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Sample records for ct colonography ctc

  1. CT- and MR colonography

    DEFF Research Database (Denmark)

    Achiam, Michael Patrick; Bülow, Steffen; Rosenberg, J

    2002-01-01

    . Lately, CT- and MR colonography have emerged as non-invasive methods for colon imaging. METHODS: At present, CTC and MRC require bowel preparation. However, preliminary studies have been carried out without colon preparation. After the colon has been filled with air or contrast, the patient is scanned...... colonography. Future developments with the use of "intelligent" computers, better resolution and faster examinations will make CT and/or MR colonography realistic options to replace conventional diagnostic colonoscopy....

  2. Prevalence and distribution of colonic diverticula assessed with CT colonography (CTC)

    Energy Technology Data Exchange (ETDEWEB)

    De Cecco, Carlo Nicola [University of Rome ' ' Sapienza' ' - Polo Pontino, Department of Radiological Sciences, Oncology and Pathology, Latina (Italy); Medical University of South Carolina, Department of Radiology and Radiological Sciences, Charleston, SC (United States); Ciolina, Maria; Rengo, Marco; Bellini, Davide; Muscogiuri, Giuseppe; Iafrate, Franco; Laghi, Andrea [University of Rome ' ' Sapienza' ' - Polo Pontino, Department of Radiological Sciences, Oncology and Pathology, Latina (Italy); Annibale, Bruno [University of Rome ' ' Sapienza' ' - Sant' Andrea Hospital, Department of Digestive and Liver Disease, Rome (Italy); Maruotti, Antonello [University ' ' Roma Tre' ' , Department of Public Institutions, Economy and Society, Rome (Italy); University of Southampton, Southampton Statistical Sciences Research Institute and School of Mathematics, Southampton (United Kingdom); Saba, Luca [Azienda Ospedaliera Universitaria di Cagliari, Department of Radiology, Cagliari (Italy)

    2016-03-15

    This study aimed to evaluate the prevalence of colonic diverticula according to age, gender, distribution, disease extension and symptoms with CT colonography (CTC). The study population included 1091 consecutive patients who underwent CTC. Patients with diverticula were retrospectively stratified according to age, gender, clinical symptoms and colonic segment involvement. Extension of colonic diverticula was evaluated using a three-point quantitative scale. Using this data, a multivariate regression analysis was applied to investigate the existence of any correlation among variables. Colonic diverticula were observed in 561 patients (240 men, mean age 68 ± 12 years). Symptomatic uncomplicated diverticular disease (SUDD) was present in 47.4 % of cases. In 25.6 % of patients ≤40 years, at least one diverticulum in the colon was observed. Prevalence of right-sided diverticula in patients >60 years was 14.2 % in caecum and 18.5 % in ascending colon. No significant difference was found between symptomatic and asymptomatic patients regarding diverticula prevalence and extension. No correlation was present between diverticula extension and symptoms. The incidence of colonic diverticula appears to be greater than expected. Right colon diverticula do not appear to be an uncommon finding, with their prevalence increasing with patient age. SUDD does not seem to be related to diverticula distribution and extension. (orig.)

  3. CT- and MR colonography

    DEFF Research Database (Denmark)

    Achiam, Michael Patrick; Bülow, Steffen; Rosenberg, J

    2002-01-01

    . Lately, CT- and MR colonography have emerged as non-invasive methods for colon imaging. METHODS: At present, CTC and MRC require bowel preparation. However, preliminary studies have been carried out without colon preparation. After the colon has been filled with air or contrast, the patient is scanned....... CONCLUSIONS: With the exponential development in computer processing power, CT- and MR colonography holds the promise for future colon examination with the advantages of non-invasiveness, no need for sedation, and probably no bowel preparation. A major disadvantage, however, is the radiation dose during CT...... colonography. Future developments with the use of "intelligent" computers, better resolution and faster examinations will make CT and/or MR colonography realistic options to replace conventional diagnostic colonoscopy....

  4. Extracolonic findings (ECF) on CT colonography (CTC) in patients presenting with colorectal symptoms

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    Sarit Badiani, Sarit; Karandikar, Sharad [Dept. of General Surgery, Heart of England Foundation Trust, Birmingham (United Kingdom); Tomas-Hernandez, Silvia; Roy-Choudhury; Shuvro [Dept. of Radiology, Heart of England Foundation Trust, Birmingham (United Kingdom)], e-mail: shurvrorc@googlemail.com

    2013-10-15

    Background: Computed tomographic colonography (CTC) is now an established method for imaging the colon and rectum in the screening and symptomatic setting. Additional benefit of CTC is the ability to assess for extracolonic findings especially in patients presenting with colorectal symptoms. Purpose: To determine prevalence of extracolonic findings (ECF) in symptomatic patients undergoing CTC and determine accuracy of CTC for exclusion of significant abdominal disease and extracolonic malignancy (ECM). Material and Methods: A total of 1359 unenhanced prone and postcontrast supine CTC studies were performed between March 2002 and December 2007. ECF were retrospectively classified according to C-RADS criteria into E1 to E4 findings. For ECM, a gold standard of clinical and/or radiological follow-up supplemented with data from the regional cancer registry with a median follow-up of 42 months was created. Sensitivity and negative predictive values for ECM was calculated. Results: Following exclusions, 1177 CTCs were analyzed. Of 1423 extracolonic findings reported, 328/1423 (23%) E3 and 100/1423 (7%) E4 (including six eventual FP studies) findings were identified. Thirty-two ECMs were confirmed following further investigations. Seven further small ECMs were detected during the entire follow-up, of which two were potentially visible in retrospect (false-negative studies). Additional tests were generated from 55/1177 (4.7%) studies. Sensitivity and negative predictive value for ECM was 94.1% (95% CI 78.9 - 98.9%) and 99.8% (95% CI 99.3 - 99.9%), respectively. Conclusion: One in 37 patients were found to have an ECM. Two potentially detectable cancers were missed. Only a small proportion of patients underwent additional work-up.

  5. CT colonography: an update

    Energy Technology Data Exchange (ETDEWEB)

    Aschoff, Andrik J.; Ernst, Andrea S.; Brambs, Hans-Juergen; Juchems, Markus S. [University Hospitals of Ulm, Diagnostic and Interventional Radiology, Ulm (Germany)

    2008-03-15

    Computed tomographic (CT) colonography (CTC) - also known as ''virtual colonoscopy'' - was first described more than a decade ago. As advancements in scanner technology and three-dimensional (3D) postprocessing helped develop this method to mature into a potential option in screening for colorectal cancer, the fundamentals of the examination remained the same. It is a minimally invasive, CT-based procedure that simulates conventional colonoscopy using 2D and 3D computerized reconstructions. The primary aim of CTC is the detection of colorectal polyps and carcinomas. However, studies reveal a wide performance variety in regard to polyp detection, especially for smaller polyps. This article reviews the available literature, discusses established indications as well as open issues and highlights potential future developments of CTC. (orig.)

  6. Errors in CT colonography.

    Science.gov (United States)

    Trilisky, Igor; Ward, Emily; Dachman, Abraham H

    2015-10-01

    CT colonography (CTC) is a colorectal cancer screening modality which is becoming more widely implemented and has shown polyp detection rates comparable to those of optical colonoscopy. CTC has the potential to improve population screening rates due to its minimal invasiveness, no sedation requirement, potential for reduced cathartic examination, faster patient throughput, and cost-effectiveness. Proper implementation of a CTC screening program requires careful attention to numerous factors, including patient preparation prior to the examination, the technical aspects of image acquisition, and post-processing of the acquired data. A CTC workstation with dedicated software is required with integrated CTC-specific display features. Many workstations include computer-aided detection software which is designed to decrease errors of detection by detecting and displaying polyp-candidates to the reader for evaluation. There are several pitfalls which may result in false-negative and false-positive reader interpretation. We present an overview of the potential errors in CTC and a systematic approach to avoid them.

  7. CT Colonography: Pitfalls in Interpretation

    Science.gov (United States)

    Pickhardt, Perry J.; Kim, David H.

    2012-01-01

    Synopsis As with any radiologic imaging test, there are a number of potential interpretive pitfalls at CT colonography (CTC) that need to be recognized and handled appropriately. Perhaps the single most important step in learning to avoid most of these diagnostic traps is simply to be aware of their existence. With a little experience, most of these potential pitfalls will be easily recognized. This review will systematically cover the key pitfalls confronting the radiologist at CTC interpretation, primarily dividing them into those related to technique and those related to underlying anatomy. Tips and pointers for how to effectively handle these potential pitfalls are included. PMID:23182508

  8. CT colonography and cost-effectiveness

    Energy Technology Data Exchange (ETDEWEB)

    Mavranezouli, Ifigeneia [University College London, National Collaborating Centre for Mental Health, Centre for Outcomes Research and Effectiveness, Sub-department of Clinical Health Psychology, London (United Kingdom); East, James E. [St Marks Hospital, Imperial College London, Wolfson Unit for Endoscopy, London (United Kingdom); Taylor, Stuart A. [University College Hospital, Specialist X-Ray, London (United Kingdom); University College Hospital, Department of Imaging, London (United Kingdom)

    2008-11-15

    CT colonography (CTC) is increasingly advocated as an effective initial screening tool for colorectal cancer. Nowadays, policy-makers are increasingly interested in cost-effectiveness issues. A number of studies assessing the cost-effectiveness of CTC have been published to date. The majority of findings indicate that CTC is probably not cost-effective when colonoscopy is available, but this conclusion is sensitive to a number of key parameters. This review discusses the findings of these studies, and considers those factors which most influence final conclusions, notably intervention costs, compliance rates, effectiveness of colonoscopy, and the assumed prevalence and natural history of diminutive advanced polyps. (orig.)

  9. Your Radiologist Explains CT Colonography

    Medline Plus

    Full Text Available ... Image/Video Gallery Your Radiologist Explains CT Colonography (Virtual colonoscopy) Transcript Welcome to Radiology Info dot org! ... colonography or, as it is more commonly known, virtual colonoscopy. Virtual colonoscopy is a diagnostic imaging test ...

  10. Diverticular disease in CT colonography

    Energy Technology Data Exchange (ETDEWEB)

    Lefere, P.; Gryspeerdt, S.; Baekelandt, M.; Holsbeeck, B. van [Dept. of Radiology, Roeselare (Belgium); Dewyspelaere, J. [Dept. of Gastroenterology, Roeselare (Belgium)

    2003-12-01

    The aim of this study was to evaluate findings on CT colonography (CTC) in patients with diverticular disease. In a retrospective analysis of 160 consecutive patients, who underwent CTC and conventional colonoscopy (CC), patients with diverticular disease were retrieved. The CTC images were compared with CC and, if possible, with pathology. Findings on both 2D and 3D images are illustrated with emphasis on diagnostic problems and the possible solutions to overcome these problems. Several aspects of diverticulosis were detected: prediverticulosis (3%); global (55.6%); and focal wall thickening (4%) caused by thickened haustral folds, fibrosis, inflammation and adenocarcinoma; diverticula (52%); pseudopolypoid lesions caused by diverticular fecaliths (39%); inverted diverticula (1.2%); and mucosal prolapse (0.6%). Solutions to overcome pitfalls are described as abdominal windowing, content of the pseudopolypoid lesion, comparison of 2D and 3D images, prone-supine imaging and the aspect of the pericolic fat. In this series there were equivocal findings in case of mucosal prolapse (0.6%) and focal wall thickening (4%). Diverticulosis is a challenge for CTC to avoid false-positive diagnosis of polypoid and tumoral disease. Knowledge of possible false causes of polypoid disease and comparison of 2D and 3D images are necessary to avoid false-positive diagnosis. In case of equivocal findings additional conventional colonoscopy should be advised whenever a clinically significant lesion ({>=}1 cm) is suspected. (orig.)

  11. CT colonography. A guide for clinical practice

    Energy Technology Data Exchange (ETDEWEB)

    Mang, Thomas [Medical Univ. of Vienna (Austria). Dept. of Radiology; Schima, Wolfgang [Krankenhaus Goettlicher Heiland, Wien (Austria). Dept. of Diagnostic and Interventional Radiology; Krankenhaus der Barmherzigen Schwestern, Wien (Austria); Sankt-Josef-Krankenhaus, Wien (Austria)

    2013-07-01

    The book on CT colonography - a guide for clinical practice - covers the following issues: indications and contraindications, examination; Image interpretation; findings at CT colonography, how to generate a useful report, screening, how to train for CT colonography.

  12. Computer Aided Detection of Polyps in CT Colonography

    NARCIS (Netherlands)

    Van Ravesteijn, V.F.

    2013-01-01

    CT colonography (CTC) is a minimally invasive method for detection of colorectal polyps and colon cancer. Limitations of CTC related to the efficiency as well as the sensitivity of radiologists. Additionally, the patient's preparation was considered burdensome and the X-ray radiation that is inheren

  13. CT colonography: methods, pathology and pitfalls

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, S.A.; Halligan, S.; Bartram, C.I

    2003-03-01

    Computed tomography colonography (CTC) is a relatively new technique that is currently challenging more established methods of large bowel imaging. Several workers have suggested CTC surpasses the barium enema and approaches conventional endoscopy for detection of colorectal neoplasia. Accurate diagnosis relies on technically good studies, the main aim of which is adequate bowel cleansing and distension. Furthermore, the learning curve is steep and normal colonic anatomy has to be re-learned in a CT context. This review aims to describe the technique, revise the imaging features of both normal and pathological colon, and to highlight potential diagnostic pitfalls and their avoidance.

  14. CT colonography atlas. For the practicing radiologist

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    Neri, Emanuele; Faggioni, Lorenzo; Bartolozzi, Carlo (eds.) [Pisa Univ. (Italy). Dept. of Diagnostic and Interventional Radiology

    2013-11-01

    Easy-to-use atlas comprising a collection of representative common and unusual virtual colonoscopy (CTC) cases that are likely to be encountered during clinical practice. Reflects the important recent advances in image acquisition, patient preparation, and image processing. An invaluable tool both for radiologists performing CTC and for clinicians who need to review the CTC examinations of their patients. This easy-to-use atlas comprises a collection of representative common and unusual virtual colonoscopy (CT colonography, CTC) cases that physicians and radiologists may expect to encounter during their clinical practice. The atlas reflects the important recent advances in image acquisition, patient preparation, and image processing and is thus completely up-to-date. Each case is presented with the native CT images, integrated images obtained by 3D image processing, and colonoscopic correlation. Topics covered include normal appearances, anatomical variants, pitfalls, diverticula, lipomas, inflammatory bowel disease, polyps, flat lesions, cancers, and the postsurgical colon. By presenting the main features of anatomy and pathology, this atlas will serve as an invaluable tool both for radiologists performing CTC and for clinicians who need to review the CTC examinations of their patients.

  15. Your Radiologist Explains CT Colonography

    Medline Plus

    Full Text Available ... you today about computed tomography colonography or, as it is more commonly known, virtual colonoscopy. Virtual colonoscopy ... might have some concerns about CT scanning. However, it’s important to consider the likelihood of benefit from ...

  16. Your Radiologist Explains CT Colonography

    Medline Plus

    Full Text Available ... you today about computed tomography colonography or, as it is more commonly known, virtual colonoscopy. Virtual colonoscopy ... might have some concerns about CT scanning. However, it’s important to consider the likelihood of benefit from ...

  17. Role of CT colonography in inflammatory bowel disease

    Energy Technology Data Exchange (ETDEWEB)

    Regge, Daniele [Institute for Cancer Research and Treatment, Candiolo, Turin (Italy)], E-mail: dregge@mauriziano.it; Neri, Emanuele; Turini, Francesca [Diagnostic and Interventional Radiology, University of Pisa (Italy); Chiara, Gabriele [Institute for Cancer Research and Treatment, Candiolo, Turin (Italy)

    2009-03-15

    CT colonography (CTC), or virtual colonoscopy, is a non-invasive imaging method that uses CT data sets combined with specialized imaging software to examine the colon. CTC is not used routinely in patients with inflammatory bowel disease (IBD). However, investigating contemporarily the colon, other abdominal organs and the peritoneum with CTC is at times useful in patients with IBD, especially when other diagnostic tools fail. Furthermore, since symptoms of colorectal cancer sometimes superimpose to those of inflammatory disease, it may happen to image patients with IBD incidentally. If clinical signs are suggestive for inflammatory disease, exam technique should be modified accordingly and distinguishing radiological findings searched for.

  18. Your Radiologist Explains CT Colonography

    Medline Plus

    Full Text Available ... Therapy November 8 is the International Day of Radiology (IDoR) Radiology and You Sponsored by Image/Video Gallery Your ... Explains CT Colonography (Virtual colonoscopy) Transcript Welcome to Radiology Info dot org! Hi, I’m Dr. Elliot ...

  19. Effect of a Tele-Training Program on Radiographers in the Interpretation of CT-Colonography

    DEFF Research Database (Denmark)

    Lauridsen, Carsten Ammitzbøl; Gerke, Oke; Gryspeerdt, Stefaan

    2011-01-01

    Objective: To assess the performance of radiographers in CT Colonography (CTC) after a tele-training programme, supervised by 2 experienced radiologists. Material and methods Five radiographers underwent training in CTC using a tele-training programme mainly based on the interpretation of 75...

  20. Small animal micro-CT colonography.

    Science.gov (United States)

    Durkee, Benjamin Y; Weichert, Jamey P; Halberg, Richard B

    2010-01-01

    Microcomputed tomography colonography (mCTC) is a new method for detecting colonic tumors in living animals and estimating their volume, which allows investigators to determine the spontaneous fate of individually annotated tumors as well as their response to chemotherapeutics. This imaging platform was developed using the Min mouse, but is applicable to any murine model of human colorectal cancer. MicroCT is capable of 20 micron resolution, however, 100 microns is sufficient for this application. Scan quality is primarily dependent on animal preparation with the most critical parameters being proper anesthesia, bowel cleansing, and sufficient insufflation. The detection of colonic tumors is possible by both 2D and 3D rendering of image data. Tumor volume is estimated using a semi-automated five-step process which is based on three algorithms within the Amira software package. The estimates are precise, accurate and reproducible enabling changes in volume as small as 16% to be readily observed. Confirmation of mCTC observations by gross examination and histology is sometimes useful in this otherwise non-invasive protocol. Finally, mCTC is compared to other newly developed small animal imaging platforms including microMRI and microoptical colonoscopy. A major advantage of these platforms is that investigators can be perform longitudinal studies, which often have much greater statistical power than traditional cross-sectional studies; consequently, fewer animals are required for testing.

  1. Improving Polyp Detection Algorithms for CT Colonography: Pareto Front Approach.

    Science.gov (United States)

    Huang, Adam; Li, Jiang; Summers, Ronald M; Petrick, Nicholas; Hara, Amy K

    2010-03-21

    We investigated a Pareto front approach to improving polyp detection algorithms for CT colonography (CTC). A dataset of 56 CTC colon surfaces with 87 proven positive detections of 53 polyps sized 4 to 60 mm was used to evaluate the performance of a one-step and a two-step curvature-based region growing algorithm. The algorithmic performance was statistically evaluated and compared based on the Pareto optimal solutions from 20 experiments by evolutionary algorithms. The false positive rate was lower (pPareto optimization process can effectively help in fine-tuning and redesigning polyp detection algorithms.

  2. Complications of CT colonography: A Review

    Energy Technology Data Exchange (ETDEWEB)

    Pendsé, D.A., E-mail: mail@dougpendse.com [Department of Imaging, University College London Hospitals NHS Foundation Trust, London (United Kingdom); Department of Medical Imaging, University College London, 250 Euston Rd (United Kingdom); Taylor, S.A., E-mail: csytaylor@yahoo.co.uk [Department of Imaging, University College London Hospitals NHS Foundation Trust, London (United Kingdom); Department of Medical Imaging, University College London, 250 Euston Rd (United Kingdom)

    2013-08-15

    Since its inception, one of the main advantages of computed tomography colonography (CTC) over colonoscopy has been its assumed superior safety profile. However CTC is not without complication and adverse events are well described. Although the risks of insufflation, bowel preparation, contrast media and radiation dose are very small, they are not insignificant. This review discusses the potential hazards and complications associated with the technique, and discuss precautions, which may lessen the risk of occurrence.

  3. Patient willingness for repeat screening and preference for CT colonography and optical colonoscopy in ACRIN 6664: the National CT Colonography trial.

    Science.gov (United States)

    Gareen, Ilana F; Siewert, Bettina; Vanness, David J; Herman, Benjamin; Johnson, C D; Gatsonis, Constantine

    2015-01-01

    Current American Cancer Society recommendations for colon cancer screening include optical colonoscopy every 10 years or computed tomography colonography (CTC) every 5 years. Bowel preparation (BP) is currently required for both screening modalities. To compare ACRIN 6664: the National CT Colonography Trial (NCTCT) participant experiences with CTC and optical colonoscopy (OC), procedure preference, and willingness to return for each procedure. Participants from fifteen NCTCT sites, who underwent CTC followed by OC under sedation, were invited to complete questionnaires 2 weeks postexam, asking about procedure preference, physical discomfort, and embarrassment experienced and whether that discomfort and embarrassment was better or worse than expected during BP, CTC, and OC, as well as willingness to return for repeat CTC and OC at different time intervals. A total of 2,310 of 2,600 patients (89%) returned their questionnaires. Of patients reporting a preference, 1,058 (46.6%) preferred CTC, 569 (25.0%) preferred OC, and 626 (27.6%) reported no preference. Participant-reported discomfort worse than expected differed significantly between CTC (32.9%) and OC (5.0%) (Pembarrassment worse than expected with OC were associated with increased intention to adhere with CTC in the future. Conversely, embarrassment experienced during CTC and discomfort worse than expected on CTC were associated with increased intention to adhere with OC in the future. While a larger proportion of participants indicated that they preferred CTC to OC, willingness to undergo repeat CTC compared to OC was limited by unanticipated exam discomfort and embarrassment and CTC's shorter screening interval.

  4. Limited-preparation CT colonography in frail elderly patients: a feasibility study.

    LENUS (Irish Health Repository)

    Keeling, Aoife N

    2010-05-01

    Full colonic preparation can be onerous and may be poorly tolerated in frail elderly patients. The purpose of this study was to prospectively assess the image quality and diagnostic yield of limited-preparation CT colonography (CTC) in elderly patients with suspected colorectal cancer who were deemed medically unfit or unsuitable for colonoscopy.

  5. Bowel preparation in CT colonography: electrolyte and renal function disturbances in the frail and elderly patient.

    LENUS (Irish Health Repository)

    Mc Laughlin, Patrick

    2010-03-01

    Elderly patients are at increased risk of biochemical disturbances secondary to cathartic medications. This study investigates the renal function, electrolyte and clinical disturbances associated with CT colonography (CTC) with sodium picosulphate-magnesium citrate (SPS-MC) in a subgroup of frail, elderly patients.

  6. Current status on performance of CT colonography and clinical indications

    Energy Technology Data Exchange (ETDEWEB)

    Laghi, Andrea, E-mail: andrea.laghi@uniroma1.it [Department of Radiological Sciences, Oncology and Pathology Sapienza – Università di Roma, Polo Pontino, I.C.O.T. Hospital, Via Franco Faggiana 43, 04100 Latina (Italy); Rengo, Marco [Department of Radiological Sciences, Oncology and Pathology Sapienza – Università di Roma, Polo Pontino, I.C.O.T. Hospital, Via Franco Faggiana 43, 04100 Latina (Italy); Graser, Anno [InstitutfürKlinische Radiologie, Klinikumder Ludwig-Maximilians-Universität München, Campus Großhadern, Marchioninistr. 15, 81377 München (Germany); Iafrate, Franco [Department of Radiological Sciences, Oncology and Pathology Sapienza – Università di Roma, Policlinico Umberto I, Viale Regina Elena 324, 00161 Rome (Italy)

    2013-08-15

    CT colonography (CTC) is a robust and reliable imaging test of the colon. Accuracy for the detection of colorectal cancer (CRC) is as high as conventional colonoscopy (CC). Identification of polyp is size dependent, with large lesions (≥10 mm) accurately detected and small lesions (6–9 mm) identified with moderate to good sensitivity. Recent studies show good sensitivity for the identification of nonpolypoid (flat) lesions as well. Current CTC indications include the evaluation of patients who had undergone a previous incomplete CC or those who are unfit for CC (elderly and frail individuals, patients with underlying severe clinical conditions, or with contraindication to sedation). CTC can also be efficiently used in the assessment of diverticular disease (excluding patients with acute diverticulitis, where the exam should be postponed), before laparoscopic surgery for CRC (to have an accurate localization of the lesion), in the evaluation of colonic involvement in the case of deep pelvic endometriosis (replacing barium enema). CTC is also a safe procedure in patients with colostomy. For CRC screening, CTC should be considered an opportunistic screening test (not available for population, or mass screening) to be offered to asymptomatic average-risk individuals, of both genders, starting at age 50. The use in individuals with positive family history should be discussed with the patient first. Absolute contraindication is to propose CTC for surveillance of genetic syndromes and chronic inflammatory bowel diseases (in particular, ulcerative colitis). The use of CTC in the follow-up after surgery for CRC is achieving interesting evidences despite the fact that literature data are still relatively weak in terms of numerosity of the studied populations. In patients who underwent previous polypectomy CTC cannot be recommended as first test because debate is still open. It is desirable that in the future CTC would be the first-line and only diagnostic test for

  7. CT colonography and transient bacteraemia: implications for antibiotic prophylaxis

    Energy Technology Data Exchange (ETDEWEB)

    Ridge, C.A.; Carter, M.R.; Ryan, R.; Hegarty, C.; Malone, D.E. [St Vincent' s University Hospital, Department of Radiology, Dublin 4 (Ireland); Browne, L.P. [Texas Children' s Hospital, Department of Diagnostic Imaging, Houston, TX (United States); Schaffer, K. [St Vincent' s University Hospital, Department of Microbiology, Dublin 4 (Ireland)

    2011-02-15

    To determine the prevalence of transient bacteraemia after CT colonography (CTC). Blood cultures were obtained at 5, 10 and 15 min after CTC from 100 consecutive consenting patients. Blood samples were cultured in both aerobic and anaerobic media and positive blood culture samples were analysed by a microbiologist. Blood culture samples were positive for growth in sixteen patients. All positive blood culture samples were confirmed skin contaminants. There were no cases of significant bacteraemia. The estimated significant bacteraemia rate as a result of CTC is 0-3.7%, based on 95% confidence intervals around extreme results using Wilson's score method. American Heart Association and National Institute for Clinical Excellence guidelines advise that antibiotic prophylaxis before lower gastrointestinal endoscopy is not indicated in patients with at risk cardiac lesions (ARCL) as the risk of a transient bacteraemia leading to infective endocarditis is low. These data show that the prevalence of transient bacteraemia after CTC is also low. It follows that patients with ARCL do not require antibiotic prophylaxis before CTC. (orig.)

  8. CT colonography and transient bacteraemia: implications for antibiotic prophylaxis.

    LENUS (Irish Health Repository)

    Ridge, C A

    2012-02-01

    OBJECTIVES: To determine the prevalence of transient bacteraemia after CT colonography (CTC). METHODS: Blood cultures were obtained at 5, 10 and 15 min after CTC from 100 consecutive consenting patients. Blood samples were cultured in both aerobic and anaerobic media and positive blood culture samples were analysed by a microbiologist. RESULTS: Blood culture samples were positive for growth in sixteen patients. All positive blood culture samples were confirmed skin contaminants. There were no cases of significant bacteraemia. The estimated significant bacteraemia rate as a result of CTC is 0-3.7%, based on 95% confidence intervals around extreme results using Wilson\\'s score method. CONCLUSIONS: American Heart Association and National Institute for Clinical Excellence guidelines advise that antibiotic prophylaxis before lower gastrointestinal endoscopy is not indicated in patients with at risk cardiac lesions (ARCL) as the risk of a transient bacteraemia leading to infective endocarditis is low. These data show that the prevalence of transient bacteraemia after CTC is also low. It follows that patients with ARCL do not require antibiotic prophylaxis before CTC.

  9. Spiral CT colonography in inflammatory bowel disease

    Energy Technology Data Exchange (ETDEWEB)

    Tarjan, Zsolt E-mail: tarjan@radi.sote.hu; Zagoni, Tamas; Gyoerke, Tamas; Mester, Adam; Karlinger, Kinga; Mako, Erno K

    2000-09-01

    Objective: Most of the studies on virtual colonoscopy are dealing with the role of detecting colorectal polyps or neoplasms. We have undertaken this study to evaluate the value of CT colonography in patients with colonic Crohn's disease. Methods and material: Five patients (three males, two females, 23-51 years, mean age 42 years) with known (4) or suspected (1) Crohn's disease of the colon underwent fiberoptic colonoscopy and CT colonography in the same day or during a 1-week period. The images were evaluated with the so called zoomed axial slice movie technique and in some regions intra- and extraluminal surface shaded and volume rendered images were generated on a separate workstation. The results were compared to those of a colonoscopy. Results: The final diagnosis was Crohn's disease in four patients and colitis ulcerosa in one. Total examination was possible by colonoscopy in two cases, and with CT colonography in all five cases. The wall of those segments severely affected by the disease were depicted by the axial CT scans to be thickened. The thick walled, segments with narrow lumen seen on CT colonography corresponded to the regions where colonoscopy was failed to pass. Air filled sinus tracts, thickening of the wall of the terminal ileum, loss of haustration pseudopolyps and deep ulcers were seen in CT colonography. Three dimensional (3D) endoluminal views demonstrated pseudopolyps similar to endoscopic images None of the colonoscopically reported shallow ulcerations or aphtoid ulcerations or granular mucosal surface were observed on 2- or 3D CT colonographic images. Conclusion: CT colonography by depicting colonic wall thickening seems to be a useful tool in the diagnosis of Crohn's colitis, which could be a single examination depicting the intraluminal, and transmural extent of the disease.

  10. Patient willingness for repeat screening and preference for CT colonography and optical colonoscopy in ACRIN 6664: the National CT Colonography trial

    Directory of Open Access Journals (Sweden)

    Gareen IF

    2015-07-01

    Full Text Available Ilana F Gareen,1,2 Bettina Siewert,3 David J Vanness,4 Benjamin Herman,2 CD Johnson,5 Constantine Gatsonis2,6 1Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA; 2Center for Statistical Sciences, Brown University School of Public Health, Providence, RI, USA; 3Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, USA; 4Population Health Sciences, University of Wisconsin, Madison, WI, USA; 5Mayo Clinic, Scottsdale, AZ, USA; 6Department of Biostatistics, Brown University School of Public Health, Providence, RI, USA Background: Current American Cancer Society recommendations for colon cancer screening include optical colonoscopy every 10 years or computed tomography colonography (CTC every 5 years. Bowel preparation (BP is currently required for both screening modalities.Purpose: To compare ACRIN 6664: the National CT Colonography Trial (NCTCT participant experiences with CTC and optical colonoscopy (OC, procedure preference, and willingness to return for each procedure.Materials and methods: Participants from fifteen NCTCT sites, who underwent CTC followed by OC under sedation, were invited to complete questionnaires 2 weeks postexam, asking about procedure preference, physical discomfort, and embarrassment experienced and whether that discomfort and embarrassment was better or worse than expected during BP, CTC, and OC, as well as willingness to return for repeat CTC and OC at different time intervals.Results: A total of 2,310 of 2,600 patients (89% returned their questionnaires. Of patients reporting a preference, 1,058 (46.6% preferred CTC, 569 (25.0% preferred OC, and 626 (27.6% reported no preference. Participant-reported discomfort worse than expected differed significantly between CTC (32.9% and OC (5.0% (P<0.001. About 79.3% were willing to be screened again with CTC in 5 years, and 96.6% with OC in 10 years. Discomfort and embarrassment worse than expected with OC were associated

  11. Electronic cleansing for visualization in CT colonography

    NARCIS (Netherlands)

    Serlie, I.W.O.

    2007-01-01

    In this thesis visualization and image processing methods are proposed that solve problems that are critical to the success of CT colonography; a non-invasive method to find the precursors of colon cancer. (1) A new optimal display mode was created and (2) the segmentation of the colon is enhanced.

  12. Burden of waiting for surveillance CT colonography in patients with screen-detected 6-9 mm polyps

    Energy Technology Data Exchange (ETDEWEB)

    Tutein Nolthenius, Charlotte J. [University of Amsterdam, Department of Radiology, Academic Medical Center, PO Box 22700, Amsterdam (Netherlands); Onze Lieve Vrouwe Gasthuis, Department of Radiology, Amsterdam (Netherlands); Boellaard, Thierry N.; Nio, C.Y.; Bipat, Shandra; Stoker, Jaap [University of Amsterdam, Department of Radiology, Academic Medical Center, PO Box 22700, Amsterdam (Netherlands); Haan, Margriet C. de [Meander Medical Center, Department of Radiology, Amersfoort (Netherlands); Thomeer, Maarten G.J. [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Montauban van Swijndregt, Alexander D. [Onze Lieve Vrouwe Gasthuis, Department of Radiology, Amsterdam (Netherlands); Essink-Bot, Marie-Louise [University of Amsterdam, Public Health, Academic Medical Center, PO Box 22700, Amsterdam (Netherlands); Kuipers, Ernst J. [Erasmus University Medical Center, Gastroenterology and Hepatology, Rotterdam (Netherlands); Erasmus University Medical Center, Internal medicine, Rotterdam (Netherlands); Dekker, Evelien [University of Amsterdam, Gastroenterology and Hepatology, Academic Medical Center, PO Box 22700, Amsterdam (Netherlands)

    2016-11-15

    We assessed the burden of waiting for surveillance CT colonography (CTC) performed in patients having 6-9 mm colorectal polyps on primary screening CTC. Additionally, we compared the burden of primary and surveillance CTC. In an invitational population-based CTC screening trial, 101 persons were diagnosed with <3 polyps 6-9 mm, for which surveillance CTC after 3 years was advised. Validated questionnaires regarding expected and perceived burden (5-point Likert scales) were completed before and after index and surveillance CTC, also including items on burden of waiting for surveillance CTC. McNemar's test was used for comparison after dichotomization. Seventy-eight (77 %) of 101 invitees underwent surveillance CTC, of which 66 (85 %) completed the expected and 62 (79 %) the perceived burden questionnaire. The majority of participants (73 %) reported the experience of waiting for surveillance CTC as 'never' or 'only sometimes' burdensome. There was almost no difference in expected and perceived burden between surveillance and index CTC. Waiting for the results after the procedure was significantly more burdensome for surveillance CTC than for index CTC (23 vs. 8 %; p = 0.012). Waiting for surveillance CTC after primary CTC screening caused little or no burden for surveillance participants. In general, the burden of surveillance and index CTC were comparable. (orig.)

  13. Screening CT Colonography: Multicenter Survey of Patient Experience, Preference, and Potential Impact on Adherence

    Science.gov (United States)

    Pooler, B. Dustin; Baumel, Mark J.; Cash, Brooks D.; Moawad, Fouad J.; Riddle, Mark S.; Patrick, Amy M.; Damiano, Mark; Lee, Matthew H.; Kim, David H.; del Rio, Alejandro Muñoz; Pickhardt, Perry J.

    2013-01-01

    OBJECTIVE Prior research indicates CT colonography (CTC) would be a cost-effective colorectal cancer (CRC) screening test if widespread availability were to increase overall CRC screening adherence rates. The primary aims of this multicenter study were to evaluate patient experience and satisfaction with CTC screening and compare preference against screening colonoscopy. MATERIALS AND METHODS A 12-question survey instrument measuring pretest choice, experience, and satisfaction was given to a consecutive cohort of adults undergoing CTC screening in three disparate screening settings: university academic center, military medical center, and community practice. The study cohort was composed of individuals voluntarily participating in clinical CTC screening programs. RESULTS A total of 1417 patients responded to the survey. The top reasons for choosing CTC for screening included “noninvasiveness” (68.0%), “avoidance of sedation/anesthesia” (63.1%), “ability to drive after the test” (49.2%), “avoidance of optical colonoscopy risks” (46.9%), and “identifying abnormalities outside the colon” (43.3%). Only 7.2% of patients reported pain during the CTC examination and only 2.5% reported greater than moderate discomfort. Of 441 patients who had experienced both CTC and optical colonoscopy, 77.1% preferred CTC and 13.8% preferred optical colonoscopy. Of all patients, 29.6% indicated that they may not have undergone optical colonoscopy screening if CTC were not available. Of all patients, 92.9% labeled their overall experience with CTC as “excellent” or “good,” and 93.0% indicated they would choose CTC for their next screening. CONCLUSION Respondents reported a very high satisfaction level with CTC, and those who had experienced both modalities indicated a preference for CTC over optical colonoscopy. These results suggest that CTC has the potential to increase adherence to CRC screening guidelines if widely available. PMID:22623549

  14. Evaluation of a radiographer tele-training programme in the interpretation of CT Colonography

    DEFF Research Database (Denmark)

    Lauridsen, Carsten Ammitzbøl; Lefere, Philippe

    2012-01-01

    Colorectal cancer is one of the most common, and deadly human cancers. By early identifi cation of suspect lesions, screening has the potential to reduce mortality. Colonos- copy remains the screening gold standard, but “virtual colonoscopy“ or CT-colonography (CTC) has been shown to generate enc...... unacceptable increases in radiologists’ work-load. This paper describes a tele-radiology-based CTC teaching program designed to alleviate radiology work-load and summarizes the results of a practical evaluation of such trai- ning programs....

  15. National survey of CT colonography practice in Ireland

    LENUS (Irish Health Repository)

    Smyth, A.E.

    2016-06-01

    CT Colonography was first introduced to Ireland in 1999. Our aim of this study is to review current CT Colonography practices in the Republic of Ireland. A questionnaire on CT Colonography practice was sent to all non-maternity adult radiology departments in the Republic of Ireland with a CT scanner. The results are interpreted in the context of the recommendations on CT Colonography quality standards as published by the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus statement in the journal of European Radiology in 2013. Thirty centres provide CT Colonography; 21 of which responded (70%). Each centre performs median 90 studies per year; the majority follow accepted patient preparation and image acquisition protocols. Seventy-six percent of the centres repsonded that the majority of patients imaged are symptomatic. Of the 51 consultant radiologists reading CT Colonography, 37 (73%) have attended a CT Colonography course. In 17 (81%) of the centres the studies are single read although 81% of the centres have access to a second radiologist’s opinion. Fourteen (67%) of the centres reported limited access to CT scanner time as the major limiting factor to expanding their service. CT Colonography is widely

  16. Cost analysis of colorectal cancer screening with CT colonography in Italy.

    Science.gov (United States)

    Mantellini, Paola; Lippi, Giuseppe; Sali, Lapo; Grazzini, Grazia; Delsanto, Silvia; Mallardi, Beatrice; Falchini, Massimo; Castiglione, Guido; Carozzi, Francesca Maria; Mascalchi, Mario; Milani, Stefano; Ventura, Leonardo; Zappa, Marco

    2017-07-05

    Unit costs of screening CT colonography (CTC) can be useful for cost-effectiveness analyses and for health care decision-making. We evaluated the unit costs of CTC as a primary screening test for colorectal cancer in the setting of a randomized trial in Italy. Data were collected within the randomized SAVE trial. Subjects were invited to screening CTC by mail and requested to have a pre-examination consultation. CTCs were performed with 64- and 128-slice CT scanners after reduced or full bowel preparation. Activity-based costing was used to determine unit costs per-process, per-participant to screening CTC, and per-subject with advanced neoplasia. Among 5242 subjects invited to undergo screening CTC, 1312 had pre-examination consultation and 1286 ultimately underwent CTC. Among 129 subjects with a positive CTC, 126 underwent assessment colonoscopy and 67 were ultimately diagnosed with advanced neoplasia (i.e., cancer or advanced adenoma). Cost per-participant of the entire screening CTC pathway was €196.80. Average cost per-participant for the screening invitation process was €17.04 and €9.45 for the pre-examination consultation process. Average cost per-participant of the CTC execution and reading process was €146.08 and of the diagnostic assessment colonoscopy process was €24.23. Average cost per-subject with advanced neoplasia was €3777.30. Cost of screening CTC was €196.80 per-participant. Our data suggest that the more relevant cost of screening CTC, amenable of intervention, is related to CTC execution and reading process.

  17. Your Radiologist Explains CT Colonography

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  18. Comparison of the Diagnostic Performance of CT Colonography Interpreted by Radiologists and Radiographers

    DEFF Research Database (Denmark)

    Lauridsen, Carsten Ammitzbøl; Lefere, Philippe

    2013-01-01

    Objective To compare computed tomographic colonography (CTC) performance of 4 trained radiographers with the CTC performance of 2 experienced radiologists. Methods Four radiographers and two radiologists interpreted 87 cases with 40 polyps ≥6 mm. Sensitivity, specificity-, and positive predictive...

  19. Positive predictive value for polyps detected at screening CT colonography

    Energy Technology Data Exchange (ETDEWEB)

    Pickhardt, Perry J.; Wise, Steven M.; Kim, David H. [University of Wisconsin School of Medicine and Public Health, Department of Radiology, Madison, WI (United States)

    2010-07-15

    To determine the positive predictive value (PPV) for polyps detected at CT colonography (CTC). Assessment of 739 colorectal lesions {>=}6 mm detected prospectively at CTC screening in 479 patients was performed. By-polyp PPV was analyzed according to small (6-9 mm) versus large ({>=}10 mm) size; morphology (sessile/pedunculated/flat); diagnostic confidence level (3 = most confident, 1 = least confident); and histology. By-patient PPV was analyzed at various polyp size thresholds. By-polyp PPV for CTC-detected lesions {>=}6 mm, 6-9 mm, and {>=}10 mm was 91.6% (677/739), 90.1% (410/451), and 92.7% (267/288), respectively (p = 0.4). By-polyp PPV according to sessile, pedunculated, flat, and mass-like morphology was 92.5% (441/477), 96.5% (139/144), 77.7% (73/94), and 97.6% (40/41), respectively (p < 0.0001 for flat versus polypoid morphology). By-polyp PPV according to diagnostic confidence level was 94.7% (554/585) for highest (= level 3), 83.5% (106/127) for intermediate (= level 2), and 63.0% (17/27) for lowest (= level 1) confidence (p < 0.0001 for levels-2/3 versus level-1). By-patient PPV at 6-mm, 8-mm, 10-mm, and 30-mm polyp size thresholds was 92.3% (442/479), 93.0% (306/329), 93.1% (228/245), and 97.4% (38/39), respectively. The overall per-polyp and per-patient PPV for lesions {>=}6 mm was 92% for CTC screening. Increased diagnostic confidence and polypoid (non-flat) morphology correlated with a higher PPV, whereas small versus large polyp size had very little effect. (orig.)

  20. Your Radiologist Explains CT Colonography

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  1. Your Radiologist Explains CT Colonography

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  2. Your Radiologist Explains CT Colonography

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  3. Your Radiologist Explains CT Colonography

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  4. Your Radiologist Explains CT Colonography

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    Full Text Available ... exam, your doctor may restrict you to clear fluids and give you instructions on clearing your colon ... CT Angiography Video: Myelography Video: CT of the Heart Video: Radioiodine I-131 Therapy Radiology and You ...

  5. Colorectal cancer screening:The role of CT colonography

    Institute of Scientific and Technical Information of China (English)

    Andrea; Laghi; Franco; Iafrate; Marco; Rengo; Cesare; Hassan

    2010-01-01

    Computed tomography colonography(CTC) in colorectal cancer(CRC) screening has two roles:one present and the other potential.The present role is,without any further discussion,the integration into established screening programs as a replacement for barium enema in the case of incomplete colonoscopy.The potential role is the use of CTC as a first-line screening method together with Fecal Occult Blood Test,sigmoidoscopy and colonoscopy.However,despite the fact that CTC has been officially endorsed for CRC scre...

  6. CT colonography with reduced bowel preparation after incomplete colonoscopy in the elderly

    Energy Technology Data Exchange (ETDEWEB)

    Iafrate, F.; Stagnitti, A. [University of Rome, Department of Radiological Sciences, Rome (Italy); Hassan, C.; Zullo, A. [Hospital-Rome, Gastroenterology and Digestive Endoscopy Unit, Rome (Italy); Spagnuolo, A. [Univeristy of Rome, I.C.O.T, Department of Radiological Sciences, Latina (Italy); Ferrari, R.; Laghi, A.

    2008-07-15

    We prospectively assessed the feasibility and acceptance of computerized tomographic colonography (CTC) without bowel cathartic preparation in elderly patients after incomplete colonoscopy. A total of 136 patients underwent CTC without cathartic preparation. The time delay between conventional colonoscopy and CTC ranged between 3 and 20 days, depending on the clinical situation. Before CTC, fecal tagging was achieved by adding diatrizoate meglumine and diatrizoate sodium to regular meals. CTCs were interpreted using a primary two-dimensional (2D) approach and 3D images for further characterization. Patients were interviewed before and 2 weeks after CTC to assess preparation acceptance. CTC was feasible and technically successful in all the 136 patients. Fecal tagging was judged as excellent in 113 (83%) patients and sufficient in 23 (17%). Average CT image interpretation time was 14.8 min. Six (4.4%) cases of colorectal cancer and nine (6.6%) large polyps were detected, as well as 23 (11.3%) extracolonic findings of high clinical importance. No major side effect occurred, although 25% patients reported minor side effects, especially diarrhea. Overall, 76/98 patients replied that they would be willing to repeat the test if necessary. CTC without cathartic preparation is a technically feasible and safe procedure to complete a colonic study in the elderly, prompting its use in clinical practice. (orig.)

  7. Your Radiologist Explains CT Colonography

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  8. Detection of flat colorectal polyps at screening CT colonography in comparison with conventional polypoid lesions

    Energy Technology Data Exchange (ETDEWEB)

    Sakamoto, Takashi; Urata, Joji [Diagnostic Imaging Center, Saiseikai Kumamoto Hospital, Kumamoto (Japan); Mitsuzaki, Katsuhiko; Matsuda, Katsuhiko; Kawakami, Megumi [Medical Examination Center, Saiseikai Kumamoto Hospital, Kumamoto (Japan); Utsunomiya, Daisuke; Yamamura, Sadahiro; Yamashita, Yasuyuki [Diagnostic Radiology, Faculty of Life Sciences, Kumamoto Univ., Kumamoto (Japan)], e-mail: utsunomi@kumamoto-u.ac.jp

    2012-09-15

    Background: Although the screening of small, flat polyps is clinically important, the role of CT colonography (CTC) screening in their detection has not been thoroughly investigated. Purpose: To evaluate the detection capability and usefulness of CTC in the screening of flat and polypoid lesions by comparing CTC with optic colonoscopy findings as the gold standard. Material and Methods: We evaluated the CTC detection capability for flat colorectal polyps with a flat surface and a height not exceeding 3 mm (n = 42) by comparing to conventional polypoid lesions (n = 418) according to the polyp diameter. Four types of reconstruction images including multiplanar reconstruction, volume rendering, virtual gross pathology, and virtual endoscopic images were used for visual analysis. We compared the abilities of the four reconstructions for polyp visualization. Results: Detection sensitivity for flat polyps was 31.3 %, 44.4 %, and 87.5 % for lesions measuring 2-3 mm, 4-5 mm, and {>=}6 mm, respectively; the corresponding sensitivity for polypoid lesions was 47.6 %, 79.0 %, and 91.7 %. The overall sensitivity for flat lesions (47.6%) was significantly lower than polypoid lesions (64.1%). Virtual endoscopic imaging showed best visualization among the four reconstructions. Colon cancers were detected in eight patients by optic colonoscopy, and CTC detected colon cancers in all eight patients. Conclusion: CTC using 64-row multidetector CT is useful for colon cancer screening to detect colorectal polyps while the detection of small, flat lesions is still challenging.

  9. Assessment of the efficacy of the education of radiographers who interpret CT-colonography examinations

    DEFF Research Database (Denmark)

    Lauridsen, Carsten Ammitzbøl; Jeppesen, Lau; Westphal, Lena

    2014-01-01

    diagnostic modalities are used for colonic evaluation including rectoscopy, flexible sigmoideoscopy, OC, fecal occult blood test, double contrast barium enema, magnetic resonance colonography and CTC. However, OC is considered to be the gold standard due to a high diagnostic accuracy and the option......) display techniques. The examination was first introduced in 1994 by Vinning,11 and since the introduction there have been further advancements in CTC technology. Multi detector CT now permits image acquisition of thin 1‐ to 2‐mm slices of the entire large intestine, well within breath‐hold imaging times......‐center trial reported excellent sensitivity for large adenomas and cancers.17 A further study by Kim et al., compared the diagnostic yield from parallel OC and CTC screening programs and found similar detection rates of advanced neoplasia in the two groups.18 Some studies have documented wide inter...

  10. Your Radiologist Explains CT Colonography

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    Full Text Available ... Us News Physician Resources Professions Site Index A-Z Spotlight September is National Ovarian Cancer Awareness Month ... asked to wear a gown. After the CT scan you can return to your normal diet and ...

  11. Your Radiologist Explains CT Colonography

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    Full Text Available ... a virtual colonoscopy, there are several things you can do to prepare for the examination. On the ... wear a gown. After the CT scan you can return to your normal diet and go back ...

  12. Your Radiologist Explains CT Colonography

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    Full Text Available ... is National Prostate Cancer Awareness Month Recently posted: Medical Imaging Costs Magnetoencephalography (MEG) Video: Coronary CT Angiography Video: ... commonly known, virtual colonoscopy. Virtual colonoscopy is a diagnostic imaging test that is used to screen the large ...

  13. Your Radiologist Explains CT Colonography

    Medline Plus

    Full Text Available ... is used to screen the large intestine or colon for cancer and growths called polyps. This procedure uses low-dose CT or CAT scanning to produce pictures of the colon and the rectum. During the examination, a small ...

  14. Your Radiologist Explains CT Colonography

    Medline Plus

    Full Text Available ... to your normal diet and go back to work the same day in most cases. Perhaps you might have some concerns about CT scanning. However, it’s important to consider the likelihood of benefit from this exam to your health. While virtual colonoscopy does use radiation, the benefit ...

  15. Does CT colonography have a role for population-based colorectal cancer screening?

    Energy Technology Data Exchange (ETDEWEB)

    Haan, Margriet C. de; Stoker, Jaap [Academic Medical Centre Amsterdam, Department of Radiology, G1-228, PO Box 22700, Amsterdam (Netherlands); Halligan, Steve [University College London, Centre for Medical Imaging, London (United Kingdom)

    2012-07-15

    Colorectal cancer (CRC) is the second most common cancer and second most common cause of cancer-related deaths in Europe. CRC screening has been proven to reduce disease-specific mortality and several European countries employ national screening programmes. These almost exclusively rely on stool tests, with endoscopy used as an adjunct in some countries. Computed tomographic colonography (CTC) is a potential screening test, with an estimated sensitivity of 88 % for advanced neoplasia {>=}10 mm. Recent randomised studies have shown that CTC and colonoscopy have similar yields of advanced neoplasia per screened invitee, indicating that CTC is potentially viable as a primary screening test. However, the evidence is not fully elaborated. It is unclear whether CTC screening is cost-effective and the impact of extracolonic findings, both medical and economic, remains unknown. Furthermore, the effect of CTC screening on CRC-related mortality is unknown, as it is also unknown for colonoscopy. It is plausible that both techniques could lead to decreased mortality, as for sigmoidoscopy and gFOBT. Although radiation exposure is a drawback, this disadvantage may be over-emphasised. In conclusion, the detection characteristics and acceptability of CTC suggest it is a viable screening investigation. Implementation will depend on detection of extracolonic disease and health-economic impact. Key Points circle Meta-analysis of CT colonographic screening showed high sensitivity for advanced neoplasia {>=}10mm. (orig.)

  16. Comparing CT colonography and flexible sigmoidoscopy: a randomised trial within a population-based screening programme.

    Science.gov (United States)

    Regge, Daniele; Iussich, Gabriella; Segnan, Nereo; Correale, Loredana; Hassan, Cesare; Arrigoni, Arrigo; Asnaghi, Roberto; Bestagini, Piero; Bulighin, Gianmarco; Cassinis, Maria Carla; Ederle, Andrea; Ferraris, Andrea; Galatola, Giovanni; Gallo, Teresa; Gandini, Giovanni; Garretti, Licia; Martina, Maria Cristina; Molinar, Daniela; Montemezzi, Stefania; Morra, Lia; Motton, Massimiliano; Occhipinti, Pietro; Pinali, Lucia; Soardi, Gian Alberto; Senore, Carlo

    2017-08-01

    The role of CT colonography (CTC) as a colorectal cancer (CRC) screening test is uncertain. The aim of our trial was to compare participation and detection rate (DR) with sigmoidoscopy (flexible sigmoidoscopy (FS)) and CTC in a screening setting. We conducted two randomised clinical trials (RCTs). (1) Participation RCT: individuals, aged 58 years, living in Turin (Italy), were randomly assigned to be invited to FS or CTC screening; (2) detection RCT: residents in northern Italy, aged 58-60, giving their consent to recruitment, were randomly allocated to CTC or FS. Polyps ≥6 mm at CTC, or 'high-risk' distal lesions at FS, were referred for colonoscopy (TC). Participation rate (proportion of invitees examined); DR of advanced adenomas or CRC (advanced neoplasia (AN)). Participation was 30.4% (298/980) for CTC and 27.4% (267/976) for FS (relative risk (RR) 1.1; 95% CI 0.98 to 1.29). Among men, participation was higher with CTC than with FS (34.1% vs 26.5%, p=0.011). In the detection RCT, 2673 subjects had FS and 2595 had CTC: the AN DR was 4.8% (127/2673, including 9 CRCs) with FS and 5.1% (133/2595, including 10 CRCs) with CTC (RR 1.08; 95% CI 0.85 to 1.37). Distal AN DR was 3.9% (109/2673) with FS and 2.9% (76/2595) with CTC (RR 0.72; 95% CI 0.54 to 0.96); proximal AN DR was 1.2% (34/2595) for FS vs 2.7% (69/2595) for CTC (RR 2.06; 95% CI 1.37 to 3.10). Participation and DR for FS and CTC were comparable. AN DR was twice as high in the proximal colon and lower in the distal colon with CTC than with FS. Men were more likely to participate in CTC screening. NCT01739608; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  17. Haustral loop extraction for CT colonography using geodesics.

    Science.gov (United States)

    Liu, Yongkai; Duan, Chaijie; Liang, Jerome; Hu, Jing; Lu, Hongbing; Luo, Mingyue

    2017-03-01

    The human colon has complex geometric structures because of its haustral folds, which are thin flat protrusions on the colon wall. The haustral loop is the curve (approximately triangular in shape) that encircles the highly convex region of the haustral fold, and is regarded as the natural landmark of the colon, intersecting the longitude of the colon in the middle. Haustral loop extraction can assist in reducing the structural complexity of the colon, and the loops can also serve as anatomic markers for computed tomographic colonography (CTC). Moreover, haustral loop sectioning of the colon can help with the performance of precise prone-supine registration. We propose an accurate approach of extracting haustral loops for CT virtual colonoscopy based on geodesics. First, the longitudinal geodesic (LG) connecting the start and end points is tracked by the geodesic method and the colon is cut along the LG. Second, key points are extracted from the LG, after which paired points that are used for seeking the potential haustral loops are calculated according to the key points. Next, for each paired point, the shortest distance (geodesic line) between the paired points twice is calculated, namely one on the original surface and the other on the cut surface. Then, the two geodesics are combined to form a potential haustral loop. Finally, erroneous and nonstandard potential loops are removed. To evaluate the haustral loop extraction algorithm, we first utilized the algorithm to extract the haustral loops. Then, we let the clinicians determine whether the haustral loops were correct and then identify the missing haustral loops. The extraction algorithm successfully detected 91.87% of all of the haustral loops with a very low false positive rate. We believe that haustral loop extraction may benefit many post-procedures in CTC, such as supine-prone registration, computer-aided diagnosis, and taenia coli extraction.

