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Characterization of Lesions Missed on Interpretation of CT Colonography Using a 2D Search Method

Thomas M. Gluecker1, J. G. Fletcher1, Timothy J. Welch1, Robert L. MacCarty1, William S. Harmsen2, Jeffrey R. Harrington2, Duane Ilstrup2, Lynn A. Wilson1, Kay E. Corcoran1 and C. Daniel Johnson1

1 Department of Radiology, Mayo Clinic Rochester, 200 First St. SW, Rochester, MN 55905.
2 Department of Health Sciences Research, Section of Biostatistics, Mayo Clinic Rochester, Rochester, MN 55905.



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  		Fig. 1. —Drawing shows location of polyps in relation to haustral folds: on fold (thin black arrows), at base of fold (white arrow), or at convergence of multiple folds (thick black arrow). Colonic lumen is denoted by asterisk.

 


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  		Fig. 2. —Drawing shows location of polyps in relation to flexures: along inner (open arrow) or outer (solid arrow) aspect of flexure.

 


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  		Fig. 3A. —70-year-old man with 1-cm adenoma in ascending colon in whom polyp was seen in prone but not supine position (missed by one observer). Prone axial CT colonography image shows 1-cm polyp (arrow) along lateral aspect of ascending colon.

 


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  		Fig. 3B. —70-year-old man with 1-cm adenoma in ascending colon in whom polyp was seen in prone but not supine position (missed by one observer). Supine axial CT colonography image fails to show polyp because of excessive colonic fluid.

 


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  		Fig. 4. —66-year-old man with tubulovillous adenoma in cecum. Supine axial CT colonography image shows 3.5 x 1.0 cm flat lesion along fold in lateral aspect of cecum (arrows) that was detected by one observer but missed by another.

 


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  		Fig. 5A. —67-year-old man with 7-mm pedunculated hyperplastic polyp missed by one observer. Two-dimensional multiplanar reformatted image shows small lesion (arrow) at base of a haustral fold.

 


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  		Fig. 5B. —67-year-old man with 7-mm pedunculated hyperplastic polyp missed by one observer. Corresponding 3D endoluminal view from CT colonography shows lesion at base of a haustral fold. Neither supine nor prone images showed true pedunculated nature of lesion.

 

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