title: CT colonography: comparison of a colon dissection display versus 3D endoluminal view for the detection of polyps.
abstract: The purpose of this study was to compare sensitivity, specificity, and postprocessing time of a colon dissection approach to regular 3D-endoluminal workup of computed tomography (CT) colonography for the detection of polypoid lesions. Twenty-one patients who had received conventional colonoscopy after CT colonography were selected; 18 patients had either colon polyps or colon cancer and three had no findings. CT colonography was performed using a 4-channel multi-detector-row (MDR) CT in ten cases and a 16-channel MDR-CT in 11 cases. A blinded reader retrospectively evaluated all colonographies using both viewing methods in a randomized order. Thirty-seven polyps were identified by optical colonoscopy. An overall per-lesion sensitivity of 47.1% for lesions smaller than 5 mm, 56.3% for lesions between 5 mm and 10 mm, and 75.0% for lesion larger than 10 mm was calculated using the colon dissection approach. This compared to an overall per-lesion sensitivity of 35.3% (<5 mm), 81.5% (5-10 mm), and 100.0% (>10 mm) using the endoluminal view. The average time consumption for CT colonography evaluation with the colon dissection software was 10 min versus 38 min using the endoluminal view. A colon dissection approach may provide a significant time advantage for evaluation of CT colonography while obtaining a high sensitivity. It is especially superior in the detection of lesions smaller than 5 mm.
authors.affiliation: Department for Diagnostic Radiology, University Hospital of Ulm, Steinhoevelstr. 9, 89075, Ulm, Germany. markus.juchems@medizin.uni-ulm.de
authors.forename: Markus S
authors.initials: MS
authors.lastname: Juchems
authors.forename: Thorsten R
authors.initials: TR
authors.lastname: Fleiter
authors.forename: Sandra
authors.initials: S
authors.lastname: Pauls
authors.forename: Stefan A
authors.initials: SA
authors.lastname: Schmidt
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Brambs
authors.forename: Andrik J
authors.initials: AJ
authors.lastname: Aschoff
mesh_terms: D000328:Adult; D000368:Aged; D003106:Colon / Q000000981:diagnostic imaging*; D003111:Colonic Polyps / Q000175:diagnosis*; D023881:Colonography, Computed Tomographic / Q000379:methods*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013997:Time Factors