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Polyp Volume Versus Linear Size Measurements at CT Colonography: Implications for Noninvasive Surveillance of Unresected Colorectal Lesions

Perry J. Pickhardt1,2, Vance T. Lehman1, Thomas C. Winter1 and Andrew J. Taylor1

1 Department of Radiology, University of Wisconsin Medical School, 600 Highland Ave., Madison, WI 53792.
2 Department of Radiology, Uniformed Services University of the Health Sciences, Bethesda, MD.


Figure 1
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  		Fig. 1A —CT colonography in 75-year-old man with 2.5-cm tubulovillous adenoma in ascending colon. Magnified 2D axial CT images (window width, 2,000 H; window level, 0 H) show lobulated polyp before border delineation

 

Figure 2
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  		Fig. 1B —CT colonography in 75-year-old man with 2.5-cm tubulovillous adenoma in ascending colon. after manual border tracing with mouse-driven stylus

 

Figure 3
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  		Fig. 1C —CT colonography in 75-year-old man with 2.5-cm tubulovillous adenoma in ascending colon. after automated interpolation and volume determination.

 

Figure 4
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  		Fig. 1D —CT colonography in 75-year-old man with 2.5-cm tubulovillous adenoma in ascending colon. Three-dimensional endoluminal image shows lobulated lesion after segmentation (blue).

 

Figure 5
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  		Fig. 2A —Polyp linear size versus volume derived from CT colonography (CTC). This graph depicts polyps measuring less than 35 mm (the one polyp exceeding this size is not shown for scaling purposes). Blue line represents fitted curve for individual data points, V = ({pi}/12) x Db, where b = 2.81 (see text), and red line shows volume-to-diameter relationship of hemisphere. For polyp diameters in 10- to 35-mm range, CTC-derived volume was usually less than hemispheric volume.

 

Figure 6
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  		Fig. 2B —Polyp linear size versus volume derived from CT colonography (CTC). This graph is similar to A but depicts medium-sized polyps measuring less than 10 mm. Blue line represents fitted curve for individual data points, V(D) = ({pi}/12) x Db, where b = 3.13 (see text). Note how medium-sized polyps approximate hemispheric curve (red line). Unlike larger polyp diameters, CTC-derived volume for medium-sized lesions is generally greater than hemispheric volume.

 

Figure 7
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  		Fig. 3 —Tubular adenoma in sigmoid colon at CT colonography in 63-year-old man. Magnified 2D sagittal CT image shows sessile polyp with roughly hemispherical shape, which is fairly typical for subcentimeter sessile lesions.

 

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