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Detectability of Small and Flat Polyps in MDCT Colonography Using 2D and 3D Imaging Tools: Results from a Phantom Study

Thomas G. Mang1, Cornelia Schaefer-Prokop2, Andrea Maier1, Ewald Schober1, Gerhard Lechner1 and Mathias Prokop3

1 Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria.
2 Academic Medical Center, Amsterdam, The Netherlands.
3 University Medical Center Utrecht, Utrecht, The Netherlands.



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Fig. 1 Colon segment turned inside out. Three simulated lesions affixed to colon wall. Small 3.5-mm polyp on right side, 7-mm flat lesion in middle, and 7-mm polypoid lesion on left side.

 


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Fig. 2A Small polypoid lesion less than or equal to 3 mm. Simulated polyp affixed to colon wall.

 


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Fig. 2B Small polypoid lesion less than or equal to 3 mm. Intraluminal volume rendering.

 


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Fig. 2C Small polypoid lesion less than or equal to 3 mm. Axial and coronal multiplanar reconstruction. Small lesion (arrow) can be localized in all 2D and 3D views, although conspicuity is highest on 3D display.

 


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Fig. 2D Small polypoid lesion less than or equal to 3 mm. Axial and coronal multiplanar reconstruction. Small lesion (arrow) can be localized in all 2D and 3D views, although conspicuity is highest on 3D display.

 


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Fig. 3A Flat lesion 7 mm in width and 2 mm in height. Simulated flat lesion affixed to haustral fold.

 


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Fig. 3B Flat lesion 7 mm in width and 2 mm in height. Intraluminal volume rendering.

 


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Fig. 3C Flat lesion 7 mm in width and 2 mm in height. Axial and coronal multiplanar reconstruction. Flat lesion (arrow) is very difficult to appreciate on multiplanar reconstruction and is much more conspicuous on 3D display.

 


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Fig. 3D Flat lesion 7 mm in width and 2 mm in height. Axial and coronal multiplanar reconstruction. Flat lesion (arrow) is very difficult to appreciate on multiplanar reconstruction and is much more conspicuous on 3D display.

 


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Fig. 4 Air-distended colon segment placed in dedicated 20 x 30 cm acrylic phantom box. Phantom box had diameter and form of abdominal transverse cross section and was filled with water to simulate abdominal attenuation. To ensure specimen was totally surrounded by water, an acrylic plate was fixed horizontally in upper third of height to keep air-distended colon segment from buoyancy in center of box.

 

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