  18. Automated mass detection in contrast-enhanced CT colonography: an approach based on contrast and volume

    Energy Technology Data Exchange (ETDEWEB)

    Luboldt, W. [University Hospital Essen, Clinic and Policlinic of Angiology, Essen (Germany); Multiorgan Screening Foundation (Germany); Tryon, C. [Philips Medical Systems, Best (Netherlands); Kroll, M.; Vogl, T.J. [University Hospital Frankfurt, Department of Radiology, Frankfurt (Germany); Toussaint, T.L. [Multiorgan Screening Foundation (Germany); Holzer, K. [University Hospital Frankfurt, Department of Visceral and Vascular Surgery, Frankfurt (Germany); Hoepffner, N. [University Hospital Frankfurt, Department of Gastroenterology, Frankfurt (Germany)

    2005-02-01

    The purpose of this feasibility study was to design and test an algorithm for automating mass detection in contrast-enhanced CT colonography (CTC). Five patients with known colorectal masses underwent a pre-surgical contrast-enhanced (120 ml volume 1.6 g iodine/s injection rate, 60 s scan delay) CTC in high spatial resolution (16-slice CT: collimation: 16 x 0.75 mm, tablefeed: 24 mm/0.5 s, reconstruction increment: 0.5 mm). A CT-density- and volume-based algorithm searched for masses in the colonic wall, which was extracted before by segmenting and dilating the colonic air lumen and subtracting the inner air. A radiologist analyzed the detections and causes of false positives. All masses were detected, and false positives were easy to identify. Combining CT density with volume as a cut-off is a promising approach for automating mass detection that should be further refined and also tested in contrast-enhanced MR colonography. (orig.)

  19. Evaluation of dose reduction and image quality in CT colonography: Comparison of low-dose CT with iterative reconstruction and routine-dose CT with filtered back projection

    Energy Technology Data Exchange (ETDEWEB)

    Nagata, Koichi [Kameda Medical Center, Department of Radiology, Kamogawa, Chiba (Japan); Jichi Medical University, Department of Radiology, Tochigi (Japan); National Cancer Center, Cancer Screening Technology Division, Research Center for Cancer Prevention and Screening, Tokyo (Japan); Fujiwara, Masanori; Mogi, Tomohiro; Iida, Nao [Kameda Medical Center Makuhari, Department of Radiology, Chiba (Japan); Kanazawa, Hidenori; Sugimoto, Hideharu [Jichi Medical University, Department of Radiology, Tochigi (Japan); Mitsushima, Toru [Kameda Medical Center Makuhari, Department of Gastroenterology, Chiba (Japan); Lefor, Alan T. [Jichi Medical University, Department of Surgery, Tochigi (Japan)

    2015-01-15

    To prospectively evaluate the radiation dose and image quality comparing low-dose CT colonography (CTC) reconstructed using different levels of iterative reconstruction techniques with routine-dose CTC reconstructed with filtered back projection. Following institutional ethics clearance and informed consent procedures, 210 patients underwent screening CTC using automatic tube current modulation for dual positions. Examinations were performed in the supine position with a routine-dose protocol and in the prone position, randomly applying four different low-dose protocols. Supine images were reconstructed with filtered back projection and prone images with iterative reconstruction. Two blinded observers assessed the image quality of endoluminal images. Image noise was quantitatively assessed by region-of-interest measurements. The mean effective dose in the supine series was 1.88 mSv using routine-dose CTC, compared to 0.92, 0.69, 0.57, and 0.46 mSv at four different low doses in the prone series (p < 0.01). Overall image quality and noise of low-dose CTC with iterative reconstruction were significantly improved compared to routine-dose CTC using filtered back projection. The lowest dose group had image quality comparable to routine-dose images. Low-dose CTC with iterative reconstruction reduces the radiation dose by 48.5 to 75.1 % without image quality degradation compared to routine-dose CTC with filtered back projection. (orig.)

  20. CT colonography as routine method; CT-Kolonographie in der taeglichen Praxis

    Energy Technology Data Exchange (ETDEWEB)

    Boehm, G.; Gschwendtner, M. [Krankenhaus Elisabethinen Linz, Institut fuer Diagnostische und Interventionelle Radiologie, Linz (Austria); Mang, T. [Medizinische Universitaet Wien, Universitaetsklinik fuer Radiodiagnostik, Wien (Austria)

    2012-06-15

    Colorectal cancer is a major public health challenge in Austria and Germany. As the participation in dedicated colonoscopy screening programs is rather low, the question of alternative methods is raised again and computed tomography (CT) colonography seems to be a gentle alternative with a very high patient acceptance. In recent years CT colonography (CTC) has been established besides conventional colonoscopy as a radiological method for the investigation of the entire colon. From axial two-dimensional images three-dimensional images can be generated, allowing a virtual flight through the colon which is why this technique is also known as virtual colonoscopy. The technique of CTC has been improved continuously during recent years. On the one hand the steady decrease in the layer thickness (currently {<=} 1 mm) has improved the resolution of volume data sets and on the other hand there has been significant progress in postprocessing. Numerous studies have recently shown that the significance of CTC in the detection of advanced adenomas is similar to conventional colonoscopy. Meanwhile CT colonography is now a routine investigation method established in both symptomatic and asymptomatic patients (screening). Study data now clearly show that CTC, as an alternative to conventional colonoscopy, is a powerful method for investigation of colorectal cancer. To achieve good results adequate preparation including fecal tagging, standardized technical procedures during the investigation and expertise in both 2D and 3D reading are essential. (orig.) [German] Das kolorektale Karzinom stellt sowohl in Oesterreich wie auch in Deutschland eine grosse gesundheitspolitische Herausforderung dar. Da die Teilnahme seitens der Betroffenen an Koloskopievorsorgeprogrammen eher gering ausfaellt, wird immer wieder die Frage nach alternativen Untersuchungsmethoden aufgeworfen. Hier scheint die CT-Kolonographie eine schonende Alternative darzustellen, welche eine hohe Patientenakzeptanz

  1. CT colonography practice in the UK: a national survey

    Energy Technology Data Exchange (ETDEWEB)

    Burling, D.; Halligan, S. E-mail: s.halligan@imperial.ac.uk; Taylor, S.A.; Usiskin, S.; Bartram, C.I

    2004-01-01

    AIM: To determine the provision of computed tomography (CT) colonography in UK radiology departments. MATERIALS AND METHODS: A questionnaire relating to the availability of CT colonography, barriers to implementation, clinical indications, technique, and practitioners was posted to clinical directors of UK radiology departments. RESULTS: One hundred and thirty-eight departments responded. Fifty (36%) offered CT colonography in day-to-day clinical practice. Of those that did not, 68 of 87 (64%) cited limited scanner capacity as the main barrier. Of the 50 departments offering a service, 39 (78%) offered CT after incomplete colonoscopy, 36 (72%), after failed barium enema, and 37 (74%) as an alternative to barium enema. Of those offering a service, the number of studies performed varied between one per month (38%) to more than one per day (8%). Total experience varied between 20 or fewer studies (28%) to more than 300 (12%). Full bowel preparation was common (92%), as was dual positioning (90%). Colonography was interpreted by radiologists with a subspecialty interest in gastrointestinal imaging in 64% of centres offering a service. CONCLUSION: CT colonography is widely available in the UK, with approximately one-third of responders offering a service. Experience and throughput varies considerably. Limited CT scanner capacity is the major barrier to further dissemination.

  2. Patient experience of CT colonography and colonoscopy after fecal occult blood test in a national screening programme

    Energy Technology Data Exchange (ETDEWEB)

    Plumb, Andrew A.; Taylor, Stuart A.; Halligan, Steve [University College London, Centre for Medical Imaging, Division of Medicine, London (United Kingdom); Ghanouni, Alex; Von Wagner, Christian [University College London, Health Behaviour Research Centre, Department of Epidemiology and Public Health, London (United Kingdom); Rees, Colin J. [Durham University School of Medicine, Pharmacy and Health, Durham (United Kingdom); Hewitson, Paul [University of Oxford, Health Services Research Unit, Nuffield Department of Population Health, Oxford (United Kingdom); Nickerson, Claire; Wright, Suzanne [Fulwood House, NHS Cancer Screening Programmes, Sheffield (United Kingdom)

    2017-03-15

    To investigate patient experience of CT colonography (CTC) and colonoscopy in a national screening programme. Retrospective analysis of patient experience postal questionnaires. We included screenees from a fecal occult blood test (FOBt) based screening programme, where CTC was performed when colonoscopy was incomplete or deemed unsuitable. We analyzed questionnaire responses concerning communication of test risks, test-related discomfort and post-test pain, as well as complications. CTC and colonoscopy responses were compared using multilevel logistic regression. Of 67,114 subjects identified, 52,805 (79 %) responded. Understanding of test risks was lower for CTC (1712/1970 = 86.9 %) than colonoscopy (48783/50975 = 95.7 %, p < 0.0001). Overall, a slightly greater proportion of screenees found CTC unexpectedly uncomfortable (506/1970 = 25.7 %) than colonoscopy (10,705/50,975 = 21.0 %, p < 0.0001). CTC was tolerated well as a completion procedure for failed colonoscopy (unexpected discomfort; CTC = 26.3 %: colonoscopy = 57.0 %, p < 0.001). Post-procedural pain was equally common (CTC: 288/1970,14.6 %, colonoscopy: 7544/50,975,14.8 %; p = 0.55). Adverse event rates were similar in both groups (CTC: 20/2947 = 1.2 %; colonoscopy: 683/64,312 = 1.1 %), but generally less serious with CTC. Even though CTC was reserved for individuals either unsuitable for or unable to complete colonoscopy, we found only small differences in test-related discomfort. CTC was well tolerated as a completion procedure and was extremely safe. CTC can be delivered across a national screening programme with high patient satisfaction. (orig.)

  3. Five year colorectal cancer outcomes in a large negative CT colonography screening cohort

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    Kim, David H.; Pooler, B.D.; Pickhardt, Perry J. [University of Wisconsin School of Medicine and Public Health, Department of Radiology, Madison, WI (United States); Weiss, Jennifer M. [University of Wisconsin School of Medicine and Public Health, Section of Gastroenterology, Department of Internal Medicine, Madison, WI (United States)

    2012-07-15

    To assess the 5-year incidence of clinically presenting colorectal cancers following a negative CT colonography (CTC) screening examination, as few patient outcome data regarding a negative CTC screening result exist. Negative CTC screening patients (n = 1,050) in the University of Wisconsin Health system over a 14-month period were included. An electronic medical record (EMR) review was undertaken, encompassing provider, colonoscopy, imaging and histopathology reports. Incident colorectal cancers and other important GI tumours were recorded. Of the 1,050 cohort (mean [{+-}SD] age 56.9 {+-} 7.4 years), 39 (3.7%) patients were excluded owing to lack of follow-up within our system beyond the initial screening CTC. The remaining 1,011 patients were followed for an average of 4.73 {+-} 1.15 years. One incident colorectal adenocarcinoma represented a crude cancer incidence of 0.2 cancers per 1,000 patient years. EMR revealed 14 additional patients with clinically important GI tumours including: advanced adenomas (n = 11), appendiceal goblet cell carcinoid (n = 1), appendiceal mucinous adenoma (n = 1) and metastatic ileocolonic carcinoid (n = 1). All positive patients including the incident carcinoma are alive at the time of review. Clinically presenting colorectal adenocarcinoma is rare in the 5 years following negative screening CTC, suggesting that current strategies, including non-reporting of diminutive lesions, are appropriate. (orig.)

  4. Bowel preparation in CT colonography: electrolyte and renal function disturbances in the frail and elderly patient

    Energy Technology Data Exchange (ETDEWEB)

    Mc Laughlin, Patrick; Mc Sweeney, Sean; Mc Williams, Sebastian; O' Regan, Kevin; Kelly, Denis; Maher, Michael M. [Cork University Hospital, Department of Radiology, Cork (Ireland); Eustace, Joseph; O' Connor, Michael [Cork University Hospital, Department of Medicine, Cork (Ireland)

    2010-03-15

    Elderly patients are at increased risk of biochemical disturbances secondary to cathartic medications. This study investigates the renal function, electrolyte and clinical disturbances associated with CT colonography (CTC) with sodium picosulphate-magnesium citrate (SPS-MC) in a subgroup of frail, elderly patients. Patients aged over 70 years considered at risk of complication during SPS-MC administration by a physician specialised in care of the elderly were included in this retrospective study. Biochemical parameters pre- and post-CTC and the presence of co-morbidities were recorded. Imaging findings and quality of bowel preparation at CTC were graded by consensus by two radiologists. Of the 72 patients 56% had co-morbidities that caution the use of SPS-MC. No significant changes in serum urea, sodium, potassium or estimated glomerular filtration rate (eGFR) occurred post-CTC (p > 0.10). Serum magnesium increased by 0.11 mmol/L in 14 patients (p = 0.03) without clinical sequelae. Good overall preparation was achieved in 88% of patients, allowing confident identification of signs of colonic neoplasia in 20 patients (27%). A mild increase in serum magnesium but no other significant biochemical disturbance was observed. In our group CTC with SPS-MC was safe and effective; however, we advise an alternate preparation be considered in patients with decreased renal function due to decreased magnesium clearance. (orig.)

  5. Large-scale validation of a computer-aided polyp detection algorithm for CT colonography using cluster computing

    Science.gov (United States)

    Bitter, Ingmar; Brown, John E.; Brickman, Daniel; Summers, Ronald M.

    2004-04-01

    The presented method significantly reduces the time necessary to validate a computed tomographic colonography (CTC) computer aided detection (CAD) algorithm of colonic polyps applied to a large patient database. As the algorithm is being developed on Windows PCs and our target, a Beowulf cluster, is running on Linux PCs, we made the application dual platform compatible using a single source code tree. To maintain, share, and deploy source code, we used CVS (concurrent versions system) software. We built the libraries from their sources for each operating system. Next, we made the CTC CAD algorithm dual-platform compatible and validate that both Windows and Linux produced the same results. Eliminating system dependencies was mostly achieved using the Qt programming library, which encapsulates most of the system dependent functionality in order to present the same interface on either platform. Finally, we wrote scripts to execute the CTC CAD algorithm in parallel. Running hundreds of simultaneous copies of the CTC CAD algorithm on a Beowulf cluster computing network enables execution in less than four hours on our entire collection of over 2400 CT scans, as compared to a month a single PC. As a consequence, our complete patient database can be processed daily, boosting research productivity. Large scale validation of a computer aided polyp detection algorithm for CT colonography using cluster computing significantly improves the round trip time of algorithm improvement and revalidation.

  6. Using CT colonography as a triage technique after a positive faecal occult blood test in colorectal cancer screening

    Science.gov (United States)

    Liedenbaum, M H; van Rijn, A F; de Vries, A H; Dekker, H M; Thomeer, M; van Marrewijk, C J; Hol, L; Dijkgraaf, M G W; Fockens, P; Bossuyt, P M M; Dekker, E; Stoker, J

    2009-01-01

    Objective: The purpose of this study was to evaluate the effectiveness of CT colonography (CTC) as a triage technique in faecal occult blood test (FOBT)-positive screening participants. Methods: Consecutive guaiac (G-FOBT) and immunochemical (I-FOBT) FOBT-positive patients scheduled for colonoscopy underwent CTC with iodine tagging bowel preparation. Each CTC was read independently by two experienced observers. Per patient sensitivity, specificity and positive and negative predictive values (PPV and NPV) were calculated based on double reading with different CTC cut-off lesion sizes using segmental unblinded colonoscopy as the reference standard. The acceptability of the technique to patients was evaluated with questionnaires. Results: 302 FOBT-positive patients were included (54 G-FOBT and 248 I-FOBT). 22 FOBT-positive patients (7%) had a colorectal carcinoma and 211 (70%) had a lesion ⩾6 mm. Participants considered colonoscopy more burdensome than CTC (p<0.05). Using a 6 mm CTC size cut-off, per patient sensitivity for CTC was 91% (95% CI 85% to 91%) and specificity was 69% (95% CI 60% to 89%) for the detection of colonoscopy lesions ⩾6 mm. The PPV of CTC was 87% (95% CI 80% to 93%) and NPV 77% (95% CI 69% to 85%). Using CTC as a triage technique in 100 FOBT-positive patients would mean that colonoscopy could be prevented in 28 patients while missing ⩾10 mm lesions in 2 patients. Conclusion: CTC with limited bowel preparation has reasonable predictive values in an FOBT-positive population and a higher acceptability to patients than colonoscopy. However, due to the high prevalence of clinically relevant lesions in FOBT-positive patients, CTC is unlikely to be an efficient triage technique in a first round FOBT population screening programme. PMID:19625276

  7. CT colonography: effect of experience and training on reader performance

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, Stuart A.; Burling, David; Morley, Simon; Bartram, Clive I. [Department of Intestinal Imaging, St. Mark' s Hospital, Watford Road, Northwick Park, HA1 3UJ, London (United Kingdom); Halligan, Steve [Department of Intestinal Imaging, St. Mark' s Hospital, Watford Road, Northwick Park, HA1 3UJ, London (United Kingdom); Department of Cancer Research UK Colorectal Cancer Unit, St. Mark' s Hospital, Northwick Park, HA1 3UJ, London (United Kingdom); Bassett, Paul [Department of Statistics, St. Mark' s Hospital, Northwick Park, HA1 3UJ, London (United Kingdom); Atkin, Wendy [Department of Cancer Research UK Colorectal Cancer Unit, St. Mark' s Hospital, Northwick Park, HA1 3UJ, London (United Kingdom)

    2004-06-01

    The purpose of this paper was to investigate the effect of radiologist experience and increasing exposure to CT colonography on reader performance. Three radiologists of differing general experience (consultant, research fellow, trainee) independently analysed 100 CT colonographic datasets. Readers had no prior experience of CT colonography and received feedback and training after the first 50 cases from an independent experienced radiologist. Diagnostic performance and reporting times were compared for the first and second 50 datasets and compared with the results of a radiologist experienced in CT colonography. Before training only the consultant reader achieved statistical equivalence with the reference standard for detection of larger polyps. After training, detection rates ranged between 25 and 58% for larger polyps. Only the trainee significantly improved after training (P=0.007), with performance of other readers unchanged or even worse. Reporting times following training were reduced significantly for the consultant and fellow (P<0.001 and P=0.03, respectively), but increased for the trainee (P<0.001). In comparison to the consultant reader, the odds of detection of larger polyps was 0.36 (CI 0.16, 0.82) for the fellow and 0.36 (CI 0.14, 0.91) for the trainee. There is considerable variation in the ability to report CT colonography. Prior experience in gastrointestinal radiology is a distinct advantage. Competence cannot be assumed even after directed training via a database of 50 cases. (orig.)

  8. Business plan to establish a CT colonography service.

    Science.gov (United States)

    Fajardo, Laurie L; Hurley, James P; Brown, Bruce P; Summers, Robert W; McDaniel, R Donald

    2006-03-01

    The authors describe the University of Iowa Department of Radiology's business planning process to initiate a new service in computed tomographic colonography (CTC). Also known as virtual colonoscopy, CTC is a noninvasive technology that offers less risk, and potentially similar sensitivity and specificity, than conventional optical colonoscopy (OC). Although not currently covered by all insurance payers, about a year ago, the Centers for Medicare and Medicaid Services instituted temporary Current Procedural Terminology codes (Category III) for CTC. In locales where the procedure is not covered by insurers, it is likely to be sought by patients willing to pay out of pocket to undergo noninvasive cancer screening as an alternative to OC. Thus, CTC could become the preferred method of colon cancer surveillance by insurance providers in the near future. In developing the business plan, the authors reviewed pertinent scientific and clinical data to evaluate the need for and efficacy of CTC. Local market data were used to estimate patient and procedure volumes and utilization. The authors modeled financial expectations with respect to return on investment on the basis of recently reported models specific to CTC, resource requirements, and the operational impact of the new service on existing hospital and departmental clinical functions. Because there are few local providers of CTC in the authors' region, the business plan also included a publicity campaign and plan to market the new service, stimulate general public interest early, and differentiate the program as a leader in applying this unique new technology to promote cancer screening. Finally, the planning committee acknowledged and accommodated needs specific to the missions of an academic medical center with respect to research and education in designing the new service.

  9. Deep learning for electronic cleansing in dual-energy CT colonography

    Science.gov (United States)

    Tachibana, Rie; Näppi, Janne J.; Hironakaa, Toru; Kim, Se Hyung; Yoshida, Hiroyuki

    2016-03-01

    The purpose of this study was to develop a novel deep-learning-based electronic cleansing (EC) method for dual-energy CT colonography (DE-CTC). In this method, an ensemble of deep convolutional neural networks (DCNNs) is used to classify each voxel of DE-CTC image volumes into one of five multi-material (MUMA) classes: luminal air, soft tissue, tagged fecal material, or a partial-volume boundary between air and tagging or that of soft tissue and tagging. Each DCNN acts as a voxel classifier. At each voxel, a region-of-interest (ROI) centered at the voxel is extracted. After mapping the pixels of the ROI to the input layer of a DCNN, a series of convolutional and max-pooling layers is used to extract features with increasing levels of abstraction. The output layer produces the probabilities at which the input voxel belongs to each of the five MUMA classes. To develop an ensemble of DCNNs, we trained multiple DCNNs based on multi-spectral image volumes derived from the DE-CTC images, including material decomposition images and virtual monochromatic images. The outputs of these DCNNs were then combined by means of a meta-classifier for precise classification of the voxels. Finally, the electronically cleansed CTC images were generated by removing regions that were classified as other than soft tissue, followed by colon surface reconstruction. Preliminary results based on 184,320 images sampled from 30 clinical CTC cases showed a higher accuracy in labeling these classes than that of our previous machine-learning methods, indicating that deep-learning-based multi-spectral EC can accurately remove residual fecal materials from CTC images without generating major EC artifacts.

  10. Use of CT colonography in the English Bowel Cancer Screening Programme

    Science.gov (United States)

    Plumb, Andrew A; Halligan, Steve; Nickerson, Claire; Bassett, Paul; Goddard, Andrew F; Taylor, Stuart A; Patnick, Julietta; Burling, David

    2014-01-01

    Objective To examine use of CT colonography (CTC) in the English Bowel Cancer Screening Programme (BCSP) and investigate detection rates. Design Retrospective analysis of routinely coded BCSP data. Guaiac faecal occult blood test (gFOBt)-positive screenees undergoing CTC from June 2006 to July 2012 as their first-line colonic investigation were included. Abnormalities found at CTC, subsequent polyp, adenoma and cancer detection and positive predictive value (PPV) were calculated. Detection rates were compared with those observed in gFOBt-positive screenees investigated by colonoscopy. Multilevel logistic regression was used to examine factors associated with variable detection. Results 2731 screenees underwent CTC. Colorectal cancer (CRC) or polyps were suspected in 1027 individuals (37.6%; 95% CI 33.8% to 41.4%); 911 of these underwent confirmatory testing. 124 screenees had CRC (4.5%) and 533 had polyps (19.5%), 468 adenomatous (17.1%). Overall detection was 24.1% (95% CI 21.5% to 26.6%) for CRC or polyps and 21.7% (95% CI 19.2% to 24.1%) for CRC or adenoma. Advanced neoplasia was detected in 504 screenees (18.5%; 95% CI 16.1% to 20.8%). PPV for CRC or polyp was 72.1% (95% CI 66.6% to 77.6%). By comparison, 9.0% of 72 817 screenees undergoing colonoscopy had cancer and 50.6% had polyps; advanced neoplasia was detected in 32.7%. CTC detection rates and PPV were higher at centres with experienced radiologists (>1000 examinations) and at high-volume centres (>175 cases/radiologist/annum). Centres using three-dimensional interpretation detected more neoplasia. Conclusions In the BCSP, detection rates after positive gFOBt are lower for CTC than colonoscopy, although populations undergoing the two tests are different. Centres with more experienced radiologists have higher detection and accuracy. Rigorous quality assurance of BCSP radiology is needed. PMID:23955527

  11. CT colonography for synchronous colorectal lesions in patients with colorectal cancer: initial experience

    Energy Technology Data Exchange (ETDEWEB)

    McArthur, D.R.; Karandikar, S.S. [Heart of England NHS Foundation Trust (Teaching), Department of Surgery, Birmingham (United Kingdom); Mehrzad, H.; Patel, R.; Dadds, J.; Pallan, A.; Roy-Choudhury, S. [Heart of England NHS Foundation Trust (Teaching), Department of Radiology, Birmingham (United Kingdom)

    2010-03-15

    To assess accuracy of CT colonography (CTC) in identifying synchronous lesions in patients with colorectal carcinoma. This study included 174 consecutive patients undergoing CTC as part of staging or primary investigation where a colorectal cancer was diagnosed between 2004 and 2007. Prone unenhanced and portal phase enhanced supine series with air or CO{sub 2} distension were acquired using 4- or 16-slice CT (Toshiba) and read by 2D {+-} 3D formats. Synchronous lesions were classified according to American College of Radiology's (ACR) polyp classification. Segmental gold standard was flexible sigmoidoscopy/colonoscopy within 1 year and/or histology of colonic resection supplemented by follow-up. Nine patients without gold standard were excluded. Sensitivity, specificity and accuracy were calculated on a per polyp, per patient and per segment basis and discrepancies analysed. Direct comparable data were available for 764/990 colonic segments from 165 patients. Of 41 (C2-C4) synchronous lesions on ''gold standard'', 33 were correctly identified on virtual colonoscopy (VC), overall per polyp sensitivity was 80.5%, with detection rates of 20/24 C3 (83.3%) and 3/3 C4 (100%) with per patient and per segment specificity of 95.4% and 99.2%, respectively. CTC is an accurate technique to assess for significant synchronous lesions in patients with colorectal cancer and is applicable for total pre-operative colonic visualisation. (orig.)

  12. Deep multi-spectral ensemble learning for electronic cleansing in dual-energy CT colonography

    Science.gov (United States)

    Tachibana, Rie; Näppi, Janne J.; Hironaka, Toru; Kim, Se Hyung; Yoshida, Hiroyuki

    2017-03-01

    We developed a novel electronic cleansing (EC) method for dual-energy CT colonography (DE-CTC) based on an ensemble deep convolution neural network (DCNN) and multi-spectral multi-slice image patches. In the method, an ensemble DCNN is used to classify each voxel of a DE-CTC image volume into five classes: luminal air, soft tissue, tagged fecal materials, and partial-volume boundaries between air and tagging and those between soft tissue and tagging. Each DCNN acts as a voxel classifier, where an input image patch centered at the voxel is generated as input to the DCNNs. An image patch has three channels that are mapped from a region-of-interest containing the image plane of the voxel and the two adjacent image planes. Six different types of spectral input image datasets were derived using two dual-energy CT images, two virtual monochromatic images, and two material images. An ensemble DCNN was constructed by use of a meta-classifier that combines the output of multiple DCNNs, each of which was trained with a different type of multi-spectral image patches. The electronically cleansed CTC images were calculated by removal of regions classified as other than soft tissue, followed by a colon surface reconstruction. For pilot evaluation, 359 volumes of interest (VOIs) representing sources of subtraction artifacts observed in current EC schemes were sampled from 30 clinical CTC cases. Preliminary results showed that the ensemble DCNN can yield high accuracy in labeling of the VOIs, indicating that deep learning of multi-spectral EC with multi-slice imaging could accurately remove residual fecal materials from CTC images without generating major EC artifacts.

  13. Diagnostic Performance of CT Colonography for the Detection of Colorectal Polyps

    Energy Technology Data Exchange (ETDEWEB)

    Yun, Ji Young; Ro, Hee Jeong; Choi, Jung Bin; Chung, Ji Eun; Kim, Yong Jin; Suh, Won Hyuck; Lee, Jong Kyun [Song-Do Hospital, Seoul (Korea, Republic of); Park, Jong Beom [East- West Neo Medical Center, Kyung Hee University, Seoul (Korea, Republic of)

    2007-12-15

    To investigate the diagnostic value of CT colonography for the detection of colorectal polyps. From December 2004 to December 2005, 399 patients underwent CT colonography and follow-up conventional colonoscopy. We excluded cases of advanced colorectal cancer. We retrospectively analyzed the CT colonography findings and follow-up conventional colonoscopy findings of 113 patients who had polyps more than 6 mm in diameter. Radiologists using 3D and 2D computer generated displays interpreted the CT colonography images. The colonoscopists were aware of the CT colonography findings before the procedure. CT colonography detected 132 polyps in 107 of the 113 patients and conventional colonoscopy detected 114 colorectal polyps more than 6 mm in diameter in 87 of the 113 patients. The sensitivity of CT colonography analyzed per polyp was 91% (41/45) for polyps more than 10 mm in diameter and 89% (101/114) for polyps more than 6 mm in diameter. Thirteen polyps were missed by CT colonography and were detected on follow-up conventional colonoscopy. CT colonography is a sensitive diagnostic tool for the detection of colorectal polyps and adequate bowel preparation, optimal bowel distention and clinical experience are needed to reduce the rate of missing appropriate lesions.

  14. Deep learning of contrast-coated serrated polyps for computer-aided detection in CT colonography

    Science.gov (United States)

    Näppi, Janne J.; Pickhardt, Perry; Kim, David H.; Hironaka, Toru; Yoshida, Hiroyuki

    2017-03-01

    Serrated polyps were previously believed to be benign lesions with no cancer potential. However, recent studies have revealed a novel molecular pathway where also serrated polyps can develop into colorectal cancer. CT colonography (CTC) can detect serrated polyps using the radiomic biomarker of contrast coating, but this requires expertise from the reader and current computer-aided detection (CADe) systems have not been designed to detect the contrast coating. The purpose of this study was to develop a novel CADe method that makes use of deep learning to detect serrated polyps based on their contrast-coating biomarker in CTC. In the method, volumetric shape-based features are used to detect polyp sites over soft-tissue and fecal-tagging surfaces of the colon. The detected sites are imaged using multi-angular 2D image patches. A deep convolutional neural network (DCNN) is used to review the image patches for the presence of polyps. The DCNN-based polyp-likelihood estimates are merged into an aggregate likelihood index where highest values indicate the presence of a polyp. For pilot evaluation, the proposed DCNN-CADe method was evaluated with a 10-fold cross-validation scheme using 101 colonoscopy-confirmed cases with 144 biopsy-confirmed serrated polyps from a CTC screening program, where the patients had been prepared for CTC with saline laxative and fecal tagging by barium and iodine-based diatrizoate. The average per-polyp sensitivity for serrated polyps >=6 mm in size was 93+/-7% at 0:8+/-1:8 false positives per patient on average. The detection accuracy was substantially higher that of a conventional CADe system. Our results indicate that serrated polyps can be detected automatically at high accuracy in CTC.

  15. Frequency analysis of gaze points with CT colonography interpretation using eye gaze tracking system

    Science.gov (United States)

    Tsutsumi, Shoko; Tamashiro, Wataru; Sato, Mitsuru; Okajima, Mika; Ogura, Toshihiro; Doi, Kunio

    2017-03-01

    It is important to investigate eye tracking gaze points of experts, in order to assist trainees in understanding of image interpretation process. We investigated gaze points of CT colonography (CTC) interpretation process, and analyzed the difference in gaze points between experts and trainees. In this study, we attempted to understand how trainees can be improved to a level achieved by experts in viewing of CTC. We used an eye gaze point sensing system, Gazefineder (JVCKENWOOD Corporation, Tokyo, Japan), which can detect pupil point and corneal reflection point by the dark pupil eye tracking. This system can provide gaze points images and excel file data. The subjects are radiological technologists who are experienced, and inexperienced in reading CTC. We performed observer studies in reading virtual pathology images and examined observer's image interpretation process using gaze points data. Furthermore, we examined eye tracking frequency analysis by using the Fast Fourier Transform (FFT). We were able to understand the difference in gaze points between experts and trainees by use of the frequency analysis. The result of the trainee had a large amount of both high-frequency components and low-frequency components. In contrast, both components by the expert were relatively low. Regarding the amount of eye movement in every 0.02 second we found that the expert tended to interpret images slowly and calmly. On the other hand, the trainee was moving eyes quickly and also looking for wide areas. We can assess the difference in the gaze points on CTC between experts and trainees by use of the eye gaze point sensing system and based on the frequency analysis. The potential improvements in CTC interpretation for trainees can be evaluated by using gaze points data.

  16. Deep transfer learning of virtual endoluminal views for the detection of polyps in CT colonography

    Science.gov (United States)

    Näppi, Janne J.; Hironaka, Toru; Regge, Daniele; Yoshida, Hiroyuki

    2016-03-01

    Proper training of deep convolutional neural networks (DCNNs) requires large annotated image databases that are currently not available in CT colonography (CTC). In this study, we employed a deep transfer learning (DETALE) scheme to circumvent this problem in automated polyp detection for CTC. In our method, a DCNN that had been pre-trained with millions of non-medical images was adapted to identify polyps using virtual endoluminal images of the polyp candidates prompted by a computer-aided detection (CADe) system. For evaluation, 154 CTC cases with and without fecal tagging were divided randomly into a development set and an external validation set including 107 polyps >=6 mm in size. A CADe system was trained to detect polyp candidates using the development set, and the virtual endoluminal images of the polyp candidates were labeled manually into true-positive and several false-positive (FP) categories for transfer learning of the DCNN. Next, the trained CADe system was used to detect polyp candidates from the external validation set, and the DCNN reviewed their images to determine the final detections. The detection sensitivity of the standalone CADe system was 93% at 6.4 FPs per patient on average, whereas the DCNN reduced the number of FPs to 2.0 per patient without reducing detection sensitivity. Most of the remaining FP detections were caused by untagged stool. In fecal-tagged CTC cases, the detection sensitivity was 94% at only 0.78 FPs per patient on average. These preliminary results indicate that DETALE can yield substantial improvement in the accuracy of automated polyp detection in CTC.

  17. Comparison between CT Colonography and Double-Contrast Barium Enema for Colonic Evaluation in Patients with Renal Insufficiency

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Sun Young; Park, Seong Ho; Lee, Seung Soo; Lee, Ju Hee; Kim, Ah Young; Park, Su Ki; Han, Duck Jong; Ha, Hyun Kwon [Asan Medical Center, Ulsan University College of Medicine, Seoul (Korea, Republic of)

    2012-06-15

    To compare the CT colonography (CTC) and double-contrast barium enema (DCBE) for colonic evaluation in patients with renal insufficiency. Two sequential groups of consecutive patients with renal insufficiency who had a similar risk for colorectal cancer, were examined by DCBE (n = 182; mean {+-} SD in age, 51 {+-} 6.4 years) and CTC (n = 176; 50 {+-} 6.7 years), respectively. CTC was performed after colon cleansing with 250-mL magnesium citrate (n = 87) or 4-L polyethylene glycol (n = 89) and fecal tagging. DCBE was performed after preparation with 250-mL magnesium citrate. Patients with colonic polyps/masses of {>=} 6 mm were subsequently recommended to undergo a colonoscopy. Diagnostic yield and positive predictive value (PPV) for colonic polyps/masses, examination quality, and examination-related serum electrolyte change were retrospectively compared between the two groups. Both the CTC and DCBE were positive for colonic polyps/masses in 28 (16%) of 176 and 11 (6%) of 182 patients, respectively (p = 0.004). Among patients with positive findings, 17 CTC and six DCBE patients subsequently underwent a colonoscopy and yielded a PPV of 88% (15 of 17 patients) and 50% (3 of 6 patients), respectively (p = 0.089). Thirteen patients with adenomatous lesions were detected in the CTC group (adenocarcinoma [n = 1], advanced adenoma [n = 6], and non-advanced adenoma [n = 6]), as compared with two patients (each with adenocarcinoma and advanced adenoma) in the DCBE group (p = 0.003). Six (3%) of 176 CTC and 16 (9%) of 182 DCBE examinations deemed to be inadequate (p 0.046). Electrolyte changes were similar in the two groups. In patients with renal insufficiency, CTC has a higher diagnostic yield and a marginally higher PPV for detecting colorectal neoplasia, despite a similar diagnostic yield for adenocarcinoma, and a lower rate of inadequate examinations as compared with DCBE.

  18. Polyp measurement based on CT colonography and colonoscopy: variability and systematic differences

    Energy Technology Data Exchange (ETDEWEB)

    Vries, Ayso H. de; Bipat, Shandra; Liedenbaum, Marjolein H.; Florie, Jasper; Vos, Frans M.; Stoker, Jaap [University of Amsterdam, Department of Radiology, Academic Medical Centre, Amsterdam (Netherlands); Dekker, Evelien; Fockens, Paul; Mathus-Vliegen, Elizabeth M. [University of Amsterdam, Department of Gastroenterology, Academic Medical Centre, Amsterdam (Netherlands); Kraan, Roel van der; Truyen, Roel [Philips Healthcare, Department of Healthcare Informatics, Best (Netherlands); Reitsma, Johannes B.; Zwinderman, Aeilko H. [University of Amsterdam, Department of Clinical Epidemiology and Biostatistics, Amsterdam Medical Center, Amsterdam (Netherlands)

    2010-06-15

    To assess the variability and systematic differences in polyp measurements on optical colonoscopy and CT colonography. Gastroenterologists measured 51 polyps by visual estimation, forceps comparison and linear probe. CT colonography observers randomly assessed polyp size two-dimensionally (abdominal and intermediate window) and three-dimensionally (manually and semi-automatically). Linear mixed models were used to assess the variability and systematic differences between CT colonography and optical colonoscopy techniques. The variability of forceps and linear probe measurements was comparable and both showed less variability than measurement by visual assessment. Measurements by linear probe were 0.7 mm smaller than measurements by visual assessment or by forceps. The variability of all CT colonography techniques was lower than for measurements by forceps or visual assessment and sometimes lower (only 2D intermediate window and manual 3D) compared with measurements by linear probe. All CT colonography measurements judged polyps to be larger than optical colonoscopy, with differences ranging from 0.7 to 2.3 mm. A linear probe does not reduce the measurement variability of endoscopists compared with the forceps. Measurement differences between observers on CT colonography were usually smaller than at optical colonoscopy. Polyps appeared larger when using various CT colonography techniques than when measured during optical colonoscopy. (orig.)

  19. Indications for and results of CT colonography: from screening to the symptomatic patient; Indikationen und Ergebnisse der CT-Kolonographie: von der Vorsorge bis zum symptomatischen Patienten

    Energy Technology Data Exchange (ETDEWEB)

    Graser, A.; Becker, C.R.; Reiser, M.F. [Klinikum Grosshadern der LMU Muenchen, Institut fuer Klinische Radiologie, Muenchen (Germany); Mang, T. [Medizinische Universitaet Wien, Universitaetsklinik fuer Radiodiagnostik, AKH Wien, Wien (Austria)

    2008-02-15

    CT colonography (CTC) is also referred to as virtual colonoscopy and is being used with increasing frequency in radiological practice. While there are still no generally accepted, clear-cut indications for its use in mass colorectal cancer screening, there is evidence that this investigation is useful in patients in whom colonoscopy has not been successful or who have known stenotic lesions in the colon. Recent results of significant comparative studies of CTC and conventional colonoscopy will have some influence on the future place of CTC in screening for cancer of the bowel; they show the great potential of CT-aided bowel examination. (orig.) [German] Die CT-Kolonographie (CTK), auch als virtuelle Koloskopie bezeichnet, wird zunehmend in der radiologischen Praxis eingesetzt. Waehrend fuer die reine Vorsorgeuntersuchung z. Z. noch keine rechtfertigende Indikation besteht, koennen symptomatische Patienten nach fehlgeschlagener Koloskopie oder zur Beurteilung des Darms proximal einer Stenose mittels CTK untersucht werden. Ergebnisse wichtiger Studien, die die CT-Kolonographie mit der herkoemmlichen Koloskopie vergleichen, beeinflussen die zukuenftige Position der Untersuchungsmethode beim Darmkrebsscreening. Vergleichsstudien mit der Koloskopie zeigen das grosse Potenzial der CT-gestuetzten Darmuntersuchung. (orig.)

  20. Electronic cleansing for CT colonography: does it help CAD software performance in a high-risk population for colorectal cancer?

    Energy Technology Data Exchange (ETDEWEB)

    Wi, Jae Yeon [Seoul National University College of Medicine, Department of Radiology, Jongno-gu, Seoul (Korea); Kim, Se Hyung; Lee, Jae Young; Han, Joon Koo; Choi, Byung Ihn [Seoul National University College of Medicine, Department of Radiology, Jongno-gu, Seoul (Korea); Seoul National University Hospital, Institute of Radiation Medicine, Seoul (Korea); Kim, Sang Gyun [Seoul National University Hospital, Department of Internal Medicine, Seoul (Korea)

    2010-08-15

    To compare the performance of computer-aided detection (CAD) for CT colonography (CTC) with and without electronic cleansing (EC) in a high-risk population tagged with a faecal tagging (FT) protocol. Thirty-two patients underwent CTC followed by same-day colonoscopy. All patients underwent bowel preparation and FT with barium and gastrografin. Each CTC dataset was processed with colon CAD with and without EC. Per-polyp sensitivity was calculated. The average number of false-positive (FP) results and their causes were also analysed and compared. Eighty-six polyps were detected in 29 patients. Per-polyp sensitivities of CAD with EC (93.8% and 100%) were higher than those without EC (84.4% and 87.5%) for polyps {>=}6 mm and {>=}10 mm, respectively. However, the differences were not significant. The average number (6.3) of FPs of CAD with EC was significantly larger than that (3.1) without EC. The distribution of FPs in both CAD settings was also significantly different. The most common cause of FPs was the ileocaecal valve in both datasets. However, untagged faeces was a significantly less common cause of FPs with EC, EC-related artefacts being more common. Electronic cleansing has the potential to improve per-polyp sensitivity of CTC CAD, although the significantly larger number of FPs with EC remains to be improved. (orig.)

  1. CT colonography: optimisation, diagnostic performance and patient acceptability of reduced-laxative regimens using barium-based faecal tagging

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, Stuart A. [University College Hospital, Department of Specialist Radiology, London (United Kingdom); University College Hospital, Department of Imaging, London (United Kingdom); Slater, Andrew [John Radcliffe Hospital, Oxford (United Kingdom); Burling, David N.; Tam, Emily; Gartner, Louise; Scarth, Julia; Bassett, Paul [St Mark' s Hospital, Northwick Park (United Kingdom); Greenhalgh, Rebecca; Pearce, Robert; Halligan, Steve [University College Hospital, Department of Specialist Radiology, London (United Kingdom)

    2008-01-15

    To establish the optimum barium-based reduced-laxative tagging regimen prior to CT colonography (CTC). Ninety-five subjects underwent reduced-laxative (13 g senna/18 g magnesium citrate) CTC prior to same-day colonoscopy and were randomised to one of four tagging regimens using 20 ml 40%w/v barium sulphate: regimen A: four doses, B: three doses, C: three doses plus 220 ml 2.1% barium sulphate, or D: three doses plus 15 ml diatriazoate megluamine. Patient experience was assessed immediately after CTC and 1 week later. Two radiologists graded residual stool (1: none/scattered to 4: >50% circumference) and tagging efficacy for stool (1: untagged to 5: 100% tagged) and fluid (1: untagged, 2: layered, 3: tagged), noting the HU of tagged fluid. Preparation was good (76-94% segments graded 1), although best for regimen D (P = 0.02). Across all regimens, stool tagging quality was high (mean 3.7-4.5) and not significantly different among regimens. The HU of layered tagged fluid was higher for regimens C/D than A/B (P = 0.002). Detection of cancer (n = 2), polyps {>=}6 mm (n = 21), and {<=}5 mm (n = 72) was 100, 81 and 32% respectively, with only four false positives {>=}6 mm. Reduced preparation was tolerated better than full endoscopic preparation by 61%. Reduced-laxative CTC with three doses of 20 ml 40% barium sulphate is as effective as more complex regimens, retaining adequate diagnostic accuracy. (orig.)

  2. Sensitivity and specificity of CT colonography for the detection of colonic neoplasia after positive faecal occult blood testing: systematic review and meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Plumb, Andrew A.; Pendse, Douglas A.; Taylor, Stuart A. [University College London, Centre for Medical Imaging, London (United Kingdom); Halligan, Steve [University College London, Centre for Medical Imaging, London (United Kingdom); University College London, University College Hospital, Centre for Medical Imaging, Podium Level 2, London (United Kingdom); Mallett, Susan [University of Oxford, Department of Primary Care Health Sciences, Oxford (United Kingdom)

    2014-05-15

    CT colonography (CTC) is recommended after positive faecal occult blood testing (FOBt) when colonoscopy is incomplete or infeasible. We aimed to estimate the sensitivity and specificity of CTC for colorectal cancer and adenomatous polyps following positive FOBt via systematic review. The MEDLINE, EMBASE, AMED and Cochrane Library databases were searched for CTC studies reporting sensitivity and specificity for colorectal cancer and adenomatous polyps. Included subjects had tested FOBt-positive by guaiac or immunochemical methods. Per-patient detection rates were summarized via forest plots. Meta-analysis of sensitivity and specificity was conducted using a bivariate random effects model and the average operating point calculated. Of 538 articles considered, 5 met inclusion criteria, describing results from 622 patients. Research study quality was good. CTC had a high per-patient average sensitivity of 88.8 % (95 % CI 83.6 to 92.5 %) for ≥6 mm adenomas or colorectal cancer, with low between-study heterogeneity. Specificity was both more heterogeneous and lower, at an average of 75.4 % (95 % CI 58.6 to 86.8 %). Few studies have investigated CTC in FOBt-positive individuals. CTC is sensitive at a ≥6 mm threshold but specificity is lower and variable. Despite the limited data, these results suggest that CTC may adequately substitute for colonoscopy when the latter is undesirable. (orig.)

  3. Strategies for improved interpretation of computer-aided detections for CT colonography utilizing distributed human intelligence.

    Science.gov (United States)

    McKenna, Matthew T; Wang, Shijun; Nguyen, Tan B; Burns, Joseph E; Petrick, Nicholas; Summers, Ronald M

    2012-08-01

    Computer-aided detection (CAD) systems have been shown to improve the diagnostic performance of CT colonography (CTC) in the detection of premalignant colorectal polyps. Despite the improvement, the overall system is not optimal. CAD annotations on true lesions are incorrectly dismissed, and false positives are misinterpreted as true polyps. Here, we conduct an observer performance study utilizing distributed human intelligence in the form of anonymous knowledge workers (KWs) to investigate human performance in classifying polyp candidates under different presentation strategies. We evaluated 600 polyp candidates from 50 patients, each case having at least one polyp ≥6 mm, from a large database of CTC studies. Each polyp candidate was labeled independently as a true or false polyp by 20 KWs and an expert radiologist. We asked each labeler to determine whether the candidate was a true polyp after looking at a single 3D-rendered image of the candidate and after watching a video fly-around of the candidate. We found that distributed human intelligence improved significantly when presented with the additional information in the video fly-around. We noted that performance degraded with increasing interpretation time and increasing difficulty, but distributed human intelligence performed better than our CAD classifier for "easy" and "moderate" polyp candidates. Further, we observed numerous parallels between the expert radiologist and the KWs. Both showed similar improvement in classification moving from single-image to video interpretation. Additionally, difficulty estimates obtained from the KWs using an expectation maximization algorithm correlated well with the difficulty rating assigned by the expert radiologist. Our results suggest that distributed human intelligence is a powerful tool that will aid in the development of CAD for CTC. Copyright © 2012. Published by Elsevier B.V.

  4. Quantification of distention in CT colonography: development and validation of three computer algorithms.

    Science.gov (United States)

    Hung, Peter W; Paik, David S; Napel, Sandy; Yee, Judy; Jeffrey, R Brooke; Steinauer-Gebauer, Andreas; Min, Juno; Jathavedam, Ashwin; Beaulieu, Christopher F

    2002-02-01

    Three bowel distention-measuring algorithms for use at computed tomographic (CT) colonography were developed, validated in phantoms, and applied to a human CT colonographic data set. The three algorithms are the cross-sectional area method, the moving spheres method, and the segmental volume method. Each algorithm effectively quantified distention, but accuracy varied between methods. Clinical feasibility was demonstrated. Depending on the desired spatial resolution and accuracy, each algorithm can quantitatively depict colonic diameter in CT colonography.

  5. Accuracy of single phase contrast enhanced multidetector CT colonography in the preoperative staging of colo-rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Mainenti, Pier Paolo [IBB CNR, Via Pansini 5, 80131 Naples (Italy) and Department of Biomorphological and Functional Sciences, University of Naples ' Federico II' , Via Pansini 5, 80131 Naples (Italy)]. E-mail: pierpamainenti@hotmail.com; Cirillo, Luigi Carlo [Department of Biomorphological and Functional Sciences, University of Naples ' Federico II' , Via Pansini 5, 80131 Naples (Italy); Hospital ' dei Pellegrini' , ASLNA 1, Via Portamedina 41, 80100 Naples (Italy); Camera, Luigi [Department of Biomorphological and Functional Sciences, University of Naples ' Federico II' , Via Pansini 5, 80131 Naples (Italy); Persico, Francesco [Department of General Surgery, Geriatry and Endoscopy, University of Naples ' Federico II' , Via Pansini 5, 80131 Naples (Italy); Cantalupo, Teresa [Department of Biomorphological and Functional Sciences, University of Naples ' Federico II' , Via Pansini 5, 80131 Naples (Italy); Pace, Leonardo [Department of Biomorphological and Functional Sciences, University of Naples ' Federico II' , Via Pansini 5, 80131 Naples (Italy); Palma, Giovanni Domenico De [Department of General Surgery, Geriatry and Endoscopy, University of Naples ' Federico II' , Via Pansini 5, 80131 Naples (Italy); Persico, Giovanni [Department of General Surgery, Geriatry and Endoscopy, University of Naples ' Federico II' , Via Pansini 5, 80131 Naples (Italy); Salvatore, Marco [Department of Biomorphological and Functional Sciences, University of Naples ' Federico II' , Via Pansini 5, 80131 Naples (Italy)

    2006-12-15

    Aim: The optimal acquisition time for staging colo-rectal carcinoma with a contrast enhanced multidetector CT colonography (CE CTC) has not yet been established. A dual phase with both arterial and portal venous acquisition has been proposed. The purpose of our study is to assess the value of single portal venous phase CE CTC in the preoperative staging of colo-rectal carcinoma. Materials and methods: Fifty two (30 M, 22 F; aged 35-82 years) consecutive patients with a histologically proven diagnosis of colo-rectal adenocarcinoma or a highly suspected colo-rectal cancer on conventional colonoscopy underwent a four-slice CE CTC. The procedure was performed 70 s (portal phase) after the intravenous bolus (3 ml/s) administration of 120 ml iodinated non-ionic contrast agent (370 mg iodine/ml). Scans were performed using the following parameters: 2.5 mm beam collimation, pitch 1.25, 120 kV, 200 mAs, rotation time 0.75 s. Images were reconstructed with an effective thickness of 3.2 mm at intervals of 1.6 mm. Two radiologists independently evaluated the depth of tumour invasion into the colo-rectal wall (T), regional lymph node involvement (N), and extracolonic metastases (M). Disagreement was resolved by means of a consensus decision. The pathological results served as the standard of reference. Assessment was made of sensitivity, specificity and accuracy, as well as positive and negative predictive values were assessed. Results: CE CTC correctly staged the pT of 52/56 (93%) and the N of 40/56 (71%) lesions, as well as properly identifying 13/14 (93%) extracolonic findings. Conclusion: The single portal venous phase CE CTC scanning protocol enables satisfactory preoperative assessment of T, N and M staging in patients with colo-rectal cancer.

  6. Effect of reducing abdominal compression during prone CT colonography on ascending colonic rotation during supine-to-prone positional change

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Jong eon; Park, Seong Ho; Lee, Jong Seok; Kim, Hyun Jin; KIm, Ah Young; Ha, Hyun Kwon [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2016-02-15

    To determine the effect of reduced abdominal compression in prone position on ascending colonic movement during supine-to-prone positional change during CT colonography (CTC). Eighteen consecutive patients who had undergone prone CTC scanning with cushion blocks placed under the chest and hip/thigh to reduce abdominal compression and had confirmed sessile polyps ≥ 6 mm in the well-distended, straight, mid-ascending colon, were included. Radial location along the ascending colonic luminal circumference (°) was measured for 24 polyps and 54 colonic teniae on supine and prone CTC images. The supine-to-prone change ranging between -180° and +180° (- and + for internal and external colonic rotations, respectively), was determined. In addition, possible causes of any ascending colonic rotations were explored. Abdominal compression during prone CTC scanning completely disappeared with the use of cushion blocks in 17 of 18 patients. However, some degrees of ascending colonic rotation were still observed, with the radial location changes of -22° to 61° (median, 13.9°) for the polyps and similar degrees for teniae. Fifty-four percent and 56% of polyps and teniae, respectively, showed changes > 10°. The radial location change of the polyps was significantly associated with the degree of anterior shift of the small bowel and mesentery (r = 0.722, p < 0.001) and the degree of posterior displacement of the ascending colon (r = 0.566, p = 0.004) during supine-to-prone positional change. Ascending colonic rotation upon supine-to-prone positional change during CTC, mostly in the form of external rotation, is not eliminated by removing abdominal compression in prone position.

  7. Uni- and bidirectional wide angle CT colonography: effect on missed areas, surface visualization, viewing time and polyp conspicuity

    Energy Technology Data Exchange (ETDEWEB)

    East, James E.; Saunders, Brian P. [St. Mark' s Hospital, Wolfson Unit for Endoscopy, London (United Kingdom); Boone, Darren; Halligan, Steve; Taylor, Stuart A. [University College Hospital, Department of Specialist Radiology, London (United Kingdom); Burling, David [St. Mark' s Hospital, Department of Intestinal Imaging, London (United Kingdom)

    2008-09-15

    The effect of field of view on mucosal visualisation and reader efficiency during three-dimensional endoluminal CT colonography (CTC) was investigated. Twenty CTC datasets were reviewed at standard 90-degree and ''wide'' 140-degree viewing angles using customised viewing software (V3D colon; Viatronix), which listed number and size of missed mucosal areas (''missed regions tool'') and percentage mucosal visualisation. We compared: (1) unidirectional and bidirectional flythrough using 140- versus 90-degree viewing angles; (2) reader analysis time comparing unidirectional 140-degree flythrough versus bidirectional 90-degree flythrough; (3) paired image snapshots of 12 polyps taken at each field of view were reviewed to assess conspicuity. All patients underwent conventional colonoscopy. Bidirectional 140-degree review reduced the numbers of missed areas by between eight- and 40-fold depending on size category, including those >1,000 mm{sup 2}, compared with standard 90-degree bidirectional flythrough (P<0.001). Combined prone-supine unidirectional 140-degree flythrough and missed area review was 3.8 min faster than 90-degree bidirectional review (9.3 versus 5.5 min, P< 0.0001) for the same surface visualisation. When viewed as pairs, polyps were rated more conspicuous with a 90-degree field of view, P=0.03. Wide-angle (140-degree) CTC can reduce both numbers of missed areas and review times. However, this may be at the expense of polyp conspicuity. (orig.)

