Colon dissection: a new three-dimensional reconstruction tool for computed tomography colonography.
OBJECTIVE
To improve the sensitivity of computed tomography (CT) colonography in the detection of polyps by comparing the 3D reconstruction tool "colon dissection" and endoluminal view (virtual colonoscopy) with axial 2D reconstructions.


METHODS
Forty-eight patients (22 M, 26 F, mean age 57 +/- 21) were studied after intra-anal air insufflation in the supine and prone positions using a 16-slice helical CT (16 x 0.625 mm, pitch 1.7; detector rotation time 0.5 s; 160 mAs und 120 kV) and conventional colonoscopy. Two radiologists blinded to the results of the conventional colonoscopy analyzed the 3D reconstruction in virtual-endoscopy mode, in colon-dissection mode, and axial 2D slices.


RESULTS
Conventional colonoscopy revealed a total of 35 polyps in 15 patients; 33 polyps were disclosed by CT methods. Sensitivity and specificity for detecting colon polyps were 94% and 94%, respectively, when using the "colon dissection", 89% and 94% when using "virtual endoscopy", and 62% and 100% when using axial 2D reconstruction. Sensitivity in relation to the diameter of colon polyps with "colon dissection", "virtual colonoscopy", and axial 2D-slices was: polyps with a diameter >5.0 mm, 100%, 100%, and 71%, respectively; polyps with a diameter of between 3 and 4.9 mm, 92%, 85%, and 46%; and polyps with a diameter < 3 mm, 89%, 78%, and 56%. The difference between "virtual endoscopy" and "colon dissection" in diagnosing polyps up to 4.9 mm in diameter was statistically significant.


CONCLUSIONS
3D reconstruction software "colon dissection" improves sensitivity of CT colonography compared with the endoluminal view.
Röttgen
R
R
Klinik für Strahlenheilkunde, Charité Campus Virchow-Klinikum, University Medical Center, Berlin, Germany. r.roettgen@t-online.de
Fischbach
F
F
Plotkin
M
M
Herzog
H
H
Freund
T
T
Schröder
R J
RJ
Felix
R
R
D003106:Colon / Q000000981:diagnostic imaging*; D003111:Colonic Polyps / Q000175:diagnosis*; D023881:Colonography, Computed Tomographic / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012680:Sensitivity and Specificity