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CT Colonography Using 360° Virtual Dissection: A Feasibility Study

¹ Department of Radiology, Mayo Clinic Rochester, 200 First St. SW, Rochester, MN 55905.
² Department of Radiology, National Institutes of Health, Bethesda, MD 20892.

View larger version (137K): [in a new window]   Fig. 1A —360° virtual dissection colonography of glass colon phantom. Single virtual dissection image shows entire luminal surface that contains 144 polyps. All 360° of colon phantom is displayed along its entire longitudinal axis.

View larger version (95K): [in a new window]   Fig. 1B —360° virtual dissection colonography of glass colon phantom. CT topogram of colon phantom shows multiple polyps in air-filled lumen.

View larger version (56K): [in a new window]   Fig. 2A —Virtual dissection CT colonography images depict four morphologic types of polyps and their distorted appearances. Four polyp shapes are flame (A), club (B), pea (C), and bizarre (D).

View larger version (92K): [in a new window]   Fig. 2B —Virtual dissection CT colonography images depict four morphologic types of polyps and their distorted appearances. Four polyp shapes are flame (A), club (B), pea (C), and bizarre (D).

View larger version (62K): [in a new window]   Fig. 2C —Virtual dissection CT colonography images depict four morphologic types of polyps and their distorted appearances. Four polyp shapes are flame (A), club (B), pea (C), and bizarre (D).

View larger version (120K): [in a new window]   Fig. 2D —Virtual dissection CT colonography images depict four morphologic types of polyps and their distorted appearances. Four polyp shapes are flame (A), club (B), pea (C), and bizarre (D).

View larger version (14K): [in a new window]   Fig. 3 —Bar graphs show morphology of polyps at virtual dissection. Sessile and flat polyps appear predominately as flame- and pea-shaped. Pedunculated polyps appear flame- and club-shaped.

View larger version (67K): [in a new window]   Fig. 4A —82-year-old man with ascending colon carcinoma. 360° virtual dissection image of right colon reveals lesion (arrow) that was considered to be normal ileocecal valve. A 2.5-cm adenoma was found at colonoscopy. Normal valve can be identified in more proximal colon (arrowhead).

View larger version (85K): [in a new window]   Fig. 4B —82-year-old man with ascending colon carcinoma. Three-dimensional endoluminal view shows proven adenoma.

View larger version (24K): [in a new window]   Fig. 5 —Bar graphs show added benefit of double interpretation (gray bars). All combinations of the three reviewers are listed. Sensitivities tended toward improvement in every case, but improvement did not reach statistical significance. Black bars indicate single interpretation.

View larger version (15K): [in a new window]   Fig. 6 —Bar graphs show benefit of adding computer-aided diagnosis (gray bars) to single blinded interpretation (black bars).

View larger version (86K): [in a new window]   Fig. 7A —87-year-old man with annular carcinoma in sigmoid colon. 360° virtual dissection image shows annular carcinoma in sigmoid colon. Abrupt margins of tumor are identified at arrows.

View larger version (77K): [in a new window]   Fig. 7B —87-year-old man with annular carcinoma in sigmoid colon. Typical features of annular cancer (arrow) are visible on this conventional axial image at level of sigmoid colon.

View larger version (88K): [in a new window]   Fig. 8A —Typical example of a sessile polyp in 77-year-old woman. 360° virtual dissection image shows 1-cm polyp (arrow) that appears elongated or flame-shaped.

View larger version (141K): [in a new window]   Fig. 8B —Typical example of a sessile polyp in 77-year-old woman. Three-dimensional endoluminal image shows sessile polyp.

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