  8. The effect of computer-aided detection markers on visual search and reader performance during concurrent reading of CT colonography

    Energy Technology Data Exchange (ETDEWEB)

    Helbren, Emma; Taylor, Stuart A. [University College London, Centre for Medical Imaging, London (United Kingdom); Fanshawe, Thomas R.; Mallett, Susan [University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford (United Kingdom); Phillips, Peter [University of Cumbria, Health and Medical Sciences Group, Lancaster (United Kingdom); Boone, Darren [Colchester Hospital University NHS Foundation Trust and Anglia University, Colchester (United Kingdom); Gale, Alastair [Loughborough University, Applied Vision Research Centre, Loughborough (United Kingdom); Altman, Douglas G. [University of Oxford, Centre for Statistics in Medicine, Oxford (United Kingdom); Manning, David [Lancaster University, Lancaster Medical School, Faculty of Health and Medicine, Lancaster (United Kingdom); Halligan, Steve [University College London, Centre for Medical Imaging, London (United Kingdom); University College Hospital, Gastrointestinal Radiology, University College London, Centre for Medical Imaging, Podium Level 2, London, NW1 2BU (United Kingdom)

    2015-06-01

    We aimed to identify the effect of computer-aided detection (CAD) on visual search and performance in CT Colonography (CTC) of inexperienced and experienced readers. Fifteen endoluminal CTC examinations were recorded, each with one polyp, and two videos were generated, one with and one without a CAD mark. Forty-two readers (17 experienced, 25 inexperienced) interpreted the videos during infrared visual search recording. CAD markers and polyps were treated as regions of interest in data processing. This multi-reader, multi-case study was analysed using multilevel modelling. CAD drew readers' attention to polyps faster, accelerating identification times: median 'time to first pursuit' was 0.48 s (IQR 0.27 to 0.87 s) with CAD, versus 0.58 s (IQR 0.35 to 1.06 s) without. For inexperienced readers, CAD also held visual attention for longer. All visual search metrics used to assess visual gaze behaviour demonstrated statistically significant differences when ''with'' and ''without'' CAD were compared. A significant increase in the number of correct polyp identifications across all readers was seen with CAD (74 % without CAD, 87 % with CAD; p < 0.001). CAD significantly alters visual search and polyp identification in readers viewing three-dimensional endoluminal CTC. For polyp and CAD marker pursuit times, CAD generally exerted a larger effect on inexperienced readers. (orig.)

  9. Current techniques in the performance, interpretation, and reporting of CT colonography.

    Science.gov (United States)

    Poullos, Peter D; Beaulieu, Christopher F

    2010-04-01

    The technical objective of computed tomographic colonography (CTC) is to acquire high-quality computed tomography images of the cleansed, well-distended colon for polyp detection. In this article the authors provide an overview of the technical components of CTC, from preparation of the patient to acquisition of the imaging data and basic methods of interpretation. In each section, the best evidence for current practices and recommendations is reviewed. Each of the technical components must be optimized to achieve high sensitivity in polyp detection.

  10. Comparison of 64-Detector CT Colonography and Conventional Colonoscopy in the Detection of Colorectal Lesions

    Directory of Open Access Journals (Sweden)

    Devir

    2016-01-01

    Full Text Available Background Colon cancer is a leading cause of morbidity and mortality in developed countries. The early detection of colorectal cancer using screening programs is important for managing early-stage colorectal cancers and polyps. Modalities that allow examination of the entire colon are conventional colonoscopy, double contrast barium enema examination and multi-detector computed tomography (MDCT colonography. Objectives To compare CT colonography and conventional colonoscopy results and to evaluate the accuracy of CT colonography for detecting colorectal lesions. Patients and Methods In a prospective study performed at Gastroenterology and Radiology Departments of Medical Faculty of Eskisehir Osmangazi University, CT colonography and colonoscopy results of 31 patients with family history of colorectal carcinoma, personal or family history of colorectal polyps, lower gastrointestinal tract bleeding, change in bowel habits, iron deficiency anemia and abdominal pain were compared. Regardless of the size, CT colonography and conventional colonoscopy findings for all the lesions were cross - tabulated and the sensitivity, specificity, and positive and negative predictive values were calculated. To assess the agreement between CT colonography and conventional colonoscopy examinations, the Kappa coefficient of agreementt was used. Statistical analysis was performed by SPSS ver 15.0. Results Regardless of the size, MDCT colonography showed 83% sensitivity and 95% specificity, with a positive predictive value of 95% and a negative predictive value of 83% for the detection of colorectal polyps and masses. MDCT colonography displayed 92% sensitivity and 95% specificity, with a positive predictive value of 92% and a negative predictive value of 95% for polyps ≥ 10 mm. For polyps between 6mm and 9 mm, MDCT colonography displayed 75% sensitivity and 100% specificity, with a positive predictive value of 100% and a negative predictive value of 90%. For polyps

  11. Insurance Coverage for CT Colonography Screening: Impact on Overall Colorectal Cancer Screening Rates.

    Science.gov (United States)

    Smith, Maureen A; Weiss, Jennifer M; Potvien, Aaron; Schumacher, Jessica R; Gangnon, Ronald E; Kim, David H; Weeth-Feinstein, Lauren A; Pickhardt, Perry J

    2017-09-01

    Purpose To compare overall colorectal cancer (CRC) screening rates for patients who were eligible and due for CRC screening and who were with and without insurance coverage for computed tomographic (CT) colonography for CRC screening. Materials and Methods The institutional review board approved this retrospective cohort study, with a waiver of consent. This study used longitudinal electronic health record data from 2005 through 2010 for patients managed by one of the largest multispecialty physician groups in the United States. It included 33 177 patients under age 65 who were eligible and due for CRC screening and managed by the participating health system. Stratified Cox regression models provided propensity-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the relationship between CT colonography coverage and CRC screening. Results After adjustment, patients who had insurance coverage for CT colonography and were due for CRC screening had a 48% greater likelihood of being screened for CRC by any method compared with those without coverage who were due for CRC screening (HR, 1.48; 95% CI: 1.41, 1.55). Similarly, patients with CT colonography coverage had a greater likelihood of being screened with CT colonography (HR, 8.35; 95% CI: 7.11, 9.82) and with colonoscopy (HR, 1.38; 95% CI: 1.31, 1.45) but not with fecal occult blood test (HR, 1.00; 95% CI: 0.91, 1.10) than those without such insurance coverage. Conclusion Insurance coverage of CT colonography for CRC screening was associated with a greater likelihood of a patient being screened and a greater likelihood of being screened with a test that helps both to detect cancer and prevent cancer from developing (CT colonography or colonoscopy). (©) RSNA, 2017.

  12. USING OF MULTISLICE HELICAL CT COLONOGRAPHY IN PATIENTS WITH MALIGNANT LESIONS OF COLON

    Institute of Scientific and Technical Information of China (English)

    Ming-wei Qin; Wei-dong Pan; Guan-ning Cong; Yun Wang; Yun-qing Zhang; Wen-bin Mou; Zheng-yu Jin

    2005-01-01

    Objective To investigate the techniques and clinical applications of multislice helical computed tomography (CT) colono graphy in colonic lesions. Methods Fifty-nine patients with malignant lesions of colon underwent volume scanning using multislice helical CT. Four types of reconstruction including CT virtual colonoscopy (CTVC), shaded surface display (SSD), Raysum, and mu ltiple planar reconstruction (MPR) were used for image post-processing. The results were compared with those of colonos copy and pathology. Results Multislice helical CT colonography detected 54 colorectal carcinomas, 4 adenomas with focal carcinoma, 1 non-Hodgkin's lymphoma (NHL). The lesions' number, size, location, morphology, stricture of intestinal cavity, infiltration, and metastasis were shown satisfactorily by multislice helical CT colonography. Whole colon could be shown in all patients. CT colonography displayed 4 synchronous colonic tumors, 1 ascending colon carcinoma combined with left renal carcinoma among 54 patients with colonic carcinomas. The accuracy of location of CT colonography was 100%. There were 9 cases that CT showed the tumor location was different from the finding of conventional colonoscopy, while all of the CT location were proven exact by operation. CT colonography also displayed the infiltration of serous layer and fatty tissue in 45 cases; 21 cases matched the pathological results in all the 24 cases of suspicious lymph node metastasis, the sensitivity was 87.5%, the specificity was 90.6%; 9 cases hepatic metastasis, 2 ovarian metastasis, and 1 double adrenal gland metastasis.Conclusions Multislice helical CT colonography is effective in preoperative diagnosis, location, stage, and making treatment plan of colorectal carcinoma. It can display the portion not seen during colonoscopy and may have an adjunctive role.

  13. CT Colonography: Role of a second reader CAD paradigm in the initial training of radiologists

    Energy Technology Data Exchange (ETDEWEB)

    Neri, Emanuele, E-mail: eneri@sirm.org [Diagnostic and Interventional Radiology, University of Pisa (Italy); Faggioni, Lorenzo [Diagnostic and Interventional Radiology, University of Pisa (Italy); Regge, Daniele [Institute for Cancer Research and Treatment, Candiolo (Italy); Vagli, Paola; Turini, Francesca; Cerri, Francesca; Picano, Eugenia; Giusti, Sabina; Bartolozzi, Carlo [Diagnostic and Interventional Radiology, University of Pisa (Italy)

    2011-11-15

    Purpose: To evaluate the influence of CAD for the evaluation of CT colonography (CTC) datasets by inexperienced readers during the attendance of a dedicated hands-on training course. Method and materials: Twenty-seven radiologists inexperienced in CTC (11 with no CTC training at all, 16 having previously reviewed no more than 10 CTC cases overall) attended a hands-on training course based on direct teaching on fifteen workstations (four Advantage Windows 4.4 with Colon VCAR software, GE; six CADCOLON, Im3D; five ColonScreen (Toshiba/Voxar) with ColonCAD{sup TM} API, Medicsight). During the course, readers were instructed to analyze 26 CTC cases including 38 colonic lesions obtained through low-dose MDCT acquisitions, consisting of 12 polyps sized less than 6 mm, 9 polyps sized between 6 and 10 mm, 12 polyps sized between 11 mm and 30 mm, and 5 colonic masses sized >3 cm. CTC images were reviewed by each reader both in 2D and 3D mode, respectively by direct evaluation of native axial images and MPR reconstructions, and virtual endoscopy or dissected views. Each reader had 15 min time for assessing each dataset without CAD, after which results were compared with those provided by CAD software. Global rater sensitivity for each lesion size before and after CAD usage was compared by means of two-tailed Student's t test, while sensitivity of each single reader before and after CAD usage was assessed with the McNemar test. Results: For lesions sized <6 mm, global rater sensitivity was 0.1852 {+-} 0.1656 (mean {+-} SD) before CAD-assisted reading and 0.2345 {+-} 0.1761 after CAD (p = 0.0018). For lesions sized 6-9 mm, sensitivity was 0.2870 {+-} 0.1016 before CAD-assisted reading and 0.3117 {+-} 0.1099 after CAD (p = 0.0027). For lesions sized 10-30 mm, sensitivity was 0.5308 {+-} 0.2120 before CAD-assisted reading and 0.5637 {+-} 0.2133 after CAD (p = 0.0086), while for lesions sized >30 mm, sensitivity before CAD-assisted reading was 0.3556 {+-} 0.3105 and did not

  14. Postprocessing techniques of CT colonography in detection of colorectal carcinoma

    Institute of Scientific and Technical Information of China (English)

    Ming-Yue Luo; Hong Shan; Li-Qing Yao; Kang-Rong Zhou; Wen-Wei Liang

    2004-01-01

    AIM: To evaluate the value of postprocessing techniques of CT colonography, including multiplanar reformation (MPR),virtual colonoscopy (VC), shaded surface display (SSD) and Raysum, in detection of colorectal carcinomas.METHODS: Sixty-four patients with colorectal carcinoma underwent volume scanning with spiral CT. MPR, VC, SSD and Raysum images were obtained by using four kinds of postprocessing techniques in workstation. The results were comparatively analyzed according to circumferential extent,lesion length and pathology pattern of colorectal carcinomas.All diagnoses were proved pathologically and surgically.RESULTS: The accuracy of circumferential extent of colorectal carcinoma determined by MPR, VC, SSD and Raysum was 100.0%, 82.8%, 79.7% and 79.7%,respectively. There was a significant statistical difference between MPR and VC. The consistent rate of lesion length was 89.1%, 76.6%, 95.3% and 100.0%, respectively.There was a statistical difference between VC and SSD.The accuracy of discriminating pathology pattern was 81.3%,92.2%, 71.9% and 71.9%, respectively. There was a statistical difference between VC and SSD. MPR could determine accurately the circumference of colorectal carcinoma, Raysum could determine the length of lesion more precisely than SSD, VC was helpful in discriminating pathology patterns.CONCLUSION: MPR, VC, SSD and Raysum have advantage and disadvantage in detection of colorectal carcinoma, use of these methods in combination can disclose the lesion more accurately.

  15. Effect of listening to music and essential oil inhalation on patients undergoing screening CT colonography: A randomized controlled trial

    Energy Technology Data Exchange (ETDEWEB)

    Nagata, Koichi, E-mail: Nagata7@aol.com [Department of Radiology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602 (Japan); Department of Radiology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498 (Japan); Cancer Screening Technology Division, Research Center for Cancer Prevention and Screening, National Cancer Center, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045 (Japan); Iida, Nao, E-mail: n.iida-xray@kameda.jp [Department of Radiology, Kameda Medical Center Makuhari, 1-3, Nakase, Mihama-ku, Chiba 261-8501 (Japan); Kanazawa, Hidenori, E-mail: r0713hk@jichi.ac.jp [Department of Radiology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498 (Japan); Fujiwara, Masanori, E-mail: m_fujiwara@kameda.jp [Department of Radiology, Kameda Medical Center Makuhari, 1-3, Nakase, Mihama-ku, Chiba 261-8501 (Japan); Mogi, Tomohiro, E-mail: mogi-xray@kameda.jp [Department of Radiology, Kameda Medical Center Makuhari, 1-3, Nakase, Mihama-ku, Chiba 261-8501 (Japan); Mitsushima, Toru, E-mail: mitsushima@kameda.jp [Department of Gastroenterology, Kameda Medical Center Makuhari, 1-3, Nakase, Mihama-ku, Chiba 261-8501 (Japan); Lefor, Alan T., E-mail: alefor@jichi.ac.jp [Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498 (Japan); Sugimoto, Hideharu, E-mail: sugimoto@jichi.ac.jp [Department of Radiology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498 (Japan)

    2014-12-15

    Highlights: • Music does not decrease patients’ perceived pain or acceptance during CTC. • Aromatherapy does not affect patients’ perceived pain or experience during CTC. • Music and aroma had little effect on vital signs during CTC. • More participants who listened to music requested music during the next CTC. • More participants who inhaled aroma requested aroma during the next CTC. - Abstract: Objective: To prospectively evaluate the effect of listening to music and inhaling aroma oil on patients undergoing screening computed tomography colonography. Materials and methods: Two hundred and twenty four participants were randomly allocated to one of the four groups including: (1) combined music and aroma, (2) music alone, (3) aroma alone, and (4) control. The visual analog scale for pain and a questionnaire were used for subjective outcomes. We also used a pre-test–post-test design to compare the differences in blood pressure and heart rate as objective outcomes. Results: There were no statistical differences between the control group and other groups in the visual analog scale or changes in heart rate. Changes in blood pressure were similar. Participants reported good overall experiences. There were no differences in terms of overall satisfaction, pain rating, willingness to repeat the computed tomography colonography procedure in the future, or preference between colonoscopy and computed tomography colonography. More participants using music and/or aroma requested music and/or aroma during the next computed tomography colonography (P < 0.0001). Conclusion: Although audio and olfactory intervention had little effect on perceived pain or discomfort and vital signs, participants who listened to music and inhaled aroma during the computed tomography colonography preferred music and aroma during the next computed tomography colonography.

  16. Vascular map combined with CT colonography for evaluating candidates for laparoscopic colorectal surgery

    Energy Technology Data Exchange (ETDEWEB)

    Flor, Nicola; Ceretti, Andrea Pisani; Maroni, Nirvana; Opocher, Enrico; Cornalba, Gianpaolo [Azienda Ospedaliera San Paolo, Milan (Italy); Campari, Alessandro; Ravelli, Anna; Lombardi, Maria Antonietta [University degli Studi di Milano, Milan (Italy)

    2015-08-15

    Contrast-enhanced computed tomography colonography (CE-CTC) is a useful guide for the laparoscopic surgeon to avoid incorrectly removing the colonic segment and the failure to diagnose of synchronous colonic and extra-colonic lesions. Lymph node dissection and vessel ligation under a laparoscopic approach can be time-consuming and can damage vessels and organs. Moreover, mesenteric vessels have extreme variations in terms of their courses and numbers. We describe the benefit of using an abdominal vascular map created by CE-CTC in laparoscopic colorectal surgery candidates. We describe patients with different diseases (colorectal cancer, diverticular disease, and inflammatory bowel disease) who underwent CE-CTC just prior to laparoscopic surgery.

  17. Vascular Map Combined with CT Colonography for Evaluating Candidates for Laparoscopic Colorectal Surgery

    Science.gov (United States)

    Campari, Alessandro; Ravelli, Anna; Lombardi, Maria Antonietta; Pisani Ceretti, Andrea; Maroni, Nirvana; Opocher, Enrico; Cornalba, Gianpaolo

    2015-01-01

    Contrast-enhanced computed tomography colonography (CE-CTC) is a useful guide for the laparoscopic surgeon to avoid incorrectly removing the colonic segment and the failure to diagnose of synchronous colonic and extra-colonic lesions. Lymph node dissection and vessel ligation under a laparoscopic approach can be time-consuming and can damage vessels and organs. Moreover, mesenteric vessels have extreme variations in terms of their courses and numbers. We describe the benefit of using an abdominal vascular map created by CE-CTC in laparoscopic colorectal surgery candidates. We describe patients with different diseases (colorectal cancer, diverticular disease, and inflammatory bowel disease) who underwent CE-CTC just prior to laparoscopic surgery. PMID:26175581

  18. CT colonography: effect of computer-aided detection of colonic polyps as a second and concurrent reader for general radiologists with moderate experience in CT colonography

    Energy Technology Data Exchange (ETDEWEB)

    Mang, Thomas; Ringel, Helmut; Weber, Michael [Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria); Bogoni, Luca; Anand, Vikram X.; Hermosillo, Gerardo; Raykar, Vikas; Salganicoff, Marcos; Wolf, Matthias [H IM SY US, Siemens Medical Solutions, Malvern, PA (United States); Chandra, Dass [Temple University, Philadelphia, PA (United States); Curtin, Andrew J. [Tristate Imaging Consultants, Abington, PA (United States); Lev-Toaff, Anna S. [University of Pennsylvania, Philadelphia, PA (United States); Noah, Ralph [Diagnostic Imaging Associates, Wilmington, DE (United States); Shaw, Robert [The Chester County Hospital, West Chester, PA (United States); Summerton, Susan [Albert Einstein Medical Center, Philadelphia, PA (United States); Tappouni, Rafel F.R. [Wake Forest University School of Medicine, Winston-Salem, NC (United States); Obuchowski, Nancy A. [Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (United States)

    2014-07-15

    To assess the effectiveness of computer-aided detection (CAD) as a second reader or concurrent reader in helping radiologists who are moderately experienced in computed tomographic colonography (CTC) to detect colorectal polyps. Seventy CTC datasets (34 patients: 66 polyps ≥6 mm; 36 patients: no abnormalities) were retrospectively reviewed by seven radiologists with moderate CTC experience. After primary unassisted evaluation, a CAD second read and, after a time interval of ≥4 weeks, a CAD concurrent read were performed. Areas under the receiver operating characteristic (ROC) curve (AUC), along with per-segment, per-polyp and per-patient sensitivities, and also reading times, were calculated for each reader with and without CAD. Of seven readers, 86 % and 71 % achieved a higher accuracy (segment-level AUC) when using CAD as second and concurrent reader respectively. Average segment-level AUCs with second and concurrent CAD (0.853 and 0.864) were significantly greater (p < 0.0001) than average AUC in the unaided evaluation (0.781). Per-segment, per-polyp, and per-patient sensitivities for polyps ≥6 mm were significantly higher in both CAD reading paradigms compared with unaided evaluation. Second-read CAD reduced readers' average segment and patient specificity by 0.007 and 0.036 (p = 0.005 and 0.011), respectively. CAD significantly improves the sensitivities of radiologists moderately experienced in CTC for polyp detection, both as second reader and concurrent reader. (orig.)

  19. Effect of different reconstruction algorithms on computer-aided diagnosis (CAD) performance in ultra-low dose CT colonography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Sun [Department of Radiology, Seoul National University Hospital (Korea, Republic of); Institute of Radiation Medicine, Seoul National University Hospital (Korea, Republic of); Kim, Se Hyung, E-mail: shkim7071@gmail.com [Department of Radiology, Seoul National University Hospital (Korea, Republic of); Institute of Radiation Medicine, Seoul National University Hospital (Korea, Republic of); Im, Jong Pil; Kim, Sang Gyun [Department of Internal Medicine, Seoul National University Hospital (Korea, Republic of); Shin, Cheong-il; Han, Joon Koo; Choi, Byung Ihn [Department of Radiology, Seoul National University Hospital (Korea, Republic of); Institute of Radiation Medicine, Seoul National University Hospital (Korea, Republic of)

    2015-04-15

    Highlights: •We assessed the effect of reconstruction algorithms on CAD in ultra-low dose CTC. •30 patients underwent ultra-low dose CTC using 120 and 100 kVp with 10 mAs. •CT was reconstructed with FBP, ASiR and Veo and then, we applied a CAD system. •Per-polyp sensitivity of CAD in ULD CT can be improved with the IR algorithms. •Despite of an increase in the number of FPs with IR, it was still acceptable. -- Abstract: Purpose: To assess the effect of different reconstruction algorithms on computer-aided diagnosis (CAD) performance in ultra-low-dose CT colonography (ULD CTC). Materials and methods: IRB approval and informed consents were obtained. Thirty prospectively enrolled patients underwent non-contrast CTC at 120 kVp/10 mAs in supine and 100 kVp/10 mAs in prone positions, followed by same-day colonoscopy. Images were reconstructed with filtered back projection (FBP), 80% adaptive statistical iterative reconstruction (ASIR80), and model-based iterative reconstruction (MBIR). A commercial CAD system was applied and per-polyp sensitivities and numbers of false-positives (FPs) were compared among algorithms. Results: Mean effective radiation dose of CTC was 1.02 mSv. Of 101 polyps detected and removed by colonoscopy, 61 polyps were detected on supine and on prone CTC datasets on consensus unblinded review, resulting in 122 visible polyps (32 polyps <6 mm, 52 6–9.9 mm, and 38 ≥ 10 mm). Per-polyp sensitivity of CAD for all polyps was highest with MBIR (56/122, 45.9%), followed by ASIR80 (54/122, 44.3%) and FBP (43/122, 35.2%), with significant differences between FBP and IR algorithms (P < 0.017). Per-polyp sensitivity for polyps ≥ 10 mm was also higher with MBIR (25/38, 65.8%) and ASIR80 (24/38, 63.2%) than with FBP (20/38, 58.8%), albeit without statistical significance (P > 0.017). Mean number of FPs was significantly different among algorithms (FBP, 1.4; ASIR, 2.1; MBIR, 2.4) (P = 0.011). Conclusion: Although the performance of stand-alone CAD

  20. CT colonography: effect of computer-aided detection of colonic polyps as a second and concurrent reader for general radiologists with moderate experience in CT colonography.

    Science.gov (United States)

    Mang, Thomas; Bogoni, Luca; Anand, Vikram X; Chandra, Dass; Curtin, Andrew J; Lev-Toaff, Anna S; Hermosillo, Gerardo; Noah, Ralph; Raykar, Vikas; Salganicoff, Marcos; Shaw, Robert; Summerton, Susan; Tappouni, Rafel F R; Ringel, Helmut; Weber, Michael; Wolf, Matthias; Obuchowski, Nancy A

    2014-07-01

    To assess the effectiveness of computer-aided detection (CAD) as a second reader or concurrent reader in helping radiologists who are moderately experienced in computed tomographic colonography (CTC) to detect colorectal polyps. Seventy CTC datasets (34 patients: 66 polyps ≥6 mm; 36 patients: no abnormalities) were retrospectively reviewed by seven radiologists with moderate CTC experience. After primary unassisted evaluation, a CAD second read and, after a time interval of ≥4 weeks, a CAD concurrent read were performed. Areas under the receiver operating characteristic (ROC) curve (AUC), along with per-segment, per-polyp and per-patient sensitivities, and also reading times, were calculated for each reader with and without CAD. Of seven readers, 86% and 71% achieved a higher accuracy (segment-level AUC) when using CAD as second and concurrent reader respectively. Average segment-level AUCs with second and concurrent CAD (0.853 and 0.864) were significantly greater (p readers' average segment and patient specificity by 0.007 and 0.036 (p = 0.005 and 0.011), respectively. CAD significantly improves the sensitivities of radiologists moderately experienced in CTC for polyp detection, both as second reader and concurrent reader. • CAD helps radiologists with moderate CTC experience to detect polyps ≥6 mm. • Second and concurrent read CAD increase the radiologist's sensitivity for detecting polyps ≥6 mm. • Second read CAD slightly decreases specificity compared with an unassisted read. • Concurrent read CAD is significantly more time-efficient than second read CAD.

  1. Colonography by CT,MRI and PET/CT combined with conventional colonoscopy in colorectal cancer screening and staging

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Colorectal cancer(CRC)remains a leading cancer killer worldwide.But the disease is both curable and preventable at an early stage.Regular CRC cancer screening has been shown to reduce the risk of dying from CRC.However,the importance of large-scale screening is only now starting to be appreciated.This article reviews a variety of imaging procedures available for detecting ulcerative colitis(UC)and Crohn's disease (CD),polyps and CRC in their early stage and also presents details on various screening options.Detecting,staging and re-staging of patients with CRC also require multimodality,multistep imaging approaches.Staging and re-staging with conventional colonoscopy(CC),computer tomography colonography(CTC),magnetic resonance colonography(MRC)and positron emission tomography/computer tomography colonography(PET/CTC)are of paramount importance in determining the most appropriate therapeutic method and in predicting the risk of tumor recurrence and overall prognosis.The advantages and limitations of these modalities are also discussed.

  2. Non- or full-laxative CT colonography vs. endoscopic tests for colorectal cancer screening: A randomised survey comparing public perceptions and intentions to undergo testing

    Energy Technology Data Exchange (ETDEWEB)

    Ghanouni, Alex; Wardle, Jane; Von Wagner, Christian [University College London, Health Behaviour Research Centre, Department of Epidemiology and Public Health, London (United Kingdom); Halligan, Steve; Plumb, Andrew; Boone, Darren [University College London, Centre for Medical Imaging, London (United Kingdom)

    2014-07-15

    Compare public perceptions and intentions to undergo colorectal cancer screening tests following detailed information regarding CT colonography (CTC; after non-laxative preparation or full-laxative preparation), optical colonoscopy (OC) or flexible sigmoidoscopy (FS). A total of 3,100 invitees approaching screening age (45-54 years) were randomly allocated to receive detailed information on a single test and asked to return a questionnaire. Outcomes included perceptions of preparation and test tolerability, health benefits, sensitivity and specificity, and intention to undergo the test. Six hundred three invitees responded with valid questionnaire data. Non-laxative preparation was rated more positively than enema or full-laxative preparations [effect size (r) = 0.13 to 0.54; p < 0.0005 to 0.036]; both forms of CTC and FS were rated more positively than OC in terms of test experience (r = 0.26 to 0.28; all p-values < 0.0005). Perceptions of health benefits, sensitivity and specificity (p = 0.250 to 0.901), and intention to undergo the test (p = 0.213) did not differ between tests (n = 144-155 for each test). Despite non-laxative CTC being rated more favourably, this study did not find evidence that offering it would lead to substantially higher uptake than full-laxative CTC or other methods. However, this study was limited by a lower than anticipated response rate. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Yonghua, E-mail: howardyonghua@gmail.com [Department of Radiology, Xuhui Central Hospital of Shanghai and China Academy of Sciences Shanghai Medical Center, 966 Huai Hai Central Road, Shanghai 200031 (China); Department of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016 (China); Cai, Wenli; Nappi, Janne; Yoshida, Hiro [Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 25 New Chardon Street 400C, Boston, MA 02114 (United States)

    2012-08-15

    Purpose: 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). Materials and methods: 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. Results: 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 (2-9 mm) 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 {>=}4 mm increased to 84% (31/37). Conclusions: The fecal-tagging CTC with structure-analysis electronic cleansing could yield a high sensitivity for detecting flat lesions {>=}4 mm. The not-on-fold flat lesions were detected with higher sensitivity than on-fold flat lesions.

  4. Patients' & healthcare professionals' values regarding true- & false-positive diagnosis when colorectal cancer screening by CT colonography: discrete choice experiment.

    Directory of Open Access Journals (Sweden)

    Darren Boone

    Full Text Available PURPOSE: To establish the relative weighting given by patients and healthcare professionals to gains in diagnostic sensitivity versus loss of specificity when using CT colonography (CTC for colorectal cancer screening. MATERIALS AND METHODS: Following ethical approval and informed consent, 75 patients and 50 healthcare professionals undertook a discrete choice experiment in which they chose between "standard" CTC and "enhanced" CTC that raised diagnostic sensitivity 10% for either cancer or polyps in exchange for varying levels of specificity. We established the relative increase in false-positive diagnoses participants traded for an increase in true-positive diagnoses. RESULTS: Data from 122 participants were analysed. There were 30 (25% non-traders for the cancer scenario and 20 (16% for the polyp scenario. For cancer, the 10% gain in sensitivity was traded up to a median 45% (IQR 25 to >85 drop in specificity, equating to 2250 (IQR 1250 to >4250 additional false-positives per additional true-positive cancer, at 0.2% prevalence. For polyps, the figure was 15% (IQR 7.5 to 55, equating to 6 (IQR 3 to 22 additional false-positives per additional true-positive polyp, at 25% prevalence. Tipping points were significantly higher for patients than professionals for both cancer (85 vs 25, p<0.001 and polyps (55 vs 15, p<0.001. Patients were willing to pay significantly more for increased sensitivity for cancer (p = 0.021. CONCLUSION: When screening for colorectal cancer, patients and professionals believe gains in true-positive diagnoses are worth much more than the negative consequences of a corresponding rise in false-positives. Evaluation of screening tests should account for this.

  5. CT colonography with limited bowel preparation: prospective assessment of patient experience and preference in comparison to optical colonoscopy with cathartic bowel preparation

    NARCIS (Netherlands)

    S. Jensch; S. Bipat; J. Peringa; A.H. de Vries; A. Heutinck; E. Dekker; L.C. Baak; A.D. Montauban van Swijndregt; J. Stoker

    2010-01-01

    The purpose of this study was to prospectively compare participant experience and preference of limited preparation computed tomography colonography (CTC) with full-preparation colonoscopy in a consecutive series of patients at increased risk of colorectal cancer. CTC preparation comprised 180 ml di

  6. Phase- and size-adjusted CT cut-off for differentiating neoplastic lesions from normal colon in contrast-enhanced CT colonography

    Energy Technology Data Exchange (ETDEWEB)

    Luboldt, W. [University Hospital Frankfurt, Department of Radiology, Frankfurt (Germany); Multiorgan Screening Foundation, Frankfurt (Germany); University Hospital Essen, Clinic of Angiology, Essen (Germany); Kroll, M.; Wetter, A.; Vogl, T.J. [University Hospital Frankfurt, Department of Radiology, Frankfurt (Germany); Toussaint, T.L. [Multiorgan Screening Foundation, Frankfurt (Germany); Hoepffner, N. [University Hospital Frankfurt, Department of Internal Medicine, Frankfurt (Germany); Holzer, K. [University Hospital Frankfurt, Department of Visceral and Vascular Surgery, Frankfurt (Germany); Kluge, A. [Kerckhoff Heart Center, Department of Radiology, Bad Nauheim (Germany)

    2004-12-01

    A computed tomography (CT) cut-off for differentiating neoplastic lesions (polyps/carcinoma) from normal colon in contrast-enhanced CT colonography (CTC) relating to the contrast phase and lesion size is determined. CT values of 64 colonic lesions (27 polyps <10 mm, 13 polyps {>=}10 mm, 24 carcinomas) were determined by region-of-interest (ROI) measurements in 38 patients who underwent contrast-enhanced CTC. In addition, the height (H) of the colonic lesions was measured in CT. CT values were also measured in the aorta (A), superior mesenteric vein (V) and colonic wall. The contrast phase was defined by xA + (1 - x)V using x as a weighting factor for describing the different contrast phases ranging from the pure arterial phase (x=1) over the intermediate phases (x=0.9-0.1) to the pure venous phase (x=0). The CT values of the lesions were correlated with their height (H), the different phases (xA + (1 - x)V) and the ratio [xA + (1 - x)V]/H. The CT cut-off was linearly adjusted to the imaged contrast phase and height of the lesion by the line y = m[xA + (1 - x)V]/H + y{sub 0}. The slope m was determined by linear regression in the correlation (lesion {proportional_to}[xA + (1 - x)V]//H) and the Y-intercept y{sub 0} by the minimal shift of the line needed to maximize the accuracy of separating the colonic wall from the lesions. The CT value of the lesions correlated best with the intermediate phase: 0.4A+ 0.6V(r=0.8 for polyps {>=}10 mm, r=0.6 for carcinomas, r=0.4 for polyps <10 mm). The accuracy in the differentiation between lesions and normal colonic wall increased with the height implemented as divisor, reached 91% and was obtained by the dynamic cut-off described by the formula: cut-off(A,V,H) = 1.1[0.4A + 0.6V]/H + 69.8. The CT value of colonic polyps or carcinomas can be increased extrinsically by scanning in the phase in which 0.4A + 0.6V reaches its maximum. Differentiating lesions from normal colon based on CT values is possible in contrast-enhanced CTC and

  7. CT colonography versus colonoscopy in the follow-up of patients after diverticulitis - A prospective, comparative study

    Energy Technology Data Exchange (ETDEWEB)

    Hjern, F. [Division of Surgery, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institut, Stockholm (Sweden)]. E-mail: fredrik.hjern@ds.se; Jonas, E. [Division of Surgery, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institut, Stockholm (Sweden); Holmstroem, B. [Division of Surgery, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institut, Stockholm (Sweden); Josephson, T. [Division of Radiology, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm (Sweden); Mellgren, A. [Division of Surgery, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institut, Stockholm (Sweden); Division of Colon and Rectal Surgery, University of Minnesota, Minneapolis, Minnesota (United States); Johansson, C. [Division of Surgery, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institut, Stockholm (Sweden)

    2007-07-15

    Aim: To assess whether computed tomography colonography (CTC) is a viable alternative to colonoscopy or double contrast barium enema in the follow-up of patients after diverticulitis. Material and methods: Fifty patients underwent CTC followed immediately by colonoscopy. Results were blinded to the examiners. Findings of diverticular disease and patient acceptance were evaluated. Results: Bowel preparation and distension were good in the majority of CTC and colonoscopy examinations. Diverticular disease was found in 96% of patients at CTC and in 90% at colonoscopy. The rate of agreement between CTC and colonoscopy for diverticular findings in the sigmoid colon was good ({kappa} = 0.64). No complications were seen. Patients found colonoscopy more uncomfortable (p < 0.03), more painful (p < 0.001), and more difficult (p < 0.01) than CTC. Of the patients favouring one examination, 74% preferred CTC. Conclusion: CTC appears to have a better diagnostic potential for imaging of diverticular disease-specific findings, when compared with colonoscopy. Also, CTC was less uncomfortable and was preferred by a majority of patients. CTC seems to be a reasonable alternative in follow-up of patients with symptomatic diverticular disease.

  8. High-performance computer aided detection system for polyp detection in CT colonography with fluid and fecal tagging

    Science.gov (United States)

    Liu, Jiamin; Wang, Shijun; Kabadi, Suraj; Summers, Ronald M.

    2009-02-01

    CT colonography (CTC) is a feasible and minimally invasive method for the detection of colorectal polyps and cancer screening. Computer-aided detection (CAD) of polyps has improved consistency and sensitivity of virtual colonoscopy interpretation and reduced interpretation burden. A CAD system typically consists of four stages: (1) image preprocessing including colon segmentation; (2) initial detection generation; (3) feature selection; and (4) detection classification. In our experience, three existing problems limit the performance of our current CAD system. First, highdensity orally administered contrast agents in fecal-tagging CTC have scatter effects on neighboring tissues. The scattering manifests itself as an artificial elevation in the observed CT attenuation values of the neighboring tissues. This pseudo-enhancement phenomenon presents a problem for the application of computer-aided polyp detection, especially when polyps are submerged in the contrast agents. Second, general kernel approach for surface curvature computation in the second stage of our CAD system could yield erroneous results for thin structures such as small (6-9 mm) polyps and for touching structures such as polyps that lie on haustral folds. Those erroneous curvatures will reduce the sensitivity of polyp detection. The third problem is that more than 150 features are selected from each polyp candidate in the third stage of our CAD system. These high dimensional features make it difficult to learn a good decision boundary for detection classification and reduce the accuracy of predictions. Therefore, an improved CAD system for polyp detection in CTC data is proposed by introducing three new techniques. First, a scale-based scatter correction algorithm is applied to reduce pseudo-enhancement effects in the image pre-processing stage. Second, a cubic spline interpolation method is utilized to accurately estimate curvatures for initial detection generation. Third, a new dimensionality

  9. Performance of CT Colonography for Detecting Small Diminutive and Flat Polyps

    Science.gov (United States)

    2010-04-01

    CT colonography with pig colonic specimens. Radiology 2007;244(1):157–64. 47. Pickhardt PJ, Kim DH, Cash BD, et al. The natural history of small...determined by back-to-back colonoscopies. Gastroenterology 1997;112(1):24–8. 61. Lefere PA, Gryspeerdt SS, Dewyspelaere J, et al. Dietary fecal tagging as a

  10. Efficacy of IV Buscopan as a muscle relaxant in CT colonography

    Energy Technology Data Exchange (ETDEWEB)

    Bruzzi, John F.; Brennan, Darren D.; Fenlon, Helen M. [Department of Radiology, Mater Misericordiae Hospital, Eccles Street, Dublin 7 (Ireland); Moss, Alan C.; MacMathuna, Padraic [Department of Gastroenterology, Mater Misericordiae Hospital, Eccles Street, Dublin 7 (Ireland)

    2003-10-01

    The aim of this study was to examine the efficacy of IV Buscopan as a muscle relaxant in CT colonography in terms of colonic distension and polyp detection, and to determine its particular efficacy in patients with diverticular disease. Seventy-three consecutive patients were randomised to receive IV Buscopan or no muscle relaxant prior to CT colonography. CT colonography was performed using a Siemens Somatom 4-detector multislice CT scanner. The following parameters were recorded: degree of colonic distension using a 4-point scale; diagnostic adequacy of colonic distension; presence or absence of diverticular disease; and presence of colonic polyps. Accuracy of polyp detection was assessed using subsequent conventional colonoscopy as a gold standard. There was no significant difference between the two groups in the number of segments that were deemed to be optimally or adequately distended (p=0.37). Although IV Buscopan did improve distension of certain segments, this effect was not sufficient to improve the number of diagnostically adequate studies in the Buscopan group (p=0.14). In patients with diverticular disease, IV Buscopan did not have any significant effect on segments affected by diverticulosis but was associated with an improvement in distension of more proximal segments. There was no significant difference between the two groups in terms of polyp detection (p=0.34). The addition of prone scanning to supine scanning was found to be the most useful technique for maximising colonic distension. Intravenous Buscopan at CT colonography does not improve the overall adequacy of colonic distension nor the accuracy of polyp detection. In patients with sigmoid diverticular disease IV Buscopan improves distension of more proximal colonic segments and may be useful in selected cases, but our results do not support its routine use for CT colonography. (orig.)

  11. CT colonography with rectal iodine tagging: Feasibility and comparison with oral tagging in a colorectal cancer screening population

    Energy Technology Data Exchange (ETDEWEB)

    Neri, Emanuele, E-mail: emanuele.neri@med.unipi.it [Diagnostic and Interventional Radiology – Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa (Italy); Mantarro, Annalisa; Faggioni, Lorenzo; Scalise, Paola; Bemi, Pietro; Pancrazi, Francesca [Diagnostic and Interventional Radiology – Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa (Italy); D’Ippolito, Giuseppe [Federal University of São Paulo – Sena Madureira 1500 – Vila Mariana, UNIFESP, São Paulo, SP (Brazil); Bartolozzi, Carlo [Diagnostic and Interventional Radiology – Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa (Italy)

    2015-09-15

    Highlights: • In the group receiving rectal tagging, mean per-polyp sensitivity, specificity were 96.1% and 95.3%; while in the group receiving oral tagging, mean per-polyp sensitivity, specificity were 89.4% and 95.8%. The difference between the two groups was not statistically significant (p = 0.549). • Rectal tagging can be an effective alternative to oral tagging. • Rectal tagging allowed greater patient acceptance and lower overall examination time. - Abstract: Purpose: To evaluate feasibility, diagnostic performance, patient acceptance, and overall examination time of CT colonography (CTC) performed through rectal administration of iodinated contrast material. Materials and methods: Six-hundred asymptomatic subjects (male:female = 270:330; mean 63 years) undergoing CTC for colorectal cancer screening on an individual basis were consecutively enrolled in the study. Out of them, 503 patients (group 1) underwent CTC with rectal tagging, of which 55 had a total of 77 colonic lesions. The remaining 97 patients (group 2) were randomly selected to receive CTC with oral tagging of which 15 had a total of 20 colonic lesions. CTC findings were compared with optical colonoscopy, and per-segment image quality was visually assessed using a semi-quantitative score (1 = poor, 2 = adequate, 3 = excellent). In 70/600 patients (11.7%), CTC was performed twice with both types of tagging over a 5-year follow-up cancer screening program. In this subgroup, patient acceptance was rated via phone interview two weeks after CTC using a semi-quantitative scale (1 = poor, 2 = fair, 3 = average, 4 = good, 5 = excellent). Results: Mean per-polyp sensitivity, specificity, positive and negative predictive values of CTC with rectal vs oral tagging were 96.1% (CI{sub 95%} 85.4 ÷ 99.3%) vs 89.4% (CI{sub 95%} 65.4 ÷ 98.1%), 95.3% (CI{sub 95%} 90.7 ÷ 97.8%) vs 95.8% (CI{sub 95%} 87.6 ÷ 98.9%), 86.0% (CI{sub 95%} 73.6 ÷ 93.3) vs 85.0% (CI{sub 95%} 61.1 ÷ 96.0%), and 98.8% (CI{sub 95

  12. CT colonography for surveillance of patients with colorectal cancer: Systematic review and meta-analysis of diagnostic efficacy

    Energy Technology Data Exchange (ETDEWEB)

    Porte, Francois; Burling, David [St. Mark' s Hospital, Department of Radiology, Harrow (United Kingdom); Uppara, Mallikarjuna; Malietzis, George; Faiz, Omar [Trials and Outcome Centre (SETOC) St Mark' s Hospital, Surgical Epidemiology, Harrow (United Kingdom); Halligan, Steve [University College London, Department of Radiology, London (United Kingdom); Athanasiou, Thanos [Imperial College London, Department of Surgery and Cancer, London (United Kingdom)

    2017-01-15

    To review primary research evidence investigating performance of CT colonography for colorectal cancer surveillance. The financial impact of using CT colonography for surveillance was also estimated. We identified primary studies of CT colonography for surveillance of colorectal cancer patients. A summary ROC curve was constructed. Inter-study heterogeneity was explored using the I2 value. Financial impact was estimated for a theoretical cohort of patients, based on Cancer Research UK statistics. Seven studies provided data on 880 patients. Five of seven studies (765 patients) were included for qualitative analysis. Sensitivity of CT colonography for detection of anastomotic recurrence was 95 % (95 % CI 62 - 100), specificity 100 % (95 % CI 75 - 100) and sensitivity for metachronous cancers was 100 %. No statistical heterogeneity was detected (I2 = 0 %). We estimated that CT colonography as a 'single test' alternative to colonoscopy and standard CT for surveillance would potentially save EUR20,785,232 (pound 14,803,404) for an annual cohort of UK patients. CT colonography compares favourably to colonoscopy for detection of anastomotic recurrence and metachronous colorectal cancer, and appears financially beneficial. These findings should be considered alongside limitations of small patient numbers and high clinical heterogeneity between studies. (orig.)

  13. Intra-individual comparison of patient acceptability of multidetector-row CT colonography and double-contrast barium enema

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, S.A. [Department of Intestinal Imaging, St Mark' s and Northwick Park Hospitals, London (United Kingdom)]. E-mail: csytaylor@yahoo.co.uk; Halligan, S. [Department of Intestinal Imaging, St Mark' s and Northwick Park Hospitals, London (United Kingdom); Burling, D. [Department of Intestinal Imaging, St Mark' s and Northwick Park Hospitals, London (United Kingdom); Bassett, P. [Department of Intestinal Imaging, St Mark' s and Northwick Park Hospitals, London (United Kingdom); Bartram, C.I. [Department of Intestinal Imaging, St Mark' s and Northwick Park Hospitals, London (United Kingdom)

    2005-02-01

    AIMS: To compare the subjective acceptability of CT colonography in comparison with barium enema in older symptomatic patients, and to ascertain preferences for future colonic investigation. MATERIALS AND METHODS: The study population comprised 78 persons aged 60 years or over with symptoms suggestive of colorectal neoplasia, who underwent CT colonography followed the same day by barium enema. A 25-point questionnaire was administered after each procedure and an additional follow-up questionnaire a week later. Responses were compared using Wilcoxon matched pairs testing, Mann-Whitney test statistics and binomial exact testing. RESULTS: Participants suffered less physical discomfort during CT colonography (p=0.03) and overall satisfaction was greater compared with barium enema (p=0.03). On follow-up, respondents reported significantly better tolerance of CT colonography (p=0.002), and were less prepared to undergo barium enema again (p<0.001). Of 52 subjects expressing an opinion, all preferred CT to barium enema. CONCLUSION: Patient satisfaction was higher with CT colonography than barium enema. CT colonography caused significantly less physical discomfort and was overwhelmingly preferred by patients.

  14. Panoramic endoluminal display with minimal image distortion using circumferential radial ray-casting for primary three-dimensional interpretation of CT colonography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Soo; Park, Seong Ho; Kim, Namkug; Lee, Jeongjin; Kim, Ah Young; Ha, Hyun Kwon [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea); Kim, Jin Kook [INFINITT Co., Ltd., Seoul (Korea); Park, Beom Jin [Korea University College of Medicine, Department of Radiology, Seoul (Korea); Kim, Young Jun [Konkuk University School of Medicine, Konkuk University Hospital, Department of Radiology, Seoul (Korea); Lee, Min Woo [Konkuk University School of Medicine, Konkuk University Hospital, Department of Radiology, Seoul (Korea); Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Radiology, Seoul (Korea)

    2009-08-15

    The purpose of this study was to develop a panoramic endoluminal display technique, the band view, which causes minimal image distortion, and to determine its feasibility as a time-efficient primary three-dimensional review method of CT colonography (CTC). Image distortion was compared between the band view and four other three-dimensional review modes using ten 10-mm and ten 20-mm electronically generated polyps. Diagnostic performance and interpretation time were compared between the band view and the conventional endoluminal view by two independent readers in 52 patients who underwent CTC and colonoscopy on the same day. Mean image distortion index values, in which 1 indicates no distortion and the larger value represents greater distortion, were significantly smaller with the band view (1.03 and 1.01 for 10-mm and 20-mm polyps, respectively) than with the filet view (1.65 and 1.55) or the virtual colon dissection (3.27 and 3.85) (P{<=}0.004). The sensitivity and specificity for detecting adenomatous polyps {>=}6 mm did not differ, but the mean interpretation time was significantly shorter with the band view than with the conventional endoluminal view by 1.8 and 4.5 minutes in readers 1 and 2, respectively (P<0.0001). The band view can be a time-efficient alternative for primary three-dimensional review of CTC. (orig.)

  15. Segmentation algorithm of colon based on multi-slice CT colonography

    Science.gov (United States)

    Hu, Yizhong; Ahamed, Mohammed Shabbir; Takahashi, Eiji; Suzuki, Hidenobu; Kawata, Yoshiki; Niki, Noboru; Suzuki, Masahiro; Iinuma, Gen; Moriyama, Noriyuki

    2012-02-01

    CT colonography is a radiology test that looks at people's large intestines(colon). CT colonography can screen many options of colon cancer. This test is used to detect polyps or cancers of the colon. CT colonography is safe and reliable. It can be used if people are too sick to undergo other forms of colon cancer screening. In our research, we proposed a method for automatic segmentation of the colon from abdominal computed Tomography (CT) images. Our multistage detection method extracted colon and spited colon into different parts according to the colon anatomy information. We found that among the five segmented parts of the colon, sigmoid (20%) and rectum (50%) are more sensitive toward polyps and masses than the other three parts. Our research focused on detecting the colon by the individual diagnosis of sigmoid and rectum. We think it would make the rapid and easy diagnosis of colon in its earlier stage and help doctors for analysis of correct position of each part and detect the colon rectal cancer much easier.

  16. CT colonography with computer-aided detection: recognizing the causes of false-positive reader results.

    Science.gov (United States)

    Trilisky, Igor; Wroblewski, Kristen; Vannier, Michael W; Horne, John M; Dachman, Abraham H

    2014-01-01

    Computed tomography (CT) colonography is a screening modality used to detect colonic polyps before they progress to colorectal cancer. Computer-aided detection (CAD) is designed to decrease errors of detection by finding and displaying polyp candidates for evaluation by the reader. CT colonography CAD false-positive results are common and have numerous causes. The relative frequency of CAD false-positive results and their effect on reader performance on the basis of a 19-reader, 100-case trial shows that the vast majority of CAD false-positive results were dismissed by readers. Many CAD false-positive results are easily disregarded, including those that result from coarse mucosa, reconstruction, peristalsis, motion, streak artifacts, diverticulum, rectal tubes, and lipomas. CAD false-positive results caused by haustral folds, extracolonic candidates, diminutive lesions (reader false-positive results. Nondismissable CAD soft-tissue polyp candidates larger than 6 mm are another common cause of reader false-positive results that may lead to further evaluation with follow-up CT colonography or optical colonoscopy. Strategies for correctly evaluating CAD polyp candidates are important to avoid pitfalls from common sources of CAD false-positive results. ©RSNA, 2014.

  17. Optimizing bowel preparation for multidetector row CT colonography: Effect of Citramag and Picolax

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, S.A.; Halligan, S. E-mail: s.halligan@ic.ac.uk; Goh, V.; Morley, S.; Atkin, W.; Bartram, C.I

    2003-09-01

    AIM: To compare the adequacy and acceptability of Picolax and Citramag bowel cleansing agents for CT colonography. MATERIALS AND METHODS: Multidetector row CT colonography was performed in 124 subjects; 43 had been prepared with Picolax and 81 with Citramag. Datasets were assessed for retained fluid and solid residue, and overall adequacy of segmental visualization. Preparation acceptability was also assessed. RESULTS: There was significantly less retained fluid with Picolax. The odds of being in the next higher category for retained fluid when using Picolax were 0.33 (CI: 0.22-0.50, p<0.0001) when compared with Citramag, for all segments combined. However there was significantly more retained solid residue with Picolax. The odds of being in the next higher category for retained residue when using Picolax were 2.44 (CI: 1.41-4.24, p=0.002) when compared with Citramag, for all segments combined. There was no significant difference with respect to overall segmental visualization: the odds of a segment being adequately visualized when using Picolax were 1.52 (CI: 0.88-2.65, p=0.14) when compared with Citramag. There was no significant difference with respect to acceptability. CONCLUSION: Picolax results in a significantly drier colon than Citramag and associated with more retained residue. We found Picolax the more suitable preparation for CT colonography.

  18. How to read and report CTC

    Energy Technology Data Exchange (ETDEWEB)

    Neri, Emanuele, E-mail: emanuele.neri@med.unipi.it [Diagnostic and Interventional Radiology, University of Pisa, 56100, Pisa (Italy); Mang, Thomas [Department of Radiology, Medical University of Vienna, Vienna (Austria); Hellstrom, Mikael [Department of Radiology, Sahlgrenska University Hospital, Gothenburg (Sweden); Mantarro, Annalisa; Faggioni, Lorenzo; Bartolozzi, Carlo [Diagnostic and Interventional Radiology, University of Pisa, 56100, Pisa (Italy)

    2013-08-15

    Owing to encouraging results achieved in the clinical practice, CT colonography (CTC) is being increasingly employed for the examination of the whole colon and rectum and is quickly becoming a widely accepted diagnostic technique that is replacing double contrast barium enema and appears a promising tool for colorectal cancer screening as well. The increasing number of symptomatic and asymptomatic patients undergoing CTC for both evaluation of symptoms and colorectal cancer screening, along with the growing availability of CTC facilities in most healthcare departments and imaging centres, requires that a sufficient number of radiologists be adequately trained in performing and interpreting CTC studies. Indeed, optimal performance of CTC depends on a number of factors, including the quality of colonic preparation (e.g. laxative bowel cleansing and optimised colonic distension), the CTC image acquisition protocol used, and reading approach and specific skills of radiologists for correct detection and interpretation of colonic findings. Consequently, dedicated training and expertise is key to obtain high sensitivity in lesion detection and reduce the number of false positives, thus ensuring an optimal clinical management of patients. To this purpose, dedicated training programmes are essential to teach and standardise not only the approach to CTC reading, but also reporting of colonic findings.

