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Comparative Performance of Two Polyp Detection Systems on CT Colonography

¹ Department of Radiology, Mayo Clinic, 200 First St. SW, Rochester, MN 55905.
² Department of Radiology, National Institutes of Health, Bethesda, MD.
³ Siemens Medical Solutions, Forchheim, Germany.

View larger version (118K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1A —60-year-old man with 2-cm rectosigmoid tubulovillous adenoma identified by prospective radiologist assessment and both polyp detection systems. Supine axial CT colonography image with lung window settings shows sessile polyp (arrow) arising from left wall of rectosigmoid colon.

View larger version (128K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1B —60-year-old man with 2-cm rectosigmoid tubulovillous adenoma identified by prospective radiologist assessment and both polyp detection systems. Same image as in A but with soft-tissue window settings shows homogeneous soft-tissue attenuation within polyp (arrow).

View larger version (95K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1C —60-year-old man with 2-cm rectosigmoid tubulovillous adenoma identified by prospective radiologist assessment and both polyp detection systems. Corresponding 3D endoluminal view of tubulovillous adenoma. Software imprints letters and numbers on image to identify patient position and number of polyps per position.

View larger version (113K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2A —86-year-old woman with hyperplastic polyp identified at endoscopy, which was detected by both polyp detection systems but not by prospective radiologist interpretation. Prospective radiologist interpretation identified two other synchronous polyps elsewhere in colon. Supine axial CT colonography image shows soft-tissue attenuation filling defect in hepatic flexure. White line points to lesion.

View larger version (109K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2B —86-year-old woman with hyperplastic polyp identified at endoscopy, which was detected by both polyp detection systems but not by prospective radiologist interpretation. Prospective radiologist interpretation identified two other synchronous polyps elsewhere in colon. Corresponding 3D endoluminal image shows irregular surface of lesion on CT colonography. Software imprints letters and numbers on image to identify patient position and number of polyps per position.

View larger version (120K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3A —52-year-old man with flat tubular adenoma prospectively identified by radiologist but missed by both polyp detection systems. Enlarged axial supine CT colonography image shows cigar-shaped filling defect (arrow) on haustral fold in ascending colon.

View larger version (109K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3B —52-year-old man with flat tubular adenoma prospectively identified by radiologist but missed by both polyp detection systems. Coronal 2D multiplanar reconstruction image shows flat lesion (arrows) to be located on superior surface of haustral fold.

View larger version (125K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3C —52-year-old man with flat tubular adenoma prospectively identified by radiologist but missed by both polyp detection systems. Corresponding 3D endoluminal image shows flat morphology of lesion. Software imprints letters and numbers on image to identify patient position and number of polyps per position.

View larger version (138K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4A —Lesion identified by both polyp detection systems that looks like polyp but was not verified endoscopically (i.e., false-positive detection). Prospective radiologist interpretation identified same filling defect in CT data sets. Transverse prone CT image with lung window settings shows 7-mm polypoid filling defect (arrow) in sigmoid colon.

View larger version (107K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4B —Lesion identified by both polyp detection systems that looks like polyp but was not verified endoscopically (i.e., false-positive detection). Prospective radiologist interpretation identified same filling defect in CT data sets. Corresponding 3D endoluminal view also shows polypoid morphology. Software imprints letters and numbers on image to identify patient position and number of polyps per position.

View larger version (50K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4C —Lesion identified by both polyp detection systems that looks like polyp but was not verified endoscopically (i.e., false-positive detection). Prospective radiologist interpretation identified same filling defect in CT data sets. Transverse supine CT image with intermediate window settings shows filling defect in same location with homogeneous soft-tissue attenuation (arrow).

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