Fecal-tagging CT colonography with structure-analysis electronic cleansing for detection of colorectal flat lesions

• Published in: European journal of radiology Vol. 81; no. 8; pp. 1712 - 1716
• Main Authors: Xu, Yonghua, Cai, Wenli, Nappi, Janne, Yoshida, Hiro
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.08.2012
• Subjects: Adult; Aged; Algorithms; Barium Sulfate; China; Colonography; Colonography, Computed Tomographic - methods; Colorectal Neoplasms - diagnostic imaging; Computed tomographic; Diagnosis; Electronic cleansing; Feces; Female; Flat polyps; Humans; Imaging, Three-Dimensional - methods; Male; Middle Aged; Pralidoxime Compounds; Radiographic Image Enhancement - methods; Radiographic Image Interpretation, Computer-Assisted - methods; Radiology; Reproducibility of Results; Sensitivity and Specificity; Computed tomographic; Electronic cleansing; Diagnosis; Flat polyps; Colonography
• ISSN: 0720-048X; 1872-7727; 1872-7727
• DOI: 10.1016/j.ejrad.2011.04.051

To evaluate the feasibility and sensitivity of the 3D-reading of fecal-tagging CT colonography (CTC) with a novel structure-analysis electronic cleansing (SAEC) in detecting colorectal flat lesions in comparison with a cleansed 3D reading with Viatronix V3D Colon system (V3D) and primary uncleansed 2D reading (2D). Forty CTC cases with flat lesions were retrospectively observed. The Subjects from a multicenter clinical trial underwent cathartic bowel preparation with orally administrated barium-based fecal-tagging. Sixty-nine flat lesions were confirmed using colonoscopy and histopathology as a reference standard. The results from SAEC reading were compared with those of prospective V3D and 2D readings. Overall detection sensitivity with SAEC was 52% (36/69), which was statistically higher than that of 32% (22/69) and 29% (20/69) with V3D and 2D readings, respectively (p<0.05). The sensitivities in detecting not-on-fold flat lesions were 63% (24/38), 45% (17/38), and 42% (16/38) with SAEC, V3D, and 2D readings, respectively; whereas those of on-fold flat lesions were 39% (12/31), 16% (5/31), and 13% (4/31), respectively. None of the eight flat lesions (2-9mm) at cecum was detected by any of the three reading methods. Excluding the flat lesions at cecum, the sensitivity with SAEC for detecting flat lesion ≥4mm increased to 84% (31/37). The fecal-tagging CTC with structure-analysis electronic cleansing could yield a high sensitivity for detecting flat lesions ≥4mm. The not-on-fold flat lesions were detected with higher sensitivity than on-fold flat lesions.