  19. Computer-aided polyp detection on CT colonography: Comparison of three systems in a high-risk human population

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hee Sun [Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul 110-744 (Korea, Republic of); Institute of Radiation Medicine, Seoul National University Hospital (Korea, Republic of); Kim, Se Hyung, E-mail: shkim@radcom.snu.ac.k [Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul 110-744 (Korea, Republic of); Institute of Radiation Medicine, Seoul National University Hospital (Korea, Republic of); Kim, Jong Hyo [Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul 110-744 (Korea, Republic of); Institute of Radiation Medicine, Seoul National University Hospital (Korea, Republic of); Interdisciplinary Program in Radiation Applied Life Science, Seoul National University College of Medicine (Korea, Republic of); Lee, June-Goo [Interdisciplinary Program in Radiation Applied Life Science, Seoul National University College of Medicine (Korea, Republic of); Kim, Sang Gyun [Department of Internal Medicine, Seoul National University Hospital (Korea, Republic of); Lee, Jeong Min; Lee, Jae Young; Han, Joon Koo; Choi, Byung Ihn [Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul 110-744 (Korea, Republic of); Institute of Radiation Medicine, Seoul National University Hospital (Korea, Republic of)

    2010-08-15

    Purpose: To compare the detection performances of two commercial and one academic computer-aided diagnosis (CAD) systems for polyp detection on CT colonography (CTC) in a high-risk human population and to assess their detection characteristics. Materials and methods: This retrospective study had institutional review board approval, but informed consent was waived. Sixty-eight patients who were suspected of having colonic polyps and scheduled for colonoscopic polyp removal were included. After CTC was performed using a 64-row MDCT, two commercial (PEV, CAR) and one academic (Hessian matrix-based) CAD systems were applied to each CTC dataset. Colonoscopy using the segmental unblinded technique was performed as a standard of reference. Per-polyp and per-patient sensitivities were calculated and compared for each CAD system. The mean number of false-positives (FPs) and false-negatives (FNs) was computed and the causes of all FPs and FNs were analyzed. Results: A total of 151 polyps in 61 patients were detected (77 polyps <6 mm, 48 6-9.9 mm, 26 {>=} 10 mm). Per-polyp sensitivity for PEV, CAR, and Hessian matrix-based CAD were: 71.6%, 78.4%, and 83.8% for polyps {>=}6 mm, and 88.5%, 96.2%, and 96.2% for polyps {>=}10 mm. Per-patient sensitivity for polyps {>=}6 mm was 80.4%, 89.1%, and 93.5%, and 87%, 95.7%, and 95.7% for polyps {>=}10 mm, respectively. Per-polyp and per-patient sensitivities were not significantly different among the three CAD systems regardless of size threshold. Mean number of FPs was 6.9 for PEV, 7.3 for CAR, and 14 for Hessian matrix-based CAD. The most common cause of FPs were feces, followed by extracolonic findings, prominent folds and ileocecal valve, and rectal tube. The distribution of the causes of FPs was significantly different among the three systems. Conclusion: Sensitivity of the three CAD systems for polyp detection was comparable regardless of the polyp size threshold; however, the number of FPs was higher in the Hessian matrix

  20. Time-efficient CT colonography interpretation using an advanced image-gallery-based, computer-aided "first-reader" workflow for the detection of colorectal adenomas.

    Science.gov (United States)

    Mang, Thomas; Hermosillo, Gerardo; Wolf, Matthias; Bogoni, Luca; Salganicoff, Marcos; Raykar, Vikas; Ringl, Helmut; Weber, Michael; Mueller-Mang, Christina; Graser, Anno

    2012-12-01

    To assess the performance of an advanced "first-reader" workflow for computer-aided detection (CAD) of colorectal adenomas ≥ 6 mm at computed tomographic colonography (CTC) in a low-prevalence cohort. A total of 616 colonoscopy-validated CTC patient-datasets were retrospectively reviewed by a radiologist using a "first-reader" CAD workflow. CAD detections were presented as galleries of six automatically generated two-dimensional (2D) and three-dimensional (3D) images together with interactive 3D target views and 2D multiplanar views of the complete dataset. Each patient-dataset was interpreted by initially using CAD image-galleries followed by a fast 2D review to address unprompted colonic areas. Per-patient, per-polyp, and per-adenoma sensitivities were calculated for lesions ≥ 6 mm. Statistical testing employed Fisher's exact and McNemar tests. In 91/616 patients, 131 polyps (92 adenomas, 39 non-adenomas) ≥ 6 mm and two cancers were identified by reference standard. Using the CAD gallery-based first-reader workflow, the radiologist detected all adenomas ≥ 10 mm (34/34) and cancers. Per-patient and polyp sensitivities for lesions ≥ 6 mm were 84.3 % (75/89), and 83.2 % (109/131), respectively, with 89.1 % (57/64) and 85.9 % (79/92) for adenomas. Overall specificity was 95.6 % (504/527). Mean interpretation time was 3.1 min per patient. A CAD algorithm, applied in an image-gallery-based first-reader workflow, can substantially decrease reading times while enabling accurate detection of colorectal adenomas in a low-prevalence population. Computer-aided detection (CAD) is increasingly used to help interpret CT colonography (CTC). An image-gallery first-reader CAD-workflow is feasible for detection of colorectal adenomas ≥ 6 mm. Image-gallery first-reader CAD yields per-patient sensitivity of 89.1 % and specificity of 95.6 %. The mean reading time for CTC was 3.1 min, making screening feasible. No large adenoma was missed by the radiologist who reviewed

  1. Current status of MR colonography.

    LENUS (Irish Health Repository)

    Thornton, Eavan

    2010-01-01

    The search for an acceptable colorectal cancer screening examination has led to the development of virtual colonoscopy, which includes both computed tomographic (CT) colonography and magnetic resonance (MR) colonography. As indicated by the much larger number of published studies on CT colonography than on MR colonography, multidetector CT appears to be more suitable for colorectal screening than does MR colonography, in part reflecting the ease and speed of performing CT, as well as the increased spatial resolution, decreased cost, and wider availability of CT colonography. The main advantage of MR colonography over CT colonography is that it does not use ionizing radiation, which has important implications for colorectal cancer screening. The use of dark-lumen MR colonography to screen patients for colorectal cancer as well as other abdominopelvic disease could make it more attractive than CT. With the integration of 3.0-T MR colonography, fecal tagging, and parallel imaging into research and clinical settings, new MR colonography protocols must be optimized. Future MR colonography research should address issues such as image characteristics, presence of artifacts, management of specific absorption rate, and hardware-related modifications.

  2. Appearances of screen-detected versus symptomatic colorectal cancers at CT colonography

    Energy Technology Data Exchange (ETDEWEB)

    Plumb, Andrew A.; Pathiraja, Fiona; Taylor, Stuart A.; Halligan, Steve [University College London, Centre for Medical Imaging, London (United Kingdom); Nickerson, Claire [Fulwood House, Public Health England, Sheffield (United Kingdom); Wooldrage, Katherine; Atkin, Wendy S. [Imperial College London, Department of Surgery and Cancer, London (United Kingdom); Burling, David [St Mark' s Hospital, Intestinal Imaging Centre, Harrow (United Kingdom)

    2016-12-15

    The aim of this study was to compare the morphology, radiological stage, conspicuity, and computer-assisted detection (CAD) characteristics of colorectal cancers (CRC) detected by computed tomographic colonography (CTC) in screening and symptomatic populations. Two radiologists independently analyzed CTC images from 133 patients diagnosed with CRC in (a) two randomized trials of symptomatic patients (35 patients with 36 tumours) and (b) a screening program using fecal occult blood testing (FOBt; 98 patients with 100 tumours), measuring tumour length, volume, morphology, radiological stage, and subjective conspicuity. A commercial CAD package was applied to both datasets. We compared CTC characteristics between screening and symptomatic populations with multivariable regression. Screen-detected CRC were significantly smaller (mean 3.0 vs 4.3 cm, p < 0.001), of lower volume (median 9.1 vs 23.2 cm{sup 3}, p < 0.001) and more frequently polypoid (34/100, 34 % vs. 5/36, 13.9 %, p = 0.02) than symptomatic CRC. They were of earlier stage than symptomatic tumours (OR = 0.17, 95 %CI 0.07-0.41, p < 0.001), and were judged as significantly less conspicuous (mean conspicuity 54.1/100 vs. 72.8/100, p < 0.001). CAD detection was significantly lower for screen-detected (77.4 %; 95 %CI 67.9-84.7 %) than symptomatic CRC (96.9 %; 95 %CI 83.8-99.4 %, p = 0.02). Screen-detected CRC are significantly smaller, more frequently polypoid, subjectively less conspicuous, and less likely to be identified by CAD than those in symptomatic patients. (orig.)

  3. Colon distension and scan protocol for CT-colonography: An overview

    Energy Technology Data Exchange (ETDEWEB)

    Boellaard, Thierry N., E-mail: t.n.boellaard@amc.uva.nl [Department of Radiology, Academic Medical Center, University of Amsterdam, PB 22660, 1100 DD Amsterdam (Netherlands); Haan, Margriet C. de, E-mail: m.c.dehaan@amc.uva.nl [Department of Radiology, Academic Medical Center, University of Amsterdam, PB 22660, 1100 DD Amsterdam (Netherlands); Venema, Henk W., E-mail: h.w.venema@amc.uva.nl [Department of Radiology, Academic Medical Center, University of Amsterdam, PB 22660, 1100 DD Amsterdam (Netherlands); Department of Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, PB 22660, 1100 DD Amsterdam (Netherlands); Stoker, Jaap, E-mail: j.stoker@amc.uva.nl [Department of Radiology, Academic Medical Center, University of Amsterdam, PB 22660, 1100 DD Amsterdam (Netherlands)

    2013-08-15

    This article reviews two important aspects of CT-colonography, namely colonic distension and scan parameters. Adequate distension should be obtained to visualize the complete colonic lumen and optimal scan parameters should be used to prevent unnecessary radiation burden. For optimal distension, automatic carbon dioxide insufflation should be performed, preferably via a thin, flexible catheter. Hyoscine butylbromide is – when available – the preferred spasmolytic agent because of the positive effect on insufflation and pain/burden and its low costs. Scans in two positions are required for adequate distension and high polyp sensitivity and decubitus position may be used as an alternative for patients unable to lie in prone position. The great intrinsic contrast between air or tagging and polyps allows the use of low radiation dose. Low-dose protocol without intravenous contrast should be used when extracolonic findings are deemed unimportant. In patients suspected for colorectal cancer, normal abdominal CT scan protocols and intravenous contrast should be used in supine position for the evaluation of extracolonic findings. Dose reduction can be obtained by lowering the tube current and/or voltage. Tube current modulation reduces the radiation dose (except in obese patients), and should be used when available. Iterative reconstructions is a promising dose reducing tool and dual-energy CT is currently evaluated for its applications in CT-colonography. This review also provides our institution's insufflation procedure and scan parameters.

  4. CT colonography in a Korean population with a high residue diet: Comparison between wet and dry preparations

    Energy Technology Data Exchange (ETDEWEB)

    Kim, S.H. [Department of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of); Choi, B.I. [Department of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of)]. E-mail: choibi@radcom.snu.ac.kr; Han, J.K. [Department of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of); Institute of Radiation Medicine, Seoul National University Hospital, Seoul (Korea, Republic of); Lee, J.M. [Department of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of); Institute of Radiation Medicine, Seoul National University Hospital, Seoul (Korea, Republic of); Eun, H.W. [Ewha Woman' s University Hospital, Seoul (Korea, Republic of); Lee, J.Y. [Department of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of); Lee, K.H. [Seoul National University Bundang Hospital, Seoul (Korea, Republic of); Han, C.J. [Health Care System, Seoul National University Hospital, Seoul (Korea, Republic of); Choi, Y.H. [Department of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of); Shin, K.-S. [Chungnam National University Hospital, Seoul (Korea, Republic of)

    2006-06-15

    AIM: To compare wet and dry preparation methods for computed tomography colonography (CTC) in terms of preparation quality, interpretation time, and diagnostic performance for polyp detection in a population with a high residue diet. MATERIALS AND METHODS: Eighty-six patients were divided into two groups. Group 1 (n=24) received a wet preparation of 4 l polyethylene glycol (PEG) solution, and group 2 (n=62) received a dry preparation of phosphor-soda. Abnormal findings, including polyps, and the time required to interpret the CTC images in both groups were documented by a radiologist. CTC findings were compared to those of colonoscopy as a reference standard. Two radiologists evaluated the quality of CTC with regard to residual fluid, faeces, and colonic distension using a four-point scale in consensus. Statistical differences for residual fluid, faeces, distensibility on CTC, and interpretation time between the two groups were analysed. The diagnostic performance of CTC in both groups was also compared. RESULTS: One-hundred and ninety polyps in 70 patients were identified using colonoscopy. Regarding the quality of images produced the wet preparation was significantly better than the dry preparation (p<0.05). The average interpretation time was significantly shorter for the wet group (11.7 min) than the dry group (16.4 min) (p<0.05). For per-patient analysis, the positive predictive value (PPV) was significantly better for the wet (100%) than the dry group (79.6%; p=0.025). Sensitivities and PPV for {>=}10 mm polyps were comparable between two groups (p>0.05). CONCLUSION: In a population with a high-residue diet, CTC with wet preparation can be interpreted in a time-efficient manner and is comparable with CTC with dry preparation.

  5. Sub-milliSievert (sub-mSv) CT colonography: a prospective comparison of image quality and polyp conspicuity at reduced-dose versus standard-dose imaging

    Energy Technology Data Exchange (ETDEWEB)

    Lubner, Meghan G.; Pooler, B.D.; Kitchin, Douglas R.; Kim, David H.; Munoz del Rio, Alejandro; Pickhardt, Perry J. [University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Sciences Center, Departments of Radiology, Madison, WI (United States); Tang, Jie [University of Wisconsin School of Medicine and Public Health, Medical Physics, Madison, WI (United States); Li, Ke; Chen, Guang-Hong [University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Sciences Center, Departments of Radiology, Madison, WI (United States); University of Wisconsin School of Medicine and Public Health, Medical Physics, Madison, WI (United States)

    2015-07-15

    To prospectively compare reduced-dose (RD) CT colonography (CTC) with standard-dose (SD) imaging using several reconstruction algorithms. Following SD supine CTC, 40 patients (mean age, 57.3 years; 17 M/23 F; mean BMI, 27.2) underwent an additional RD supine examination (targeted dose reduction, 70-90 %). DLP, CTDI{sub vol}, effective dose, and SSDE were compared. Several reconstruction algorithms were applied to RD series. SD-FBP served as reference standard. Objective image noise, subjective image quality and polyp conspicuity were assessed. Mean CTDI{sub vol} and effective dose for RD series was 0.89 mGy (median 0.65) and 0.6 mSv (median 0.44), compared with 3.8 mGy (median 3.1) and 2.8 mSv (median 2.3) for SD series, respectively. Mean dose reduction was 78 %. Mean image noise was significantly reduced on RD-PICCS (24.3 ± 19HU) and RD-MBIR (19 ± 18HU) compared with RD-FBP (90 ± 33), RD-ASIR (72 ± 27) and SD-FBP (47 ± 14 HU). 2D image quality score was higher with RD-PICCS, RD-MBIR, and SD-FBP (2.7 ± 0.4/2.8 ± 0.4/2.9 ± 0.6) compared with RD-FBP (1.5 ± 0.4) and RD-ASIR (1.8 ± 0.44). A similar trend was seen with 3D image quality scores. Polyp conspicuity scores were similar between SD-FBP/RD-PICCS/RD-MBIR (3.5 ± 0.6/3.2 ± 0.8/3.3 ± 0.6). Sub-milliSievert CTC performed with iterative reconstruction techniques demonstrate decreased image quality compared to SD, but improved image quality compared to RD images reconstructed with FBP. (orig.)

  6. Population screening for colorectal cancer by flexible sigmoidoscopy or CT colonography: study protocol for a multicenter randomized trial.

    Science.gov (United States)

    Regge, Daniele; Iussich, Gabriella; Senore, Carlo; Correale, Loredana; Hassan, Cesare; Bert, Alberto; Montemezzi, Stefania; Segnan, Nereo

    2014-03-28

    Colorectal cancer (CRC) is the second most prevalent type of cancer in Europe. A single flexible sigmoidoscopy (FS) screening at around the age of 60 years prevents about one-third of CRC cases. However, FS screens only the distal colon, and thus mortality from proximal CRC is unaffected. Computed tomography colonography (CTC) is a highly accurate examination that allows assessment of the entire colon. However, the benefit of CTC testing as a CRC screening test is uncertain. We designed a randomized trial to compare participation rate, detection rates, and costs between CTC (with computer-aided detection) and FS as primary tests for population-based screening. An invitation letter to participate in a randomized screening trial comparing CTC versus FS will be mailed to a sample of 20,000 people aged 58 or 60 years, living in the Piedmont region and the Verona district of Italy. Individuals with a history of CRC, adenomas, inflammatory bowel disease, or recent colonoscopy, or with two first-degree relatives with CRC will be excluded from the study by their general practitioners. Individuals responding positively to the invitation letter will be then randomized to the intervention group (CTC) or control group (FS), and scheduled for the screening procedure. The primary outcome parameter of this part of the trial is the difference in advanced neoplasia detection between the two screening tests. Secondary outcomes are cost-effectiveness analysis, referral rates for colonoscopy induced by CTC versus FS, and the expected and perceived burden of the procedures. To compare participation rates for CTC versus FS, 2,000 additional eligible subjects will be randomly assigned to receive an invitation for screening with CTC or FS. In the CTC arm, non-responders will be offered fecal occult blood test (FOBT) as alternative screening test, while in the FS arm, non-responders will receive an invitation letter to undergo screening with either FOBT or CTC. Data on reasons for

  7. Diagnostic value of CT-colonography as compared to colonoscopy in an asymptomatic screening population: a meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Haan, Margriet C. de [University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); Academic Medical Center, Amsterdam, Department of Radiology, G1-223.1, Amsterdam (Netherlands); Gelder, Rogier E. van; Bipat, Shandra; Stoker, Jaap [University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); Graser, Anno [University of Munich, Department of Clinical Radiology, Klinikum Grosshadern, Munich (Germany)

    2011-08-15

    Previous meta-analyses on CT-colonography included both average and high risk individuals, which may overestimate the diagnostic value in screening. A meta-analysis was performed to obtain the value of CT-colonography for screening. A search was performed using PubMed, Embase and Cochrane. Article selection and critical appraisal was done by two reviewers. Inclusion criteria: prospective, randomized trials or cohort studies comparing CT-colonography with colonoscopy ({>=}50 participants), {>=}95% average risk participants {>=}50 years. Study characteristics and 2 x 2 contingency Tables were recorded. Sensitivity and specificity estimates were calculated per patient and per polyp ({>=}6 mm, {>=}10 mm), using univariate and bivariate analyses. Five of 1,021 studies identified were included, including 4,086 participants (<1% high risk). I{sup 2}-values showed substantial heterogeneity, especially for 6-9 mm polyps and adenomas: 68.1% vs. 78.6% (sensitivity per patient). Estimated sensitivities for patients with polyps or adenomas {>=} 6 mm were 75.9% and 82.9%, corresponding specificities 94.6% and 91.4%. Estimated sensitivities for patients with polyps or adenomas {>=} 10 mm were 83.3% and 87.9%, corresponding specificities 98.7% and 97.6%. Estimated sensitivities per polyp for advanced adenomas {>=} 6 mm and {>=} 10 mm were 83.9% and 83.8%. Compared to colonoscopy, CT-colonography has a high sensitivity for adenomas {>=} 10 mm. For (advanced) adenomas {>=} 6 mm sensitivity is somewhat lower. (orig.)

  8. Teleradiology based CT colonography to screen a population group of a remote island; at average risk for colorectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lefere, Philippe, E-mail: radiologie@skynet.be [VCTC, Virtual Colonoscopy Teaching Centre, Akkerstraat 32c, B-8830 Hooglede (Belgium); Silva, Celso, E-mail: caras@uma.pt [Human Anatomy of Medical Course, University of Madeira, Praça do Município, 9000-082 Funchal (Portugal); Gryspeerdt, Stefaan, E-mail: stefaan@sgryspeerdt.be [VCTC, Virtual Colonoscopy Teaching Centre, Akkerstraat 32c, B-8830 Hooglede (Belgium); Rodrigues, António, E-mail: nucleo@nid.pt [Nucleo Imagem Diagnostica, Rua 5 De Outubro, 9000-216 Funchal (Portugal); Vasconcelos, Rita, E-mail: rita@uma.pt [Department of Engineering and Mathematics, University of Madeira, Praça do Município, 9000-082 Funchal (Portugal); Teixeira, Ricardo, E-mail: j.teixeira1947@gmail.com [Department of Gastroenterology, Central Hospital of Funchal, Avenida Luís de Camões, 9004513 Funchal (Portugal); Gouveia, Francisco Henriques de, E-mail: fhgouveia@netmadeira.com [LANA, Pathology Centre, Rua João Gago, 10, 9000-071 Funchal (Portugal)

    2013-06-15

    Purpose: To prospectively assess the performance of teleradiology-based CT colonography to screen a population group of an island, at average risk for colorectal cancer. Materials and methods: A cohort of 514 patients living in Madeira, Portugal, was enrolled in the study. Institutional review board approval was obtained and all patients signed an informed consent. All patients underwent both CT colonography and optical colonoscopy. CT colonography was interpreted by an experienced radiologist at a remote centre using tele-radiology. Per-patient sensitivity, specificity, positive (PPV) and negative (NPV) predictive values with 95% confidence intervals (95%CI) were calculated for colorectal adenomas and advanced neoplasia ≥6 mm. Results: 510 patients were included in the study. CT colonography obtained a per-patient sensitivity, specificity, PPV and, NPV for adenomas ≥6 mm of 98.11% (88.6–99.9% 95% CI), 90.97% (87.8–93.4% 95% CI), 56.52% (45.8–66.7% 95% CI), 99.75% (98.4–99.9% 95% CI). For advanced neoplasia ≥6 mm per-patient sensitivity, specificity, PPV and, NPV were 100% (86.7–100% 95% CI), 87.07% (83.6–89.9% 95% CI), 34.78% (25.3–45.5% 95% CI) and 100% (98.8–100% 95% CI), respectively. Conclusion: In this prospective trial, teleradiology-based CT colonography was accurate to screen a patient cohort of a remote island, at average risk for colorectal cancer.

  9. CT colonography with limited bowel preparation: prospective assessment of patient experience and preference in comparison to optical colonoscopy with cathartic bowel preparation

    Energy Technology Data Exchange (ETDEWEB)

    Jensch, Sebastiaan [University of Amsterdam, Department of Radiology, Amsterdam (Netherlands); Onze Lieve Vrouwe Gasthuis, Department of Radiology, Amsterdam (Netherlands); Academic Medical Center, Department of Radiology, Amsterdam (Netherlands); Bipat, Shandra; Vries, Ayso H. de; Heutinck, Anneke; Stoker, Jaap [University of Amsterdam, Department of Radiology, Amsterdam (Netherlands); Peringa, Jan; Montauban van Swijndregt, Alexander D. [Onze Lieve Vrouwe Gasthuis, Department of Radiology, Amsterdam (Netherlands); Dekker, Evelien [University of Amsterdam, Department of Gastroenterology and Hepatology, Amsterdam (Netherlands); Baak, Lubbertus C. [Onze Lieve Vrouwe Gasthuis, Department of Gastroenterology, Amsterdam (Netherlands)

    2010-01-15

    The purpose of this study was to prospectively compare participant experience and preference of limited preparation computed tomography colonography (CTC) with full-preparation colonoscopy in a consecutive series of patients at increased risk of colorectal cancer. CTC preparation comprised 180 ml diatrizoate meglumine, 80 ml barium and 30 mg bisacodyl. For the colonoscopy preparation 4 l of polyethylene glycol solution was used. Participants' experience and preference were compared using the Wilcoxon signed rank test and the chi-squared test, respectively. Associations between preference and experience parameters for the 173 participants were determined by logistic regression. Diarrhoea occurred in 94% of participants during CTC preparation. This side effect was perceived as severely or extremely burdensome by 29%. Nonetheless, the total burden was significantly lower for the CTC preparation than for colonoscopy (9% rated the CTC preparation as severely or extremely burdensome compared with 59% for colonoscopy; p<0.001). Participants experienced significantly more pain, discomfort and total burden with the colonoscopy procedure than with CTC (p<0.001). After 5 weeks, 69% preferred CTC, 8% were indifferent and 23% preferred colonoscopy (p<0.001). A burdensome colonoscopy preparation and pain at colonoscopy were associated with CTC preference (p<0.04). In conclusion, participants' experience and preference were rated in favour of CTC with limited bowel preparation compared with full-preparation colonoscopy. (orig.)

  10. Primary Gallbladder Lymphoma in a Male Patient with No Risk Factors Detected Incidentally by CT Colonography

    Science.gov (United States)

    Karia, Monil; Mitsopoulos, Grigorios; Patel, Ketan; Rafique, Akkib; Sheth, Hemant

    2015-01-01

    Primary gallbladder lymphoma, although rare, usually presents in females with symptoms mimicking cholecystitis. We present a rare case of primary gallbladder in an 81-year-old male with no risk factors whose only symptom was weight loss. Routine blood tests including liver function tests were unremarkable. A CT colonography was carried out to exclude colonic malignancy. Unilateral gallbladder wall thickening and lymphadenopathy were incidentally detected and confirmed by ultrasound and a decision for the patient to undergo laparoscopic cholecystectomy and intraoperative cholangiogram was made. Histology confirmed extranodal marginal zone lymphoma with follow-up staging and biopsy of the bone marrow not demonstrating spread. Cholecystectomy was therefore deemed curative and no adjuvant therapy was necessary. Thickening of the gallbladder wall on any imaging with or without symptoms should not be ignored or assumed to be cholecystitis, even in males with no risk factors. In these patients urgent cholecystectomy with intraoperative cholangiogram is indicated with histology and haematology follow-up. PMID:26587306

  11. Towards a framework for analysis of eye-tracking studies in the three dimensional environment: a study of visual search by experienced readers of endoluminal CT colonography.

    Science.gov (United States)

    Helbren, E; Halligan, S; Phillips, P; Boone, D; Fanshawe, T R; Taylor, S A; Manning, D; Gale, A; Altman, D G; Mallett, S

    2014-05-01

    Eye tracking in three dimensions is novel, but established descriptors derived from two-dimensional (2D) studies are not transferable. We aimed to develop metrics suitable for statistical comparison of eye-tracking data obtained from readers of three-dimensional (3D) "virtual" medical imaging, using CT colonography (CTC) as a typical example. Ten experienced radiologists were eye tracked while observing eight 3D endoluminal CTC videos. Subsequently, we developed metrics that described their visual search patterns based on concepts derived from 2D gaze studies. Statistical methods were developed to allow analysis of the metrics. Eye tracking was possible for all readers. Visual dwell on the moving region of interest (ROI) was defined as pursuit of the moving object across multiple frames. Using this concept of pursuit, five categories of metrics were defined that allowed characterization of reader gaze behaviour. These were time to first pursuit, identification and assessment time, pursuit duration, ROI size and pursuit frequency. Additional subcategories allowed us to further characterize visual search between readers in the test population. We propose metrics for the characterization of visual search of 3D moving medical images. These metrics can be used to compare readers' visual search patterns and provide a reproducible framework for the analysis of gaze tracking in the 3D environment. This article describes a novel set of metrics that can be used to describe gaze behaviour when eye tracking readers during interpretation of 3D medical images. These metrics build on those established for 2D eye tracking and are applicable to increasingly common 3D medical image displays.

  12. Exploration of Analysis Methods for Diagnostic Imaging Tests: Problems with ROC AUC and Confidence Scores in CT Colonography.

    OpenAIRE

    Susan Mallett; Steve Halligan; Gary S Collins; Altman, Doug G.

    2014-01-01

    BACKGROUND: Different methods of evaluating diagnostic performance when comparing diagnostic tests may lead to different results. We compared two such approaches, sensitivity and specificity with area under the Receiver Operating Characteristic Curve (ROC AUC) for the evaluation of CT colonography for the detection of polyps, either with or without computer assisted detection. METHODS: In a multireader multicase study of 10 readers and 107 cases we compared sensitivity and specificity, using ...

  13. PET/CT colonography: a novel non-invasive technique for assessment of extent and activity of ulcerative colitis

    Energy Technology Data Exchange (ETDEWEB)

    Das, Chandan J.; Sharma, Raju [All India Institute of Medical Sciences, Department of Radiodiagnosis, New Delhi (India); Makharia, Govind K.; Tiwari, Rajeew P. [All India Institute of Medical Sciences, Department of Gastroenterology and Human Nutrition, New Delhi (India); Kumar, Rakesh; Kumar, Rajender; Malhotra, Arun [All India Institute of Medical Sciences, Department of Nuclear Medicine, New Delhi (India)

    2010-04-15

    Extent of involvement and activity of ulcerative colitis (UC) is best evaluated by colonoscopy. Colonoscopy however carries risk during acute exacerbation. We investigated the utility of PET/CT colonography for assessment of extent and activity of UC. Within a 1-week window, 15 patients with mild to moderately active UC underwent colonoscopy and PET/CT colonography 60 min after injection of 10 mCi of {sup 18}F-fluorodeoxyglucose (FDG). PET activity score based on the amount of FDG uptake and endoscopic mucosal activity in seven colonic segments of each patient was recorded. The mean maximum standardized uptake value (SUV{sub max}) of seven segments was compared with activity in liver. A PET activity grade of 0, 1, 2 or 3 was assigned to each region depending upon their SUV{sub max} ratio (colon segment to liver). The extent of disease was left-sided colitis in five and pancolitis in ten. The mean Ulcerative Colitis Disease Activity Index (UCDAI) was 7.6. The number of segments involved as per colonoscopic evaluation and PET/CT colonography was 67 and 66, respectively. There was a good correlation for extent evaluation between the two modalities (kappa 55.3%, p = 0.02). One patient had grade 0 PET activity, nine had grade 2 and five had grade 3 PET activity. In six patients, there was one to one correlation between PET activity grades with that of endoscopic grade. One patient showed activity in the sacroiliac joint suggesting active sacroiliitis. PET/CT colonography is a novel non-invasive technique for the assessment of extent and activity of the disease in patients with UC. (orig.)

  14. Use of multidetector-row CT colonography for detection of colorectal neoplasia in patients referred via the Department of Health '2-week-wait' initiative

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, S.A.; Halligan, S. E-mail: s.halligan@ic.ac.uk; Saunders, B.P.; Morley, S.; Riesewyk, C.; Atkin, W.; Bartram, C.I

    2003-11-01

    AIM: Patients referred under the Department of Health 2-week wait initiative with symptoms of colorectal cancer frequently undergo whole-colon examination. We investigated the use of computed tomography (CT) colonography as an alternative to colonoscopy in this scenario. MATERIALS AND METHODS: Fifty-four consecutive patients, referred via the 2-week wait initiative and scheduled for colonoscopy, consented to undergo multidetector CT colonography immediately before endoscopy. The site and morphology of any polyp or cancer detected by CT was noted and comparison made with subsequent colonoscopy. RESULTS: Colonoscopy detected polyps or cancer in 29 patients (53.7%). CT colonography prospectively detected 18 of 41 (44%) polyps of 1-5 mm, three of four (75%) polyps of 6-9 mm, four of four (100%) polyps 10 mm or larger, and five of six (83%) cancers. The missed cancer occurred early in the series and was a perceptive error. The overall sensitivity, specificity, positive predictive value and negative predictive value of CT colonography for cancer and polyps 10 mm or greater on a per patient basis were 90, 100, 100 and 98%, respectively. CT detected one renal cancer and one colonic cancer, initially missed due to incomplete colonoscopy. CONCLUSION: CT colonography is a robust technique for investigation of symptomatic patients. The learning curve must be overcome for optimal performance.

  15. Comparison of a 4-Day versus 2-Day Low Fiber Diet Regimen in Barium Tagging CT Colonography in Incomplete Colonoscopy Patients

    Directory of Open Access Journals (Sweden)

    Kaan Meric

    2015-01-01

    Full Text Available Our aim was to compare the amount of residual feces, residual fluid, the tagging quality, and patient compliance using 4-day versus 2-day low fiber diet regimen in barium tagging CT colonography in incomplete colonoscopy patients. Methods. A total of 101 patients who underwent CT colonography were assigned to 2-day diet group (n=56 and 4-day diet group (n=45. Fecal tagging was achieved with barium sulphate while bisacodyl and sennoside B were used for bowel preparation. Residual solid stool was divided into two groups measuring 0.05. The prevalence of moderate discomfort was significantly higher in 4-day group (P<0.001. Conclusion. Our study shows that 2-day limited bowel preparation regimen for fecal tag CT colonography is a safe and reasonable technique to evaluate the entire colon, particularly in incomplete conventional colonoscopy patients.

  16. Primary Gallbladder Lymphoma in a Male Patient with No Risk Factors Detected Incidentally by CT Colonography

    Directory of Open Access Journals (Sweden)

    Monil Karia

    2015-01-01

    Full Text Available Primary gallbladder lymphoma, although rare, usually presents in females with symptoms mimicking cholecystitis. We present a rare case of primary gallbladder in an 81-year-old male with no risk factors whose only symptom was weight loss. Routine blood tests including liver function tests were unremarkable. A CT colonography was carried out to exclude colonic malignancy. Unilateral gallbladder wall thickening and lymphadenopathy were incidentally detected and confirmed by ultrasound and a decision for the patient to undergo laparoscopic cholecystectomy and intraoperative cholangiogram was made. Histology confirmed extranodal marginal zone lymphoma with follow-up staging and biopsy of the bone marrow not demonstrating spread. Cholecystectomy was therefore deemed curative and no adjuvant therapy was necessary. Thickening of the gallbladder wall on any imaging with or without symptoms should not be ignored or assumed to be cholecystitis, even in males with no risk factors. In these patients urgent cholecystectomy with intraoperative cholangiogram is indicated with histology and haematology follow-up.

  17. Massive-training support vector regression and Gaussian process for false-positive reduction in computer-aided detection of polyps in CT colonography.

    Science.gov (United States)

    Xu, Jian-Wu; Suzuki, Kenji

    2011-04-01

    A massive-training artificial neural network (MTANN) has been developed for the reduction of false positives (FPs) in computer-aided detection (CADe) of polyps in CT colonography (CTC). A major limitation of the MTANN is the long training time. To address this issue, the authors investigated the feasibility of two state-of-the-art regression models, namely, support vector regression (SVR) and Gaussian process regression (GPR) models, in the massive-training framework and developed massive-training SVR (MTSVR) and massive-training GPR (MTGPR) for the reduction of FPs in CADe of polyps. The authors applied SVR and GPR as volume-processing techniques in the distinction of polyps from FP detections in a CTC CADe scheme. Unlike artificial neural networks (ANNs), both SVR and GPR are memory-based methods that store a part of or the entire training data for testing. Therefore, their training is generally fast and they are able to improve the efficiency of the massive-training methodology. Rooted in a maximum margin property, SVR offers excellent generalization ability and robustness to outliers. On the other hand, GPR approaches nonlinear regression from a Bayesian perspective, which produces both the optimal estimated function and the covariance associated with the estimation. Therefore, both SVR and GPR, as the state-of-the-art nonlinear regression models, are able to offer a performance comparable or potentially superior to that of ANN, with highly efficient training. Both MTSVR and MTGPR were trained directly with voxel values from CTC images. A 3D scoring method based on a 3D Gaussian weighting function was applied to the outputs of MTSVR and MTGPR for distinction between polyps and nonpolyps. To test the performance of the proposed models, the authors compared them to the original MTANN in the distinction between actual polyps and various types of FPs in terms of training time reduction and FP reduction performance. The authors' CTC database consisted of 240 CTC

  18. Distributed human intelligence for colonic polyp classification in computer-aided detection for CT colonography.

    Science.gov (United States)

    Nguyen, Tan B; Wang, Shijun; Anugu, Vishal; Rose, Natalie; McKenna, Matthew; Petrick, Nicholas; Burns, Joseph E; Summers, Ronald M

    2012-03-01

    To assess the diagnostic performance of distributed human intelligence for the classification of polyp candidates identified with computer-aided detection (CAD) for computed tomographic (CT) colonography. This study was approved by the institutional Office of Human Subjects Research. The requirement for informed consent was waived for this HIPAA-compliant study. CT images from 24 patients, each with at least one polyp of 6 mm or larger, were analyzed by using CAD software to identify 268 polyp candidates. Twenty knowledge workers (KWs) from a crowdsourcing platform labeled each polyp candidate as a true or false polyp. Two trials involving 228 KWs were conducted to assess reproducibility. Performance was assessed by comparing the area under the receiver operating characteristic curve (AUC) of KWs with the AUC of CAD for polyp classification. The detection-level AUC for KWs was 0.845 ± 0.045 (standard error) in trial 1 and 0.855 ± 0.044 in trial 2. These were not significantly different from the AUC for CAD, which was 0.859 ± 0.043. When polyp candidates were stratified by difficulty, KWs performed better than CAD on easy detections; AUCs were 0.951 ± 0.032 in trial 1, 0.966 ± 0.027 in trial 2, and 0.877 ± 0.048 for CAD (P = .039 for trial 2). KWs who participated in both trials showed a significant improvement in performance going from trial 1 to trial 2; AUCs were 0.759 ± 0.052 in trial 1 and 0.839 ± 0.046 in trial 2 (P = .041). The performance of distributed human intelligence is not significantly different from that of CAD for colonic polyp classification. © RSNA.

  19. Computed tomographic colonography:Hope or hype?

    Institute of Scientific and Technical Information of China (English)

    Otto; Schiueh-Tzang; Lin

    2010-01-01

    Computed tomographic colonography (CTC) is a promising emerging technology for imaging of the colon. This concise review discusses the currently available data on CTC technique,test characteristics,acceptance,safety,cost-effectiveness,follow-up strategy,and extracolonic findings. In summary,CTC technique is still evolving,and further research is needed to clarify the role of automated colonic insufflation,smooth-muscle relaxants,intravenous and oral contrast,soft-ware rendering,and patient positioning. Curr...

  20. The feasibility study of low-dose gem energy spectrum CT colonography in the diagnosis of colonic polyps%低剂量宝石能谱 CT 结肠成像在检测结肠息肉中的可行性研究

    Institute of Scientific and Technical Information of China (English)

    李家言; 黄乔统; 何欣; 黄增超; 刘熙荣; 廖海; 袁文昭; 张锡流; 袁捷; 韦兰珍

    2014-01-01

    Objective To explore the feasibility of low doses of gem energy spectrum CT colonography ( CTC) in detecting polyps of the colon .Methods A total of 50 patients with suspected colonic polyps underwent low-dose gem energy spectrum CTC and endoscopy .The colonic polyps were observed by endoscopy and gem energy spectrum CTC,with the endoscopic finding as gold standard .The coincidence was evaluated for colonic polyps by the gem energy spectrum CTC ,and calculated CT dose index ( CTDIw) in prone was recorded .Results Thirty-eight pa-tients were diagnosed to have colonic polyps by endoscopy and 12 were negative ,the CTC negative diagnosis of colonic polyps in 16 cases and positive 34 cases.Total 79 polyps in 50 patients were found by CTC .For polyp size≥0.5 cm and <0.5 cm, the compliance was 91.07%, and 50.00%,respectively.Conclusion Reduction of the effective dose to 1.01 mGy significantly affects images quality on gemstone energy spectrum CTC ,but the perception of ≥0.5 cm lesion not significantly impaired .%目的:探讨低剂量宝石能谱CT结肠成像( CTC)在检测结肠息肉中的可行性。方法对50例疑似结肠息肉患者行低剂量宝石能谱CTC及内镜检查,以内镜结果作为金标准,计算低剂量宝石能谱CTC检测结肠息肉的符合率,并记录扫描的CT剂量指数( CTDIw )。结果内镜诊断结肠息肉阴性12例,阳性38例;低剂量宝石能谱CTC诊断结肠息肉阴性16例,阳性34例;共发现79个息肉。对于≥0.5 cm的息肉,低剂量宝石能谱CTC的符合率为91.07%,<5 mm的息肉符合率为50%。结论辐射剂量降低至1.01 mGy的宝石能谱CTC检测≥0.5 cm的息肉,与内镜有较高的符合率。

  1. CT colonography with minimal bowel preparation: evaluation of tagging quality, patient acceptance and diagnostic accuracy in two iodine-based preparation schemes

    Energy Technology Data Exchange (ETDEWEB)

    Liedenbaum, Marjolein H. [Academic Medical Centre, Department of Radiology, Amsterdam (Netherlands); Academic Medical Center, Amsterdam (Netherlands); Vries, A.H. de; Bipat, S.; Stoker, J. [Academic Medical Centre, Department of Radiology, Amsterdam (Netherlands); Gouw, C.I.B.F. [Academic Medical Centre, Department of Radiology, Amsterdam (Netherlands); Gelre Hospitals, Department of Radiology, Apeldoorn (Netherlands); Rijn, A.F. van; Dekker, E. [Academic Medical Centre, Department of Gastroenterology and Hepatology, Amsterdam (Netherlands)

    2010-02-15

    The aim of this study was to compare a 1-day with a 2-day iodine bowel preparation for CT colonography in a positive faecal occult blood test (FOBT) screening population. One hundred consecutive patients underwent CT colonography and colonoscopy with segmental unblinding. The first 50 patients (group 1) ingested 7*50 ml iodinated contrast starting 2 days before CT colonography. The latter 50 patients (group 2) ingested 4*50 ml iodinated contrast starting 1 day before CT colonography. Per colonic segment measurements of residual stool attenuation and homogeneity were performed, and a subjective evaluation of tagging quality (grade 1-5) was done. Independently, two reviewers performed polyp and carcinoma detection. The tagging density was 638 and 618 HU (p = 0.458) and homogeneity 91 and 86 HU for groups 1 and 2, respectively (p = 0.145). The tagging quality was graded 5 (excellent) in 90% of all segments in group 1 and 91% in group 2 (p = 0.749). Mean per-polyp sensitivity for lesions {>=}10 mm was 86% in group 1 and 97% in group 2 (p = 0.355). Patient burden from diarrhoea significantly decreased for patients in group 2. One-day preparation with meglumine ioxithalamate results in an improved patient acceptability compared with 2-day preparation and has a comparable, excellent image quality and good diagnostic performance. (orig.)

  2. Polyp measurement and size categorisation by CT colonography: effect of observer experience in a multi-centre setting

    Energy Technology Data Exchange (ETDEWEB)

    Burling, David; Bartram, Clive; De Villiers, Melinda; Honeyfield, Lesley [St. Marks Hospital, Intestinal Imaging Centre, London (United Kingdom); Halligan, Steve; Taylor, Stuart [University College Hospital, Specialist Radiology, Level 2 Podium, London (United Kingdom); Altman, Douglas G. [Centre for Medical Statistics, Oxford (United Kingdom); Atkin, Wendy [St Mark' s Hospital, Cancer Research UK, London (United Kingdom); Fenlon, Helen; Foley, Shane; O' Hare, Alan [Mater Misericordiae, Dublin (Ireland); Laghi, Andrea; Iannaccone, Riccardo; Mangiapane, Filipo; Ori, Sante [La Sapienza, Rome (Italy); Stoker, Jaap; Florie, Jasper; Poulus, Martin; Hulst, Victor van der [Amersterdam Medican Centre, Amsterdam (Netherlands); Frost, Roger [Salisbury District Hospital, Salisbury (United Kingdom); Dessey, Guido; Lefere, Philippe; Marrannes, Jesse [Stedelijk Ziekenhuis, Roeselare (Belgium); Gallo, Teresa; Nieddu, Giulia; Regge, Daniele; Signoretta, Saverio [Candiolo Oncologic Hospital, Turin (Italy); Kay, Clive; Lowe, Andrew; Williams-Butt, Jane [Bradford Royal Infirmary, Bradford (United Kingdom); Neri, Emmanuele; Politi, Benedetta; Vagli, Paola [University of Pisa, Pisa (Italy); Nicholson, David; Renaut, Lisa; Rudralingham, Velauthan [Hope Hospital, Salford (United Kingdom)

    2006-08-15

    The extent measurement error on CT colonography influences polyp categorisation according to established management guidelines is studied using twenty-eight observers of varying experience to classify polyps seen at CT colonography as either 'medium' (maximal diameter 6-9 mm) or 'large' (maximal diameter 10 mm or larger). Comparison was then made with the reference diameter obtained in each patient via colonoscopy. The Bland-Altman method was used to assess agreement between observer measurements and colonoscopy, and differences in measurement and categorisation was assessed using Kruskal-Wallis and Chi-squared test statistics respectively. Observer measurements on average underestimated the diameter of polyps when compared to the reference value, by approximately 2-3 mm, irrespective of observer experience. Ninety-five percent limits of agreement were relatively wide for all observer groups, and had sufficient span to encompass different size categories for polyps. There were 167 polyp observations and 135 (81%) were correctly categorised. Of the 32 observations that were miscategorised, 5 (16%) were overestimations and 27 (84%) were underestimations (i.e. large polyps misclassified as medium). Caution should be exercised for polyps whose colonographic diameter is below but close to the 1-cm boundary threshold in order to avoid potential miscategorisation of advanced adenomas. (orig.)

  3. CT attenuation of colorectal polypoid lesions: evaluation of contrast enhancement in CT colonography

    Energy Technology Data Exchange (ETDEWEB)

    Oto, Aytekin [Department of Radiology, Hacettepe University School of Medicine, Ankara (Turkey); Department of Radiology, University of Texas Medical Branch at Galveston, 301 University Boulevard, 77555-0709, Galveston, TX (United States); Gelebek, Veli; Oguz, Berna Sayan; Deger, Ahmet; Akhan, Okan; Besim, Aytekin [Department of Radiology, Hacettepe University School of Medicine, Ankara (Turkey); Sivri, Buelent [Department of Gastroenterology, Hacettepe University School of Medicine, Ankara (Turkey)

    2003-07-01

    The aim of this study was to calculate pre- and postcontrast CT attenuation values of benign colorectal polyp and carcinoma lesions detected by virtual colonoscopy, and to investigate whether contrast enhancement of these lesions can be potentially used for differentiation from residual fluid in the colon. Fifteen benign polyps and 21 colorectal carcinoma lesions detected by virtual colonoscopy in 18 patients were included in our study. All of the polyps and carcinoma lesions were confirmed by colonoscopic biopsy. Measurement of CT attenuation values was performed in precontrast (supine) and postcontrast (prone) scans for each polyp and carcinoma. The CT attenuation values of residual fluid in the colon was also measured from the same location before and after intravenous contrast administration. On unenhanced CT scan mean attenuation values of benign polyps and colorectal carcinomas were 32.4 and 42.6 HU, respectively. Following contrast enhancement, mean attenuation value increased to 78.9 HU for polyps and 90.7 HU for carcinomas. Increase in the CT attenuation values of these lesions was significant (p <0.0001). Mean CT attenuation value of residual fluid before and after administration of IV contrast were 14.6 and 13.8 HU, respectively. The difference between CT attenuation value of residual fluid in the colon before and after contrast material was not significant (p =0.29). Colorectal benign polyps and carcinomas demonstrate significant enhancement following contrast administration and use of intravenous contrast material during virtual colonoscopy may help in some cases in differentiating these solid lesions from residual colonic fluid that does not enhance. (orig.)

  4. Computer-Aided Detection of Polyps in CT Colonography Using Logistic Regression

    NARCIS (Netherlands)

    Van Ravesteijn, V.F.; Van Wijk, C.; Vos, F.M.; Truyen, R.; Peters, J.F.; Stoker, J.; Van Vliet, L.J.

    2010-01-01

    We present a computer-aided detection (CAD) system for computed tomography colonography that orders the polyps according to clinical relevance. TheCADsystem consists of two steps: candidate detection and supervised classification. The characteristics of the detection step lead to specific choices fo

  5. Computer-aided detection of colonic polyps with level set-based adaptive convolution in volumetric mucosa to advance CT colonography toward a screening modality

    Science.gov (United States)

    Zhu, Hongbin; Duan, Chaijie; Pickhardt, Perry; Wang, Su; Liang, Zhengrong

    2009-01-01

    As a promising second reader of computed tomographic colonography (CTC) screening, the computer-aided detection (CAD) of colonic polyps has earned fast growing research interest. In this paper, we present a CAD scheme to automatically detect colonic polyps in CTC images. First, a thick colon wall representation, ie, a volumetric mucosa (VM) with several voxels wide in general, was segmented from CTC images by a partial-volume image segmentation algorithm. Based on the VM, we employed a level set-based adaptive convolution method for calculating the first- and second-order spatial derivatives more accurately to start the geometric analysis. Furthermore, to emphasize the correspondence among different layers in the VM, we introduced a middle-layer enhanced integration along the image gradient direction inside the VM to improve the operation of extracting the geometric information, like the principal curvatures. Initial polyp candidates (IPCs) were then determined by thresholding the geometric measurements. Based on IPCs, several features were extracted for each IPC, and fed into a support vector machine to reduce false positives (FPs). The final detections were displayed in a commercial system to provide second opinions for radiologists. The CAD scheme was applied to 26 patient CTC studies with 32 confirmed polyps by both optical and virtual colonoscopies. Compared to our previous work, all the polyps can be detected successfully with less FPs. At the 100% by polyp sensitivity, the new method yielded 3.5 FPs/dataset. PMID:20428331

  6. A randomized double-blind placebo-controlled trial to evaluate the value of a single bolus intravenous alfentanil in CT colonography

    Directory of Open Access Journals (Sweden)

    Boellaard Thierry N

    2011-11-01

    Full Text Available Abstract Background Although CT colonography is a less invasive alternative for colonoscopy for the detection of colorectal polyps and cancer, procedural pain is common. In several studies, CT colonography pain and burden is higher than in colonoscopy. Apart from discomfort, anxiety and its related stress-induced peri- procedural side effects, this may influence the adherence for CT colonography as a possible screening tool for colorectal cancer. We hypothesize that a single bolus intravenous alfentanil will give a clinically relevant reduction in maximum pain defined as at least 1.3 point reduction on an 11-point numeric rating scale (NRS. Methods/Design A randomized double-blind placebo-controlled trial in which patients scheduled for elective CT colonography in a single tertiary centre are eligible for inclusion. The first 90 consenting patient will be block-randomized to either the alfentanil group or the placebo group. Before bowel insufflation, the alfentanil group receives a single bolus intravenous alfentanil 7.5 μg/kg dissolved in 0.9% NaCl, while the placebo group receives an intravenous bolus injection of pure 0.9% NaCl. For both groups an equal amount of fluid per kilogram (75 μL/kg is injected. The primary outcome is the difference in maximum pain on an 11-point NRS. Secondary outcomes include: pain and burden of different CT colonography aspects, side effects, procedural time and recovery time. For the primary outcome an independent samples t-test is performed and a P value Discussion This study will provide evidence whether a single bolus intravenous alfentanil gives a clinically relevant reduction in maximum pain during CT colonography. Trial registration Netherlands Trial Register (NTR: NTR2902 This trial will be conducted in accordance with the protocol and in compliance with the moral, ethical, and scientific principles governing clinical research as set out in the Declaration of Helsinki (1989 and Good Clinical Practice

  7. High-Performance CAD-CTC Scheme Using Shape Index, Multiscale Enhancement Filters, and Radiomic Features.

    Science.gov (United States)

    Ren, Yacheng; Ma, Jingchen; Xiong, Junfeng; Lu, Lin; Zhao, Jun

    2017-08-01

    Computer-aided detection (CAD) systems for computed tomography colonography (CTC) can automatically detect colorectal polyps. The main problem of currently developed CAD-CTC systems is the numerous false positives (FPs) caused by the existence of complicated colon structures (e.g., haustral fold, residual fecal material, inflation tube, and ileocecal valve). This study proposes a CAD-CTC scheme using shape index, multiscale enhancement filters, and radiomic features to address the FP issue. Shape index and multiscale enhancement filter calculated in the Gaussian smoothed geodesic distance field are combined to generate the polyp candidates. A total of 440 well-defined radiomic features collected from previous radiomic studies and 200 newly developed radiomic features are used to construct a supervised classification model to reduce the numerous FPs. The proposed CAD-CTC scheme was evaluated on 152 oral contrast-enhanced CT datasets from 76 patients with 103 polyps ≥5 mm. The detection results were 98.1% and 95.3% by-polyp sensitivity and per-scan sensitivity, respectively, with the same FP rate of 1.3 FPs per dataset for polyps ≥5 mm. Experimental results indicate that the proposed CAD-CTC scheme can achieve high sensitivity while maintaining a low FP rate. The proposed CAD-CTC scheme would be a beneficial tool in clinical colon examination.

  8. CT colonography interpretation times: effect of reader experience, fatigue, and scan findings in a multi-centre setting

    Energy Technology Data Exchange (ETDEWEB)

    Burling, David; Bartram, Clive; De Villiers, Melinda; Honeyfield, Lesley [St. Marks Hospital, Intestinal Imaging Centre, London (United Kingdom); Halligan, Steve; Taylor, Stuart [University College Hospital, Specialist Radiology, Level 2 Podium, London (United Kingdom); Altman, Douglas G. [Centre for Medical Statistics, Oxford (United Kingdom); Atkin, Wendy [St Mark' s Hospital, Cancer Research UK, London (United Kingdom); Fenlon, Helen; Foley, Shane; O' Hare, Alan [Mater Misericordiae, Dublin (Ireland); Laghi, Andrea; Iannaccone, Riccardo; Mangiapane, Filipo; Ori, Sante [La Sapienza, Rome (Italy); Stoker, Jaap; Florie, Jasper; Poulus, Martin; Hulst, Victor van der [Amsterdam Medical Centre, Amsterdam (Netherlands); Frost, Roger [Salisbury District Hospital, Salisbury (United Kingdom); Dessey, Guido; Lefere, Philippe; Marrannes, Jesse [Stedelijk Ziekenhuis, Roeselare (Belgium); Gallo, Teresa; Nieddu, Giulia; Regge, Daniele; Signoretta, Saverio [Candiolo Oncologic Hospital, Turin (Italy); Kay, Clive; Lowe, Andrew; Williams-Butt, Jane [Bradford Royal Infirmary, Bradford (United Kingdom); Neri, Emmanuele; Politi, Benedetta; Vagli, Paola [University of Pisa, Pisa (Italy); Nicholson, David; Renaut, Lisa; Rudralingham, Velauthan [Hope Hospital, Salford (United Kingdom)

    2006-08-15

    Our purpose was to assess the effect of reader experience, fatigue, and scan findings on interpretation time for CT colonography. Nine radiologists (experienced in CT colonography); nine radiologists and ten technicians (both groups trained using 50 validated examinations) read 40 cases (50% abnormal) under controlled conditions. Individual interpretation times for each case were recorded, and differences between groups determined. Multi-level linear regression was used to investigate effect of scan category (normal or abnormal) and observer fatigue on interpretation times. Experienced radiologists (mean time 10.9 min, SD 5.2) reported significantly faster than less experienced radiologists and technicians; odds ratios of reporting times 1.4 (CI 1.1, 1.8) and 1.6 (1.3, 2.0), respectively (P{<=}0.001). Experienced and less-experienced radiologists took longer to report abnormal cases; ratio 1.2 (CI 1.1,1.4, P<0.001) and 1.2 (1.0, 1.3, P=0.03), respectively. All groups took 70% as long to report the final five cases as they did with an initial five; ratio 0.7 (CI 0.6 to 0.8), P<0.001. For technicians only, accuracy increased with longer reporting times (P=0.04). Experienced radiologists report faster than do less-experienced observers and proportionally spend less time interpreting normal cases. Technicians who report more slowly are more accurate. All groups reported faster as the study period progressed. (orig.)

  9. Comparative performance of a primary-reader and second-reader paradigm of computer-aided detection for CT colonography in a low-prevalence screening population.

