3a: (a) CT colonographic image demonstrates 6-mm polyp (arrow) in descending colon seen only on 2D transverse view with CAR software. (b) Three-dimensional endoluminal fly-through image. Polyp (long arrow) is visible but is located behind a fold (short arrow).

 

Figure 3
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  		Figure 3b: (a) CT colonographic image demonstrates 6-mm polyp (arrow) in descending colon seen only on 2D transverse view with CAR software. (b) Three-dimensional endoluminal fly-through image. Polyp (long arrow) is visible but is located behind a fold (short arrow).

 

Figure 4
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  		Figure 4a: (a) CT colonographic image demonstrates 6-mm polyp in hepatic flexure seen only on 2D transverse view with CAR software. Polyp (arrow) is located between two folds. (b) Antegrade 3D endoluminal view reveals polyp (arrow). (c) Retrograde 3D endoluminal view of colon. Polyp is not visible because it is hidden behind fold (arrow).

 

Figure 4
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  		Figure 4b: (a) CT colonographic image demonstrates 6-mm polyp in hepatic flexure seen only on 2D transverse view with CAR software. Polyp (arrow) is located between two folds. (b) Antegrade 3D endoluminal view reveals polyp (arrow). (c) Retrograde 3D endoluminal view of colon. Polyp is not visible because it is hidden behind fold (arrow).

 

Figure 4
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  		Figure 4c: (a) CT colonographic image demonstrates 6-mm polyp in hepatic flexure seen only on 2D transverse view with CAR software. Polyp (arrow) is located between two folds. (b) Antegrade 3D endoluminal view reveals polyp (arrow). (c) Retrograde 3D endoluminal view of colon. Polyp is not visible because it is hidden behind fold (arrow).

 

Figure 5
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  		Figure 5a: Two-dimensional transverse CT colonographic images show 8-mm sigmoid polyp not highlighted by CAR software but detected by readers with 3D endoluminal analysis on supine view only. (a) Supine 2D transverse CT colonographic image demonstrates polyp (arrow). (b) Prone 2D transverse CT colonographic image. Polyp is still visible (arrow) but is submerged in tagged fluid.

 

Figure 5
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  		Figure 5b: Two-dimensional transverse CT colonographic images show 8-mm sigmoid polyp not highlighted by CAR software but detected by readers with 3D endoluminal analysis on supine view only. (a) Supine 2D transverse CT colonographic image demonstrates polyp (arrow). (b) Prone 2D transverse CT colonographic image. Polyp is still visible (arrow) but is submerged in tagged fluid.

 

Figure 6
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  		Figure 6a: (a) Two-dimensional transverse CT colonographic image of 10-mm transverse colonic polyp detected by readers with 3D endoluminal analysis only. Polyp (arrow) is well visualized on supine view. (b) Antegrade 3D endoluminal view and (c) retrograde 3D endoluminal view reveal polyp (arrow).

 

Figure 6
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  		Figure 6b: (a) Two-dimensional transverse CT colonographic image of 10-mm transverse colonic polyp detected by readers with 3D endoluminal analysis only. Polyp (arrow) is well visualized on supine view. (b) Antegrade 3D endoluminal view and (c) retrograde 3D endoluminal view reveal polyp (arrow).

 

Figure 6
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  		Figure 6c: (a) Two-dimensional transverse CT colonographic image of 10-mm transverse colonic polyp detected by readers with 3D endoluminal analysis only. Polyp (arrow) is well visualized on supine view. (b) Antegrade 3D endoluminal view and (c) retrograde 3D endoluminal view reveal polyp (arrow).

 




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