    Science.gov (United States)

    Miyake, Mototaka; Iinuma, Gen; Taylor, Stuart A; Halligan, Steve; Morimoto, Tsuyoshi; Ichikawa, Tamaki; Tomimatsu, Hideto; Beddoe, Gareth; Sugimura, Kazuro; Arai, Yasuaki

    2013-05-01

    To compare the efficacy of computer-aided detection (CAD) for computed tomographic colonography (CTC) when employed as either primary-reader or second-reader paradigms in a low-prevalence screening population. Ninety screening patients underwent same-day CTC and colonoscopy. Four readers prospectively interpreted all CTC data sets using a second-reader paradigm (unassisted interpretation followed immediately by CAD assistance). Three months later, randomized anonymous data sets were re-interpreted by all readers using a primary-reader paradigm (only CAD prompts evaluated). Compared with the average per-patient sensitivity for unassisted interpretation (0.57), both CAD paradigms significantly increased sensitivity: 0.78 (p reader paradigm and 0.83 (p reader paradigm. There was no significant difference between CAD paradigms (p = 0.25). The average per-patient specificity for polyps ≥6 mm was significantly higher using the primary-reader paradigm than the second-reader paradigm (0.90 vs. 0.83, respectively, p = 0.006), with ROC AUCs of 0.83 and 0.68, respectively. Reading time using CAD as a primary-reader paradigm (median 1.4 min) was significantly shorter than both unassisted (median 4.0 min, p reader paradigms (median 5.5 min, p reader paradigm, although the latter may improve specificity and efficiency more.

  10. Survey update on implementation, indications, and technical performance of computed tomography colonography in Sweden

    Energy Technology Data Exchange (ETDEWEB)

    Fisichella, Valeria A.; Hellstroem, Mikael (Dept. of Radiology, Sahlgrenska Univ. Hospital and Sahlgrenska Academy at Univ. of Goeteborg, Goeteborg (Sweden)), e-mail: valeria.fisichella@vgregion.se

    2010-01-15

    Background: Computed tomographic colonography (CTC) has gained increased acceptance in the last few years as a valid substitute for double-contrast barium enema (DCBE). However, implementation of new technologies is complex, since several factors may influence the process. Purpose: To evaluate the current situation in Sweden concerning implementation of CTC, as compared to a previous national survey in 2005. Material and Methods: In December 2008, a structured, self-assessed questionnaire regarding implementation and technical performance of CTC was mailed to all radiology departments in Sweden. In March 2009, departments who had not replied were contacted by e-mail or by telephone. All (100%, 119/119) departments answered the questionnaire. Results: CTC is currently performed in 50/119 (42%) departments, i.e., 18 additional departments compared to 2005. Twenty-three out of 60 (38%) responding departments stated that they intend to start to perform CTC in the near future. DCBE is currently performed in 77/119 (65%) departments, 12 departments less compared to 2005. The most common reasons for non-implementation of CTC are non-availability of spiral CT scanner (41%, 26/64) and/or multidetector-row CT scanner (39%, 25/64), and lack of doctors' time (34%, 22/64). Only 3% (2/64) of departments are 'awaiting further scientific documentation' on CTC, a significant reduction compared to 2005 (P=0.002). Until 2009, 59% (29/49) of CTC centers had performed more than 200 CTCs compared to 13% (4/32) of CTC centers in 2005. Intravenous contrast material is routinely administered in 86% (42/49), and carbon dioxide is used to distend the colon in 90% (44/49). Almost all radiology departments (93%, 93/100) currently believe that CTC will 'absolutely' or 'probably' replace barium enema in the future, while in 2005 only 56% (55/99) gave similar answers. Conclusion: The survey reflects a further transition process from DCBE to CTC, with attitudes

  11. Assessment of the Incremental Benefit of Computer-Aided Detection (CAD) for Interpretation of CT Colonography by Experienced and Inexperienced Readers.

    Science.gov (United States)

    Boone, Darren; Mallett, Susan; McQuillan, Justine; Taylor, Stuart A; Altman, Douglas G; Halligan, Steve

    2015-01-01

    To quantify the incremental benefit of computer-assisted-detection (CAD) for polyps, for inexperienced readers versus experienced readers of CT colonography. 10 inexperienced and 16 experienced radiologists interpreted 102 colonography studies unassisted and with CAD utilised in a concurrent paradigm. They indicated any polyps detected on a study sheet. Readers' interpretations were compared against a ground-truth reference standard: 46 studies were normal and 56 had at least one polyp (132 polyps in total). The primary study outcome was the difference in CAD net benefit (a combination of change in sensitivity and change in specificity with CAD, weighted towards sensitivity) for detection of patients with polyps. Inexperienced readers' per-patient sensitivity rose from 39.1% to 53.2% with CAD and specificity fell from 94.1% to 88.0%, both statistically significant. Experienced readers' sensitivity rose from 57.5% to 62.1% and specificity fell from 91.0% to 88.3%, both non-significant. Net benefit with CAD assistance was significant for inexperienced readers but not for experienced readers: 11.2% (95%CI 3.1% to 18.9%) versus 3.2% (95%CI -1.9% to 8.3%) respectively. Concurrent CAD resulted in a significant net benefit when used by inexperienced readers to identify patients with polyps by CT colonography. The net benefit was nearly four times the magnitude of that observed for experienced readers. Experienced readers did not benefit significantly from concurrent CAD.

  12. Efficacy of Barium-Based Fecal Tagging for CT Colonography: a Comparison between the Use of High and Low Density Barium Suspensions in a Korean Population - a Preliminary Study

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Min Ju; Park, Seong Ho; Lee, Seung Soo; Byeon, Jeong Sik; Kim, Jung Hoon; Kim, Yeoung Nam; Kim, Ah Young; Ha, Hyun Kwon [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Choi, Eugene K. [University of California Los Angeles, Los Angeles (United States)

    2009-02-15

    This preliminarily study was designed to determine and to compare the efficacy of two commercially available barium-based fecal tagging agents for CT colonography (CTC) (high-density [40% w/v] and low-density [4.6% w/v] barium suspensions) in a population in Korea. In a population with an identified with an average-risk for colorectal cancer, 15 adults were administered three doses of 20 ml 40% w/v barium for fecal tagging (group I) and 15 adults were administered three doses of 200 ml 4.6% w/v barium (group II) for fecal tagging. Excluding five patients in group I and one patient in group II that left the study, ten patients in group I and 14 patients in group II were finally included in the analysis. Two experienced readers evaluated the CTC images in consensus regarding the degree of tagging of stool pieces 6 mm or larger. Stool pieces were confirmed with the use of standardized CTC criteria or the absence of matched lesions as seen on colonoscopy. The rates of complete fecal tagging were analyzed on a per-lesion and a per-segment basis and were compared between the patients in the two groups. Per-lesion rates of complete fecal tagging were 52% (22 of 42; 95% CI, 37.7-66.6%) in group I and 78% (28 of 36; 95% CI, 61.7-88.5%) in group II. The difference between the two groups did not reach statistical significance (p = 0.285). The per-segment rates of complete tagging were 33% (6 of 18; 95% CI, 16.1%-56.4%) in group I and 60% (9 of 15; 95% CI, 35.7%-80.3%) in group II; again, the difference between the two groups did not reach statistical significance (p = 0.171). Barium-based fecal tagging using both the 40% w/v and the 4.6% w/v barium suspensions showed moderate tagging efficacy. The preliminary comparison did not demonstrate a statistically significant difference in the tagging efficacy between the use of the two tagging agents, despite the tendency toward better tagging with the use of the 4.6% w/v barium suspension.

  13. [Virtual reality in MR colonography].

    Science.gov (United States)

    Schoenfelder, D; Debatin, J F

    2000-03-01

    Early detection and subsequent removal of colorectal polyps have been shown to constitute an effective approach for decreasing the incidence of colorectal cancer. The lack of an ideal modality for colorectal polyp screening stimulated interest in the development of CT-colonography and MR-colonography. Both techniques allow the colon to be analyzed in a cross-sectional as well as a virtual endoscopic format. Causing no side-effects and not concerning for radiation exposure MR-colonography warrants further consideration. Additional to detecting polyps down to 6 mm in size the inner wall contour and the morphology of the colonic wall itself can be assessed. New developments like fecal tagging will increase patients acceptance comparing to other diagnostic techniques. In search of an ideal modality for polyp screening MR-colonography will become a potent option in the diagnostic arsenal.

  14. Ascending colon rotation following patient positional change during CT colonography: a potential pitfall in interpretation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ji Yeon; Park, Seong Ho; Lee, Seung Soo; Kim, Ah Young; Ha, Hyun Kwon [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea, Republic of)

    2011-02-15

    To investigate the degree and pattern of ascending colonic rotation as patients moved from supine to prone positions during CTC. A search of our CTC and colonoscopy database found 37 patients (43 eligible lesions) who fulfilled the following criteria: colonoscopy-proven sessile polyps {>=}6 mm in the straight mid-ascending colon, lesion visualisation in both supine and prone CTC, and optimal colonic distension. A coordinate system was developed to designate the polyp radial location ( ) along the luminal circumference, unaffected by rotation of the torso. The degree/direction of polyp radial location change (i.e. ascending colonic rotation) between supine and prone positions correlated with anthropometric measurements. Movement from supine to prone positions resulted in a change in the radial polyp location of between -23 and 79 (median, 21 ), demonstrating external rotation of the ascending colon in almost all cases (2 to 79 in 36/37 patients and 42/43 lesions). The degree/direction of rotation mildly correlated with the degree of abdominal compression in the anterior-posterior direction in prone position (r = 0.427 [P = 0.004] and r = 0.404 [P = 0.007]). The ascending colon was usually found to rotate externally as patients moved from supine to prone positions, partly dependent on the degree of abdominal compression. (orig.)

  15. Exploration of analysis methods for diagnostic imaging tests: problems with ROC AUC and confidence scores in CT colonography.

    Science.gov (United States)

    Mallett, Susan; Halligan, Steve; Collins, Gary S; Altman, Doug G

    2014-01-01

    Different methods of evaluating diagnostic performance when comparing diagnostic tests may lead to different results. We compared two such approaches, sensitivity and specificity with area under the Receiver Operating Characteristic Curve (ROC AUC) for the evaluation of CT colonography for the detection of polyps, either with or without computer assisted detection. In a multireader multicase study of 10 readers and 107 cases we compared sensitivity and specificity, using radiological reporting of the presence or absence of polyps, to ROC AUC calculated from confidence scores concerning the presence of polyps. Both methods were assessed against a reference standard. Here we focus on five readers, selected to illustrate issues in design and analysis. We compared diagnostic measures within readers, showing that differences in results are due to statistical methods. Reader performance varied widely depending on whether sensitivity and specificity or ROC AUC was used. There were problems using confidence scores; in assigning scores to all cases; in use of zero scores when no polyps were identified; the bimodal non-normal distribution of scores; fitting ROC curves due to extrapolation beyond the study data; and the undue influence of a few false positive results. Variation due to use of different ROC methods exceeded differences between test results for ROC AUC. The confidence scores recorded in our study violated many assumptions of ROC AUC methods, rendering these methods inappropriate. The problems we identified will apply to other detection studies using confidence scores. We found sensitivity and specificity were a more reliable and clinically appropriate method to compare diagnostic tests.

  16. Computer-assisted detection of colonic polyps with CT colonography using neural networks and binary classification trees.

    Science.gov (United States)

    Jerebko, Anna K; Summers, Ronald M; Malley, James D; Franaszek, Marek; Johnson, C Daniel

    2003-01-01

    Detection of colonic polyps in CT colonography is problematic due to complexities of polyp shape and the surface of the normal colon. Published results indicate the feasibility of computer-aided detection of polyps but better classifiers are needed to improve specificity. In this paper we compare the classification results of two approaches: neural networks and recursive binary trees. As our starting point we collect surface geometry information from three-dimensional reconstruction of the colon, followed by a filter based on selected variables such as region density, Gaussian and average curvature and sphericity. The filter returns sites that are candidate polyps, based on earlier work using detection thresholds, to which the neural nets or the binary trees are applied. A data set of 39 polyps from 3 to 25 mm in size was used in our investigation. For both neural net and binary trees we use tenfold cross-validation to better estimate the true error rates. The backpropagation neural net with one hidden layer trained with Levenberg-Marquardt algorithm achieved the best results: sensitivity 90% and specificity 95% with 16 false positives per study.

  17. Effect of listening to music and essential oil inhalation on patients undergoing screening CT colonography: a randomized controlled trial.

    Science.gov (United States)

    Nagata, Koichi; Iida, Nao; Kanazawa, Hidenori; Fujiwara, Masanori; Mogi, Tomohiro; Mitsushima, Toru; Lefor, Alan T; Sugimoto, Hideharu

    2014-12-01

    To prospectively evaluate the effect of listening to music and inhaling aroma oil on patients undergoing screening computed tomography colonography. Two hundred and twenty four participants were randomly allocated to one of the four groups including: (1) combined music and aroma, (2) music alone, (3) aroma alone, and (4)control. The visual analog scale for pain and a questionnaire were used for subjective outcomes. We also used a pre-test–post-test design to compare the differences in blood pressure and heart rate as objective outcomes. There were no statistical differences between the control group and other groups in the visual analog scale or changes in heart rate. Changes in blood pressure were similar. Participants reported good overall experiences. There were no differences in terms of overall satisfaction, pain rating, willingness to repeat the computed tomography colonography procedure in the future, or preference between colonoscopy and computed tomography colonography. More participants using music and/or aroma requested music and/or aroma during the next computed tomography colonography (P pain or discomfort and vital signs, participants who listened to music and inhaled aroma during the computed tomography colonography preferred music and aroma during the next computed tomography colonography. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. Colon distension, perceived burden and side-effects of CT-colonography for screening using hyoscine butylbromide or glucagon hydrochloride as bowel relaxant

    Energy Technology Data Exchange (ETDEWEB)

    Haan, Margriet C. de, E-mail: margrietcdehaan@gmail.com [Department of Radiology, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Boellaard, Thierry N., E-mail: t.n.boellaard@amc.uva.nl [Department of Radiology, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Bossuyt, Patrick M., E-mail: p.m.bossuyt@amc.uva.nl [Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Stoker, Jaap, E-mail: j.stoker@amc.uva.nl [Department of Radiology, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands)

    2012-08-15

    Objective: Compare colonic distension and perceived burden of CT-colonography between participants receiving hyoscine butylbromide (buscopan) and glucagon hydrochloride as bowel relaxant. Materials and methods: Data were collected within a screening trial. Participants received 20 mg buscopan intravenously or 1 mg of glucagon intravenously (if buscopan contra-indicated). Colon distension per segment was assessed using a 4-point scale (prone and supine). Data on perceived burden of CT-colonography were collected using a questionnaire two weeks after the examination. Outcome measures between groups were compared using propensity score matching. We used a stratified Wilcoxon-Mann-Whitney test statistic for quantitative and Cochran-Mantel-Haenszel statistics for categorical variables. Results: 541 participants were included: 336 (62%) received buscopan and 205 received glucagon. All buscopan recipients had an adequately distended colon, compared to 96% in the glucagon group (RR 7.31, 95% CI: 1.61-33.28). More glucagon recipients scored the insufflation as rather or extremely burdensome (25% vs. 16%; overall mean score 2.7 vs. 2.4; p < 0.001) and more found the entire CT-colonography rather or extremely burdensome (14% vs. 7%; 2.2 vs. 1.9; p = 0.001). Most frequently reported side effects were a dry mouth in the buscopan group (15%) and nausea in the glucagon group (13%). Conclusion: Compared to glucagon, premedication with buscopan results in significantly more adequately distended colons and a less burdensome procedure. When buscopan can be used, it is the preferred bowel relaxant.

  19. Assessment of the Incremental Benefit of Computer-Aided Detection (CAD for Interpretation of CT Colonography by Experienced and Inexperienced Readers.

    Directory of Open Access Journals (Sweden)

    Darren Boone

    Full Text Available To quantify the incremental benefit of computer-assisted-detection (CAD for polyps, for inexperienced readers versus experienced readers of CT colonography.10 inexperienced and 16 experienced radiologists interpreted 102 colonography studies unassisted and with CAD utilised in a concurrent paradigm. They indicated any polyps detected on a study sheet. Readers' interpretations were compared against a ground-truth reference standard: 46 studies were normal and 56 had at least one polyp (132 polyps in total. The primary study outcome was the difference in CAD net benefit (a combination of change in sensitivity and change in specificity with CAD, weighted towards sensitivity for detection of patients with polyps.Inexperienced readers' per-patient sensitivity rose from 39.1% to 53.2% with CAD and specificity fell from 94.1% to 88.0%, both statistically significant. Experienced readers' sensitivity rose from 57.5% to 62.1% and specificity fell from 91.0% to 88.3%, both non-significant. Net benefit with CAD assistance was significant for inexperienced readers but not for experienced readers: 11.2% (95%CI 3.1% to 18.9% versus 3.2% (95%CI -1.9% to 8.3% respectively.Concurrent CAD resulted in a significant net benefit when used by inexperienced readers to identify patients with polyps by CT colonography. The net benefit was nearly four times the magnitude of that observed for experienced readers. Experienced readers did not benefit significantly from concurrent CAD.

  20. Exploration of analysis methods for diagnostic imaging tests: problems with ROC AUC and confidence scores in CT colonography.

    Directory of Open Access Journals (Sweden)

    Susan Mallett

    Full Text Available BACKGROUND: Different methods of evaluating diagnostic performance when comparing diagnostic tests may lead to different results. We compared two such approaches, sensitivity and specificity with area under the Receiver Operating Characteristic Curve (ROC AUC for the evaluation of CT colonography for the detection of polyps, either with or without computer assisted detection. METHODS: In a multireader multicase study of 10 readers and 107 cases we compared sensitivity and specificity, using radiological reporting of the presence or absence of polyps, to ROC AUC calculated from confidence scores concerning the presence of polyps. Both methods were assessed against a reference standard. Here we focus on five readers, selected to illustrate issues in design and analysis. We compared diagnostic measures within readers, showing that differences in results are due to statistical methods. RESULTS: Reader performance varied widely depending on whether sensitivity and specificity or ROC AUC was used. There were problems using confidence scores; in assigning scores to all cases; in use of zero scores when no polyps were identified; the bimodal non-normal distribution of scores; fitting ROC curves due to extrapolation beyond the study data; and the undue influence of a few false positive results. Variation due to use of different ROC methods exceeded differences between test results for ROC AUC. CONCLUSIONS: The confidence scores recorded in our study violated many assumptions of ROC AUC methods, rendering these methods inappropriate. The problems we identified will apply to other detection studies using confidence scores. We found sensitivity and specificity were a more reliable and clinically appropriate method to compare diagnostic tests.

  1. Computer-aided detection (CAD) as a second reader using perspective filet view at CT colonography: effect on performance of inexperienced readers

    Energy Technology Data Exchange (ETDEWEB)

    Fisichella, V.A. [Department of Radiology, Sahlgrenska University Hospital and Sahlgrenska Academy at University of Gothenburg, Gothenburg (Sweden)], E-mail: valeria.fisichella@vgregion.se; Jaederling, F. [Department of Radiology, St. Goeran' s Hospital, Stockholm (Sweden); Horvath, S. [Department of Radiology, Sahlgrenska University Hospital and Sahlgrenska Academy at University of Gothenburg, Gothenburg (Sweden); Stotzer, P.-O.; Kilander, A. [Department of Gastroenterology, Sahlgrenska University Hospital, Gothenburg (Sweden); Bath, M. [Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg (Sweden); Hellstroem, M. [Department of Radiology, Sahlgrenska University Hospital and Sahlgrenska Academy at University of Gothenburg, Gothenburg (Sweden)

    2009-10-15

    Aim: To evaluate whether computer-aided detection (CAD) as a second reader using perspective filet view [three-dimensional (3D) filet] improves the performance of inexperienced readers at computed tomography colonography (CTC) compared with unassisted 3D filet and unassisted two-dimensional (2D) CTC. Material and methods: Fifty symptomatic patients underwent CTC and same-day colonoscopy with segmental unblinding. Two inexperienced readers read the CTC studies on 3D filet and 2D several weeks apart. Four months later, readers re-read the cases only evaluating CAD marks using 3D filet. Suspicious CAD marks not previously described on 3D filet were recorded. Jackknife free-response receiver operating characteristic (JAFROC-1) analysis was used to compare the observers' performances in detecting lesions with 3D filet, 2D and 3D filet with CAD. Results: One hundred and three lesions {>=}3 mm were detected at colonoscopy with segmental unblinding. CAD alone had a sensitivity of 73% (75/103) at a mean false-positive rate per patient of 12.8 in supine and 11.4 in prone. For inexperienced readers sensitivities with 3D filet with CAD were 58% (60/103) and 48% (50/103) with an improvement of 14-16 percentage points (p < 0.05) compared with 2D and of 10-11 percentage points (p < 0.05) compared with 3D filet. For inexperienced readers, the false-positive rate was 25-41% and 71-200% higher with 3D filet with CAD compared with 3D filet and 2D, respectively. JAFROC-1 analysis showed no significant differences in per-lesion overall performance among reading modes (p = 0.8). Conclusion: CAD applied as a second reader using 3D filet increased both sensitivity and the number of false positives by inexperienced readers compared with 3D filet and 2D, thus not improving overall performance, i.e., the ability to distinguish between lesions and non-lesions.

  2. Irritable bowel syndrome evaluation using computed tomography colonography.

    Science.gov (United States)

    Ohgo, Hideki; Imaeda, Hiroyuki; Yamaoka, Minoru; Yoneno, Kazuaki; Hosoe, Naoki; Mizukami, Takeshi; Nakamoto, Hidetomo

    2016-11-14

    To evaluate the morphology of the colon in patients with irritable bowel syndrome (IBS) by using computed tomography colonography (CTC). Twelve patients with diarrhea type IBS (IBS-D), 13 patients with constipation type IBS (IBS-C), 12 patients with functional constipation (FC) and 14 control patients underwent colonoscopy following CTC. The lengths of the rectosigmoid colon, transverse colon and the total colon were measured. The diameters of the rectum, sigmoid colon, descending colon, transverse colon, and ascending colon were measured. The mean length of the total colon was 156.5 cm in group C, 158.9 cm in group IBS-D, 172.0 cm in group IBS-C, and 188.8 cm in group FC. The total colon in group FC was significantly longer than that in group C (P colon was 56.2 cm, 55.9 cm, 63.6cm, and 77.4 cm (NS). The mean length of the transverse colon was 49.9 cm, 43.1 cm, 57.0 cm, and 55.0 cm. The transverse colon in group IBS-D was significantly shorter than that in group IBS-C (P colon was 4.0 cm, 3.3 cm, 4.2 cm, and 4.3 cm (NS). The mean diameter of the descending colon was 3.6 cm, 3.1 cm, 3.8 cm, and 4.3 cm. The descending colon diameter in group IBS-D was significantly less than that in group IBS-C (P = 0.03) and that in group FC (P colon diameter in group FC was significantly greater than that in group C (P = 0.04). The mean diameter of the transverse colon was 4.4 cm, 3.3 cm, 4.2 cm, and 5.0 cm (NS). CT colonography might contribute the clarification of subtypes of IBS.

  3. Diagnostic performance of CT colonography with limited cathartic preparation in colorectal cancer screening; comparison with conventional colonoscopy

    Directory of Open Access Journals (Sweden)

    Mohammed Farghally Amin

    2015-09-01

    Conclusion: This study proved that CTC with limited cathartic bowel preparation and iodinated agents for fecal tagging can obtain high sensitivity and PPV values results for <5 mm polyps comparable to those obtained with conventional preparation with laxatives. Furthermore, this method could really improve the acceptance of CTC for colorectal cancer screening.

  4. Design of a multicentre randomized trial to evaluate CT colonography versus colonoscopy or barium enema for diagnosis of colonic cancer in older symptomatic patients: The SIGGAR study

    Directory of Open Access Journals (Sweden)

    Edwards Rob

    2007-10-01

    Full Text Available Abstract Background and Aims The standard whole-colon tests used to investigate patients with symptoms of colorectal cancer are barium enema and colonoscopy. Colonoscopy is the reference test but is technically difficult, resource intensive, and associated with adverse events, especially in the elderly. Barium enema is safer but has reduced sensitivity for cancer. CT colonography ("virtual colonoscopy" is a newer alternative that may combine high sensitivity for cancer with safety and patient acceptability. The SIGGAR trial aims to determine the diagnostic efficacy, acceptability, and economic costs associated with this new technology. Methods The SIGGAR trial is a multi-centre randomised comparison of CT colonography versus standard investigation (barium enema or colonoscopy, the latter determined by individual clinician preference. Diagnostic efficacy for colorectal cancer and colonic polyps measuring 1 cm or larger will be determined, as will the physical and psychological morbidity associated with each diagnostic test, the latter via questionnaires developed from qualitative interviews. The economic costs of making or excluding a diagnosis will be determined for each diagnostic test and information from the trial and other data from the literature will be used to populate models framed to summarise the health effects and costs of alternative approaches to detection of significant colonic neoplasia in patients of different ages, prior risks and preferences. This analysis will focus particularly on the frequency, clinical relevance, costs, and psychological and physical morbidity associated with detection of extracolonic lesions by CT colonography. Results Recruitment commenced in March 2004 and at the time of writing (July 2007 5025 patients have been randomised. A lower than expected prevalence of end-points in the barium enema sub-trial has caused an increase in sample size. In addition to the study protocol, we describe our approach to

  5. Multi-detector CT-colonography in inflammatory bowel disease: Prospective analysis of CT-findings to high-resolution video colonoscopy

    Energy Technology Data Exchange (ETDEWEB)

    Andersen, Kjel [Institute of Diagnostic Radiology, University Hospital Duesseldorf (Germany)]. E-mail: kjel_andersen@web.de; Vogt, Christoph [Department of Gastroenterology, Hepatology and Infectiology, University Hospital Duesseldorf (Germany); Blondin, Dirk [Institute of Diagnostic Radiology, University Hospital Duesseldorf (Germany); Beck, Andreas [Institute of Informatics, Heinrich-Heine-University, Duesseldorf (Germany); Heinen, Wolfram [Institute of Diagnostic Radiology, University Hospital Duesseldorf (Germany); Aurich, Volker [Institute of Informatics, Heinrich-Heine-University, Duesseldorf (Germany); Haeussinger, Dieter [Department of Gastroenterology, Hepatology and Infectiology, University Hospital Duesseldorf (Germany); Moedder, Ulrich [Institute of Diagnostic Radiology, University Hospital Duesseldorf (Germany); Cohnen, Mathias [Institute of Diagnostic Radiology, University Hospital Duesseldorf (Germany)

    2006-04-15

    Aim: Prospective analysis of multi-detector CT-colonography (MDCTC) in patients with inflammatory bowel disease (IBD) compared to high-resolution video-endoscopy (HRVC). Materials and methods: Twenty-one patients (mean age 49.6 years) with Crohn's disease or ulcerative colitis underwent MDCTC (Somatom Volume Zoom, Siemens, Erlangen; 1 mm collimation, Pitch 8, 100 mAs, 120 kVp). HRVC was performed within 2 h after MDCTC. MDCTC was analyzed by two blinded readers. MDCTC-findings including bowel wall alterations and extraintestinal changes were compared to results of HRVC. Results: Over-all-sensitivity was 100% for endoluminal lesions with correct diagnosis of two cancers. Acute and chronic IBD were correctly identified by MDCTC in 63.6%, and 100%, respectively, with a specificity of 75%, and 100%. Sensitivity, specificity, positive and negative predictive values of MDCTC for diagnosis of acute and chronic disease were best for chronic disease. Sensitivity was worst for acute ulcerative colitis and specificity was worst for acute Crohn's disease. Haustral loss was seen only in ulcerative colitis. Pseudopolyps and fistulae were findings exclusive to Crohn's disease. Particularly extraintestinal findings as increased vascularization and local lymphadenopathy correlated well with endoscopic definition of acute disease. Because of the possibly more vulnerable colonic wall in acute inflammatory bowel disease, the air inflation for MDCTC should be performed most carefully to avoid any risk of colonic perforation. Conclusion: MDCTC may help to distinguish between patients with acute and chronic IBD. Especially extraintestinal complications, tumorous as well as pseudo-tumorous lesions can be detected with high sensitivity and specificity.

  6. Effectiveness and efficiency of CT-colonography compared to conventional colonoscopy for the early detection and diagnosis of colorectal cancer

    Directory of Open Access Journals (Sweden)

    Hiebinger, Cora

    2009-02-01

    Full Text Available Health political background: Colorectal cancer (CC is the second most common cancer and cause of cancer death for both men and women in Germany. Various methods for early detection of CC exist, including conventional coloscopy which is reimbursed within the scope of cancer screening, as well as computertomography-coloscopy (CTC which is currently not reimbursed. Scientific background: CTC is a mere diagnostic procedure which has a lower risk of perforation than conventional coloscopy. However, as it is an x-ray procedure, it exposes the patient to radiation. Conventional coloscopy is considered the gold standard due to its high sensitivity and specificity for locating adenomas. Furthermore, it offers the advantage that in addition to extended diagnostic measures therapeutic measures can be undertaken during the procedure. Research questions: This HTA-report aims to evaluate the effectiveness and efficiency of CTC in comparison to conventional coloscopy in the early detection and diagnosis of colorectal cancer and/or its precursors and which ethical and legal aspects have to be considered. Methods: The systematic literature search (27 international literature data bases yielded a total of 1,713 abstracts. After a two-step selection process 36 publications remained to be assessed. Results: The results regarding the effectivity of CTC in diagnosis and screening for colorectal cancer and/or its precursors are partly promising, however, they are very heterogeneous. Therefore, regarding its sensitivity and specificity, CTC cannot be considered an equivalent alternative to conventional coloscopy for diagnosis and screening. The heterogeneity of results is due to technical (device type, settings, patient dependent (preparation and operator dependent (training factors. No economic results for a comparison of the procedures for diagnosis exist. Regarding the cost-effectiveness of a CTC-screening, international model calculations are available. According

  7. Comparison of a unidirectional panoramic 3D endoluminal interpretation technique to traditional 2D and bidirectional 3D interpretation techniques at CT colonography: preliminary observations

    Energy Technology Data Exchange (ETDEWEB)

    Lenhart, D.K.; Babb, J.; Bonavita, J.; Kim, D. [Department of Radiology, NYU Medical Center, 560 First Avenue, Suite HW-202, New York, NY 10016 (United States); Bini, E.J. [Department of Medicine, NYU School of Medicine, NYU Medical Center, 560 First Avenue, Suite HW-202, New York, NY 10016 (United States); Megibow, A.J. [Department of Radiology, NYU Medical Center, 560 First Avenue, Suite HW-202, New York, NY 10016 (United States); Macari, M., E-mail: michael.macari@med.nyu.ed [Department of Radiology, NYU Medical Center, 560 First Avenue, Suite HW-202, New York, NY 10016 (United States)

    2010-02-15

    Aim: To compare the evaluation times and accuracy of unidirectional panoramic three-dimensional (3D) endoluminal interpretation to traditional two-dimensional (2D) and bidirectional 3D endoluminal techniques. materials and methods: Sixty-nine patients underwent computed tomography colonography (CTC) after bowel cleansing. Forty-five had no polyps and 24 had at least one polyp >=6 mm. Patients underwent same-day colonoscopy with segmental unblinding. Three experienced abdominal radiologists evaluated the data using one of three primary interpretation techniques: (1) 2D; (2) bidirectional 3D; (3) panoramic 3D. Mixed model analysis of variance and logistic regression for correlated data were used to compare techniques with respect to time and sensitivity and specificity. Results: Mean evaluation times were 8.6, 14.6, and 12.1 min, for 2D, 3D, and panoramic, respectively. 2D was faster than either 3D technique (p < 0.0001), and the panoramic technique was faster than bidirectional 3D (p = 0.0139). The overall sensitivity of each technique per polyp and per patient was 68.4 and 76.7% for 2D, 78.9 and 93.3% for 3D; and 78.9 and 86.7% for panoramic 3D. Conclusion: 2D interpretation was the fastest overall, the panoramic technique was significantly faster than the bidirectional with similar sensitivity and specificity. The sensitivity for a single reader was significantly lower using the 2D technique. Each reader should select the technique with which they are most successful.

  8. CT Colonography (Virtual Colonoscopy)

    Science.gov (United States)

    ... passes through the body, recording an image on photographic film or a special image recording plate. Bones ... American College of Radiology (ACR) and the Radiological Society of North America (RSNA), comprising physicians with expertise ...

  9. Single-center study comparing computed tomography colonography with conventional colonoscopy

    Institute of Scientific and Technical Information of China (English)

    Ian C Roberts-Thomson; Graeme R Tucker; Peter J Hewett; Peter Cheung; Ruben A Sebben; EE Win Khoo; Julie D Marker; Wayne K Clapton

    2008-01-01

    AIM: To compare the results from computed tomography (CT) colonography with conventional colonoscopy in symptomatic patients referred for colonoscopy. METHODS: The study included 227 adult outpatients, mean age 60 years, with appropriate indications for colonoscopy. CT colonography and colonoscopy were performed on the same day in a metropolitan teaching hospital. Colonoscopists were initially blinded to the results of CT colonography but there was segmental unblinding during the procedure. The primary outcome measures were the sensitivity and specificity of CT colonography for the identification of polyps seen at colonoscopy (i.e. analysis by polyp). Secondary outcome measures included an analysis by patient, extracolonic findings at CT colonography, adverse events with both procedures and patient acceptance and preference. RESULTS: Twenty-five patients (11%) were excluded from the analysis because of incomplete colonoscopy or poor bowel preparation that affected either CT colonography, colonoscopy or both procedures. Polyps and masses (usually cancers) were detected at colonoscopy and CT colonography in 35% and 42% of patients, respectively. Of nine patients with a final diagnosis of cancer, eight (89%) were identified by CT colonography as masses (5) or polyps (3). For polyps analyzed according to polyp, the overall sensitivity of CT colonography was 50% (95% CI, 39%-61%) but this increased to 71% (95% CI, 52%-85%) for polyps ≥ 6 mm in size. Similarly, specificity for all polyps was 48% (95% CI, 39%-58%) increasing to 67% (95% CI, 56%-76%) for polyps ≥ 6 mm. Adverse events were uncommon but included one colonic perforation at colonoscopy, Patient acceptance was high for both procedures but preference favoured CT colonography. CONCLUSION: Although CT colonography was more sensitive in this study than in some previous studies, the procedure is not yet sensitive enough for widespread application in symptomatic patients.

  10. Adoption of Computed Tomographic Colonography by U.S. Hospitals

    Science.gov (United States)

    McHugh, Megan; Osei-Anto, Awo; Klabunde, Carrie N.; Galen, Barbara A.

    2010-01-01

    Purpose Computed tomographic colonography (CTC) is a new non-invasivetechnology proposed as an option for colorectal cancer screening. The purpose of this study was to identify the percent of U.S. hospitals that offered CTC between 2005 and 2008 and factors that motivated or impeded adoption. Methods We analyzed data on the provision of colorectal cancer screening services by non-federal, general hospitals using the 2005 – 2008 American Hospital Association Annual Surveys. Additionally, in 2009, we conducted exploratory interviews with representatives from radiology departments at nine hospitals – six that provided CTC and three that did not. Results In 2008, 17% of hospitals offered CTC, up from 13% in 2005. Sixty-nine percent of hospitals that offered CTC in 2008 also offered optical colonoscopy services. Factors motivating adoption of CTC included a desire to provide an alternative screening option for frail, elderly patients and patients with a failed optical colonoscopy; long waits for optical colonoscopy; and promising evidence on CTC published in peer-reviewed literature. Lack of reimbursement was a commonly-cited barrier. Conclusion Growth of CTC services at U.S. hospitals occurred even in the absence of Medicare coverage or agreement among national guideline-setting organizations regarding CTC’s use in screening. Almost one-third of hospitals that offer CTC do not offer optical colonoscopy, and may not be prepared to provide adequate follow-up for patients with failed CTCs. PMID:21371666

  11. Iatrogenic Colonic Perforation due to Computed Tomographic Colonography

    Directory of Open Access Journals (Sweden)

    Takashi Kato

    2015-05-01

    Full Text Available Although the complications of computed tomographic colonography (CTC are very rare, CTC is associated with potential risk of colonic perforation. In the present report we describe two cases of colonic perforation secondary to CTC. In the first case with ascending colonic carcinoma, insertion of a rigid double-balloon catheter caused direct rectal wall perforation. In the second case with obstructive colonic carcinoma, pneumoperitoneum developed due to automated carbon dioxide insufflation. Both patients were asymptomatic after examination and recovered without any complications. Based on the findings of the current cases, we recommend that a soft-tip catheter be used for CTC, and suggest that colonic perforation can occur even with automatic insufflation, depending on patient characteristics.

  12. Time-efficient CT colonography interpretation using an advanced image-gallery-based, computer-aided ''first-reader'' workflow for the detection of colorectal adenomas

    Energy Technology Data Exchange (ETDEWEB)

    Mang, Thomas; Ringl, Helmut; Weber, Michael; Mueller-Mang, Christina [Medical University of Vienna, Department of Radiology, Vienna (Austria); Hermosillo, Gerardo; Wolf, Matthias; Bogoni, Luca; Salganicoff, Marcos; Raykar, Vikas [Siemens Healthcare, Siemens Medical Solutions, H IM SY CAD R and D, Malvern, PA (United States); Graser, Anno [University of Munich - Grosshadern Campus, Department of Clinical Radiology, Munich (Germany)

    2012-12-15

    To assess the performance of an advanced ''first-reader'' workflow for computer-aided detection (CAD) of colorectal adenomas {>=} 6 mm at computed tomographic colonography (CTC) in a low-prevalence cohort. A total of 616 colonoscopy-validated CTC patient-datasets were retrospectively reviewed by a radiologist using a ''first-reader'' CAD workflow. CAD detections were presented as galleries of six automatically generated two-dimensional (2D) and three-dimensional (3D) images together with interactive 3D target views and 2D multiplanar views of the complete dataset. Each patient-dataset was interpreted by initially using CAD image-galleries followed by a fast 2D review to address unprompted colonic areas. Per-patient, per-polyp, and per-adenoma sensitivities were calculated for lesions {>=} 6 mm. Statistical testing employed Fisher's exact and McNemar tests. In 91/616 patients, 131 polyps (92 adenomas, 39 non-adenomas) {>=} 6 mm and two cancers were identified by reference standard. Using the CAD gallery-based first-reader workflow, the radiologist detected all adenomas {>=} 10 mm (34/34) and cancers. Per-patient and polyp sensitivities for lesions {>=} 6 mm were 84.3 % (75/89), and 83.2 % (109/131), respectively, with 89.1 % (57/64) and 85.9 % (79/92) for adenomas. Overall specificity was 95.6 % (504/527). Mean interpretation time was 3.1 min per patient. A CAD algorithm, applied in an image-gallery-based first-reader workflow, can substantially decrease reading times while enabling accurate detection of colorectal adenomas in a low-prevalence population. (orig.)

  13. Computer-aided teniae coli detection using height maps from computed tomographic colonography images

    Science.gov (United States)

    Wei, Zhuoshi; Yao, Jianhua; Wang, Shijun; Summers, Ronald M.

    2011-03-01

    Computed tomographic colonography (CTC) is a minimally invasive technique for colonic polyps and cancer screening. Teniae coli are three bands of longitudinal smooth muscle on the colon surface. They are parallel, equally distributed on the colon wall, and form a triple helix structure from the appendix to the sigmoid colon. Because of their characteristics, teniae coli are important anatomical meaningful landmarks on human colon. This paper proposes a novel method for teniae coli detection on CT colonography. We first unfold the three-dimensional (3D) colon using a reversible projection technique and compute the two-dimensional (2D) height map of the unfolded colon. The height map records the elevation of colon surface relative to the unfolding plane, where haustral folds corresponding to high elevation points and teniae to low elevation points. The teniae coli are detected on the height map and then projected back to the 3D colon. Since teniae are located where the haustral folds meet, we break down the problem by first detecting haustral folds. We apply 2D Gabor filter banks to extract fold features. The maximum response of the filter banks is then selected as the feature image. The fold centers are then identified based on piecewise thresholding on the feature image. Connecting the fold centers yields a path of the folds. Teniae coli are finally extracted as lines running between the fold paths. Experiments were carried out on 7 cases. The proposed method yielded a promising result with an average normalized RMSE of 5.66% and standard deviation of 4.79% of the circumference of the colon.

  14. Cooperative Tagging Center (CTC)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Cooperative Tagging Center (CTC) began as the Cooperative Game Fish Tagging Program (GTP) at Woods Hole Oceanographic Institute (WHOI) in 1954. The GTP was...

  15. Your Radiologist Explains CT Colonography

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    Full Text Available ... for the exam to be performed with the most accuracy. If you have any questions about the ... go back to work the same day in most cases. Perhaps you might have some concerns about ...

  16. Your Radiologist Explains CT Colonography

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    Full Text Available ... Index A-Z Spotlight October is National Breast Cancer Awareness Month Recently posted: Medical Imaging Costs Magnetoencephalography ( ... to screen the large intestine or colon for cancer and growths called polyps. This procedure uses low- ...

  17. Your Radiologist Explains CT Colonography

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    Full Text Available ... Resources Professions Site Index A-Z Spotlight September is National Ovarian Cancer Awareness Month September is National Prostate Cancer Awareness Month Recently posted: Medical ...

  18. Your Radiologist Explains CT Colonography

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    Full Text Available ... A-Z Spotlight October is National Breast Cancer Awareness Month Recently posted: Medical Imaging Costs Magnetoencephalography (MEG) ... your attention! Spotlight October is National Breast Cancer Awareness Month Recently posted: Medical Imaging Costs Magnetoencephalography (MEG) ...

  19. Your Radiologist Explains CT Colonography

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    Full Text Available ... Index A-Z Spotlight September is National Ovarian Cancer Awareness Month September is National Prostate Cancer Awareness Month Recently posted: Magnetoencephalography (MEG) Venous Insufficiency ( ...

  20. Your Radiologist Explains CT Colonography

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    Full Text Available ... Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Spotlight September ... examination. On the day of your exam, your doctor may restrict you to clear fluids and give ...

  1. Your Radiologist Explains CT Colonography

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    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician ... virtual colonoscopy. Virtual colonoscopy is a diagnostic imaging test that is used to screen the large intestine ...

  2. Your Radiologist Explains CT Colonography

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    Full Text Available ... Index A-Z Spotlight September is National Ovarian Cancer Awareness Month September is National Prostate Cancer Awareness Month Recently posted: Medical Imaging Costs Magnetoencephalography ( ...

  3. Your Radiologist Explains CT Colonography

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    Full Text Available ... Site Index A-Z Spotlight October is National Breast Cancer Awareness Month Recently posted: Medical Imaging Costs Magnetoencephalography ( ... and for your attention! Spotlight October is National Breast Cancer Awareness Month Recently posted: Medical Imaging Costs Magnetoencephalography ( ...

  4. Your Radiologist Explains CT Colonography

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    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician ... virtual colonoscopy. Virtual colonoscopy is a diagnostic imaging test that is used to screen the large intestine ...

  5. Automatic segmentation of kidneys from non-contrast CT images using efficient belief propagation

    Science.gov (United States)

    Liu, Jianfei; Linguraru, Marius George; Wang, Shijun; Summers, Ronald M.

    2013-03-01

    CT colonography (CTC) can increase the chance of detecting high-risk lesions not only within the colon but anywhere in the abdomen with a low cost. Extracolonic findings such as calculi and masses are frequently found in the kidneys on CTC. Accurate kidney segmentation is an important step to detect extracolonic findings in the kidneys. However, noncontrast CTC images make the task of kidney segmentation substantially challenging because the intensity values of kidney parenchyma are similar to those of adjacent structures. In this paper, we present a fully automatic kidney segmentation algorithm to support extracolonic diagnosis from CTC data. It is built upon three major contributions: 1) localize kidney search regions by exploiting the segmented liver and spleen as well as body symmetry; 2) construct a probabilistic shape prior handling the issue of kidney touching other organs; 3) employ efficient belief propagation on the shape prior to extract the kidneys. We evaluated the accuracy of our algorithm on five non-contrast CTC datasets with manual kidney segmentation as the ground-truth. The Dice volume overlaps were 88%/89%, the root-mean-squared errors were 3.4 mm/2.8 mm, and the average surface distances were 2.1 mm/1.9 mm for the left/right kidney respectively. We also validated the robustness on 27 additional CTC cases, and 23 datasets were successfully segmented. In four problematic cases, the segmentation of the left kidney failed due to problems with the spleen segmentation. The results demonstrated that the proposed algorithm could automatically and accurately segment kidneys from CTC images, given the prior correct segmentation of the liver and spleen.

  6. Computed tomography colonography for the practicing radiologist:A review of current recommendations on methodology and clinical indications

    Institute of Scientific and Technical Information of China (English)

    Paola Scalise; Annalisa Mantarro; Francesca Pancrazi; Emanuele Neri

    2016-01-01

    Colorectal cancer(CRC) represents one of the most relevant causes of morbidity and mortality in Western societies. CRC screening is actually based on faecal occult blood testing, and optical colonoscopy still remains the gold standard screening test for cancer detection. However, computed tomography colonography(CT colonography) constitutes a reliable, minimally-invasive method to rapidly and effectively evaluate the entire colon for clinically relevant lesions. Furthermore, even if the benefits of its employment in CRC mass screening have not fully established yet, CT colonography may represent a reasonable alternative screening test in patients who cannot undergo or refuse colonoscopy. Therefore, the purpose of our review is to illustrate the most updated recommendations on methodology and the current clinical indications of CT colonography, according to the data of the existing relevant literature.

  7. Predictors of incomplete optical colonoscopy using computed tomographic colonography

    Directory of Open Access Journals (Sweden)

    Reetika Sachdeva

    2016-01-01

    Full Text Available Background/Aims: Optical colonoscopy (OC is the primary modality for investigation of colonic pathology. Although there is data on demographic factors for incomplete OC, paucity of data exists for anatomic variables that are associated with an incomplete OC. These anatomic variables can be visualized using computed tomographic colonography (CTC. We aim to retrospectively identify variables associated with incomplete OC using CTC and develop a scoring method to predict the outcome of OC. Patients and Methods: In this case-control study, 70 cases ( with incomplete OC and 70 controls (with complete OC were identified. CTC images of cases and controls were independently reviewed by a single CTC radiologist. Demographic and anatomical parameters were recorded. Data was examined using descriptive linear statistics and multivariate logistic regression model. Results: On analysis, female gender (80% vs 58.6% P = 0.007, prior abdominal/pelvic surgeries (51.4% vs 14.3% P < 0.001, colonic length (187.6 ± 30.0 cm vs 163.8 ± 27.2 cm P < 0.001, and number of flexures (11.4 ± 3.1 vs 8.4 ± 2.9 P < 0.001 increased the risk for incomplete OC. No significant association was observed for increasing age (P = 0.881 and history of severe diverticulosis (P = 0.867 with incomplete OC. A scoring system to predict the outcome of OC is proposed based on CTC findings. Conclusion: Female gender, prior surgery, and increasing colonic length and tortuosity were associated with incomplete OC, whereas increasing age and history of severe diverticulosis were not. These factors may be used in the future to predict those patients who are at risk of incomplete OC.

  8. Micro-CT辅助结肠造影在小鼠炎性肠病中的应用%Monitoring Colitis Development in Mice by Micro-CT Colonography

    Institute of Scientific and Technical Information of China (English)

    王维刚; 刘震泽; 严惠敏

    2011-01-01

    To evaluate colon wall thickness noninvasively in the dextran sodium sulfate (DSS) induced mouse model of colitis, we performed micro-CT colonography. Mice were scanned by micro-CT at day 0, day 8 and day 13 after induction of colitis and calculated the colon wall thickness. Iopamidol was used by oral and intraperitoneal injection to show the colon wall. The value of the descending colon wall thickness were 0.4586±0.04 mm (day 8) and 0.40325±0.03 mm (day 13) significantly (P<0.001) higher than the control group (0.28±0.02 mm). The related body weight loss, clinical score, histological section and score were consistent with the result of micro-CT. Thus, the results suggested that micro-CT can be used directly, consecutively and noninvasively in monitoring of the inflammatory response in mouse colitis in future studies.%用DSS喂饲小鼠建立小鼠IBD模型,在建模的第0、8、13天分别用碘帕醇灌胃加腹腔注射的方法造影并micro-CT扫描降结肠壁厚度,结果第8天和第13天分别为0.4586±0.04 mm和0.40325±0.03 mm,显著(P<0.001)大于对照组((0.28±0.02 mm).同时检测小鼠体重变化、临床评分、结肠病理切片并评分,发现结肠壁厚度变化趋势和常规指标一致.应用micro-CT辅助小鼠结肠造影方法,可以直观、动态、无创地对小鼠肠道进行影像学分析.

  9. Virtual colonoscopy (CT colonography) in the identification of colorectal cancer. A prospective study in symptomatic patients; Impiego dell'endoscopia virtuale con Tomografia Computerizzata nell'identificazione delle neoplasie colorettali. Studio prospettivo in pazienti sintomatici

    Energy Technology Data Exchange (ETDEWEB)

    Regge, D.; Martincich, L.; Gallo, T.; Pollone, M. [Istituto per la Ricerca e la Cura del Cancro, Ordine Mauriziano, Reparto di Radiologia, Candiolo, TO (Italy); Galatola, G.; Secreto, P.; Pera, A. [Ospedale Mauriziano Umberto, Turin (Italy). Unita' Operativa di Gastroenterologia; Rivolta, A. [Istituto per la Ricerca e la Cura del Cancro, Ordine Mauriziano, Candiolo, TO (Italy). Servizio di Fisica Sanitaria

    2000-06-01

    Aim of this study was to evaluate the sensitivity of virtual colonoscopy (CT colonography) in the identification of colorectal cancer and to define the limitations and the advantages of this imaging modality, as well as indications to the examination. It was examined prospectively 62 symptomatic patients aged 36 to 82 years (28 women and 34 men). All patients underwent both conventional and virtual colonoscopy on the same day; the conventional examination allowed exploration of the entire colon. Conventional colonoscopy identified 89 lesions 3-50 mm in diameter, namely 84 benign and 5 malignant lesions. No lesions were identified in 12 patients. CT colonography identified 52 of the 89 lesions, with 57.1% diagnostic accuracy. They were 11 false positives (82.5% positive predictive value and 52.2% specificity) and 37 false negatives (24.5% negative predictive value and 58.4% sensitivity). Sensitivity was significantly higher (85.7%) for polyps {>=} 1 cm. Virtual colonoscopy is an imaging modality with good diagnostic yield, well tolerated by patients and with great potentials for further development. It was suggested that the examination be performed in symptomatic patients who cannot undergo total colonoscopy or refuse the other imaging modalities. Further studies are warranted in larger series of patients, possibly introducing it in screening programs. [Italian] Scopo di questo lavoro e' valutare la sensibilita' della colonscopia virtuale con TC nell'identificazione delle neoplasie colorettali, definendo gli attuali limiti e vantaggi della metodica e le possibili indicazioni dell'indagine. E' stato condotto uno studio prospettico su 62 pazienti sintomatici con eta' compresa fra 36 e 82 anni di cui 28 donne e 34 uomini. Tutti i pazienti sono stati sottoposti nello stesso giorno sia a colonscopia tradizionale, che in ogni caso ha consentito l'esplorazione di tutto il colon, sia a colonscopia virtuale. Con colonscopia tradizionale

  10. CTC-ask: a new algorithm for conversion of CT numbers to tissue parameters for Monte Carlo dose calculations applying DICOM RS knowledge

    DEFF Research Database (Denmark)

    Ottosson, Rickard; Behrens, Claus F.

    2011-01-01

    One of the building blocks in Monte Carlo (MC) treatment planning is to convert patient CT data to MC compatible phantoms, consisting of density and media matrices. The resulting dose distribution is highly influenced by the accuracy of the conversion. Two major contributing factors are precise c...

  11. Patient acceptance of MR colonography with improved fecal tagging versus conventional colonoscopy

    Energy Technology Data Exchange (ETDEWEB)

    Achiam, M.P. [Department of Diagnostic Radiology and Department of Surgical Gastroenterology D, Copenhagen University Hospital Herlev, Herlev Ringvej, DK-2730 Herlev (Denmark)], E-mail: achiam1@dadlnet.dk; Logager, V.; Chabanova, E.; Thomsen, H.S.; Rosenberg, J. [Department of Diagnostic Radiology and Department of Surgical Gastroenterology D, Copenhagen University Hospital Herlev, Herlev Ringvej, DK-2730 Herlev (Denmark)

    2010-01-15

    Objective: Conventional colonoscopy (CC) is the gold standard for colonic examinations. However, patient acceptance is not high. Patient acceptance is influenced by several factors, notably anticipation and experience. This has led to the assumption that patient acceptance would be higher in non-invasive examinations such as MR/CT colonography (MRC/CTC) and perhaps even higher without bowel preparation. The purpose of this study was to evaluate patient acceptance of MRC with fecal tagging versus CC. Materials and methods: In a 14-month period, all patients first-time referred to our department for CC were asked to participate in the study. Two days prior to MRC, patients ingested an oral contrast mixture (barium/ferumoxsil) together with four meals each day. Standard bowel purgation was performed before CC. Before and after MRC and CC a number of questions were addressed. Results: Sixty-four (34 men, 30 women) patients referred for CC participated in the study. 27% had some discomfort ingesting the contrast mixture, and 49% had some discomfort with the bowel purgation. As a future colonic examination preference, 71% preferred MRC, 13% preferred CC and 15% had no preference. If MRC was to be performed with bowel purgation, 75% would prefer MRC, 12% would prefer CC and 12% had no preference. Conclusion: This study shows that there is a potential gain in patient acceptance by using MRC for colonic examination, since MRC is considered less painful and less unpleasant than CC. In addition, the results indicate that patients in this study prefer fecal tagging instead of bowel purgation.

  12. An international review of the main cost-effectiveness drivers of virtual colonography versus conventional colonoscopy for colorectal cancer screening: Is the tide changing due to adherence?

    Energy Technology Data Exchange (ETDEWEB)

    Kriza, Christine, E-mail: Christine.kriza@uk-erlangen.de [Interdisciplinary Centre for Health Technology Assessment and Public Health, University of Erlangen-Nuremberg, National BMBF-Cluster of Excellence, “Medical Technologies - Medical Valley EMN”, Schwabachanlage 6, 91054 Erlangen (Germany); Emmert, Martin, E-mail: Martin.Emmert@fau.de [School of Business and Economics, Institute of Management, University of Erlangen-Nuremberg, Lange Gasse 20, 90403 Nuremberg (Germany); Wahlster, Philip, E-mail: Philip.wahlster@uk-erlangen.de [Interdisciplinary Centre for Health Technology Assessment and Public Health, University of Erlangen-Nuremberg, National BMBF-Cluster of Excellence, “Medical Technologies - Medical Valley EMN”, Schwabachanlage 6, 91054 Erlangen (Germany); Niederländer, Charlotte, E-mail: Charlotte.niederlaender@uk-erlangen.de [Interdisciplinary Centre for Health Technology Assessment and Public Health, University of Erlangen-Nuremberg, National BMBF-Cluster of Excellence, “Medical Technologies - Medical Valley EMN”, Schwabachanlage 6, 91054 Erlangen (Germany); Kolominsky-Rabas, Peter, E-mail: Peter.kolominsky@uk-erlangen.de [Interdisciplinary Centre for Health Technology Assessment and Public Health, University of Erlangen-Nuremberg, National BMBF-Cluster of Excellence, “Medical Technologies - Medical Valley EMN”, Schwabachanlage 6, 91054 Erlangen (Germany)

    2013-11-01

    Objectives: The majority of recent cost-effectiveness reviews concluded that computerised tomographic colonography (CTC) is not a cost-effective colorectal cancer (CRC) screening strategy yet. The objective of this review is to examine cost-effectiveness of CTC versus optical colonoscopy (COL) for CRC screening and identify the main drivers influencing cost-effectiveness due to the emergence of new research. Methods: A systematic review was conducted for cost-effectiveness studies comparing CTC and COL as a screening tool and providing outcomes in life-years saved, published between January 2006 and November 2012. Results: Nine studies were included in the review. There was considerable heterogeneity in modelling complexity and methodology. Different model assumptions and inputs had large effects on resulting cost-effectiveness of CTC and COL. CTC was found to be dominant or cost-effective in three studies, assuming the most favourable scenario. COL was found to be not cost effective in one study. Conclusions: CTC has the potential to be a cost-effective CRC screening strategy when compared to COL. The most important assumptions that influenced the cost-effectiveness of CTC and COL were related to CTC threshold-based reporting of polyps, CTC cost, CTC sensitivity for large polyps, natural history of adenoma transition to cancer, AAA parameters and importantly, adherence. There is a strong need for a differential consideration of patient adherence and compliance to CTC and COL. Recent research shows that laxative-free CTC screening has the potential to become a good alternative screening method for CRC as it can improve patient uptake of screening.

  13. Integration of 3D scale-based pseudo-enhancement correction and partial volume image segmentation for improving electronic colon cleansing in CT colonograpy.

    Science.gov (United States)

    Zhang, Hao; Li, Lihong; Zhu, Hongbin; Han, Hao; Song, Bowen; Liang, Zhengrong

    2014-01-01

    Orally administered tagging agents are usually used in CT colonography (CTC) to differentiate residual bowel content from native colonic structures. However, the high-density contrast agents tend to introduce pseudo-enhancement (PE) effect on neighboring soft tissues and elevate their observed CT attenuation value toward that of the tagged materials (TMs), which may result in an excessive electronic colon cleansing (ECC) since the pseudo-enhanced soft tissues are incorrectly identified as TMs. To address this issue, we integrated a 3D scale-based PE correction into our previous ECC pipeline based on the maximum a posteriori expectation-maximization partial volume (PV) segmentation. The newly proposed ECC scheme takes into account both the PE and PV effects that commonly appear in CTC images. We evaluated the new scheme on 40 patient CTC scans, both qualitatively through display of segmentation results, and quantitatively through radiologists' blind scoring (human observer) and computer-aided detection (CAD) of colon polyps (computer observer). Performance of the presented algorithm has shown consistent improvements over our previous ECC pipeline, especially for the detection of small polyps submerged in the contrast agents. The CAD results of polyp detection showed that 4 more submerged polyps were detected for our new ECC scheme over the previous one.

  14. MicroPET/CT Colonoscopy in long-lived Min mouse using NM404

    Science.gov (United States)

    Christensen, Matthew B.; Halberg, Richard B.; Schutten, Melissa M.; Weichert, Jamey P.

    2009-02-01

    Colon cancer is a leading cause of death in the US, even though many cases are preventable if tumors are detected early. One technique to promote screening is Computed Tomography Colonography (CTC). NM404 is a second generation phospholipid ether analogue which has demonstrated selective uptake and prolonged retention in 43/43 types of malignant tumors but not inflammatory sites or premalignant lesions. The purpose of this experiment was to evaluate (SWR x B6 )F1.Min mice as a preclinical model to test MicroPET/CT dual modality virtual colonoscopy. Each animal was given an IV injection of 124I-NM404 (100 uCi) 24, 48 and 96 hours prior to scanning on a dedicated microPET/CT system. Forty million counts were histogrammed in 3D and reconstructed using an OSEM 2D algorithm. Immediately after PET acquisition, a 93 m volumetric CT was acquired at 80 kVp, 800 uA and 350 ms exposures. Following CT, the mouse was sacrificed. The entire intestinal tract was excised, washed, insufflated, and scanned ex vivo A total of eight tissue samples from the small intestine were harvested: 5 were benign adenomas, 2 were malignant adenocarcinomas, and 1 was a Peyer's patch (lymph tissue) . The sites of these samples were positioned on CT and PET images based on morphological cues and the distance from the anus. Only 1/8 samples showed tracer uptake. several hot spots in the microPET image were not chosen for histology. (SWR x B6)F1.Min mice develop benign and malignant tumors, making this animal model a strong candidate for future dual modality microPET/CT virtual colonography studies.

  15. Effect of intravenous Buscopan on colonic distention during computed tomography colonography

    Energy Technology Data Exchange (ETDEWEB)

    Behrens, C. [Univ. of British Columbia, Vancouver, British Columbia (Canada); Stevenson, G. [Dept. of Radiology, McMaster Univ., Hamilton, Ontario (Canada); Vancouver Island Health Authority, Victoria, British Columbia (Canada)], E-mail: gilse@shaw.ca; Eddy, R. [Royal Jublilee Hospital, Victoria, British Columbia (Canada); Mathieson, J. [Vancouver Island Health Authority, Victoria, British Columbia (Canada)

    2008-10-15

    This study was designed to assess whether spasmolytic drugs are helpful in computed tomography colonography (CTC), as there is conflict in the literature. We assessed retrospectively in a blinded fashion colonic distention in 149 individuals, one-half of whom had intravenous (IV) Buscopan during CTC. Colonic segments (n = 1788) were analyzed by 2 observers, and allocated to one of 4 grades of the distention. We also recorded the presence and severity of diverticular disease. Buscopan increased the likelihood of optimal distention by an OR of 5 when considering individual colonic segments from ascending colon to sigmoid, with little effect on rectum or cecum. Considering the colon as a whole, the OR of optimal distention occurring throughout the entire colon was 7.9 times greater with Buscopan than without. In the sigmoid colon, Buscopan had a significantly greater impact on obtaining optimal distention in those with diverticulosis than in those without. Buscopan increases the probability of obtaining optimal distention during CTC, especially in the sigmoid colon in diverticular disease. Buscopan is likely to improve polyp conspicuity and patient comfort, and to reduce both the examination time during and the interpretation time We recommend routine use of Buscopan during CTC. (author)

  16. Clinical indications for computed tomographic colonography: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) Guideline

    Energy Technology Data Exchange (ETDEWEB)

    Spada, Cristiano; Barbaro, Federico; Petruzziello, Lucio [Catholic University, Digestive Endoscopy Unit, Rome (Italy); Stoker, Jaap; Haan, Margriet C. de [University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); Alarcon, Onofre [Universidad de La Laguna, Department of Gastroenterology, Hospital Universitario de Canarias, Facultad de Medicina, La Laguna, Tenerife (Spain); Bellini, Davide; Laghi, Andrea [Sapienza University of Rome, I.C.O.T. Hospital, Department of Radiological Sciences, Oncology and Pathology, Latina (Italy); Bretthauer, Michael [Oslo University Hospital, Department of Health Economy and Health Management, University of Oslo, and Department of Transplantation Medicine, Gastroenterology Unit, Oslo (Norway); Dumonceau, Jean-Marc [Gedyt Endoscopy Center, Buenos Aires (Argentina); Ferlitsch, Monika [Medical University of Vienna, Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Vienna (Austria); Halligan, Steve; Helbren, Emma; Plumb, Andrew; Taylor, Stuart A. [University College London, Centre for Medical Imaging, London (United Kingdom); Hellstrom, Mikael [Sahlgrenska University Hospital and Sahlgrenska Academy at University of Gothenburg, Department of Radiology, Gothenburg (Sweden); Kuipers, Ernst J. [Erasmus MC University Medical Center, Department of Gastroenterology and Hepatology, Rotterdam (Netherlands); Lefere, Philippe [Virtual Colonoscopy Teaching Centre, Hooglede (Belgium); AZ Delta, Roeselare (Belgium); Mang, Thomas [Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria); Neri, Emanuele [University of Pisa, Diagnostic and Interventional Radiology, Pisa (Italy); Regge, Daniele [Institute for Cancer Research and Treatment, Candiolo-Torino (Italy); Hassan, Cesare [Catholic University, Digestive Endoscopy Unit, Rome (Italy); Ospedale Nuovo Regina Margherita, Department of Gastroenterology, Rome (Italy)

    2014-10-03

    Colorectal cancer (CRC) is a major cause of morbidity and mortality [1, 2]. CRC screening by fecal occult blood testing (FOBT) has been shown to reduce CRC mortality [3, 4], and is currently used in several European countries. Colonoscopy is highly effective for detecting advanced neoplasia, and endoscopic polypectomy reduces subsequent CRCspecific incidence and mortality [5]. In Europe, colonoscopy is mainly used to investigate FOBT-positive or symptomatic patients, or as a preventive strategy in those with increased CRC risk [6]. Computed tomographic colonography (CTC) is a minimally invasive imaging technique that is highly accurate for detecting colorectal cancer (CRC) and adenomatous polyps. The technique is standardized [7], and CTC is more easily performed than barium enema. Evidence-based data suggest that CTC is the natural replacement for barium enema and a complementary rather than an alternative examination to colonoscopy. However, the clinical scenarios for which CTC is indicated remain unclear. To address this uncertainty - 20 years after the first presentation of CTC at a radiological meeting [8] - the European Society of Gastrointestinal Endoscopy (ESGE) and the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) decided to produce a common guideline regarding indications for CTC in clinical practice. Technical and quality issues of CTC have been deliberately excluded from this work as these have already been discussed separately [7].

  17. Ultrasound colonography in visualization of large intestine cancer pathology

    Directory of Open Access Journals (Sweden)

    N. V. Tumanskaya

    2013-08-01

    Full Text Available Introduction: colon oncopathology takes the 2-nd place among different kinds of cancer and tends to grow constantly. Thus, the incidence of colorectal cancer (CRC in Ukraine is 20.6 cases per 100 thousands of population. 70-75% of patients are diagnosed only at the 3-4 stage of the disease, due to its long asymptomatic initial period. The gold standard of diagnostic of CRC is endoscopy, which enables not only to visualize altered intestinal mucosa, but also to perform a biopsy for morphological study. Modern imaging diagnostic methods (virtual CT colonography, MRI, PET / CT, which are used in developed countries, are not been widely spreded in Ukraine, unfortunately. Complex ultrasound examination reveals new diagnostic capabilities in the solution of this problem. Ultrasound colonography allows morphology assessing of all parts of the large intestine. This method is primarily justified for those patients who can’t be examined with conventional irrigoscopy and endoscopic colonoscopy because of some objective reasons. Objectives of the research: to objectify the diagnostic capabilities of ultrasound colonography as an alternative method of imaging of colorectal cancer. Matherials and methods: The colonography was performed with the ultrasound scanner HD11 (Philips in 26 patients with clinically suspected large intestine pathology. There were 10 male and 16 female patients with the average age 55,3±9,2. All patients were performed X-ray multislice computed tomography (MSCT as the reference method. 9 patients were operated on with the followed morphological analysis of affected parts of the intestine. Results and discussion: the colon pathology in our research was found in 10 patients (38.5% of the patients. Among them stenotic form of colorectal cancer was diagnosed in 6 patients (22.8%. In 4 patients (15.2% the polypoid form of colorectal cancer was found. In both cases, the affected area was located in the region of rectosigmoid junction. In

  18. Virtual reality in MR-colonography; Die virtuelle Realitaet der MR-Kolonographie

    Energy Technology Data Exchange (ETDEWEB)

    Schoenfelder, D.; Debatin, J.F. [Zentralinstitut fuer Roentgendiagnostik, Universitaetsklinikum Essen (Germany)

    2000-03-01

    Early detection and subsequent removal of colorectal polyps have been shown to constitute an effective approach for decreasing the incidence of colorectal cancer. The lack of an ideal modality for colorectal polyp screening stimulated interest in the development of CT-colonography and MR-colonography. Both techniques allow the colon to be analyzed in a cross-sectional as well as a virtual endoscopic format. Causing no side-effects and not concerning for radiation exposure MR-colonography warrants further consideration. Additional to detecting polyps down to 6 mm in size the inner wall contour and the morphology of the colonic wall itself can be assessed. New developments like fecal tagging will increase patients acceptance comparing to other diagnostic techniques. In search of an ideal modality for polyp screening MR-colonography will become a potent option in the diagnostic arsenal. (orig.) [German] Die fruehzeitige Entdeckung und Entfernung eines Polypen kann das Risiko fuer die Entwicklung eines kolorektalen Karzinoms entscheidend reduzieren. Das bisherige Fehlen einer geeigneten Vorsorgeuntersuchung eroeffnet hier Moeglichkeiten fuer die Entwicklung der CT- und MR-Kolonographie. Beide Techniken erlauben die selektive Darstellung des Kolons - Kolonographie - sowie die Simulation einer endoskopischen Untersuchung - virtuelle Koloskopie. Insbesondere die nebenwirkungsfreie und ohne Strahlenbelastung durchzufuehrende MR-Kolonographie verdient hier besonderes Augenmerk. Zusaetzlich zur Detektion von Polypen bis hin zu 6 mm Groesse kann anhand der Schnittbilder eine Beurteilung der Koloninnenwand erfolgen und auch die Morphologie der Kolonwand kann beurteilt werden. Neue Entwicklungen in der MR-Kolonographie - wie etwa das fecal tagging - werden eine Verbesserung der Patientenakzeptanz im Vergleich zu anderen Untersuchungstechniken ermoeglichen. Auf der Suche nach der optimalen Vorsorgeuntersuchung zum Nachweis kolorektaler Polypen zeigt die MR-Kolonographie einen

  19. Combining heterogeneous features for colonic polyp detection in CTC based on semi-definite programming

    Science.gov (United States)

    Wang, Shijun; Yao, Jianhua; Petrick, Nicholas A.; Summers, Ronald M.

    2009-02-01

    Colon cancer is the second leading cause of cancer-related deaths in the United States. Computed tomographic colonography (CTC) combined with a computer aided detection system provides a feasible combination for improving colonic polyps detection and increasing the use of CTC for colon cancer screening. To distinguish true polyps from false positives, various features extracted from polyp candidates have been proposed. Most of these features try to capture the shape information of polyp candidates or neighborhood knowledge about the surrounding structures (fold, colon wall, etc.). In this paper, we propose a new set of shape descriptors for polyp candidates based on statistical curvature information. These features, called histogram of curvature features, are rotation, translation and scale invariant and can be treated as complementing our existing feature set. Then in order to make full use of the traditional features (defined as group A) and the new features (group B) which are highly heterogeneous, we employed a multiple kernel learning method based on semi-definite programming to identify an optimized classification kernel based on the combined set of features. We did leave-one-patient-out test on a CTC dataset which contained scans from 50 patients (with 90 6-9mm polyp detections). Experimental results show that a support vector machine (SVM) based on the combined feature set and the semi-definite optimization kernel achieved higher FROC performance compared to SVMs using the two groups of features separately. At a false positive per patient rate of 7, the sensitivity on 6-9mm polyps using the combined features improved from 0.78 (Group A) and 0.73 (Group B) to 0.82 (p<=0.01).

  20. Does a computer-aided detection algorithm in a second read paradigm enhance the performance of experienced computed tomography colonography readers in a population of increased risk?

    Energy Technology Data Exchange (ETDEWEB)

    Vries, Ayso H. de; Liedenbaum, Marjolein H.; Florie, Jasper; Nio, Chung Y.; Bipat, Shandra; Stoker, Jaap [University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); Jensch, Sebastiaan [University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); Onze Lieve Vrouwe Gasthuis, Department of Radiology, Amsterdam (Netherlands); Truyen, Roel [Philips Medical Systems, Department of Healthcare Informatics, Best (Netherlands); Dekker, Evelien; Fockens, Paul [University of Amsterdam, Department of Gastroenterology, Academic Medical Center, Amsterdam (Netherlands); Baak, Lubbertus C. [Onze Lieve Vrouwe Gasthuis, Department of Gastroenterology, Amsterdam (Netherlands)

    2009-04-15

    We prospectively determined whether computer-aided detection (CAD) could improve the performance characteristics of computed tomography colonography (CTC) in a population of increased risk for colorectal cancer. Therefore, we included 170 consecutive patients that underwent both CTC and colonoscopy. All findings {>=}6 mm were evaluated at colonoscopy by segmental unblinding. We determined per-patient sensitivity and specificity for polyps {>=}6 mm and {>=}10 mm without and with computer-aided detection (CAD). The McNemar test was used for comparison the results without and with CAD. Unblinded colonoscopy detected 50 patients with lesions {>=}6 mm and 25 patients with lesions {>=}10 mm. Sensitivity of CTC without CAD for these size categories was 80% (40/50, 95% CI: 69-81%) and 64% (16/25, 95% CI: 45-83%), respectively. CTC with CAD detected one additional patient with a lesion {>=}6 mm and two with a lesion {>=}10 mm, resulting in a sensitivity of 82% (41/50, 95% CI: 71-93%) (p = 0.50) and 72% (18/25, 95% CI: 54-90%) (p = 1.0), respectively. Specificity without CAD for polyps {>=}6 mm and {>=}10 mm was 84% (101/120, 95% CI: 78-91%) and 94% (136/145, 95% CI: 90-98%), respectively. With CAD, the specificity remained (nearly) unchanged: 83% (99/120, 95% CI: 76-89%) and 94% (136/145, 95% CI: 90-98%), respectively. Thus, although CTC with CAD detected a few more patients than CTC without CAD, it had no statistically significant positive influence on CTC performance. (orig.)

  1. Feasibility study of computed tomography colonography using limited bowel preparation at normal and low-dose levels study

    Energy Technology Data Exchange (ETDEWEB)

    Florie, Jasper; Gelder, Rogier E. van; Schutter, Michiel P.; Randen, Adrienne van; Jager, Steven de; Prent, Anna; Bipat, Shandra [Academic Medical Center, Department of Radiology, G1-230, P.O. Box 22660, Amsterdam (Netherlands); Venema, Henk W. [Academic Medical Center, Department of MedicaPhysics, L0-106, P.O. Box 22660, Amsterdam (Netherlands); Hulst, Victor P.M. van der [Onze Lieve Vrouwe Gasthuis, Department of Radiology, P.O. BOX 95500, Amsterdam (Netherlands); Bossuyt, Patrick M.M. [Academic Medical Center, Department Clinical Epidemiology and Biostatistics, J1b-212, P.O. BOX 22660, Amsterdam (Netherlands); Baak, Lubbertus C. [Onze Lieve Vrouwe Gasthuis, Department Gastroenterology, P.O. BOX 95500, Amsterdam (Netherlands); Stoker, Jaap [Academic Medical Center, Department of Radiology, G1-211, P.O. BOX 22660, Amsterdam (Netherlands)

    2007-12-15

    The purpose was to evaluate low-dose CT colonography without cathartic cleansing in terms of image quality, polyp visualization and patient acceptance. Sixty-one patients scheduled for colonoscopy started a low-fiber diet, lactulose and amidotrizoic-acid for fecal tagging 2 days prior to the CT scan (standard dose, 5.8-8.2 mSv). The original raw data of 51 patients were modified and reconstructed at simulated 2.3 and 0.7 mSv levels. Two observers evaluated the standard dose scan regarding image quality and polyps. A third evaluated the presence of polyps at all three mSv levels in a blinded prospective way. All observers were blinded to the reference standard: colonoscopy. At three times patients were given questionnaires relating to their experiences and preference. Image quality was sufficient in all patients, but significantly lower in the cecum, sigmoid and rectum. The two observers correctly identified respectively 10/15 (67%) and 9/15 (60%) polyps {>=}10 mm, with 5 and 8 false-positive lesions (standard dose scan). Dose reduction down to 0.7 mSv was not associated with significant changes in diagnostic value (polyps {>=}10 mm). Eighty percent of patients preferred CT colonography and 13% preferred colonoscopy (P<0.001). CT colonography without cleansing is preferred to colonoscopy and shows sufficient image quality and moderate sensitivity, without impaired diagnostic value at dose-levels as low as 0.7 mSv. (orig.)

  2. Machine Learning in Computer-aided Diagnosis of the Thorax and Colon in CT: A Survey.

    Science.gov (United States)

    Suzuki, Kenji

    2013-04-01

    Computer-aided detection (CADe) and diagnosis (CAD) has been a rapidly growing, active area of research in medical imaging. Machine leaning (ML) plays an essential role in CAD, because objects such as lesions and organs may not be represented accurately by a simple equation; thus, medical pattern recognition essentially require "learning from examples." One of the most popular uses of ML is the classification of objects such as lesion candidates into certain classes (e.g., abnormal or normal, and lesions or non-lesions) based on input features (e.g., contrast and area) obtained from segmented lesion candidates. The task of ML is to determine "optimal" boundaries for separating classes in the multidimensional feature space which is formed by the input features. ML algorithms for classification include linear discriminant analysis (LDA), quadratic discriminant analysis (QDA), multilayer perceptrons, and support vector machines (SVM). Recently, pixel/voxel-based ML (PML) emerged in medical image processing/analysis, which uses pixel/voxel values in images directly, instead of features calculated from segmented lesions, as input information; thus, feature calculation or segmentation is not required. In this paper, ML techniques used in CAD schemes for detection and diagnosis of lung nodules in thoracic CT and for detection of polyps in CT colonography (CTC) are surveyed and reviewed.

  3. Diagnostic accuracy and tolerability of contrast enhanced CT colonoscopy in symptomatic patients with increased risk for colorectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ozsunar, Yelda [Department of Radiology, School of Medicine, Adnan Menderes University, Aydin (Turkey)], E-mail: yozsunar@adu.edu.tr; Coskun, Guelten [Izmir Ataturk Egitim ve Arastirma Hastanesi, Izmir (Turkey); Delibas, Naciye; Uz, Burcin [Department of Radiology, School of Medicine, Adnan Menderes University, Aydin (Turkey); Yuekselen, Vahit [Department of Gastroenterology, School of Medicine, Adnan Menderes University, Aydin (Turkey)

    2009-09-15

    Objective: We compared the accuracy and tolerability of intravenous contrast enhanced spiral computed tomography colonography (CTC) and optical colonoscopy (OC) for the detection of colorectal neoplasia in symptomatic patients for colorectal neoplasia. Methods: A prospective study was performed in 48 patients with symptomatic patients with increased risk for colorectal cancer. Spiral CTC was performed in supine and prone positions after colonic cleansing. The axial, 2D MPR and virtual endoluminal views were analyzed. Results of spiral CTC were compared with OC which was done within 15 days. The psychometric tolerance test was asked to be performed for both CTC and colonoscopy after the procedure. Results: Ten lesions in 9 of 48 patients were found in CTC and confirmed with OC. Two masses and eight polyps, consisted of 1 tubulovillous, 1 tubular, 2 villous adenoma, 4 adenomatous polyp, 4 adenocarcinoma, were identified. Lesion prevalence was 21%. Sensitivity, specificity, accuracy, positive and negative predictive values were found 100%, 87%, 89%, 67% and 100%, respectively. Psychometric tolerance test showed that CTC significantly more comfortable comparing with OC (p = 0.00). CTC was the preferred method in 37% while OC was preferred in 6% of patients. In both techniques, the most unpleasant part was bowel cleansing. Conclusion: Contrast enhanced CTC is a highly accurate method in detecting colorectal lesions. Since the technique was found to be more comfortable and less time consuming compare to OE, it may be preferable in management of symptomatic patients with increased risk for colorectal cancer.

  4. CTC Sentinel. Volume 1, Issue 1, December 2007. West Point Releases First Issue of CTC Sentinel

    Science.gov (United States)

    2007-12-01

    Early next year, the CTC will launch an entirely redesigned website, which will feature an interactive tool for searching our growing collection...author’s testimony, titled, “Using the Web as a Weapon: The Internet as a Tool for Violent Radicalization and Homegrown Terrorism,” that was...undertone of a sort not apparent in past years. Reflective of this have been frequent attacks against drinking dens, gambling halls, karaoke bars and

  5. Potential pitfalls in the anorectal region during CT colonography: A ...

    African Journals Online (AJOL)

    2017-02-28

    Feb 28, 2017 ... the balloon in the prone view: (1) to obtain a full scan series without an inflated balloon, to ... a 360° fly around the rectal catheter to ensure adequate ... from a sessile polyp.16 On 2D views, foci of air may be present.

  6. MR and CT cholangiography in evaluation of the biliary tract

    Energy Technology Data Exchange (ETDEWEB)

    Masui, T.; Fujiwara, T.; Ichijo, K.; Imaoka, I.; Naito, M. [Seirei Mikatabara General Hospital, Hamamatsu (Japan). Dept. of Radiology; Takehara, Y.; Kaneko, M. [Hamamatsu Univ. School of Medicine (Japan). Dept. of Radiology; Yamamoto, H.; Watahiki, H. [Seirei Mikatabara General Hospital, Hamamatsu (Japan). Dept. of Gastroenterology

    1998-09-01

    Objective: To compare MR and CT cholangiography (MRC and CTC) in evaluating the anatomy of the extrahepatic biliary tract and the pathology related to the gallbladder. Material and Methods: Twenty-three patients underwent MRC and CTC with a biliary contrast medium for investigation of biliary disease. 3D displays of both were also obtained. Endoscopic retrograde cholangiography was performed in 17 patients, and the pathology of all 23 was evaluated. Results: Overall, the image quality was higher with CTC than with MRC (4.7 vs 3.9, p<0.05). The cystic duct was demonstrated better by CTC than MRC (p<0.05). Multiplanar reformation (MPR) and source images provided additional information to that obtained from 3D MRC and CTC images. Gallstones were revealed in 6 patients by CTC and in 5 of these 6 by MRC. In 2 patients with cholecystitis, CTC demonstrated gallbladder wall thickening but MRC did not. In 3 patients with adenomyomatosis, MRC demonstrated Rokitansky-Aschoff sinuses (RAS) while CTC demonstrated focal gallbladder wall thickening in all 3 and RAS in 1 of them. Conclusion: Both MRC and CTC provided anatomical and pathological information about the biliary system. With both techniques, however, either MPR or source images proved necessary in addition for evaluating the biliary system anatomy and pathology. The gallbladder wall was depicted clearly in source CTC, but MRC is recommended for the evaluation of adenomyomatosis because its depicts RAS clearly. (orig.)

  7. SmAHTR-CTC Neutronic Design

    Energy Technology Data Exchange (ETDEWEB)

    Ilas, Dan [ORNL; Holcomb, David Eugene [ORNL; Gehin, Jess C [ORNL

    2014-01-01

    Building on prior experience for the 2010 initial SmAHTR neutronic design and on 2012 neutronic design for the advanced high temperature reactor (AHTR), this paper presents the main results of the neutronic design effort for the newly re-purposed SmAHTR-CTC reactor concept. The results are obtained based on full-core simulations performed with SCALE6.1. The dimensionality of the SmAHTR design space is reduced by using constraints originating in material fabricability, fuel licensing, molten salt chemistry, thermal-hydraulic and mechanical considerations. The new design represents in many regards a substantial improvement from the neutronic performance standpoint over the 2010 SmAHTR concept. Among other results, it is shown that fuel cycle length of over 2 years or discharged fuel burnup of 40GWd/MTHM are possible with a low, 8% fuel enrichment in a once-through fuel cycle, while 8-year once-through fuel cycle lengths are possible at higher fuel enrichments.

  8. CTC Sentinel: January 2017, Volume 10, Issue 1

    Science.gov (United States)

    2017-01-01

    Colonel Bryan Price , Ph.D. Director, CTC Brian Dodwell Deputy Director, CTC CONTACT Combating Terrorism Center U.S. Military Academy 607 Cullum...the House -Tree-Person Drawing test. Suicide bombers obtained significantly more diagnoses of Avoidant-De- pendent Personality Disorder (60% vs. 17...counterter- rorism officers in the parking lot of a police station in Melbourne , Australia. Haider was shot dead at the scene. There is evidence that

  9. Quantitative radiology: automated measurement of polyp volume in computed tomography colonography using Hessian matrix-based shape extraction and volume growing

    Science.gov (United States)

    Epstein, Mark L.; Obara, Piotr R.; Chen, Yisong; Liu, Junchi; Zarshenas, Amin; Makkinejad, Nazanin; Dachman, Abraham H.

    2015-01-01

    Background Current measurement of the single longest dimension of a polyp is subjective and has variations among radiologists. Our purpose was to develop a computerized measurement of polyp volume in computed tomography colonography (CTC). Methods We developed a 3D automated scheme for measuring polyp volume at CTC. Our scheme consisted of segmentation of colon wall to confine polyp segmentation to the colon wall, extraction of a highly polyp-like seed region based on the Hessian matrix, a 3D volume growing technique under the minimum surface expansion criterion for segmentation of polyps, and sub-voxel refinement and surface smoothing for obtaining a smooth polyp surface. Our database consisted of 30 polyp views (15 polyps) in CTC scans from 13 patients. Each patient was scanned in the supine and prone positions. Polyp sizes measured in optical colonoscopy (OC) ranged from 6-18 mm with a mean of 10 mm. A radiologist outlined polyps in each slice and calculated volumes by summation of volumes in each slice. The measurement study was repeated 3 times at least 1 week apart for minimizing a memory effect bias. We used the mean volume of the three studies as “gold standard”. Results Our measurement scheme yielded a mean polyp volume of 0.38 cc (range, 0.15-1.24 cc), whereas a mean “gold standard” manual volume was 0.40 cc (range, 0.15-1.08 cc). The “gold-standard” manual and computer volumetric reached excellent agreement (intra-class correlation coefficient =0.80), with no statistically significant difference [P (F≤f) =0.42]. Conclusions We developed an automated scheme for measuring polyp volume at CTC based on Hessian matrix-based shape extraction and volume growing. Polyp volumes obtained by our automated scheme agreed excellently with “gold standard” manual volumes. Our fully automated scheme can efficiently provide accurate polyp volumes for radiologists; thus, it would help radiologists improve the accuracy and efficiency of polyp volume

  10. Common findings and pseudolesions at computed tomography colonography: pictorial essay

    OpenAIRE

    Augusto Castelli von Atzingen; Dario Ariel Tiferes; Carlos Alberto Matsumoto; Thiago Franchi Nunes; Marcos Vinicius Alvim Soares Maia; Giuseppe D'Ippolito

    2012-01-01

    Computed tomography colonography is a minimally invasive method for screening for polyps and colorectal cancer, with extremely unusual complications, increasingly used in the clinical practice. In the last decade, developments in bowel preparation, imaging, and in the training of investigators have determined a significant increase in the method sensitivity. Images interpretation is accomplished through a combined analysis of two-dimensional source images and several types of three-dimensiona...

  11. 迎合现状的CTcP

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    CTcP(Computer To Conventional Plate)是由德国贝斯印公司开发的一种新的电脑直接制片技术。CTcP是Computer to Conventional Plate的英文缩写,含义是指在传统版材上进行计算机直接制版。它采用波长范围为360nm-450nm的紫外线光源,对传统PS版进行曝光。由德国贝斯印basysPrint公司开发的Digital Screen Imaging(DSI)即数字加网成像技术是CTcP系统的核心技术。

  12. Lactobacillus salivarius CTC2197 Prevents Salmonella enteritidis Colonization in Chickens

    Science.gov (United States)

    Pascual, Mònica; Hugas, Marta; Badiola, Jose Ignacio; Monfort, Josep Maria; Garriga, Margarita

    1999-01-01

    A rifampin-resistant Lactobacillus salivarius strain, CTC2197, was assessed as a probiotic in poultry, by studying its ability to prevent Salmonella enteritidis C-114 colonization in chickens. When the probiotic strain was dosed by oral gavage together with S. enteritidis C-114 directly into the proventriculus in 1-day-old Leghorn chickens, the pathogen was completely removed from the birds after 21 days. The same results were obtained when the probiotic strain was also administered through the feed and the drinking water apart from direct inoculation into the proventriculus. The inclusion of L. salivarius CTC2197 in the first day chicken feed revealed that a concentration of 105 CFU g−1 was enough to ensure the colonization of the gastrointestinal tract of the birds after 1 week. However, between 21 and 28 days, L. salivarius CTC2197 was undetectable in the gastrointestinal tract of some birds, showing that more than one dose would be necessary to ensure its presence till the end of the rearing time. Freeze-drying and freezing with glycerol or skim milk as cryoprotective agents, appeared to be suitable methods to preserve the probiotic strain. The inclusion of the L. salivarius CTC2197 in a commercial feed mixture seemed to be a good way to supply it on the farm, although the strain showed sensitivity to the temperatures used during the feed mixture storage and in the chicken incubator rooms. Moreover, survival had been improved after several reinoculations in chicken feed mixture. PMID:10543812

  13. Direct estimate of active bacteria: CTC use and limitations

    NARCIS (Netherlands)

    Creach, V.; Baudoux, A.C.; Bertru, G.; Le Rouzic, B.

    2003-01-01

    During the last 10 years, the dye 5-cyano-2,3-ditolyl tetrazolium chloride (CTC) has been used to determine the in situ number of "active" bacteria in different ecosystems. A part of this success is due to a simple protocol, which does not require sophisticated equipment. However, it has not been es

  14. The utility of flexible sigmoidoscopy after a computerized tomographic colonography revealing only rectosigmoid lesions.

    Science.gov (United States)

    Young, P E; Gentry, A B; Cash, B D

    2008-03-15

    Identifying polyps by computerized tomographic colonography typically prompts colonoscopy, increasing its cost, risk and inconvenience. Many polyps are confined to the rectosigmoid and theoretically amenable to resection via flexible sigmoidoscopy. To determine the prevalence of advanced proximal colonic neoplasia when computerized tomographic colonography reveals only rectosigmoid polyps, and characterize the yield of polypectomy via flexible sigmoidoscopy in such patients. Subjects underwent computerized tomographic colonography and colonoscopy with segmental unblinding. Patients with only rectosigmoid findings by computerized tomographic colonography were identified retrospectively. Flexible sigmoidoscopy findings were estimated by including lesions distal to the descending/sigmoid colon junction during colonoscopy. Proximal lesions were also reviewed. Advanced lesions were defined as: adenocarcinoma, tubular adenoma >1 cm, > or =3 tubular adenomas, tubulovillous histology or high-grade dysplasia. By computerized tomographic colonography, 15% (203 of 1372) had only rectosigmoid polyps. Concomitant lesions in the proximal colon were seen in 32% (64 of 203) during colonoscopy. Advanced proximal neoplasia occurred in 2% (three of 203) with only rectosigmoid polyps on computerized tomographic colonography. Using flexible sigmoidoscopy to follow-up computerized tomographic colonography demonstrating only rectosigmoid polyps would eliminate 15% of subsequent colonoscopies. This strategy carries a small risk of missed proximal advanced neoplasia. This miss rate appears comparable to that of colonoscopy alone. Further study on the cost-effectiveness of this approach is warranted.

  15. Preoperative evaluation of synchronous colorectal cancer using MR colonography

    DEFF Research Database (Denmark)

    Achiam, Michael P; Andersen, Lars Peter Holst; Klein, Mads

    2009-01-01

    it is noninvasive, and most of the colon can be evaluated. Furthermore, it has higher patient acceptance, and no sedation or radiation is used. The purpose of this study was to determine the feasibility of performing MRC preoperatively in an everyday clinical situation in a group of patients who were not offered......RATIONALE AND OBJECTIVES: It is well known that synchronous cancers (incidence, 2%-11%) and polyps (incidence, 12%-58%) occur in patients with colorectal cancer. Magnetic resonance colonography (MRC) seems like the obvious choice as a diagnostic tool in preoperative evaluation, because...

  16. Mechanisms of CTC Biomarkers in Breast Cancer Brain Metastasis

    Science.gov (United States)

    2015-10-01

    Supplementary Fig. 1) in which the endomembrane furrow separates the daughter and mother cell during cell -division events18. Biomarker profiling of...CD44+/CD24- stem cell signature; along with combinatorial expression of uPAR and int β1, two markers directly implicated in breast cancer dormancy...development of manuscripts. 2. KEYWORDS: Partnering PI, patient blood samples, and circulating tumor cells (CTC), breast cancer brain metastasis

  17. Mechanisms of CTC Biomarkers in Breast Cancer Brain Metastasis

    Science.gov (United States)

    2015-10-01

    represents the most devastating and feared consequence of breast cancer . BCBM is usually fatal and is increasing in frequency with occult brain...metastatic breast cancer (stage IV) patients with or without clinically diagnosed BCBM employing multiparametric flow cytometry (FACS; ARIA IIID system)(10...AWARD NUMBER: W81XWH-14-1-0214 TITLE: Mechanisms of CTC Biomarkers in Breast Cancer Brain Metastasis PRINCIPAL INVESTIGATOR: Dario

  18. Computed Tomography Colonography Technique: The Role of Intracolonic Gas Volume

    Directory of Open Access Journals (Sweden)

    Patrick D. McLaughlin

    2013-01-01

    Full Text Available Introduction. Poor distention decreases the sensitivity and specificity of CTC. The total volume of gas administered will vary according to many factors. We aim to determine the relationship between the volume of retained gas at the time of image acquisition and colonic distention and specifically the presence of collapsed bowel segments at CTC. Materials and Methods. All patients who underwent CTC over a 12-month period at a single institution were included in the study. Colonic luminal distention was objectively scored by 2 radiologists using an established 4-point scale. Quantitative analysis of the volume of retained gas at the time of image acquisition was conducted using the threshold 3D region growing function of OsiriX. Results. 108 patients were included for volumetric analysis. Mean retained gas volume was 3.3 L. 35% (38/108 of patients had at least one collapsed colonic segment. Significantly lower gas volumes were observed in the patients with collapsed colonic segments when compared with those with fully distended colons 2.6 L versus 3.5 L (P=0.031. Retained volumes were significantly higher for the 78% of patients with ileocecal reflux at 3.4 L versus 2.6 L without ileocecal reflux (P=0.014. Conclusion. Estimation of intraluminal gas volume at CTC is feasible using image segmentation and thresholding tools. An average of 3.5 L of retained gas was found in diagnostically adequate CTC studies with significantly lower mean gas volume observed in patients with collapsed colonic segments.

  19. Common findings and pseudolesions at computed tomography colonography: pictorial essay

    Energy Technology Data Exchange (ETDEWEB)

    Atzingen, Augusto Castelli von [Clinical Radiology, Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, SP (Brazil); Tiferes, Dario Ariel; Matsumoto, Carlos Alberto; Nunes, Thiago Franchi; Maia, Marcos Vinicius Alvim Soares [Abdominal Imaging Section, Department of Imaging Diagnosis - Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, SP (Brazil); D' Ippolito, Giuseppe, E-mail: giuseppe_dr@uol.com.br [Department of Imaging Diagnosis, Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, SP (Brazil)

    2012-05-15

    Computed tomography colonography is a minimally invasive method for screening for polyps and colorectal cancer, with extremely unusual complications, increasingly used in the clinical practice. In the last decade, developments in bowel preparation, imaging, and in the training of investigators have determined a significant increase in the method sensitivity. Images interpretation is accomplished through a combined analysis of two-dimensional source images and several types of three-dimensional renderings, with sensitivity around 96% in the detection of lesions with dimensions equal or greater than 10 mm in size, when analyzed by experienced radiologists. The present pictorial essay includes examples of diseases and pseudolesions most frequently observed in this type of imaging study. The authors present examples of flat and polypoid lesions, benign and malignant lesions, diverticular disease of the colon, among other conditions, as well as pseudolesions, including those related to inappropriate bowel preparation and misinterpretation. (author)

  20. Parallel imaging enhanced MR colonography using a phantom model.

    LENUS (Irish Health Repository)

    Morrin, Martina M

    2008-09-01

    To compare various Array Spatial and Sensitivity Encoding Technique (ASSET)-enhanced T2W SSFSE (single shot fast spin echo) and T1-weighted (T1W) 3D SPGR (spoiled gradient recalled echo) sequences for polyp detection and image quality at MR colonography (MRC) in a phantom model. Limitations of MRC using standard 3D SPGR T1W imaging include the long breath-hold required to cover the entire colon within one acquisition and the relatively low spatial resolution due to the long acquisition time. Parallel imaging using ASSET-enhanced T2W SSFSE and 3D T1W SPGR imaging results in much shorter imaging times, which allows for increased spatial resolution.

  1. Clinical aspects of MR colonography as a diagnostic tool

    DEFF Research Database (Denmark)

    Achiam, Michael

    2010-01-01

    Since first described in 1997, MR colonography (MRC) has since been labelled as a promising new, non-invasive technique for examining the colon. At present time, the examination is ready to be implemented as a supplement to incomplete colonoscopy or preoperative colonic evaluation. Furthermore, MRC...... and that polypectomy might be curative. Colonoscopy remains the gold standard for full colon evaluation. However, the result of our studies can justify clinical use of MRC on selected indications, e.g. in the cases where colonoscopy is incomplete or technically difficult. Since up to 54% of all preoperative colon...... evaluations in patients with colorectal cancer and up to 17-23% of regular colonoscopies are incomplete, the clinical potential of MRC is evident. Furthermore, in our studies we have shown the insufficiency of preoperative colonic evaluation by CC. In addition, considering the invasiveness, the serious...

  2. Evaluation of contrast-enhanced computed tomographic colonography in detection of local recurrent colorectal cancer

    Institute of Scientific and Technical Information of China (English)

    Yau-Tong You; Chung-Rong Chang Chien; Jeng-Yi Wang; Koon-Kwan Ng; Jinn-Shiun Chen; Reiping Tang; Jy-Ming Chiang; Chien-Yuh Yeh; Pao-Shiu Hsieh

    2006-01-01

    AIM: To evaluate the diagnostic accuracy, sensitivity,specificity of contrast-enhanced computed tomographic colonography in detecting local recurrence of colorectal cancer.METHODS: From January 2000 to December 2004,434 patients after potentially curative resection for invasive colorectal cancer were followed up for a period ranging from 20 to 55 mo. Eighty of the four hundred and thirty-four patients showing strong clinical evidence for recurring colorectal cancer during the last followup were enrolled in this study. Each patient underwent contrast-enhanced computed tomographic colonography and colonoscopy on the same day. Any lesions, biopsies,identified during the colonoscopic examination, immediate complications and the duration of the procedure were recorded. The results of contrast-enhanced computed tomographic colonography were evaluated by comparing to those of colonoscopy, surgical finding, and clinical follow-up.RESULTS: Contrast-enhanced computed tomographic colonography had a sensitivity of 100%, a specificity of 83% and an overall accuracy of 94% in detecting local recurrent colorectal cancer.CONCLUSION: Conventional colonoscopy and contrastenhanced tomographic colonography can complement each other in detecting local recurrence of colorectal cancer.

  3. Myeloid-derived suppressor cells (MDSC) facilitate distant metastasis of malignancies by shielding circulating tumor cells (CTC) from immune surveillance.

    Science.gov (United States)

    Liu, Qiaofei; Liao, Quan; Zhao, Yupei

    2016-02-01

    The mechanisms of distant metastasis of malignancies largely remain unknown. Circulating tumor cells (CTC) derived from the primary cancer initiate distant metastasis by entering and traversing the bloodstream. Current methods to detect CTC are based on the notion that CTC do not express the common leukocyte antigen CD45. However, these methods neglect the fact that CTC can directly adhere to platelets and immune cells and therefore appear to be CD45-positive. The potential effects of interactions between CTC and adhesive immune cells have been largely overlooked, despite the fact that most CTC are killed by immune effector cells and only those that evade immune surveillance result in clonal expansion and metastatic lesions. It is crucial to define the characteristics that allow a select CTC population to escape immune surveillance; particularly, it must be determined whether interactions between CTC and adhesive immune cells provide a protective effect on CTC survival. If interactions between CTC and adhesive immune cells offer a selective advantage to those CTC cells, the next consideration is which characteristics of a CTC-immune cell population allow sufficient protection to facilitate immune evasion. Myeloid-derived suppressor cells (MDSC) are a large heterogeneous population of immature myeloid cells that accumulate during cancer progression to induce extensively systemic and local immunosuppression, a phenomenon that has been demonstrated to facilitate cancer distant metastasis. We hypothesize, therefore, that CTC populations interacting with adhesive immune cells will have different biological behavior than CTC populations alone. Further, we hypothesize that CTC can create a defensive shield consisting of adhesive MDSC, which allows evasion of immune surveillance and therefore facilitates distant metastatic lesions. This possibility highlights the importance of direct interactions between CTC and adhesive immune cells and suggests the potential target that

  4. Simply Talks about TDCS/CTC Network Security System%浅议 TDCS/CTC 系统网络安全

    Institute of Scientific and Technical Information of China (English)

    周桂强

    2010-01-01

    TDCS/CTC 系统是铁路运输指挥的重要行车设备,其网络覆盖全路各铁路局及车站,系统网络安全是保障其正常运行的重要因素.详细介绍了现有 TDCS/CTC 信息安全防护体系,对目前系统网络中存在的安全风险进行分析,提出了解决 TDCS/CTC 系统存在安全风险的途径,为确保全路 TDCS/CTC 系统网络的安全提供保障.

  5. Colovesical fistula causing an uncommon reason for failure of computed tomography colonography: a case report

    Directory of Open Access Journals (Sweden)

    Neroladaki Angeliki

    2012-07-01

    Full Text Available Abstract Introduction Computed tomography colonography, or virtual colonoscopy, is a good alternative to optical colonoscopy. However, suboptimal patient preparation or colon distension may reduce the diagnostic accuracy of this imaging technique. Case presentation We report the case of an 83-year-old Caucasian woman who presented with a five-month history of pneumaturia and fecaluria and an acute episode of macrohematuria, leading to a high clinical suspicion of a colovesical fistula. The fistula was confirmed by standard contrast-enhanced computed tomography. Optical colonoscopy was performed to exclude the presence of an underlying colonic neoplasm. Since optical colonoscopy was incomplete, computed tomography colonography was performed, but also failed due to inadequate colon distension. The insufflated air directly accumulated within the bladder via the large fistula. Conclusions Clinicians should consider colovesical fistula as a potential reason for computed tomography colonography failure.

  6. Bacterial 5S rRNA-binding proteins of the CTC family.

    Science.gov (United States)

    Gongadze, G M; Korepanov, A P; Korobeinikova, A V; Garber, M B

    2008-12-01

    The presence of CTC family proteins is a unique feature of bacterial cells. In the CTC family, there are true ribosomal proteins (found in ribosomes of exponentially growing cells), and at the same time there are also proteins temporarily associated with the ribosome (they are produced by the cells under stress only and incorporate into the ribosome). One feature is common for these proteins - they specifically bind to 5S rRNA. In this review, the history of investigations of the best known representatives of this family is described briefly. Structural organization of the CTC family proteins and their occurrence among known taxonomic bacterial groups are discussed. Structural features of 5S rRNA and CTC protein are described that predetermine their specific interaction. Taking into account the position of a CTC protein and its intermolecular contacts in the ribosome, a possible role of its complex with 5S rRNA in ribosome functioning is discussed.

  7. Colorectal neoplasm: Magnetic resonance colonography with fat enema-initial clinical experience

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To assess Magnetic resonance colonography with fat enema as a method for detection of colorectal neoplasm. METHODS: Consecutive twenty-two patients underwent MR colonography with fat enema before colonoscopy. T1-weighted three-dimensional fast spoiled gradientecho with inversion recovery sequence was acquired with the patient in the supine position before and 75 s after Gadopentetate Dimelumine administration. Where by, pre and post MR coronal images were obtained with a single breath hold for about 20 s to cover the entire colon. The quality of MR colonographs and patients' tolerance to fat contrast medium was investigated. Colorectal neoplasms identified by MR colonography were compared with those identified on colonoscopy and sensitivity of detecting the lesions was calculated accordingly. RESULTS: MR colonography with fat enema was well tolerated without sedation and analgesia. 120 out of 132 (90.9%) colonic segments were well distended and only 1 (0.8%) colonic segment was poor distension. After contrast enhancement scan, mean contrast-to-noise ratio (CNR) value between the normal colonic wall and lumen was 18.5 ± 2.9 while mean CNR value between colorectal neoplasm and lumen was 20.2 ± 3.1. By Magnetic resonance colonography, 26 of 35 neoplasms (sensitivity 74.3%) were detected. However, sensitivity of MRC was 95.5% (21 of 22) for neoplasm larger than 10 mm and 55.6% (5 of 9) for 5-10 mm neoplasm. CONCLUSION: MR colonography with fat enema and T1-weighted three-dimensional fast spoiled gradientecho with inversion recovery sequence is feasible in detecting colorectal neoplasm larger than 10 mm.

  8. Preliminary study on MR colonography with air enema in detection of colorectal neoplasms

    Institute of Scientific and Technical Information of China (English)

    LUO Ming-yue; LIU Li; YAN Fu-hua; SHEN Ji-zhang; YAO Li-qing; ZHOU Kang-rong

    2010-01-01

    Background The few studies on MR colonography with air enema involved feasibility of bowel distention and imaging quality and lacked detection sensitivity of colorectal neoplasms. The purpose of this prospective study was to assess the detection sensitivity of colorectal neoplasms with the three-dimensional Fourier transform fast spoiled gradient-recalled MR colonography with air enema.Methods A total of 30 patients scheduled for optical colonoscopy due to rectal bleeding, positive fecal occult blood test results or altered bowel habits were recruited and successfully underwent entire colorectal examinations with three-dimensional Fourier transform fast spoiled gradient-recalled MR colonography and subsequent optical colonoscopy on the same day. Detection sensitivity of colorectal neoplasms with MR colonography was statistically analyzed on a per-neoplasm size basis by using findings from optical colonoscopy and histopathological examinations as the reference standards.Results Seventy-six neoplasms were detected with optical colonoscopy, consisting of 1 mm-5 mm (n=11), 6 mm-9 mm (n=29) and >10 mm (n=36) in diameter. Detection sensitivities of 1 mm-5 mm, 6 mm-9 mm, ≥10 mm and >6 mm colorectal neoplasms with MR colonography were 9.1%, 75.9%, 100% and 89.2%, respectively; overall detection sensitivity for all sizes colorectal neoplasms was 77.6%.Conclusions Detection sensitivity of three-dimensional Fourier transform fast spoiled gradient-recalled MR colonography with air enema is low for 1 mm-5 mm colorectal neoplasms, but the detection sensitivity is 89.2% for ≥6 mm neoplasms, and all ≥10 mm neoplasms could be detected.

  9. Comparison of Volume Rendering CT cholangiography and Minimum intensity projection CT cholangiography in patients with obstructive biliary disease

    OpenAIRE

    牛見, 尚史; 佃, 俊二; 平敷, 淳子

    2002-01-01

     We compared the detectability and conspicuity of minimum intensity projection CT cholangiography (Min-IP CTC)with volume rendering CT cholangiography (VRCTC).The subjects were ten patients (6 men, 4 women, mean age 64.7) who clinically suspected obstructive biliary truct disease. They underwent enhanced helical CT. Volume data of delayed phase that reconstructed by 2 or 1 mm thickness was transferred to work station (Advantage Windows) and data processing by Minimum Intensity Projection (Min...

  10. Magnetic resonance colonography in severe attacks of ulcerative colitis

    Energy Technology Data Exchange (ETDEWEB)

    Savoye-Collet, C.; Roset, J.B.; Koning, E.; Dacher, J.N. [Rouen University Hospital Charles Nicolle, Radiology Department - QUANTIF - LITIS EA 4108, Rouen (France); Charpentier, C.; Hommel, S.; Lerebours, E.; Savoye, G. [Rouen University Hospital Charles Nicolle, Gastroenterology Department - ADEN U 1073, Rouen (France)

    2012-09-15

    To evaluate the ability of MR colonography (MRC) to detect lesions in severe attacks of ulcerative colitis (UC) and to assess its concordance with rectosigmoidoscopy. Eighteen patients underwent MRC and rectosigmoidoscopy. MRC consisted of a water-filled colonic procedure followed by T1/T2w images. Image quality was recorded. Inflammatory lesions and the existence of signs of severity were analysed. We calculated MR accuracy in the diagnosis of inflammatory lesions, as well as per segment and per patient concordance depending on the presence or absence of severe lesions. The MR image quality of the 108 segments was satisfactory. Endoscopy was used to study 36 segments (rectum and sigmoid). MRC had a positive predictive value of 100% and a sensitivity of 64% in the diagnosis of inflammatory lesions. Concordance for the diagnosis of severe lesions was excellent for the rectum (k = 0.85) and good for the sigmoid (k = 0.64). MRC diagnosed signs of severity in all patients affected at endoscopy. MRC also disclosed signs of severity located higher in the colon in four patients with nonsevere lesions at rectosigmoidoscopy. MRC can accurately diagnose inflammatory lesions in severe attacks of UC and significantly correlates with rectosigmoidoscopy in the diagnosis of severe lesions. (orig.)

  11. Circulating tumor cells: clinically relevant molecular access based on a novel CTC flow cell.

    Directory of Open Access Journals (Sweden)

    Jessamine P Winer-Jones

    Full Text Available BACKGROUND: Contemporary cancer diagnostics are becoming increasing reliant upon sophisticated new molecular methods for analyzing genetic information. Limiting the scope of these new technologies is the lack of adequate solid tumor tissue samples. Patients may present with tumors that are not accessible to biopsy or adequate for longitudinal monitoring. One attractive alternate source is cancer cells in the peripheral blood. These rare circulating tumor cells (CTC require enrichment and isolation before molecular analysis can be performed. Current CTC platforms lack either the throughput or reliability to use in a clinical setting or they provide CTC samples at purities that restrict molecular access by limiting the molecular tools available. METHODOLOGY/PRINCIPAL FINDINGS: Recent advances in magetophoresis and microfluidics have been employed to produce an automated platform called LiquidBiopsy®. This platform uses high throughput sheath flow microfluidics for the positive selection of CTC populations. Furthermore the platform quantitatively isolates cells useful for molecular methods such as detection of mutations. CTC recovery was characterized and validated with an accuracy (<20% error and a precision (CV<25% down to at least 9 CTC/ml. Using anti-EpCAM antibodies as the capture agent, the platform recovers 78% of MCF7 cells within the linear range. Non specific recovery of background cells is independent of target cell density and averages 55 cells/mL. 10% purity can be achieved with as low as 6 CTCs/mL and better than 1% purity can be achieved with 1 CTC/mL. CONCLUSIONS/SIGNIFICANCE: The LiquidBiopsy platform is an automated validated platform that provides high throughput molecular access to the CTC population. It can be validated and integrated into the lab flow enabling CTC enumeration as well as recovery of consistently high purity samples for molecular analysis such as quantitative PCR and Next Generation Sequencing. This tool opens

  12. Protein CTC from Aquifex aeolicus possesses a full-sized 5S rRNA-binding domain.

    Science.gov (United States)

    Korobeinikova, A V; Shestakov, S A; Korepanov, A P; Garber, M B; Gongadze, G M

    2009-03-01

    Ribosomal 5S RNA is the only identified target for proteins of the CTC family. All known proteins of this family, except for CTC from Aquifex aeolicus, contain a full-sized 5S rRNA-binding domain. In the present study a mistake in the published A. aeolicus genome is corrected. It has been demonstrated that the ctc gene of this organism encodes the protein with a full-length 5S rRNA-binding domain. This protein binds specifically to the bacterial 5S rRNA. Thereby, our data show that CTC A. aeolicus is not an exception from the other known CTC proteins.

  13. Perioperative Colonic Evaluation in Patients with Rectal Cancer; MR Colonography Versus Standard Care

    DEFF Research Database (Denmark)

    Achiam, Michael Patrick; Løgager, Vibeke; Lund Rasmussen, Vera;

    2015-01-01

    was to prospectively evaluate the completion rate of preoperative colonic evaluation and the quality of perioperative colonic evaluation using magnetic resonance colonography (MRC) in patients with rectal cancer. MATERIALS AND METHODS: Patients diagnosed with rectal cancer were randomized to either group A: standard...... is a valuable tool and is recommended as part of the standard preoperative evaluation for patients with rectal cancer....

  14. MR colonography without colonic cleansing: a new strategy to improve patient acceptance.

    Science.gov (United States)

    Lauenstein, T; Holtmann, G; Schoenfelder, D; Bosk, S; Ruehm, S G; Debatin, J F

    2001-10-01

    MR colonography permits accurate detection of colonic polyps larger than 8 mm. Patient acceptance remains limited because of the need for bowel cleansing. The aim of this study was to develop and assess a strategy obviating colonic cleansing by performing MR colonography in conjunction with fecal tagging based on the oral administration of barium. Six healthy volunteers and six patients with suspected colorectal tumors, undergoing conventional colonoscopy within 1 week of MR imaging, were included in this study. For fecal tagging, 200 mL of a barium-containing contrast agent was ingested with each of four principal meals preceding the examination. For MR colonography, the colon was filled with a barium and water mixture while gadobenate dimeglumine (0.2 mmol/kg) was injected IV. The combination of fecal tagging and colonic filling with barium resulted in a homogeneously low signal throughout the colonic lumen in all 12 subjects. IV injection of gadolinium caused avid enhancement of the colonic wall. Similarly, lesions arising from the colonic wall enhanced avidly. In the six evaluated patients, MR colonography correctly identified two colonic carcinomas in two patients and one polyp in each of another two patients. Fecal tagging obviates bowel cleansing and should, therefore, enhance patient acceptance for MR colonoscopy. Barium used as the tagging agent is promising because it is inexpensive, commercially available, and characterized by an excellent safety profile.

  15. Diagnostic performance of radiographers as compared to radiologists in magnetic resonance colonography

    Energy Technology Data Exchange (ETDEWEB)

    Zijta, F.M., E-mail: f.m.zijta@amc.uva.n [Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); Department of Radiology, Onze Lieve Vrouwe Gasthuis, Amsterdam (Netherlands); Florie, J., E-mail: j.florie@amc.uva.n [Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); Jensch, S., E-mail: s.jensch@amc.uva.n [Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); Department of Radiology, Onze Lieve Vrouwe Gasthuis, Amsterdam (Netherlands); Bipat, S., E-mail: s.bipat@amc.uva.n [Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); Nievelstein, R.A.J., E-mail: R.A.J.Nievelstein@umcutrecht.n [Department of Radiology, University Medical Center Utrecht, Utrecht (Netherlands); Poulus, M., E-mail: M.Poulus@amc.uva.n [Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); Thomassen-de Graaf, M.A., E-mail: TomassenM@zgv.n [Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); Montauban van Swijndregt, A.D., E-mail: A.D.MontaubanvanSwijndregt@olvg.n [Department of Radiology, Onze Lieve Vrouwe Gasthuis, Amsterdam (Netherlands); Stoker, J., E-mail: j.stoker@amc.uva.n [Department of Radiology, Academic Medical Center, Amsterdam (Netherlands)

    2010-08-15

    Purpose: To evaluate the diagnostic performance of radiographers compared to radiologists in the detection of colorectal lesions in MR colonography. Material and methods: 159 patients at increased risk of colorectal cancer were included. Four different experienced observers, one MR radiologist, one radiologist in training and two radiographers evaluated all MR colonography examinations. The protocol included T1-weighted and T2-weighted sequences in prone and supine position. Colonoscopy was used as reference standard. Mean sensitivity rates with 95% confidence intervals (CIs) were determined on a per-patient and per-polyp basis, segmented by size ({>=}6 mm and {>=}10 mm). Specificity was calculated on a per-patient basis. The McNemar and chi-square ({chi}{sup 2}) test was used to determine significant differences. Results: At colonoscopy 74 patients (47%) had normal findings; 23 patients had 40 polyps with a size {>=}6 mm. In 10 patients at least 1 polyp {>=}10 mm was found (20 polyps in total). Similar sensitivities for patients with lesions {>=}10 mm were found for radiologists and radiographers (65% (95%CI: 44-86%) vs. 50% (95%CI: 28-72%)) (p = n.s.). For lesions {>=}10 mm combined per-patient specificity for radiologists and radiographers was 96% (95%CI: 94-98%) and 73% (95%CI: 68-79%) (p < 0.0001). Combined per-patient sensitivity for lesions {>=}6 mm differed significantly between both groups of observers (57% (95%CI: 42-71%) vs. 33% (95%CI: 19-46%)) (p = 0.03). Conclusion: Radiographers have comparable sensitivity but lower specificity relative to radiologists in the detection of colorectal lesions {>=}10 mm at MR colonography. Adequate training in evaluating MR colonography is necessary, especially for readers with no prior experience with colonography.

  16. Active bacteria (CTC+) in temperate lakes: temporal and cross-system variations

    DEFF Research Database (Denmark)

    Søndergaard, Morten; Danielsen, M.

    2001-01-01

    -phenylindole (DAPI) staining. The proportion of CTC+ cells in Lake Esrum and Frederiksborg Slotssø was normally ... consequence of the low abundance of active bacteria is that in situ growth rates scaled to CTC+ cells are 3- to 7-fold higher than those scaled to DAPI counts. It is suggested that studies on factors controlling bacterioplankton activity at the single-cell level should be investigated scaled to active cells....

  17. Primary Three-Dimensional Analysis with Perspective-Filet View Versus Primary Two-Dimensional Analysis: Evaluation of Lesion Detection by Inexperienced Readers at Computed Tomographic Colonography in Symptomatic Patients

    Energy Technology Data Exchange (ETDEWEB)

    Fisichella, V.A.; Horvath, S.; Hellstroem, M. (Dept. of Radiology, Sahlgrenska Univ. Hospital and Sahlgrenska Academy, Univ. of Gothenburg, Gothenburg (Sweden)); Jaederling, F. (Dept. of Radiology, St. Goerans Hospital, Stockholm (Sweden)); Stotzer, P.O.; Kilander, A. (Dept. of Gastroenterology, Sahlgrenska Univ. Hospital, Gothenburg (Sweden))

    2009-04-15

    Background: 'Perspective-filet view' is a novel three-dimensional (3D) viewing technique for computed tomography colonography (CTC). Studies with experienced readers have shown a sensitivity for perspective-filet view similar to that of 2D or 3D endoluminal fly-through in detection of colorectal lesions. It is not known whether perspective-filet view, compared to axial images, improves lesion detection by inexperienced readers. Purpose: To compare primary 3D analysis using perspective-filet view (3D Filet) with primary 2D analysis, as used by inexperienced CTC readers. Secondary aims were to compare lesion detection by 3D Filet when used by experienced and inexperienced readers, and to evaluate the effect of combined 3D Filet + 2D analysis. Material and Methods: Fifty symptomatic patients were prospectively enrolled. An experienced reader performed 3D Filet analysis followed by complete 2D analysis (3D Filet + 2D), before colonoscopy with segmental unblinding. Two inexperienced readers (readers 2 and 3), blinded to CTC and colonoscopy findings, retrospectively performed 3D Filet analysis and, after 5 weeks, 2D analysis. True positives =6 mm detected by the inexperienced readers with 3D Filet and/or 2D were combined to obtain 3D Filet + 2D. Results: Colonoscopy revealed 116 lesions: 16 lesions =10 mm, 19 lesions 6-9 mm, and 81 lesions =5 mm. For the experienced reader, sensitivities for lesions =6 mm with 3D Filet and 3D Filet + 2D were 77% and 83%, respectively. For the inexperienced readers, sensitivities for lesions =6 mm with 3D Filet and 2D were 51% and 57% (reader 2) and 40% and 43% (reader 3), respectively. There was no significant difference between 3D Filet and 2D regarding sensitivity and reading time. For lesions =6 mm, 3D Filet + 2D improved the sensitivity of reader 2 to 63% and of reader 3 to 51%. Conclusion: Lesion detection by inexperienced readers using perspective-filet view is comparable to that obtained by 2D. Lesion detection improves

  18. EpCAM-independent capture of circulating tumor cells with a 'universal CTC-chip'.

    Science.gov (United States)

    Chikaishi, Yasuhiro; Yoneda, Kazue; Ohnaga, Takashi; Tanaka, Fumihiro

    2017-01-01

    Capture of circulating tumor cells (CTCs), which are shed from the primary tumor site and circulate in the blood, remains a technical challenge. CellSearch® is the only clinically approved CTC detection system, but has provided only modest sensitivity in detecting CTCs mainly because epithelial cell adhesion molecule (EpCAM)-negative tumor cells may not be captured. To achieve more sensitive CTC‑capture, we have developed a novel microfluidic platform, a 'CTC-chip' comprised of light-curable resins that has a unique advantage in that any capture antibody is easily conjugated. In the present study, we showed that EpCAM-negative tumor cells as well as EpCAM-positive cells were captured with the novel 'universal CTC-chip' as follows: i) human lung cancer cells (PC-9), with strong EpCAM expression, were efficiently captured with the CTC-chip coated with an anti-EpCAM antibody (with an average capture efficiency of 101% when tumor cells were spiked in phosphate‑buffered saline (PBS) and 88% when spiked in blood); ii) human mesothelioma cells (ACC-MESO-4), with no EpCAM expression but with podoplanin expression, were captured with the CTC-chip coated with an anti-podoplanin antibody (average capture efficiency of 78% when tumor cells were spiked in PBS and 38% when spiked in blood), whereas ACC-MESO-4 cells were not captured with the CTC-chip coated with the anti-EpCAM antibody. These results indicate that the novel 'CTC-chip' can be useful in sensitive EpCAM-independent detection of CTCs, which may provide new insights into personalized medicine.

  19. Colovesical fistula causing an uncommon reason for failure of computed tomography colonography: a case report

    OpenAIRE

    2012-01-01

    Abstract Introduction Computed tomography colonography, or virtual colonoscopy, is a good alternative to optical colonoscopy. However, suboptimal patient preparation or colon distension may reduce the diagnostic accuracy of this imaging technique. Case presentation We report the case of an 83-year-old Caucasian woman who presented with a five-month history of pneumaturia and fecaluria and an acute episode of macrohematuria, leading to a high clinical suspicion of a colovesical fistula. The fi...

  20. Magnetic resonance colonography with automated carbon dioxide insufflation: Diagnostic accuracy and distension

    Energy Technology Data Exchange (ETDEWEB)

    Paardt, M.P. van der, E-mail: m.p.vanderpaardt@amc.uva.nl [Department of Radiology, Academic Medical Center Amsterdam, Amsterdam (Netherlands); Zijta, F.M., E-mail: fmzijta@yahoo.com [Department of Radiology, Academic Medical Center Amsterdam, Amsterdam (Netherlands); Department of Radiology, Onze Lieve Vrouwe Gasthuis, Amsterdam (Netherlands); Department of Radiology, Medisch Centrum Haaglanden, Den Haag (Netherlands); Boellaard, T.N., E-mail: t.n.boellaard@amc.uva.nl [Department of Radiology, Academic Medical Center Amsterdam, Amsterdam (Netherlands); Jensch, S., E-mail: s.jensch@slaz.nl [Department of Radiology, Sint Lucas-Andreas Ziekenhuis, Amsterdam (Netherlands); Baak, L.C., E-mail: l.c.baak@olvg.nl [Department of Gastroenterology and Hepatology, Onze Lieve Vrouwe Gasthuis, Amsterdam (Netherlands); Depla, A.C.T.M., E-mail: actm.depla@slz.nl [Department of Gastroenterology and Hepatology, Slotervaartziekenhuis, Amsterdam (Netherlands); Dekker, E., E-mail: e.dekker@amc.uva.nl [Department of Gastroenterology and Hepatology, Academic Medical Center Amsterdam, Amsterdam (Netherlands); Nederveen, A.J., E-mail: a.j.nederveen@amc.uva.nl [Department of Radiology, Academic Medical Center Amsterdam, Amsterdam (Netherlands); Bipat, S., E-mail: s.bipat@amc.uva.nl [Department of Radiology, Academic Medical Center Amsterdam, Amsterdam (Netherlands); Stoker, J., E-mail: j.stoker@amc.uva.nl [Department of Radiology, Academic Medical Center Amsterdam, Amsterdam (Netherlands)

    2014-05-15

    Objectives: To evaluate the diagnostic performance of MR colonography using automated carbon dioxide (CO{sub 2}) insufflation for colonic distension, with colonoscopy serving as the reference standard. Methods: Ninety-eight symptomatic patients underwent MR colonography with faecal tagging and automated CO{sub 2} insufflation. Three readers (one expert (reader 1), and two less experienced (readers 2 and 3)) evaluated the images for the presence of colorectal lesions. Bowel distension was evaluated on a 4-point scale. Results were verified with colonoscopy and histopathological analysis. Results: Per-patient sensitivity for lesions ≥10 mm was 91.7% (11 of 12) (reader 1), 75.0% (9 of 12) (reader 2), and 75% (9 of 12) (reader 3). Specificity was 96.5% (82 of 85) (reader 1), 97.7% (83 of 85) (reader 2), 95.3% (81 of 85) (reader 3). Per-patient sensitivity for lesions ≥6 mm was 85.7% (18 of 21) (reader 1), 57.1% (12 of 21) (reader 2), and 57.1% (12 of 21) (reader 3). Specificity was 86.8% (66 of 76), 98.7% (75 of 76), 90.8% (69 of 76), respectively. Per-patient sensitivity for advanced neoplasia of ≥10 mm and ≥6 mm was 88.9% (8 of 9) for all readers. Specificity for ≥10 mm and ≥6 mm was 98.9% (87 of 88) (reader 1), 97.7% (86 of 88) (reader 2), 96.6% (85 of 88) (reader 3). 94.4% of the colon segments were adequate to optimal distended with dual positioning. Conclusion: MR colonography can accurately detect lesions ≥10 mm, and advanced neoplasia ≥6 mm. Sufficient distension was achieved using automated CO{sub 2} insufflation for colonic distension in MR colonography.

  1. Magnetic resonance (MR) colonography in the detection of colorectal lesions: a systematic review of prospective studies

    Energy Technology Data Exchange (ETDEWEB)

    Zijta, Frank M. [University of Amsterdam, Department of Radiology, Academic Medical Centre, Amsterdam (Netherlands); Onze Lieve Vrouwe Gasthuis, Department of Radiology, Amsterdam (Netherlands); Academic Medical Centre, Amsterdam (Netherlands); Bipat, Shandra; Stoker, Jaap [University of Amsterdam, Department of Radiology, Academic Medical Centre, Amsterdam (Netherlands)

    2010-05-15

    To determine the diagnostic accuracy of MR-colonography for the detection of colorectal lesions. A comprehensive literature search was performed for comparative MR-colonography studies, published between May 1997 and February 2009, using the MEDLINE, EMBASE and Cochrane databases. We included studies if MR-colonography findings were prospectively compared with conventional colonoscopy in (a)symptomatic patients. Two reviewers independently extracted study design characteristics and data for summarising sensitivity and specificity. Heterogeneity in findings between studies was tested using I{sup 2} test statistics. Sensitivity and specificity estimates with 95% confidence intervals (CI) were calculated on per patient basis and summary sensitivity on per polyp basis, using bivariate and univariate statistical models. Thirty-seven studies were found to be potentially relevant and 13 fulfilled the inclusion criteria. The study population comprised 1,285 patients with a mean disease prevalence of 44% (range 22-63%). Sensitivity for the detection of CRC was 100%. Significant heterogeneity was found for overall per patient sensitivity and specificity. For polyps with a size of 10 mm or larger, per patient sensitivity and specificity estimates were 88% (95% CI 63-97%; I{sup 2} = 37%) and 99% (95% CI 95-100%; I {sup 2} = 60%). On a per polyp basis, polyps of 10 mm or larger were detected with a sensitivity of 84% (95% CI 66-94%; I {sup 2} = 51%). The data were too heterogeneous for polyps smaller than 6 mm and 6-9 mm. MR-colonography can accurately detect colorectal polyps more than 10 mm in size. (orig.)

  2. Determination analaysis of the power losses of transformers with continuously transpored conductors (CTC) based fuzzy logic

    Science.gov (United States)

    Kaloko, Bambang Sri; Atsari, Erinna Dyah

    2017-03-01

    Electric motive force which flows into the iron core continuously on a plate - plate iron isolated may cause heat posed by current eddy (eddy current). No water loss occurs due to detainees on the circuit at the the flow of current load because this loss happened on the entanglement of the transformer is made of copper. Continuously Transposed Conductors (CTC) consist of a number of enameled rectangular wires (5-84 strands) made into an assembly. Each strand is transposed in turn to each position in the cable and is then covered with layers of insulation paper. Continuously Transposed Conductors are used in winding wires for medium and ultra high power transformers. CTC is manufactured by OFHC copper and indeed, is able to supply polyester roped. CTC which has been designed to reduce production cost, oil pocket and improve cooling efficiency. Hardened type CTC (CPR1, CPR2, and CPR3: BS1432) and Self-bonding CTC which can be used to improve mechanical and electrical strength are also available. This analysis is performed using the methods of fuzzy logic in taking account of the resources.

  3. Quantum physics, fields and closed timelike curves: The D-CTC condition in quantum field theory

    CERN Document Server

    Tolksdorf, Juergen

    2016-01-01

    The D-CTC condition is a condition originally proposed by David Deutsch as a condition on states of a quantum communication network that contains "backward time-steps" in some of its branches. It has been argued that this is an analogue for quantum processes in the presence of closed timelike curves (CTCs). The unusual properties of states of quantum communication networks that fulfill the D-CTC condition have been discussed extensively in recent literature. In this work, the D-CTC condition is investigated in the framework of quantum field theory in the local, operator-algebraic approach due to Haag and Kastler. It is shown that the D-CTC condition cannot be fulfilled in states which are analytic for the energy, or satisfy the Reeh-Schlieder property, for a certain class of processes and initial conditions. On the other hand, if a quantum field theory admits sufficiently many uncorrelated states across acausally related spacetime regions (as implied by the split property), then the D-CTC condition can always...

  4. Magnetic resonance colonography with a limited bowel preparation and automated carbon dioxide insufflation in comparison to conventional colonoscopy: Patient burden and preferences

    Energy Technology Data Exchange (ETDEWEB)

    Paardt, M.P. van der, E-mail: m.p.vanderpaardt@amc.uva.nl [Department of Radiology, Academic Medical Center Amsterdam, Amsterdam (Netherlands); Boellaard, T.N., E-mail: t.n.boellaard@amc.uva.nl [Department of Radiology, Academic Medical Center Amsterdam, Amsterdam (Netherlands); Zijta, F.M., E-mail: fmzijta@yahoo.com [Department of Radiology, Medisch Centrum Haaglanden, Den Haag (Netherlands); Baak, L.C., E-mail: l.c.baak@olvg.nl [Department of Gastroenterology and Hepatology, Onze Lieve Vrouwe Gasthuis, Amsterdam (Netherlands); Depla, A.C.T.M., E-mail: actm.depla@slz.nl [Department of Gastroenterology and Hepatology, Slotervaartziekenhuis, Amsterdam (Netherlands); Dekker, E., E-mail: e.dekker@amc.uva.nl [Department of Gastroenterology and Hepatology, Academic Medical Center Amsterdam, Amsterdam (Netherlands); Nederveen, A.J., E-mail: a.j.nederveen@amc.uva.nl [Department of Radiology, Academic Medical Center Amsterdam, Amsterdam (Netherlands); Bipat, S., E-mail: s.bipat@amc.uva.nl [Department of Radiology, Academic Medical Center Amsterdam, Amsterdam (Netherlands); Stoker, J., E-mail: j.stoker@amc.uva.nl [Department of Radiology, Academic Medical Center Amsterdam, Amsterdam (Netherlands)

    2015-01-15

    Highlights: • MR colonography with a limited bowel preparation and automated carbon dioxide insufflation demonstrated less burden compared to colonoscopy. • When discarding the bowel preparation, the examinations were rated equally burdensome. • The majority of patients preferred MR colonography over colonoscopy for their future examination of the bowel. - Abstract: Objectives: To evaluate patient burden and preferences for MR colonography with a limited bowel preparation and automated carbon dioxide insufflation in comparison to conventional colonoscopy. Methods: Symptomatic patients were consecutively recruited to undergo MR colonography with automated carbon dioxide insufflation and a limited bowel preparation followed within four weeks by colonoscopy with a standard bowel cleansing preparation. Four questionnaires regarding burden (on a five-point scale) and preferences (on a seven-point scale) were addressed after MR colonography and colonoscopy and five weeks after colonoscopy. Results: Ninety-nine patients (47 men, 52 women; mean age 62.3, SD 8.7) were included. None of the patients experienced severe or extreme burden from the MR colonography bowel preparation compared to 31.5% of the patients for the colonoscopy bowel preparation. Colonoscopy was rated more burdensome (25.6% severe or extreme burden) compared to MR colonography (5.2% severe or extreme burden) (P < 0.0001). When discarding the bowel preparations, the examinations were rated equally burdensome (P = 0.35). The majority of patients (61.4%) preferred MR colonography compared to colonoscopy (29.5%) immediately after the examinations and five weeks later (57.0% versus 39.5%). Conclusion: MR colonography with a limited bowel preparation and automated carbon dioxide insufflation demonstrated less burden compared to colonoscopy. The majority of patients preferred MR colonography over colonoscopy.

  5. Extracolonic Findings on CT Colonography Increases Yield of Colorectal Cancer Screening

    Science.gov (United States)

    2010-09-01

    gallstones; hiatal hernia E3 Likely unimportant finding, incompletely characterized: workup may be indicated Complex renal cyst; lung nodule E4...of which were renal cysts, neph­ rolithiasis, hiatal hernias , or benign liver cysts. The majority of findings for patients in the E3 group (n = 211...costs and studies generated. In addition, following patients out to their final diagnosis and, especially , establishing histologic diagno­ ses for

  6. Effect of a tele-training programme on radiographers in the interpretation of CT colonography

    DEFF Research Database (Denmark)

    Lauridsen, Carsten; Lefere, Philippe; Gerke, Oke;

    2012-01-01

    (95% CI). The results were compared by comparing 95% CI with a 5% significance level. RESULTS: In the training cases overall per-polyp sensitivity was 57% (95% CI 46.1-67.9) and 69.1% (95% CI 50.6-87.5) for lesions ≥6mm and ≥10mm, respectively. Overall per patient sensitivity, specificity and PPV were...

  7. Increasing computer-aided detection specificity by projection features for CT colonography

    OpenAIRE

    Zhu, Hongbin; Liang, Zhengrong; Pickhardt, Perry J.; Barish, Matthew A.; You, Jiangsheng; Fan, Yi; Lu, Hongbing; Posniak, Erica J.; Richards, Robert J.; Cohen, Harris L.

    2010-01-01

    Purpose: A large number of false positives (FPs) generated by computer-aided detection (CAD) schemes is likely to distract radiologists’ attention and decrease their interpretation efficiency. This study aims to develop projection-based features which characterize true and false positives to increase the specificity while maintaining high sensitivity in detecting colonic polyps.

  8. Eigenvalue-weighting and feature selection for computer-aided polyp detection in CT colonography

    Science.gov (United States)

    Zhu, Hongbin; Wang, Su; Fan, Yi; Lu, Hongbing; Liang, Zhengrong

    2010-03-01

    With the development of computer-aided polyp detection towards virtual colonoscopy screening, the trade-off between detection sensitivity and specificity has gained increasing attention. An optimum detection, with least number of false positives and highest true positive rate, is desirable and involves interdisciplinary knowledge, such as feature extraction, feature selection as well as machine learning. Toward that goal, various geometrical and textural features, associated with each suspicious polyp candidate, have been individually extracted and stacked together as a feature vector. However, directly inputting these high-dimensional feature vectors into a learning machine, e.g., neural network, for polyp detection may introduce redundant information due to feature correlation and induce the curse of dimensionality. In this paper, we explored an indispensable building block of computer-aided polyp detection, i.e., principal component analysis (PCA)-weighted feature selection for neural network classifier of true and false positives. The major concepts proposed in this paper include (1) the use of PCA to reduce the feature correlation, (2) the scheme of adaptively weighting each principal component (PC) by the associated eigenvalue, and (3) the selection of feature combinations via the genetic algorithm. As such, the eigenvalue is also taken as part of the characterizing feature, and the necessary number of features can be exposed to mitigate the curse of dimensionality. Learned and tested by radial basis neural network, the proposed computer-aided polyp detection has achieved 95% sensitivity at a cost of average 2.99 false positives per polyp.

  9. Differential diagnosis of frontal lobe atrophy from chronic subdural hematoma or subdural hygroma on CT in aged patients. Usefulness of CT cisternogram

    Energy Technology Data Exchange (ETDEWEB)

    Hayashi, Hideaki [Osaka Univ. (Japan). Faculty of Medicine

    1995-02-01

    Metrizamide CT cisternograms (CTC) were performed in order to examine the CSF passage to subarachnoid space, cerebral sulci and Sylvian fissure. The old aged 20 patients (from 63 to 88 years old) with the layer of low density area around bilateral frontal lobe (bi-frontal LDA) in plain CT finding were selected from 2000 aged patients hospitalized in Hanwa-Senboku Hospital. In these 20 patients, it was difficult to differentiate frontal lobe atrophy from the chronic subdural hematoma and subdural hygroma. Conservative therapy was applied in 19 patients for their old age or their complicated diseases. Only 1 patient was operated for subdural hygroma. The 20 patients were investigated in EEGs, severity of dementia, disturbance of consciousness, activity of daily life, their clinical course and prognosis. Only 2 of the 11 patients with type 1 CTC findings (cerebral sulci, Sylvian fissure and bi-frontal LDA were simultaneously enhanced by metrizamide) showed disturbance of consciousness and/or delirium for their serious somatic disorders. All of 6 patients with type 3 CTC findings (only bi-frontal LDA was not enhanced by metrizamide) showed disturbance of consciousness. Three patients with type 2 CTC findings (atypical findings) were reported independently. Subdural disorder elevating intracranial pressure were clarified in the cases with type 3 CTC findings. (author).

  10. Genome-wide meta-analysis points to CTC1 and ZNF676 as genes regulating telomere homeostasis in humans

    DEFF Research Database (Denmark)

    Mangino, Massimo; Hwang, Shih-Jen; Spector, Timothy D

    2012-01-01

    3027234 was associated with both shorter LTL and lower expression of CTC1. Our findings are consistent with the recent observations that point mutations in CTC1 cause short telomeres in both Arabidopsis and humans affected by a rare Mendelian syndrome. Overall, our results provide novel insights...

  11. CTC Sentinel. Volume 2, Issue 11, November 2009. Lashkar-i-Tayyiba: One Year After Mumbai

    Science.gov (United States)

    2009-11-01

    mechanical engineering. Muhammad `Atif (al-Qa`ida’s former military chief) was an agricultural engineer and later a policeman. Abd al-Salam Faraj (who...Illicit and Terrorist Activ- ity in Algeria’s Tamanrasset,” CTC Sentinel 1:9 (2008). 17 “Plan de Securite Alimentaire Commune Urbaine de Kidal

  12. 5S rRNA-recognition module of CTC family proteins and its evolution.

    Science.gov (United States)

    Korobeinikova, A V; Gongadze, G M; Korepanov, A P; Eliseev, B D; Bazhenova, M V; Garber, M B

    2008-02-01

    The effects of amino acid replacements in the RNA-binding sites of homologous ribosomal proteins TL5 and L25 (members of the CTC family) on ability of these proteins to form stable complexes with ribosomal 5S RNA were studied. It was shown that even three simultaneous replacements of non-conserved amino acid residues by alanine in the RNA-binding site of TL5 did not result in noticeable decrease in stability of the TL5-5S rRNA complex. However, any replacement among five conserved residues in the RNA-binding site of TL5, as well as of L25 resulted in serious destabilization or complete impossibility of complex formation. These five residues form an RNA-recognition module in TL5 and L25. These residues are strictly conserved in proteins of the CTC family. However, there are several cases of natural replacements of these residues in TL5 and L25 homologs in Bacilli and Cyanobacteria, which are accompanied by certain changes in the CTC-binding site of 5S rRNAs of the corresponding organisms. CTC proteins and specific fragments of 5S rRNA of Enterococcus faecalis and Nostoc sp. were isolated, and their ability to form specific complexes was tested. It was found that these proteins formed specific complexes only with 5S rRNA of the same organism. This is an example of coevolution of the structures of two interacting macromolecules.

  13. Business Education in the Secondary School: A CTC Response. Number 4.

    Science.gov (United States)

    Gillmon, Eve

    City Technology Colleges (CTC) in England are founded on the concept of business education and industry partnerships ensuring the integration of work and education. Secondary school business education is concerned with how business organizations function, technological problem solving, and applied skills. Business education occupies a position of…

  14. Bridge Mode of TDCS/CTC Network Firewall in Railway Bureau Data Center%TDCS/CTC系统路局中心网络防火墙桥接模式

    Institute of Scientific and Technical Information of China (English)

    周佩琦

    2012-01-01

    As one of the critical equipment of train operation dispatching and command in railway transportation system,the network security of the TDCS/CTC is one of the key factors to ensure its normal operation and the firewall is one kind of key devices for protecting the network.In this article,the usage and access mode of the firewall in TDCS/CTC is introduced.According to the features of TDCS/CTC,the two access modes,Route Mode and Bridging Mode,in the center network are analyzed and the advantages of the transparent bridging mode are described%TDCS/CTC系统作为铁路运输指挥的重要行车设备,系统网络安全是保障其正常运行的因素之一,防火墙是重要的网络安全设备。简单介绍防火墙在TDCS/CTC系统中应用情况及接入模式,并根据TDCS/CTC系统的特点详细分析中心网络的2种防火墙接入模式(路由模式和桥接模式)及透明桥接模式的优势。

  15. Clearance Analysis of CTC2 (on ELC4) to S-TRRJ HRS Radiator Rotation Envelope

    Science.gov (United States)

    Liddle, Donn

    2014-01-01

    In response to the planned retirement of the Space Shuttle Program, International Space Station (ISS) management began stockpiling spare parts on the ISS. Many of the larger orbital replacement units were stored on the Expedite the Processing of Experiments to Space Station (EXPRESS) Logistics Carriers (ELCs) mounted on the end of the S3 and P3 truss segments, immediately outboard of the Thermal Radiator Rotary Joints (TRRJs) and their attached radiators. In an August 2009 computer-aided design (CAD) assessment, it was determined that mounting the Cargo Transport Container (CTC) 2 on the inboard face of ELC4 as planned would create insufficient clearance between the CTC2 and the rotational envelope of the radiators when the TRRJs were rotated to a gamma angle of 35.0 degrees. The true clearance would depend on how the Unpressurized Cargo Carrier Attachment System (UCCAS) was mounted to the S3 truss and how the ELC4 was attached to it. If the plane of the UCCAS attachment points were tilted even slightly inboard, it would significantly change the clearance between CTC2 and the Starboard TRRJ (S-TRRJ) radiators. Additionally, since CTC2 would be covered in multilayer insulation (MLI), the true outer profile of CTC2 was not captured in the CAD models used for the clearance assessment. It was possible that, even if the S-TRRJ radiators cleared CTC2, they could snag the MLI covering. In the fall of 2010, the Image Science and Analysis Group (ISAG) was asked to perform an on-orbit clearance analysis to determine the location of CTC2 on ELC4 and the S-TRRJ radiators at the angle of closest approach so that a positive clearance could be assured. To provide the measurements as quickly as possible to aid in the assessment, it was decided that the clearance analysis would be broken into two phases. Phase I: The location and orientation of the UCCAS fittings, which support and hold the ELC4 in place, would be measured relative to the ISS Analytical Coordinate System (ISSACS

  16. Controlling Mechatronic Set-up Using Real-time Linux and CTC ++

    OpenAIRE

    Broenink, Johannes F.; Jovanovic, D.S.; Hilderink, G.H.; van Amerongen, J.; Jonker, B.; Regtien, P.; Stramigioli, S.

    2002-01-01

    The development of control software for mechatronic systems is presented by means of a case study: a 2 DOF mechanical rotational set-up usable as a camera-positioning device. The control software is generated using the code generation facility of 20-SIM, thus guaranteeing the generated code being the same as verified by simulation during the controller design phase. We use CTC++ (Communicating Threads for C++) as Communication Abstraction Layer to facilitate the conversion process from the bl...

  17. Complete genome sequence of Bacillus thuringiensis CTC-A typical strain with high production of S-layer proteins.

    Science.gov (United States)

    Dong, Zhaoxia; Li, Junhua; Zheng, Jinshui; Geng, Ce; Peng, Donghai; Sun, Ming

    2016-02-20

    Bacillus thuringiensis CTC, which is identified as serotype H2, serovar. finitimus, is high production of S-layer protein. Due to the property of forming isoporous lattices on the whole cell surface, S-layer protein has been widely used in (nano) biotechnology, biomimetics, biomedicine, especially been employed for displaying many important active proteins. Here, we report the complete genome of strain CTC, which contains one circular chromosome and one linear plasmid.

  18. Phytoremediation and absorption isotherms of heavy metal ions by Convolvulus tricolor (CTC).

    Science.gov (United States)

    Valizadeh, Rezvan; Mahdavian, Leila

    2016-01-01

    In recent years, use of plants for remediation of contaminated soils, especially removal of heavy metals, is considered. The current study tends to investigate the removal of lead and nickel ions by the Convolvulus tricolor (CTC), was grown for 30 days in different concentrations of lead and nickel ions. Then concentration of them in soil and different organs of the plant was measured by atomic absorption spectrometry. The highest absorbed of them occurred in concentration 0.001N, which highest Pb(2+) accumulation is in the aerial parts of the plant: leaf > stem > root and for Ni(2)+: root > stem > leaf. No ion was observed into the flowers and nickel ion absorption is more of lead ion in different plant organs of CTC. The experimental isotherm data were investigated using isotherms of Langmuir, Freundlich, BET, Temkin and Dubinin-Radushkevich (DRK). The correlation coefficient for all of them is calculated that show the best correlation coefficient for Ni(2+) adsorption is obtained BET model, whereas for Pb(2+) adsorption in root is Freundlich model but for its leaf and stem is BET model. The results show, CTC is suitable for Pb(2+) and Ni(2+) and this technique is in-situ method, simple, and low cost.

  19. CP-Miner : A hybrid Approach for Colorectal Polyp Detection

    OpenAIRE

    Ms. M. Vanitha,; Prof. P. Tamije Selvy; Dr. V.Palanisamy,; Prof. AR.Sivakumaran

    2010-01-01

    Computed Tomography Colonography (CTC) is the new generation technique for detecting colorectal polyps using volumetric CT data combined with Computer Aided Detection (CAD) system. The aim of this paper is to detail the implementation of a fully integrated CP-Minersystem that is able to identify the polyps in the CT data. The CP-Miner system has a multistage implementation whose main system components are: 1. Interpolation, 2. Automatic Colon Segmentation,3.Feature extraction, 4.Polyp Detecti...

  20. Rapid detection of viable bacteria by integrated CTC (5-Cyano-2, 3-ditoyl tetrazolium chloride) dying and flow cytometry assay (CTC-FCM)%基于CTC-流式细胞仪活性细菌总数的快速检测技术研究

    Institute of Scientific and Technical Information of China (English)

    林怡雯; 杨天; 李丹; 何苗

    2013-01-01

    以大肠杆菌作为研究对象,建立一种5-cyano-2,3-ditolyl tetrazolium chloride(CTC)染色结合流式细胞仪(CTC-FCM)的方法,以选择性检测水环境中具有代谢活性的细菌总数.该方法的原理是细菌与具有氧化还原性的染料CTC发生反应,形成红色荧光物质,被流式细胞仪特异性识别进而可选择性检测活性菌.研究结果表明,CTC染色的最佳反应条件为:CTC浓度为2 mmol·L-1、37℃避光孵育3h.该方法最低检测限为103个·mL-1.通过比较培养法和CTC-FCM方法检测热灭活后的大肠杆菌,结果表明CTC-FCM方法可准确区分活性菌和灭活菌,且与培养法之间具有较好的线性关系(R2=0.9465).应用CTC-FCM方法检测实际样品,结果显示该方法与培养法之间有较好的线性关系(R2=0.8121).本研究建立的CTC-FCM方法可满足饮用水水质标准需求,且检测时间比平板培养法缩短20~40 h,可以用于环境水样中活性细菌总数检测.%An integrated tetrazolium redox CTC (5-Cyano-2,3-ditoyl tetrazolium chloride) dying and flow cytometry assay (CTC-FCM) was developed by using Escherichia coli as a representative organism.This method can selectively detect and quantify bacteria with metabolic activity,based on the principle that only active bacteria can react with CTC and form a fluorescent red intracellular CTC-formazan (CTF) easily detected and counted by flow cytometry.The results showed that the optimized detection parameters were 2 mmol· L-1 CTC at 37 ℃ for 3-hour incubation.The detection limit of CTC-FCM method was 103 CFU·mL-1.Compared with culture-based method for detection of heat-treated bacteria,CTC-FCM method can effectively distinguish viable bacteria from non-viable bacteria,and a good correlation was observed between these two methods (R2 =0.9465).This method was also applied to detect viable bacteria in environmental water samples,including tap water and reclaimed water.Results showed that the correlation

  1. Thoracic CT

    Science.gov (United States)

    ... lungs; CT scan - chest Images CT scan Thyroid cancer - CT scan Pulmonary nodule, solitary - CT scan Lung mass, right upper ... Chest Injuries and Disorders CT Scans Emphysema Lung Cancer Lung Diseases Pleural Disorders Pneumonia Pulmonary Embolism Tuberculosis Browse the Encyclopedia A.D.A. ...

  2. Monitoring of Tumor Promotion and Progression in a Mouse Model of Inflammation-Induced Colon Cancer with Magnetic Resonance Colonography

    Directory of Open Access Journals (Sweden)

    Matthew R. Young

    2009-03-01

    Full Text Available Early detection of precancerous tissue has significantly improved survival of most cancers including colorectal cancer (CRC. Animal models designed to study the early stages of cancer are valuable for identifying molecular events and response indicators that correlate with the onset of disease. The goal of this work was to investigate magnetic resonance (MR colonography in a mouse model of CRC on a clinical MR imager. Mice treated with azoxymethane and dextran sulfate sodium were imaged by serial MR colonography (MRC from initiation to euthanasia. Magnetic resonance colonography was obtained with both T1- and T2-weighted images after administration of a Fluorinert enema to remove residual luminal signal and intravenous contrast to enhance the colon wall. Individual tumor volumes were calculated and validated ex vivo. The Fluorinert enema provided a clear differentiation of the lumen of the colon from the mucosal lining. Inflammation was detected 3 days after dextran sulfate sodium exposure and subsided during the next week. Tumors as small as 1.2 mm3 were detected and as early as 29 days after initiation. Individual tumor growths were followed over time, and tumor volumes were measured by MR imaging correlated with volumes measured ex vivo. The use of a Fluorinert enema during MRC in mice is critical for differentiating mural processes from intraluminal debris. Magnetic resonance colonography with Fluorinert enema and intravenous contrast enhancement will be useful in the study of the initial stages of colon cancer and will reduce the number of animals needed for preclinical trials of prevention or intervention.

  3. Tricistronic operon expression of the genes gcaD (tms), which encodes N-acetylglucosamine 1-phosphate uridyltransferase, prs, which encodes phosphoribosyl diphosphate synthetase, and ctc in vegetative cells of Bacillus subtilis

    DEFF Research Database (Denmark)

    Hilden, Ida; Krath, Britta N.; Hove-Jensen, Bjarne

    1995-01-01

    The gcaD, prs, and ctc genes were shown to be organized as a tricistronic operon. The transcription of the prs gene, measured as phosphoribosyl diphosphate synthetase activity, and of the ctc gene, measured as β-galactosidase activity specified by a ctc-lacZ protein fusion, were dependent...

  4. Mutations in CTC1, encoding the CTS telomere maintenance complex component 1, cause cerebroretinal microangiopathy with calcifications and cysts.

    Science.gov (United States)

    Polvi, Anne; Linnankivi, Tarja; Kivelä, Tero; Herva, Riitta; Keating, James P; Mäkitie, Outi; Pareyson, Davide; Vainionpää, Leena; Lahtinen, Jenni; Hovatta, Iiris; Pihko, Helena; Lehesjoki, Anna-Elina

    2012-03-09

    Cerebroretinal microangiopathy with calcifications and cysts (CRMCC) is a rare multisystem disorder characterized by extensive intracranial calcifications and cysts, leukoencephalopathy, and retinal vascular abnormalities. Additional features include poor growth, skeletal and hematological abnormalities, and recurrent gastrointestinal bleedings. Autosomal-recessive inheritance has been postulated. The pathogenesis of CRMCC is unknown, but its phenotype has key similarities with Revesz syndrome, which is caused by mutations in TINF2, a gene encoding a member of the telomere protecting shelterin complex. After a whole-exome sequencing approach in four unrelated individuals with CRMCC, we observed four recessively inherited compound heterozygous mutations in CTC1, which encodes the CTS telomere maintenance complex component 1. Sanger sequencing revealed seven more compound heterozygous mutations in eight more unrelated affected individuals. Two individuals who displayed late-onset cerebral findings, a normal fundus appearance, and no systemic findings did not have CTC1 mutations, implying that systemic findings are an important indication for CTC1 sequencing. Of the 11 mutations identified, four were missense, one was nonsense, two resulted in in-frame amino acid deletions, and four were short frameshift-creating deletions. All but two affected individuals were compound heterozygous for a missense mutation and a frameshift or nonsense mutation. No individuals with two frameshift or nonsense mutations were identified, which implies that severe disturbance of CTC1 function from both alleles might not be compatible with survival. Our preliminary functional experiments did not show evidence of severely affected telomere integrity in the affected individuals. Therefore, determining the underlying pathomechanisms associated with deficient CTC1 function will require further studies.

  5. The effects of 3D channel geometry on CTC passing pressure--towards deformability-based cancer cell separation.

    Science.gov (United States)

    Zhang, Zhifeng; Xu, Jie; Hong, Bin; Chen, Xiaolin

    2014-07-21

    Various lab on a chip devices have been developed recently to detect and separate circulating tumour cells (CTCs) for early stage cancer detection. Because CTCs are extremely rare in the blood, next generation CTC microfilters aim at significant improvement in both efficiency and throughput. CTC microfilters based on cell deformability seem to be a promising direction. In the present research, we study a CTC passing event through a micro-filtering channel with various 3D geometries. The pressure signatures for different types of cells passing through different channels are characterized numerically. Specifically, five kinds of cross-sections, circular, square, triangular and two kinds of rectangular channels with aspect ratios of 2 and 5, are studied in this work. The total pressures for cells passing through the channels are calculated and reveal different behaviour from what is predicted by the static surface tension model. Among all five cross-sections studied, the circular cross-section features the highest critical pressure and thus is most suitable for high efficiency CTC separation. The square filtering channel provides the second largest critical pressure, and the triangular cross-section provides the least critical pressure among these three cross-sections. All these three cross-sections are better than the rectangular channels with aspect ratios of 2 and 5. For the rectangular channel, a high aspect ratio channel may lead to cell splitting at high speed, which will result in a periodic pressure signature. Our findings will provide valuable information for the design of next generation CTC microfilters.

  6. Dark-lumen magnetic resonance colonography in patients with suspected sigmoid diverticulitis: a feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Ajaj, Waleed; Lauenstein, Thomas; Goehde, Susanne; Kuehle, Christiane; Herborn, Christoph U. [University Hospital, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Ruehm, Stefan G. [University of California, Department of Radiology, David Geffen School of Medicine, Los Angeles, CA (United States); Langhorst, Jost; Zoepf, Thomas; Gerken, Guido [University Hospital, Department of Gastroenterology and Hepatology, Essen (Germany); Goyen, Mathias [Medical Center Hamburg-Eppendorf, Hamburg (Germany)

    2005-11-01

    To assess dark-lumen magnetic resonance colonography (MRC) for the evaluation of patients with suspected sigmoid diverticulitis. Forty patients with suspected sigmoid diverticulitis underwent MRC within 72 h prior to conventional colonoscopy (CC). A three-dimensional T1-weighted volumetric interpolated breath-hold examination sequence was acquired after an aqueous enema and intravenous administration of gadolinium-based contrast agents. All MRC data were evaluated by two radiologists. Based on wall thickness and focal uptake of contrast material and pericolic reaction including mesenteric infiltration on T1-weighted sequence the sigmoid colon was assessed for the presence of diverticulitis. MRC classified 17 of the 40 patients as normal with regard to sigmoid diverticulitis. However, CC confirmed the presence of light inflammatory signs in four patients which were missed in MRC. MRC correctly identified wall thickness and contrast uptake of the sigmoid colon in the other 23 patients. In three of these patients false-positive findings were observed, and MRC classified the inflammation of the sigmoid colon as diverticulitis whereas CC and histopathology confirmed invasive carcinoma. MRC detected additionally relevant pathologies of the entire colon and could be performed in cases where CC was incomplete. MRC may be considered a promising alternative to CC for the detection of sigmoid diverticulitis. (orig.)

  7. CT Colonography in the Detection of Colorectal Cancer in Ireland; Economical Considerations and the Potential for Centralisation of Service Provision

    LENUS (Irish Health Repository)

    Torreggiani, WC

    2016-10-01

    Colorectal cancer (CRC) is the second most common cancer in Ireland (excluding non melanomatous skin cancer)1.There were roughly 950 women and 1,330 men diagnosed with colorectal cancer annually in Ireland during 2007-20091. By 2020, with our aging population it is estimated that there will be an increase in colorectal cancer of 79 per cent in men and 56 per cent in women1. Colorectal cancer screening by faecal occult blood testing has been shown to reduce CRC mortality. In Europe, colonoscopy is mainly used to investigate faecal occult blood test positive or symptomatic patients, or as a preventive strategy in those with increased CRC risk2

  8. Reduced image noise at low-dose multidetector CT of the abdomen with prior image constrained compressed sensing algorithm.

    Science.gov (United States)

    Lubner, Meghan G; Pickhardt, Perry J; Tang, Jie; Chen, Guang-Hong

    2011-07-01

    To assess the effect of prior image constrained compressed sensing (PICCS) on noise reduction and image quality at low-dose computed tomography (CT). This HIPAA-compliant institutional review board-approved retrospective study was performed by using DICOM CT colonography data sets obtained in 20 adult patients. Informed consent was waived. Low-dose CT colonography was performed with 64-detector CT by using the standard protocol with mean effective dose per series of 3.06 mSv (range, 1.4-7.7 mSv). PICCS was applied to standard filtered back-projection (FBP) series. For FBP and PICCS series, mean and standard deviation (SD) of attenuation were obtained with 100-mm(2) circular region of interest (ROI) at six sites (240 soft-tissue, colonic gas, and subcutaneous fat measurements). Two abdominal radiologists reviewed two- and three-dimensional CT colonography displays and graded image quality with a five-point scale. Phantom studies were performed to compare spatial resolution and image quality between FBP and PICCS. Mean image noise and image quality scores were calculated and compared for clinical and phantom data sets. Bland-Altman, generalized estimating equation regression model, and Student t tests were used to obtain limits of agreement and to compare noise ratios and subjective image quality. Mean SD of attenuation (image noise) for ROIs was 38.0 for FBP and 12.2 for PICCS, corresponding to a noise-reduction factor of 3.1 (P < .001). Average noise reduction was 3.3 for soft tissue, 2.8 for air, and 3.0 for fat attenuation. Attenuation did not substantially change between FBP and PICCS images. Average two-dimensional image quality was 2.45 for FBP and 3.4 for PICCS (P < .001). Average three-dimensional image quality at three sites in the colon was 3.5 for FBP and 3.7 for PICCS (P = .34). Phantom data sets revealed no loss of spatial resolution in a line phantom and reduced noise in a liver tumor phantom when PICCS was compared with FBP. Application of PICCS to

  9. Cascaded Thermoelectric Conversion-Advanced Radioisotope Power Systems (CTC-ARPSs)

    Science.gov (United States)

    El-Genk, Mohamed S.; Saber, Hamed H.

    2004-02-01

    Conceptual designs of Advanced Radioisotope Power System (ARPS) with Cascaded Thermoelectric Converters (CTCs) are developed and optimized for maximum efficiency operation for End-Of Mission (EOM) electrical power of at least 100 We. These power systems each employs four General Purpose Heat Source (GPHS) bricks generating 1000 Wth at Beginning-of-Life (BOL) and 32 Cascaded Thermoelectric Modules (CTMs). Each CTM consists of a top and a bottom array of thermoelectric unicouples, which are thermally, but not electrically, coupled. The top and bottom arrays of the CTMs are connected electrically in series in two parallel strings with the same nominal voltage of > 28 VDC. The SiGe unicouples in the top array of the CTMs are optimized for nominal hot shoe temperature of 1273 K and constant cold shoe temperature of either 780 K or 980 K, depending on the thermoelectric materials of the unicouples in the bottom array. For a SiGe cold junction temperature of 780 K, the unicouples in the bottom array have p-legs of TAGS-85 and n-legs of 2N-PbTe and operate at constant hot junction temperature of 765 K and nominal cold junction temperature of 476.4 K. When the SiGe cold junction temperature is 980 K, the unicouples in the bottom arrays of CTMs have p-legs of CeFe3.5Co0.5Sb12 or CeFe3.5Co0.5Sb12 and Zn4Sb3, segments and n-legs of CoSb3 and operate at constant hot junction temperature of 965 K and nominal cold junction temperatures of 446.5 K or 493.5 K, respectively. The CTC-ARPSs have a nominal efficiency of 10.82% - 10.85% and generate BOL power of 108 We. This system efficiency is ~ 80% higher than that of State-of-the-Art (SOA) Radioisotope Thermoelectric Generators (RTGs), requiring 7 GHPS bricks and generating 105 We at BOL. The CTC-ARPSs have specific powers of 8.2 We/kg to 8.8 We/kg, which are 71% to 83% higher, respectively, than that of the SOA-RTGs, and use ~ 43% less 238PuO2 fuel.

  10. Magnetic resonance colonography without bowel cleansing using oral and rectal stool softeners (fecal cracking) - a feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Ajaj, Waleed; Lauenstein, Thomas C.; Kuehle, Christiane; Herborn, Christoph U.; Goehde, Susanne C. [University Hospital of Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Schneemann, Hubert [University Hospital of Essen, Institute of Pharmacy and Pharmaceutical Sciences, Essen (Germany); Ruehm, Stefan G. [David Geffen School of Medicine at UCLA, Department of Radiology, Los Angeles, CA (United States); Goyen, Mathias [University Hospital of Hamburg-Eppendorf, Medical Center, Hamburg (Germany)

    2005-10-01

    The aim of our study was to assess the effect of oral and rectal stool softeners on dark-lumen magnetic resonance (MR) colonography without bowel cleansing. Ten volunteers underwent MR colonography without colonic cleansing. A baseline examination was performed without oral or rectal administration of stool softeners. In a second set, volunteers ingested 60 ml of lactulose 24 h prior to MR examination. In a third examination, water as a rectal enema was replaced by a solution of 0.5%-docusate sodium (DS). A fourth MR examination was performed, in conjunction with both oral administration of lactulose and rectal application of DS. A T1-weighted data set was acquired at scanning times of 0, 5 and 10 min after colonic filling. A fourth data set was acquired 75 s after i.v. injection of contrast agent. Signal intensity of stool was calculated for all colonic segments. Without oral ingestion of lactulose or rectal enema with DS stool signal intensity was high and did not decrease over time. However, lactulose and DS caused a decrease in stool signal intensity. Both substances together led to a decreasing signal intensity of feces. Combination of lactulose and DS provided the lowest signal intensity of stool. Thus, feces could hardly be distinguished from dark rectal enema allowing for the assessment of the colonic wall. (orig.)

  11. Head CT scan

    Science.gov (United States)

    Brain CT; Cranial CT; CT scan - skull; CT scan - head; CT scan - orbits; CT scan - sinuses; Computed tomography - cranial; CAT scan - brain ... hold your breath for short periods. A complete scan usually take only 30 seconds to a few ...

  12. Cytometric characterization of circulating tumor cells captured by microfiltration and their correlation to the CellSearch(®) CTC test.

    Science.gov (United States)

    Adams, Daniel L; Stefansson, Steingrimur; Haudenschild, Christian; Martin, Stuart S; Charpentier, Monica; Chumsri, Saranya; Cristofanilli, Massimo; Tang, Cha-Mei; Alpaugh, R Katherine

    2015-02-01

    Recent studies reporting hundreds, to thousands, of circulating tumor cells (CTCs) in the blood of cancer patients have raised questions regarding the prevalence of CTCs, as enumerated by the CellSearch(®) CTC Test. Although CellSearch has been shown to consistently detect clinically relevant CTCs; the ability to only capture EpCAM positive cells has led to speculation that it captures limited subsets of CTCs. In contrast, alternative approaches to CTC isolation are often cited as capturing large numbers of CTCs from patient blood. Not surprisingly the number of cells isolated by alternative approaches show poor correlations when compared to CellSearch, even when accounting for EpCAM presence or absence. In an effort to address this discrepancy, we ran an exploratory method comparison study to characterize and compare the CTC subgroups captured from duplicate blood samples from 30 breast and prostate cancer patients using a microfiltration system (CellSieve™) and CellSearch. We then categorized the CellSieve Cytokeratin(CK)+/CD45-/DAPI+ cells into five morphologically distinct subpopulations for correlative analysis. Like other filtration techniques, CellSieve isolated greater numbers of CK+/CD45- cells than CellSearch. Furthermore, analysis showed low correlation between the total CK+/CD45- cells captured by these two assays, regardless of EpCAM presence. However, subgrouping of CK+/CD45-/DAPI+ cells based on distinct cytokeratin staining patterns and nuclear morphologies elucidated a subpopulation correlative to CellSearch. Using method comparison analyses, we identified a specific CTC morphology which is highly correlative between two distinct capture methods. These data suggests that although various morphologic CTCs with similar phenotypic expressions are present in the blood of cancer patients, the clinically relevant cells isolated by CellSearch can potentially be identified using non-EpCAM dependent isolation. © 2014 The Authors. Published by Wiley

  13. EGFR-Based Immunoisolation as a Recovery Target for Low-EpCAM CTC Subpopulation

    Science.gov (United States)

    Vila, Ana; Abal, Miguel; Muinelo-Romay, Laura; Rodriguez-Abreu, Carlos; Rivas, José; López-López, Rafael; Costa, Clotilde

    2016-01-01

    Circulating tumour cells (CTCs) play a key role in the metastasis process, as they are responsible for micrometastasis and are a valuable tool for monitoring patients in real-time. Moreover, efforts to develop new strategies for CTCs isolation and characterisation, and the translation of CTCs into clinical practice needs to overcome the limitation associated with the sole use of Epithelial Cell Adhesion Molecule (EpCAM) expression to purify this tumour cell subpopulation. CTCs are rare events in the blood of patients and are believed to represent the epithelial population from a primary tumour of epithelial origin, thus EpCAM immunoisolation is considered an appropriate strategy. The controversy stems from the impact that the more aggressive mesenchymal tumour phenotypes might have on the whole CTC population. In this work, we first characterised a panel of cell lines representative of tumour heterogeneity, confirming the existence of tumour cell subpopulations with restricted epithelial features and supporting the limitations of EpCAM-based technologies. We next developed customised polystyrene magnetic beads coated with antibodies to efficiently isolate the phenotypically different subpopulations of CTCs from the peripheral blood mononuclear cells (PBMCs) of patients with metastatic cancer. Besides EpCAM, we propose Epidermal Growth Factor Receptor (EGFR) as an additional isolation marker for efficient CTCs detection. PMID:27711186

  14. miRNA in situ hybridization in circulating tumor cells - MishCTC

    Science.gov (United States)

    Ortega, Francisco G.; Lorente, Jose A.; Garcia Puche, Jose L.; Ruiz, Maria P.; Sanchez-Martin, Rosario M.; de Miguel-Pérez, Diego; Diaz-Mochon, Juan J.; Serrano, Maria J.

    2015-01-01

    Circulating tumor cells (CTCs) must be phenotypically and genetically characterized before they can be utilized in clinical applications. Here, we present the first protocol for the detection of miRNAs in CTCs using in situ hybridization (ISH) combined with immunomagnetic selection based on cytokeratin (CK) expression and immunocytochemistry. Locked-Nucleic Acid (LNA) probes associated with an enzyme-labeled fluorescence (ELF) signal amplification approach were used to detect miRNA-21 in CTCs. This protocol was optimized using both epithelial tumor (MDA-MB468) and epithelial non-tumor (MCF-10A) cell lines, and miRNA-21 was selected as the target miRNA because of its known role as an onco-miRNA. Hematopoietic cells do not express miRNA-21; thus, miRNA-21 is an ideal marker for detecting CTCs. Peripheral blood samples were taken from 25 cancer patients and these samples were analyzed using our developed protocol. Of the 25 samples, 11 contained CTCs. For all 11 CTC-positive samples, the isolated CTCs expressed both CK and miRNA-21. Finally, the protocol was applied to monitor miRNA-21 expression in epithelial to mesenchymal transition (EMT)-induced MCF-7 cells, an epithelial tumor cell line. CK expression was lost in these cells, whereas miRNA-21 was still expressed, suggesting that miRNA-21 might be a good marker for detecting CTCs with an EMT phenotype. PMID:25777797

  15. The human enhancer blocker CTC-binding factor interacts with the transcription factor Kaiso.

    Science.gov (United States)

    Defossez, Pierre-Antoine; Kelly, Kevin F; Filion, Guillaume J P; Pérez-Torrado, Roberto; Magdinier, Frédérique; Menoni, Hervé; Nordgaard, Curtis L; Daniel, Juliet M; Gilson, Eric

    2005-12-30

    CTC-binding factor (CTCF) is a DNA-binding protein of vertebrates that plays essential roles in regulating genome activity through its capacity to act as an enhancer blocker. We performed a yeast two-hybrid screen to identify protein partners of CTCF that could regulate its activity. Using full-length CTCF as bait we recovered Kaiso, a POZ-zinc finger transcription factor, as a specific binding partner. The interaction occurs through a C-terminal region of CTCF and the POZ domain of Kaiso. CTCF and Kaiso are co-expressed in many tissues, and CTCF was specifically co-immunoprecipitated by several Kaiso monoclonal antibodies from nuclear lysates. Kaiso is a bimodal transcription factor that recognizes methylated CpG dinucleotides or a conserved unmethylated sequence (TNGCAGGA, the Kaiso binding site). We identified one consensus unmethylated Kaiso binding site in close proximity to the CTCF binding site in the human 5' beta-globin insulator. We found, in an insulation assay, that the presence of this Kaiso binding site reduced the enhancer-blocking activity of CTCF. These data suggest that the Kaiso-CTCF interaction negatively regulates CTCF insulator activity.

  16. CTC测试平台结构分析与设计%Design and construction analysis for CTC testing platform

    Institute of Scientific and Technical Information of China (English)

    赵宇坤

    2011-01-01

    CTC System was a significant part of CTCS-3. The System converted train stage plan into command and sent them to the station interlocking system, implemented the dispatch of the train. This paper given a designing method and building plan of the CTC platform in the testing circumstances, proposed two ways of time correction in CTC System. The result showed that the plan could help the System finishing the function testing quicker and higher efficient under the conditions of the security.%CTC系统主要负责将阶段计划自动转化为进路命令发送给车站联锁系统来实现对列车的调度,是CTCS-3级列控系统的重要组成部分.本文主要给出了CTC系统在测试环境下的平台设计方案,以及对此平台的具体搭建过程研究.服务器及自律机的设计采用稳定性好且安全性高的Linux系统.最后还提出了2种关于CTC系统整体校时的方法.结果表明该方案在保证安全的前提条件下使系统能够更为快捷高效的完成功能测试.

  17. Cerebro-retinal microangiopathy with calcifications and cysts due to recessive mutations in the CTC1 gene.

    Science.gov (United States)

    Bisserbe, A; Tertian, G; Buffet, C; Turhan, A; Lambotte, O; Nasser, G; Alvin, P; Tardieu, M; Riant, F; Bergametti, F; Tournier-Lasserve, E; Denier, C

    2015-05-01

    Cerebro-retinal microangiopathy with calcifications and cysts (CRMCC) or Coats plus syndrome is a pleiotropic disorder affecting the eyes, brain, bone and gastrointestinal tract. Its primary pathogenesis involves small vessel obliterative microangiopathy. Recently, autosomal recessively inherited mutations in CTC1 have been reported in CRMCC patients. We herein report an adolescent referred to our hospital following new seizures in a context of an undefined multisystem disorder. Cerebral imaging disclosed asymmetrical leukopathy, intracranial calcifications and cysts. In addition, he presented other typical CRMCC features i.e. a history of intrauterine growth retardation, skeletal demineralization and osteopenia, bilateral exudative vitreo-retinopathy reminiscent of Coats disease, recurrent gastrointestinal hemorrhages secondary to watermelon stomach and variceal bleeding of the esophagus due to idiopathic portal hypertension and telangiectatic and angiodysplasic changes in the small intestine and colon, and anemia due to recurrent bleeding and bone marrow abnormalities. The patient was diagnosed with Coats plus syndrome. CTC1 gene screening confirmed the diagnosis with the identification of heterozygous deleterious mutations. CRMCC due to CTC1 mutations has a broad clinical expressivity. Our case report illustrates the main possible associated phenotypes and their complications, demonstrating the need for a careful etiological search in order to initiate appropriate therapeutic and preventive measures.

  18. Is standard breast-conserving therapy (BCT in elderly breast cancer patients justified? A prospective measurement of acute toxicity according CTC-classification

    Directory of Open Access Journals (Sweden)

    Eilf Kirsten

    2010-11-01

    Full Text Available Abstract Background Breast conserving therapy (BCT is an accepted treatment for early-stage breast cancer. This study aimed to measure prospectively acute radiation-related toxicity and to create a comprehensive data base for long-term temporal analyses of 3D conformal adjuvant radiotherapy. The specific aspect of age has been neglected by traditional research. Therefore, the impact of age on acute BCT toxicity should be also specifically adressed. Methods Toxicity was measured in 109 patients at initiation (t1, during radiotherapy (t2-t7, and 6 weeks after treatment completion (t8 using a new topographic module. Organ systems were recorded in 15 scales and scored according to symptom intensity (grade 0-5 based on CTC (Common Toxicity Criteria -classification. Radiotherapy was virtually CT-based planned and applied with 6-MeV-photons. Mean total dose was 60.1 Gy. Patients were stratified by age in 3 Groups: 60 years. Results Registered toxicity was generally low. Mean overall-grade climbed from 0.29-0.40 (t1-t7, and dropped to 0.23 (t8. Univariate analyses revealed slightly higher toxicity in older (> 60 years versus young patients ( 60 years patients (p = 0.039. Toxicity differences in all other scales were not significant. Between older (> 60 years and midaged patients (50-60 years no significant differences in toxicity were found. This was also true for the comparison between young ( Conclusion The treatment concept of BCT for breast cancer is generally well tolerated. The toxicity-measurement with the new topographic module is feasible. Not modified standard treatment for BC should be performed in elderly women.

  19. Magnetic resonance colonography for fibrosis assessment in rats with chronic colitis.

    Directory of Open Access Journals (Sweden)

    Chloé Melchior

    Full Text Available BACKGROUND: Magnetic resonance colonography (MRC has been developed to assess inflammatory bowel diseases. We aimed to assess the feasibility of MRC in rats with TNBS-induced chronic colitis and to confront imaging results with fibrosis and stenosing features of the model. MATERIALS AND METHODS: Chronic colitis was induced in 12 rats by weekly intra-rectal injection of increasing doses of TNBS for 6 weeks, while 8 control rats received the vehicle. At week 7, MRC was performed. Fibrosis scores were assessed and fibrosis mediators measured. RESULTS: Chronic colitis was associated with significant body weight loss (p<0.0001 and higher colon weight/length compared to controls (p = 0.0004. Fibrosis mediators and histological scores were significantly higher in rats with TNBS than in controls: α-SMA expression (0.9 versus 0.61, p = 0.0311 and fibrosis score (p = 0.0308. Colon wall thickness was higher in rats with TNBS than in controls: maximal thickness (2.38 versus 0.74 mm, p<0.0001 and minimal thickness (1.33 versus 0.48 mm, p<0.0001. Wall signal intensity on T2w images was higher in rats with TNBS than in controls (9040 versus 6192, p = 0.0101 and correlated with fibrosis score (r = 0.5214; p = 0.04. Luminal narrowing was higher in rats with TNBS (50.08 versus 10.33%, p<0.0001 and correlated with α-SMA expression (r = 0.5618; p = 0.01. Stenosis was observed in 7/9 rats with TNBS and in no controls (p = 0.0053. CONCLUSIONS: MRC is feasible and easily distinguishes rats with colitis from controls. MRC signs correlated with fibrosis parameters. MRC evaluation may be part of a new anti-fibrosis drug assessment in experimental models of chronic colitis.

  20. Effects of substrates and phosphate on INT (2-(4-iodophenyl)-3-(4-nitrophenyl)-5-phenyl tetrazolium chloride) and CTC (5-cyano-2,3-ditolyl tetrazolium chloride) reduction in Escherichia coli

    Science.gov (United States)

    Smith, J. J.; McFeters, G. A.

    1996-01-01

    The effects of substrates of primary aerobic dehydrogenases, and inorganic phosphate on aerobic INT and CTC reduction in Escherichia coli were examined. In general, INT produced less formazan than CTC, but INT (+) cell counts remained near values of CTC (+) cells. INT and CTC (+) cell numbers were higher than plate counts on R2A medium using succinate, formate, lactate, casamino acids, glucose, glycerol (INT only) and no substrate. Formate resulted in the greatest amount of INT and CTC formazan. Reduction of both INT and CTC was inhibited above 10 mmol l-1 phosphate, and this appeared to be related to decreased rates of O2 consumption. Formation of fluorescent CTC (+), but not INT (+) cells was also inhibited in a concentration dependent manner by phosphate above 10 mmol l-1. From light microscopic observations it appeared CTC formed increasing amounts of poorly or non-fluorescent formazan with increasing phosphate. Therefore, use of phosphate buffer in excess of 10 mmol l-1 may not be appropriate in CTC and INT reduction assays.

  1. Efficacy of topical cobalt chelate CTC-96 against adenovirus in a cell culture model and against adenovirus keratoconjunctivitis in a rabbit model

    Directory of Open Access Journals (Sweden)

    Srivilasa Charlie

    2006-06-01

    Full Text Available Abstract Background Adenovirus (Ad, associated with significant morbidity, has no topical treatment. A leading CTC compound (CTC-96, a CoIII chelate, was found to have potent in vitro and in vivo antiviral efficacy against herpes viruses. In this study CTC-96 is being tested for possible anti-Adenovirus activity. Methods The biological anti-adenovirus activity of CTC-96 in concentrations from 5 to 250 ug/ml, was evaluated initially by viral inactivation (viral exposure to CTC-96 followed by dilution and inoculation of cells, virucidal (viral exposure to CTC-96 and inoculation of cells without dilution and antiviral (effect of CTC-96 on previously adsorbed virus plaque assays on HeLa (human cervical carcinoma, A549 (human lung carcinoma and SIRC (rabbit corneal cells. After verifying the antiviral activity, New Zealand White rabbits were infected with Ad-5 into: 1 the anterior cul-de-sac scarifying the conjunctiva (Group "C+"; 2 the anterior cul-de-sac scarifying the conjunctiva and cornea (Group "CC+"; 3 the stroma (Group "CI+". Controls were sham-infected ("C-", "CC-", "CI-". Other rabbits, after "CC", were treated for 21 days with: 1 placebo, 9x/day ("-"; 2 CTC-96, 50 ug/ml, 9x/day ("50/9"; CTC-96, 50 ug/ml, 6x/day ("50/6"; CTC-96, 25 ug/ml, 6x/day ("25/6". All animals were monitored via examination and plaque assays. Results In vitro viral inactivation, virucidal and antiviral assays all demonstrated CTC-96 to be effective against Adenvirus type 5 (ad-5. The in vivo model of Ad keratoconjunctivitis most similar to human disease and producing highest viral yield was "CC". All eyes (6/6 developed acute conjunctivitis. "CI" yielded more stromal involvement (1/6 and iritis (5/6, but lower clinical scores (area × severity. Infection via "C" was inconsistent (4/6. Fifty (50 ug/ml was effective against Ad-5 at 6x, 9x dosings while 25 ug/ml (6x was only marginally effective. Conclusion CTC-96 demonstrated virucidal activity against Ad5 in tissue

  2. CTC Sentinel. January 2008, Volume 1 Issue 2. A Profile of Tehrik-i-Taliban Pakistan

    Science.gov (United States)

    2008-01-01

    a Terrorist (Westport, CT: Praeger, 2005), pp. 53-65. Malaysia and Texas before it was taken off at the request of U.S. officials. It then...of terrorist activities or causes. Recruiters can log into chat rooms or visit cyber- cafes to find receptive members of the public, especially the

  3. Control Design Of Robot Manipulator Position Based On Pd-Fuzzy Mamdani Controlled With Computed Torque Control (Pd-Fuzzy-Ctc

    Directory of Open Access Journals (Sweden)

    Duli Ridlo Istriantono

    2015-03-01

    Full Text Available Robotics science has evolved significantly, driven by rapid advances in computer and sensor technology; and theoretical advances in control and computer vision. These development make widespread use of robot manipulators in industrial environments. Major problem in controlling a robot manipulator is to control the robot in order to achieve the desired position. Therefore the design issue of the robot control is to choose the right type controller. Computed Torque Controller (CTC is a powerful nonlinear controllers are widely used in the control of robot manipulators. CTC controller is designed based on feedback linearization and the required torque of the robot arm by using a nonlinear feedback control law. Simulation is done by providing joint trajectory from point to point. The simulation results show that the PD-Fuzzy-CTC controller is able to follow the joint trajectory with The RMSE value of the joint angle position of PD-Fuzzy-CTC controller is 10 times smaller than that of the PD-CTC controller with the end-effector position accuracy is 0.1 mm.  

  4. Documentos sobre el X Congreso Nacional de la CTC en 1950 y la persecución sindical en Colombia

    Directory of Open Access Journals (Sweden)

    Eduardo Saenz Rovner

    1991-01-01

    Full Text Available En 1949, los Estado Unidos, como parte de su política anticomunista y antisindical durante la Guerra Fría, presionaron al Ministerio del Trabajo de Colombia, requiriéndole que removiese a aquellos líderes de la Confederación de Trabajadores de Colombia (CTC que el Departamento de Estado norteamericano consideraba comunistas. Ya que el FBI tenía agentes en Colombia recogiendo información sobre las vidas y actividades de los "comunistas" -reales o imaginarios-, era fácil para los norteamericanos señalar a quienes querían ver perseguidos. El Ministerio conservador no quiso ayudar directamente a la Embajada, argumentando con buenas razones, que el Partido Liberal era el que tenía la influencia sobre las facciones "moderadas'' dentro de la CTC. El embajador Willard Beaulac se puso entonces en contacto con el político Carlos Lleras Restrepo y le solicitó que se encargase de coordinar la expulsión de los líderes izquierdistas de la Confederación.

  5. Documentos sobre el X Congreso Nacional de la CTC en 1950 y la persecución sindical en Colombia

    Directory of Open Access Journals (Sweden)

    Eduardo Saenz Rovner

    2012-08-01

    Full Text Available En 1949, los Estado Unidos, como parte de su política anticomunista y antisindical durante la Guerra Fría, presionaron al Ministerio del Trabajo de Colombia, requiriéndole que removiese a aquellos líderes de la Confederación de Trabajadores de Colombia (CTC que el Departamento de Estado norteamericano consideraba comunistas. Ya que el FBI tenía agentes en Colombia recogiendo información sobre las vidas y actividades de los "comunistas" -reales o imaginarios-, era fácil para los norteamericanos señalar a quienes querían ver perseguidos. El Ministerio conservador no quiso ayudar directamente a la Embajada, argumentando con buenas razones, que el Partido Liberal era el que tenía la influencia sobre las facciones "moderadas'' dentro de la CTC. El embajador Willard Beaulac se puso entonces en contacto con el político Carlos Lleras Restrepo y le solicitó que se encargase de coordinar la expulsión de los líderes izquierdistas de la Confederación.

  6. CT Enterography

    Science.gov (United States)

    ... You may also be asked to remove hearing aids and removable dental work. Women will be asked to remove bras ... kind, unlike MRI. No radiation remains in a patient's body after a CT ... side effects. Risks There is always a slight chance of cancer ...

  7. A Robust and Fast System for CTC Computer-Aided Detection of Colorectal Lesions

    OpenAIRE

    2010-01-01

    We present a complete, end-to-end computer-aided detection (CAD) system for identifying lesions in the colon, imaged with computed tomography (CT). This system includes facilities for colon segmentation, candidate generation, feature analysis, and classification. The algorithms have been designed to offer robust performance to variation in image data and patient preparation. By utilizing efficient 2D and 3D processing, software optimizations, multi-threading, feature selection, and an optimiz...

  8. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... a stroke, especially with a new technique called Perfusion CT. brain tumors. enlarged brain cavities (ventricles) in ... X-Ray and CT Exams Blood Clots CT Perfusion of the Head CT Angiography (CTA) Stroke Brain ...

  9. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... Professions Site Index A-Z Computed Tomography (CT) - Head Computed tomography (CT) of the head uses special ... the Head? What is CT Scanning of the Head? Computed tomography, more commonly known as a CT ...

  10. The potential probiotic Lactobacillus rhamnosus CTC1679 survives the passage through the gastrointestinal tract and its use as starter culture results in safe nutritionally enhanced fermented sausages.

    Science.gov (United States)

    Rubio, Raquel; Martín, Belén; Aymerich, Teresa; Garriga, Margarita

    2014-09-01

    The human-derived potential probiotic strain Lactobacillus rhamnosus CTC1679 was used as a starter culture in reduced fat and sodium low-acid fermented sausages (fuets) to assess its ability to survive through the gastrointestinal tract (GIT) in a human intervention study consisting of 5 healthy volunteers who consumed 25 g fuet a day for 21 days. Faecal samples were analysed during and after consumption. L. rhamnosus CTC1679 produced a transient colonisation of the human GIT and persisted during the ingestion period of fuet containing L. rhamnosus CTC1679 at levels ca. 8log CFU/g. After 3 days of non-consumption, the strain was still recovered in the faeces of all the volunteers. To evaluate the safety of the nutritionally enhanced manufactured fuets, a challenge test was designed in a separately manufactured batch. L. rhamnosus CTC1679 was able to grow, survive and dominate (levels ca. 10(8) CFU/g) the endogenous lactic acid bacteria (LAB), prevented the growth of Listeria monocytogenes throughout the whole ripening process of the fuets and eliminated Salmonella. After 35 days of storage at 4 °C, L. monocytogenes was not detected, achieving absence in 25 g of the product. The application of high hydrostatic pressure (HHP) treatment (600 MPa for 5 min) at the end of ripening (day 14) produced an immediate reduction of L. monocytogenes to levels fermented sausages.

  11. Effect of sex sorting on CTC staining, actin cytoskeleton and tyrosine phosphorylation in bull and boar spermatozoa.

    Science.gov (United States)

    Bucci, D; Galeati, G; Tamanini, C; Vallorani, C; Rodriguez-Gil, J E; Spinaci, M

    2012-04-01

    Sperm sorting is a useful technology that permits sex preselection. It presents some troubles because of low fertility after the process. The main aim of this work was to analyze the putative existence of capacitation-like changes in both boar and bull sperm subjected to sex sorting that could lead to a detriment of semen quality. The parameters used were CTC staining patterns, actin cytoskeleton organization and tyrosine phosphorylation patterns; the last two were determined by both western blotting and immunofluorescence. Sex sorted spermatozoa were compared with fresh, in vitro capacitated and in vitro acrosome reacted sperm. In both species, sex sorted sperm showed a CTC staining pattern similar to that observed after in vitro capacitation. The actin pattern distribution after sperm sorting also tended to be similar to that observed after in vitro capacitation, but this effect was more pronounced in bull than in boar spermatozoa. However, actin expression analysis through western blot did not show any change in either species. The tyrosine phosphorylation pattern in boar sperm was practically unaltered after the sex sorting process, but in bulls about 40% of spermatozoa had a staining pattern indicative of capacitation. Additionally, western blotting analysis evidenced some differences in the expression of protein tyrosine phosphorylation among fresh, capacitated, acrosome reacted and sex sorted sperm cells in both species. Our results indicate that not all the sex-sorted-related modifications of the studied parameters were similar to those occurring after "in vitro" capacitation, thus suggesting that sex sorting-induced alterations of sperm function and structure do not necessarily indicate the achievement of the capacitated status of sorted sperm.

  12. Native acetabular version: 3D CT analysis 
of the psoas valley.

    Science.gov (United States)

    Osmani, Humza Tariq; Henckel, Johann; Cobb, Justin; Hart, Alister J

    2013-01-01

    Insufficient version has been demonstrated to be a significant factor in increasing metal-on-metal cup wear. Another implication is the impingement of the psoas tendon at the anatomical depression on the anterior acetabular rim, called the psoas valley. It is not known whether the psoas valley has any anatomical significance when measuring native version. The effect of this landmark on the measurement of acetabular version has not been assessed using 3D CT.
Sixty five high resolution CT scans of non-diseased hips (performed for colonography) were used to measure the anatomical version angles of the bony acetabular rim. Our new method, using the psoas valley, was compared to the reference method, which used the full 320° of the acetabular rim. The measurement of acetabular version was highly reproducible between the methods. Both methods measured the angle of version over a wide range: 5° to 35° for males and 10° to 40° for females. There were no statistically significant differences between genders (p = 0.3670). The Bland-Altman 1.96 SD lower and upper limits of agreement between the two methods were +4.6° and -4.3°, respectively. Intra-observer and inter-observer reliability were high for the new method. This adds to our understanding of native bony anatomy, and specifically provides a landmark that 3D CT has demonstrated to be potentially useful in assessing native version.

  13. A Robust and Fast System for CTC Computer-Aided Detection of Colorectal Lesions

    Directory of Open Access Journals (Sweden)

    Gareth Beddoe

    2010-01-01

    Full Text Available We present a complete, end-to-end computer-aided detection (CAD system for identifying lesions in the colon, imaged with computed tomography (CT. This system includes facilities for colon segmentation, candidate generation, feature analysis, and classification. The algorithms have been designed to offer robust performance to variation in image data and patient preparation. By utilizing efficient 2D and 3D processing, software optimizations, multi-threading, feature selection, and an optimized cascade classifier, the CAD system quickly determines a set of detection marks. The colon CAD system has been validated on the largest set of data to date, and demonstrates excellent performance, in terms of its high sensitivity, low false positive rate, and computational efficiency.

  14. CT urography

    Energy Technology Data Exchange (ETDEWEB)

    Korobkin, M. [Dept. of Radiology, Univ. of Michigan, Ann Arbor, MI (United States)

    2005-11-15

    With the advent of multidetector row CT scanners, evaluation of the urothelium of the entire urinary tract with high-resolution thin sections during a single breath-hold has become a reality. Multidetector CT urography (MDCTU) is a single examination that allows evaluation of potential urinary tract calculi, renal parenchymal masses, and both benign and malignant urothelial lesions. Initial results with this new technique are encouraging. Current investigations of MDCTU focus on methods to improve opacification and distension of the upper urinary tract - the collecting systems, pelvis, and ureters. The role of abdominal compression, infusion of saline and/or furosemide, and optimal time delay of excretory phase imaging is being explored. Upper tract urothelial malignancies, including small lesions less the 5 mmin diameter, can be detected with high sensitivity. Methods to reduce radiation exposure are being explored, including split-bolus contrast injection techniques that combine nephrographic and excretory phases into a single phase. It is likely that in the near future, radiological evaluation of significant unexplained hematuria or of known or prior urothelial malignancy will consist of a single examination - MDCTU. (orig.)

  15. Variabilidade espacial de MO, P, K e CTC do solo sob diferentes usos e manejos Spatial variability of MO, P, K and CTC of soil under different use and management conditions

    Directory of Open Access Journals (Sweden)

    Eloiza Gomes Silva Cavalcante

    2007-04-01

    Full Text Available O estudo da variabilidade espacial dos atributos químicos dos solos é particularmente importante em áreas onde o solo está submetido a diferentes manejos. O trabalho foi desenvolvido em Selvíria (MS, com o objetivo de avaliar a variabilidade espacial da matéria orgânica (MO, o fósforo (P, do potássio (K e a capacidade de troca catiônica (CTC em um Latossolo Vermelho distrófico sob diferentes usos e manejos. Os solos foram amostrados em uma malha, com intervalos regulares de 2m, perfazendo um total de 64 pontos, nas profundidades de 0,0-0,1m e 0,1-0,2m, nas seguintes áreas: vegetação natural (cerrado, plantio direto, plantio convencional e pastagem. O sistema de plantio direto apresentou acúmulo significativo de matéria orgânica, fósforo, potássio e elevação da CTC em relação aos demais sistemas estudados, além da melhoria nas condições químicas do solo. A matéria orgânica foi maior em relação ao sistema natural. As maiores variabilidades medidas por meio do coeficiente de variação foram observadas para o fósforo e o potássio, sendo que a matéria orgânica e a CTC apresentaram coeficiente de variação médio nos diferentes usos e manejos do solo.The study of the spatial variability of the chemical attributes of the soils is particularly important in areas where the soil is submitted to different management. This work was developed in Selvíria (MS with the objective of evaluating the spatial variability of the organic matter (MO, phosphorus (P, potassium (K and cation exchange capacity (CEC in a oxisol under different use and management conditions. The soils were collected in a grid, with regular intervals of 2m, total of 64 points, in the depths of 0,0-0,1m and 0,1-0,2m, in the use and management were: native vegetation (savannah, no-tillage, conventional system and pasture. The system of no-tillage presented significant accumulation of organic matter, phosphorus, potassium and elevation of CEC in relation to

  16. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... a relatively short time, especially when compared to magnetic resonance imaging (MRI). CT scanning is painless, noninvasive and accurate. A ... CT is less sensitive to patient movement than MRI. CT can be performed if you have an ...

  17. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... CT is less sensitive to patient movement than MRI. CT can be performed if you have an implanted medical device of any kind, unlike MRI. A diagnosis determined by CT scanning may eliminate ...

  18. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... CT Scanning of the Abdomen and Pelvis? What is CT Scanning of the Abdomen/Pelvis? Computed tomography, ... the body being studied. top of page How is the CT scan performed? The technologist begins by ...

  19. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... additional view capabilities. Modern CT scanners are so fast that they can scan through large sections of ... after the procedure? CT exams are generally painless, fast and easy. With multidetector CT, the amount of ...

  20. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... Professions Site Index A-Z Computed Tomography (CT) - Abdomen and Pelvis Computed tomography (CT) of the abdomen ... and Pelvis? What is CT Scanning of the Abdomen/Pelvis? Computed tomography, more commonly known as a ...

  1. Abdominal and Pelvic CT

    Science.gov (United States)

    ... Professions Site Index A-Z Computed Tomography (CT) - Abdomen and Pelvis Computed tomography (CT) of the abdomen ... and Pelvis? What is CT Scanning of the Abdomen/Pelvis? Computed tomography, more commonly known as a ...

  2. CT Colonographic Screening of Patients With a Family History of Colorectal Cancer: Comparison With Adults at Average Risk and Implications for Guidelines.

    Science.gov (United States)

    Pickhardt, Perry J; Mbah, Ifeanyi; Pooler, B Dustin; Chen, Oliver T; Hinshaw, J Louis; Weiss, Jennifer M; Kim, David H

    2017-04-01

    The purposes of this study were to compare rates of lesion detection at CT colonographic (CTC) screening of adults without symptoms who had and who did not have a family history of colorectal cancer according to American Cancer Society guidelines and to consider the clinical implications. Over 134 months, consecutively registered CTC cohorts of adults without symptoms who had (n = 156; 88 [56.4%] women; 68 [43.6%] men; mean age, 56.3 years) and who did not have (n = 8857; 4757 [53.7%] women; 4100 [46.3%] men; mean age, 56.6 years) an American Cancer Society-defined family history of colorectal cancer (first-degree relative with diagnosis before age 60 years or two first-degree relatives with diagnosis at any age) were compared for relevant colorectal findings. For the family history versus no family history cohorts, the frequency of all nondiminutive polyps (≥ 6 mm) reported at CTC was 23.7% versus 15.5% (p = 0.007); small polyps (6-9 mm), 13.5% versus 9.1% (p = 0.068); and large polyps (≥ 10 mm), 10.2% versus 6.5% (p = 0.068). The rate of referral for colonoscopy was greater for the family history cohort (16.0% vs 10.5%; p = 0.035). However, the frequencies of proven advanced adenoma (4.5% vs 3.2%; p = 0.357), nonadvanced adenoma (5.1% vs 2.6%; p = 0.070), and cancer (0.0% vs 0.4%; p = 0.999) were not significantly increased. The difference in positive rates between the two cohorts (11.5% vs 4.3%; p colorectal cancer relevance, such as small hyperplastic polyps, diverticular disease, and false-positive CTC findings. Although the overall CTC-positive and colonoscopy referral rates were higher in the family history cohort, the clinically relevant frequencies of advanced neoplasia and cancer were not sufficiently increased to preclude CTC screening. These findings support the use of CTC as a front-line screening option in adults with a family history of colorectal cancer.

  3. Intravenous, contrast-enhanced MR colonography using air as endoluminal contrast agent: Impact on colorectal polyp detection.

    LENUS (Irish Health Repository)

    Keeling, Aoife N

    2012-02-01

    PURPOSE: To compare diagnostic accuracy and patient tolerance of MR colonography with intravenous contrast and luminal air (MRC) to conventional colonoscopy (CC). MATERIALS AND METHODS: IRB approval and written informed consent were obtained. Forty-six patients, both screening and symptomatic, underwent MRC followed by CC. The MRC technique employed 3D T1W spoiled gradient echo sequences performed after the administration of gadopenetate dimeglumine, with parallel imaging. The diagnostic accuracy and tolerance of patients for MRC was compared to CC. RESULTS: Twenty-four polyps were detected in eighteen patients with CC (5 polyps >\\/=10mm, 4 polyps 6-9mm, 15 polyps <\\/=5mm). MRC was 66.7% (12\\/18) sensitive and 96.4% (27\\/28) specific for polyp detection on a per-patient basis. When analyzed by polyp size, sensitivity and specificity of MRC was 100% (5\\/5) and 100% (19\\/19), respectively, for lesions greater than 10mm, 100% (4\\/4) and 100% (20\\/20) for lesions 6-9mm, and sensitivity of 20% (3\\/15) lesions less than 5mm. The sensitivity and specificity of MRC for detecting significant lesions (>6mm) was 100% (9\\/9) and 100% (15\\/15), respectively. Regarding tolerance of the exams, there were no significant differences between MRC and CC. Thirty-five percent (n=16) of patients preferred MRC as a future screening test compared to 33% (n=15) for CC. CONCLUSION: MRC using air as an intraluminal contrast agent is a feasible and well-tolerated technique for detecting colonic polyps >\\/=6mm in size. Further studies are warranted.

  4. Incidental extracolonic findings on bright lumen MR colonography in a population at increased risk for colorectal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Yusuf, Erlangga, E-mail: angga.yusuf@gmail.com [Department of Radiology, Academic Medical Center, Amsterdam, Postbus 22660, 1100 DD Amsterdam (Netherlands); Florie, Jasper; Nio, Chung Yung; Jensch, Sebastian; Nievelstein, Rutger A.J.; Baak, Lubbertus; Stoker, Jaap [Department of Radiology, Academic Medical Center, Amsterdam, Postbus 22660, 1100 DD Amsterdam (Netherlands)

    2011-04-15

    Purpose: Incidental extracolonic findings affect patient treatment and cost. Therefore, to consider magnetic resonance colonography (MRC) as a tool for colorectal cancer and polyps screening, more knowledge is needed on extracolonic findings. In this study, we sought to determine the prevalence and the spectrum of extracolonic findings in patients with an increased risk colorectal cancer that underwent bright lumen MRC. Materials and methods: MRC examinations were performed in 210 patients. A gadolinium solution was administered rectally for distension of the colon. Extracolonic findings were scored by two radiologists and classified by using C-RADS Reporting System. All findings (with advice regarding work-up) were reported to the patient's physician and followed up for 4.5 years on average. Results: Extracolonic findings were found in 125 (59.5%) patients. Ten (4.8%) had 'potentially important' findings (C-RADS category E4). Twenty-five patients (11.9%) had 'likely unimportant' findings (E3), 90 (42.8%) had 'clinically unimportant' findings (E2) and 85 (40.5%) had a normal exam (E1). In 14 (6.7%) patients additional work-up was performed for their incidentally discovered lesions. In three of them surgery was performed. After work-up, only in two (1.0%) patients a malignancy was found. Conclusion: The number of new relevant extracolonic findings is small and the required additional work-up is limited. This should be considered for implementation of 'bright lumen' MRC as a screening tool.

  5. Intravenous, contrast-enhanced MR colonography using air as endoluminal contrast agent: Impact on colorectal polyp detection.

    LENUS (Irish Health Repository)

    Keeling, Aoife N

    2010-12-03

    PURPOSE: To compare diagnostic accuracy and patient tolerance of MR colonography with intravenous contrast and luminal air (MRC) to conventional colonoscopy (CC). MATERIALS AND METHODS: IRB approval and written informed consent were obtained. Forty-six patients, both screening and symptomatic, underwent MRC followed by CC. The MRC technique employed 3D T1W spoiled gradient echo sequences performed after the administration of gadopenetate dimeglumine, with parallel imaging. The diagnostic accuracy and tolerance of patients for MRC was compared to CC. RESULTS: Twenty-four polyps were detected in eighteen patients with CC (5 polyps ≥10mm, 4 polyps 6-9mm, 15 polyps ≤5mm). MRC was 66.7% (12\\/18) sensitive and 96.4% (27\\/28) specific for polyp detection on a per-patient basis. When analyzed by polyp size, sensitivity and specificity of MRC was 100% (5\\/5) and 100% (19\\/19), respectively, for lesions greater than 10mm, 100% (4\\/4) and 100% (20\\/20) for lesions 6-9mm, and sensitivity of 20% (3\\/15) lesions less than 5mm. The sensitivity and specificity of MRC for detecting significant lesions (>6mm) was 100% (9\\/9) and 100% (15\\/15), respectively. Regarding tolerance of the exams, there were no significant differences between MRC and CC. Thirty-five percent (n=16) of patients preferred MRC as a future screening test compared to 33% (n=15) for CC. CONCLUSION: MRC using air as an intraluminal contrast agent is a feasible and well-tolerated technique for detecting colonic polyps ≥6mm in size. Further studies are warranted.

  6. Differentiation between benign and malignant colon tumors using fast dynamic gadolinium-enhanced MR colonography; a feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Achiam, M.P., E-mail: achiam1@dadlnet.d [Department of Diagnostic Radiology, Copenhagen University Hospital Herlev, Herlev Ringvej, DK-2730 Herlev (Denmark); Department of Surgical Gastroenterology D, Copenhagen University Hospital Herlev, Herlev Ringvej, DK-2730 Herlev (Denmark); Department of Diagnostic Sciences, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3C, DK-2200 Copenhagen (Denmark); Andersen, L.P.H.; Klein, M. [Department of Surgical Gastroenterology D, Copenhagen University Hospital Herlev, Herlev Ringvej, DK-2730 Herlev (Denmark); Department of Diagnostic Sciences, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3C, DK-2200 Copenhagen (Denmark); Logager, V.; Chabanova, E.; Thomsen, H.S. [Department of Diagnostic Radiology, Copenhagen University Hospital Herlev, Herlev Ringvej, DK-2730 Herlev (Denmark); Department of Diagnostic Sciences, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3C, DK-2200 Copenhagen (Denmark); Rosenberg, J. [Department of Surgical Gastroenterology D, Copenhagen University Hospital Herlev, Herlev Ringvej, DK-2730 Herlev (Denmark); Department of Diagnostic Sciences, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3C, DK-2200 Copenhagen (Denmark)

    2010-06-15

    Background: Colorectal cancer will present itself as a bowel obstruction in 16-23% of all cases. However, not all obstructing tumors are malignant and the differentiation between a benign and a malignant tumor can be difficult. The purpose of our study was to determine whether fast dynamic gadolinium-enhanced MR imaging combined with MR colonography could be used to differentiate a benign from a malignant obstructing colon tumor. Methods: Patients with benign colon tumor stenosis, based on diverticulitis, were asked to participate in the study. The same number of patients with verified colorectal cancer was included. Both groups had to be scheduled for surgery to be included. Two blinded observers analyzed the tumors on MR by placing a region of interest in the tumor and a series of parameters were evaluated, e.g. wash-in, wash-out and time-to-peak. Results: 14 patients were included. The wash-in and wash-out rates were significantly different between the benign and malignant tumors, and a clear distinction between benign and malignant disease was therefore possible by looking only at the MR data. Furthermore, MR colography evaluating the rest of the colon past the stenosis was possible with all patients. Conclusion: The results showed the feasibility of using fast dynamic gadolinium-enhanced MR imaging to differentiate between benign and malignant colonic tumors. With a high intra-class correlation and significant differences found on independent segments of the tumor, the method appears to be reproducible. Furthermore, the potential is big in performing a full preoperative colon evaluation even in patients with obstructing cancer. Trial number: (NCT00114829).

  7. Work Breakdown Structure and Plant/Equipment Designation System Numbering Scheme for the High Temperature Gas- Cooled Reactor (HTGR) Component Test Capability (CTC)

    Energy Technology Data Exchange (ETDEWEB)

    Jeffrey D Bryan

    2009-09-01

    This white paper investigates the potential integration of the CTC work breakdown structure numbering scheme with a plant/equipment numbering system (PNS), or alternatively referred to in industry as a reference designation system (RDS). Ideally, the goal of such integration would be a single, common referencing system for the life cycle of the CTC that supports all the various processes (e.g., information, execution, and control) that necessitate plant and equipment numbers be assigned. This white paper focuses on discovering the full scope of Idaho National Laboratory (INL) processes to which this goal might be applied as well as the factors likely to affect decisions about implementation. Later, a procedure for assigning these numbers will be developed using this white paper as a starting point and that reflects the resolved scope and outcome of associated decisions.

  8. Community Mobilization and Readiness: Planning Flaws which Challenge Effective Implementation of 'Communities that Care' (CTC) Prevention System.

    Science.gov (United States)

    Basic, Josipa

    2015-01-01

    This article reviews the experience of implementing a community approach to drug use and youth delinquency prevention based on the 'Communities that Care' (CTC) system implemented in one Croatian county consisting of 12 communities, 2002 to 2013 (Hawkins, 1999; Hawkins & Catalano, 2004). This overview explores selected critical issues which are often not considered in substance use(r) community intervention planning, implementation as well as in associated process and outcome assessments. These issues include, among others, the mobilization process of adequate representation of people; the involvement of relevant key individual and organizational stakeholders and being aware of the stakeholders' willingness to participate in the prevention process. In addition, it is important to be aware of the stakeholders' knowledge and perceptions about the 'problems' of drug use and youth delinquency in their communities as well as the characteristics of the targeted population(s). Sometimes there are community members and stakeholders who block needed change and therefore prevention process enablers and 'bridges' should be involved in moving prevention programming forward. Another barrier that is often overlooked in prevention planning is community readiness to change and a realistic assessment of available and accessible resources for initiating the planned change(s) and sustaining them. All of these issues have been found to be potentially related to intervention success. At the end of this article, I summarize perspectives from prevention scientists and practitioners and lessons learned from communities' readiness research and practice in Croatian that has international relevance.

  9. Health economic aspects of evaluation with diffusion weighted MR and MR colonography compared to standard evaluation with colonoscopy and CT before rectal cancer surgery

    DEFF Research Database (Denmark)

    Achiam, Michael P; Kjellberg, Jakob; Rosenberg, Jacob

    2017-01-01

    BACKGROUND: Colorectal cancer is a frequent type of cancer, and with the risk of synchronous disease, the need for a complete staging leads to an extensive and costly preoperative diagnostic evaluation. Previously we described a total preoperative evaluation using magnetic resonance (MR...

  10. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... the scanner at one time such as with MRI. If an intravenous contrast material is used, you ... CT is less sensitive to patient movement than MRI. CT can be performed if you have an ...

  11. Computed Tomography (CT) -- Head

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    Full Text Available ... of the Head? What is CT Scanning of the Head? Computed tomography, more commonly known as a ... of page What are some common uses of the procedure? CT scanning of the head is typically ...

  12. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... the Sinuses? What is CT (Computed Tomography) of the Sinuses? Computed tomography, more commonly known as a ... of page What are some common uses of the procedure? CT of the sinuses is primarily used ...

  13. Computed Tomography (CT) -- Head

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    Full Text Available ... view of the body's interior. Refinements in detector technology allow nearly all CT scanners to obtain multiple ... lives. CT has been shown to be a cost-effective imaging tool for a wide range of ...

  14. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... view of the body's interior. Refinements in detector technology allow nearly all CT scanners to obtain multiple ... lives. CT has been shown to be a cost-effective imaging tool for a wide range of ...

  15. Abdominal and Pelvic CT

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    Full Text Available ... view of the body's interior. Refinements in detector technology allow nearly all CT scanners to obtain multiple ... lives. CT has been shown to be a cost-effective imaging tool for a wide range of ...

  16. Computed Tomography (CT) -- Head

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    Full Text Available ... limitations of CT Scanning of the Head? What is CT Scanning of the Head? Computed tomography, more ... the body being studied. top of page How is the procedure performed? The technologist begins by positioning ...

  17. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... the limitations of CT of the Sinuses? What is CT (Computed Tomography) of the Sinuses? Computed tomography, ... the body being studied. top of page How is the procedure performed? The technologist begins by positioning ...

  18. Abdominal and Pelvic CT

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    Full Text Available ... the cause of unexplained pain. CT scanning is fast, painless, noninvasive and accurate. In emergency cases, it ... additional view capabilities. Modern CT scanners are so fast that they can scan through large sections of ...

  19. Computed Tomography (CT) -- Head

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    Full Text Available ... view of the body's interior. Refinements in detector technology allow nearly all CT scanners to obtain multiple ... Neck Cancer X-ray, Interventional Radiology and Nuclear Medicine Radiation Safety Images related to Computed Tomography (CT) - ...

  20. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... view of the body's interior. Refinements in detector technology allow nearly all CT scanners to obtain multiple ... Neck Cancer X-ray, Interventional Radiology and Nuclear Medicine Radiation Safety Images related to Computed Tomography (CT) - ...

  1. Abdominal and Pelvic CT

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    Full Text Available ... scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, ... prescribed procedure with your doctor, the medical facility staff and/or your insurance provider to get a ...

  2. Computed Tomography (CT) -- Head

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    Full Text Available ... scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, ... prescribed procedure with your doctor, the medical facility staff and/or your insurance provider to get a ...

  3. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, ... prescribed procedure with your doctor, the medical facility staff and/or your insurance provider to get a ...

  4. CT Grading of Otosclerosis

    National Research Council Canada - National Science Library

    Lee, T.C; Aviv, R.I; Chen, J.M; Nedzelski, J.M; Fox, A.J; Symons, S.P

    2009-01-01

    ...: The CT grading system for otosclerosis was proposed by Symons and Fanning in 2005. The purpose of this study was to determine if this CT grading system has high interobserver and intraobserver agreement...

  5. Abdominal and Pelvic CT

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    Full Text Available ... CT scanner technique will be adjusted to their size and the area of interest to reduce the ... Patient undergoing computed tomography (CT) scan View full size with caption Pediatric Content Some imaging tests and ...

  6. Computed Tomography (CT) -- Head

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    Full Text Available ... CT scanner technique will be adjusted to their size and the area of interest to reduce the ... Patient undergoing computed tomography (CT) scan. View full size with caption Pediatric Content Some imaging tests and ...

  7. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... CT scanner technique will be adjusted to their size and the area of interest to reduce the ... Patient undergoing computed tomography (CT) scan. View full size with caption Pediatric Content Some imaging tests and ...

  8. Abdominal and Pelvic CT

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    Full Text Available ... page How should I prepare for the CT scan? You should wear comfortable, loose-fitting clothing to ... studied. top of page How is the CT scan performed? The technologist begins by positioning you on ...

  9. Computed Tomography (CT) -- Head

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    Full Text Available ... be viewed on a computer monitor, printed on film or transferred to a CD or DVD. CT ... distinguished from one another on an x-ray film or CT electronic image. In a conventional x- ...

  10. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... be viewed on a computer monitor, printed on film or transferred to a CD or DVD. CT ... distinguished from one another on an x-ray film or CT electronic image. In a conventional x- ...

  11. Abdominal and Pelvic CT

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    Full Text Available ... be viewed on a computer monitor, printed on film or transferred to a CD or DVD. CT ... distinguished from one another on an x-ray film or CT electronic image. In a conventional x- ...

  12. Computed Tomography (CT) -- Head

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    Full Text Available ... top of page What are the benefits vs. risks? Benefits CT scanning is painless, noninvasive and accurate. ... CT scans should have no immediate side effects. Risks There is always a slight chance of cancer ...

  13. Abdominal and Pelvic CT

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    Full Text Available ... top of page What are the benefits vs. risks? Benefits Viewing a CT scan, an experienced radiologist ... CT scans should have no immediate side effects. Risks There is always a slight chance of cancer ...

  14. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... top of page What are the benefits vs. risks? Benefits A CT scan is one of the ... CT scans should have no immediate side effects. Risks There is always a slight chance of cancer ...

  15. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, ... special pediatric considerations. The teddy bear denotes child-specific content. Related Articles and Media Magnetic Resonance Imaging ( ...

  16. Computed Tomography (CT) -- Head

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    Full Text Available ... scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, ... special pediatric considerations. The teddy bear denotes child-specific content. Related Articles and Media Radiation Dose in ...

  17. Abdominal and Pelvic CT

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    Full Text Available ... scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, ... special pediatric considerations. The teddy bear denotes child-specific content. Related Articles and Media Ultrasound - Abdomen X- ...

  18. Abdominal and Pelvic CT

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    Full Text Available ... CT scanning is fast, painless, noninvasive and accurate. In emergency cases, it can reveal internal injuries and ... generated during a CT scan can be reformatted in multiple planes, and can even generate three-dimensional ...

  19. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... to a CD or DVD. CT images of internal organs, bones, soft tissue and blood vessels provide ... clicking and whirring sounds as the CT scanner's internal parts, not usually visible to you, revolve around ...

  20. Abdominal and Pelvic CT

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    Full Text Available ... the cause of unexplained pain. CT scanning is fast, painless, noninvasive and accurate. In emergency cases, it ... additional view capabilities. Modern CT scanners are so fast that they can scan through large sections of ...

  1. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... which may be causing hearing problems. determine whether inflammation or other changes are present in the paranasal ... CT scans . CT is not sensitive in detecting inflammation of the meninges —the membranes covering the brain. ...

  2. Computed Tomography (CT) -- Head

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    Full Text Available ... a stroke. a stroke, especially with a new technique called Perfusion CT. brain tumors. enlarged brain cavities ( ... brain. assess aneurysms or arteriovenous malformations through a technique called CT angiography. For more information, see the ...

  3. Computed Tomography (CT) -- Head

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    Full Text Available ... view of the body's interior. Refinements in detector technology allow nearly all CT scanners to obtain multiple ... to urinate; however, this is actually a contrast effect and subsides quickly. When you enter the CT ...

  4. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... view of the body's interior. Refinements in detector technology allow nearly all CT scanners to obtain multiple ... to urinate; however, this is actually a contrast effect and subsides quickly. When you enter the CT ...

  5. Cardiac CT Scan

    Science.gov (United States)

    ... combine these pictures to create a three-dimensional (3D) model of the whole heart. This imaging test ... findings from earlier chest x rays. Different CT scanners are used for different purposes. A multidetector CT ...

  6. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... of the Head? What is CT Scanning of the Head? Computed tomography, more commonly known as a ... of page What are some common uses of the procedure? CT scanning of the head is typically ...

  7. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... the Sinuses? What is CT (Computed Tomography) of the Sinuses? Computed tomography, more commonly known as a ... of page What are some common uses of the procedure? CT of the sinuses is primarily used ...

  8. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... benefits vs. risks? Benefits A CT scan is one of the safest means of studying the sinuses. ... CT scanning provides very detailed images of many types of tissue as well as the lungs, bones, ...

  9. Gallstone ileus: CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Delabrousse, E.; Bartholomot, B.; Sohm, O.; Kastler, B. [Dept. of Radiology A, CHU Jean Minjoz, University of Besancon (France); Wallerand, H. [Dept. of Surgery, CHU Jean Minjoz, University of Besancon (France)

    2000-06-01

    Gallstone ileus is a rare complication of recurrent gallstone cholecystitis. The classic radiographic triad of small bowel obstruction, pneumobilia and ectopic gallstone on abdominal plain radiograph is described with CT imaging. Because of the better resolution of CT compared with abdominal radiography and its recent accession to emergency use, radiologists should be aware of CT findings of gallstone ileus. We report a case in which gallstone ileus was initially diagnosed by CT. (orig.)

  10. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... microphone. top of page How does the procedure work? In many ways CT scanning works very much like other x-ray examinations. Different ... scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, ...

  11. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... microphone. top of page How does the procedure work? In many ways CT scanning works very much like other x-ray examinations. Different ... scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, ...

  12. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... microphone. top of page How does the procedure work? In many ways CT scanning works very much like other x-ray examinations. Different ... scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, ...

  13. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... a sudden severe headache. a blood clot or bleeding within the brain shortly after a patient exhibits symptoms of a stroke. a ... CT scanning may eliminate the need for exploratory surgery and surgical biopsy. No radiation remains in a patient's body after a CT examination. X-rays used in CT ...

  14. CT angiography and CT perfusion in acute ischemic stroke

    NARCIS (Netherlands)

    Seeters, T. van

    2016-01-01

    CT angiography and CT perfusion are used in patients with acute ischemic stroke for diagnostic purposes and to select patients for treatment. In this thesis, the reproducibility of CT angiography and CT perfusion is examined, the additional value of CT angiography and CT perfusion for stroke outcome

  15. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Children's (Pediatric) CT (Computed Tomography) Pediatric computed tomography (CT) ... are the limitations of Children's CT? What is Children's CT? Computed tomography, more commonly known as a ...

  16. Tricistronic operon expression of the genes gcaD (tms), which encodes N-acetylglucosamine 1-phosphate uridyltransferase, prs, which encodes phosphoribosyl diphosphate synthetase, and ctc in vegetative cells of Bacillus subtilis

    DEFF Research Database (Denmark)

    Hilden, Ida; Krath, Britta N.; Hove-Jensen, Bjarne

    1995-01-01

    The gcaD, prs, and ctc genes were shown to be organized as a tricistronic operon. The transcription of the prs gene, measured as phosphoribosyl diphosphate synthetase activity, and of the ctc gene, measured as β-galactosidase activity specified by a ctc-lacZ protein fusion, were dependent...... on the promoter in front of the gcaD gene. Analysis of cDNA molecules prepared with gcaD-prs-ctc-specified mRNA as the template revealed an RNA transcript that encompassed all three cistrons....

  17. 一种新型集装箱堆场起重机--堆场吊%CTC - a New Type Yard Container Stacking Crane

    Institute of Scientific and Technical Information of China (English)

    王卫昌

    2015-01-01

    分析集装箱专用起重机和自动化码头堆场起重机的现状和缺陷,阐述一种颠覆性的堆场起重机———堆场吊,介绍其基本参数和性能。%By analyzing the situation and disadvantage of the container crane and yard crane on automatic wharf, this paper expounds a subversive yard container stacking crane-CTC and introduces its parameters and properties.

  18. Características da bacteriocina produzida por Lactococcus lactis ssp. hordniae CTC 484 e seu efeito sobre Listeria monocytogenes em carne bovina

    OpenAIRE

    Bromberg,Renata; Moreno,Izildinha; Delboni,Roberta R.; Cintra,Helen C.

    2006-01-01

    O isolamento de linhagens de bactérias lácticas produtoras de bacteriocinas em carnes e seus produtos derivados resultou na detecção de Lactococcus lactis ssp. hordniae CTC 484, proveniente de frango. A bacteriocina inibiu não apenas uma outra bactéria láctica (Lactobacillus helveticus), mas também microorganismos patogênicos (Staphylococcus aureus, Listeria monocytogenes, Bacillus cereus, Clostridium perfringens e Enterococcus faecalis). Ela foi inativada por causa de enzimas como: alfa-quim...

  19. Marketing cardiac CT programs.

    Science.gov (United States)

    Scott, Jason

    2010-01-01

    There are two components of cardiac CT discussed in this article: coronary artery calcium scoring (CACS) and coronary computed tomography angiography (CCTA).The distinctive advantages of each CT examination are outlined. In order to ensure a successful cardiac CT program, it is imperative that imaging facilities market their cardiac CT practices effectively in order to gain a competitive advantage in this valuable market share. If patients receive quality care by competent individuals, they are more likely to recommend the facility's cardiac CT program. Satisfied patients will also be more willing to come back for any further testing.

  20. Avaliação do desempenho da colonografia tomográfica computadorizada (colonoscopia virtual no diagnóstico de pólipos colorretais Evaluation of computed tomographic colonography for detection of colorectal polyps

    Directory of Open Access Journals (Sweden)

    Gustavo Kuhn Pfeifer

    2008-12-01

    Full Text Available RACIONAL: A colonografia tomográfica computadorizada tem sido proposta como teste substituto da colonoscopia para o diagnóstico de pólipos colorretais em programas de rastreamento de câncer de intestino grosso. OBJETIVO: Avaliar o desempenho da colonografia tomográfica computadorizada na detecção de pólipos colorretais, considerando a colonoscopia como padrão-ouro. MÉTODOS: Foram estudados 20 pacientes com alto risco para neoplasia colorretal (14 homens e 6 mulheres com idades médias de 55 e 59 anos, respectivamente. A colonografia tomográfica computadorizada foi realizada até 3 horas antes da colonoscopia. Um cateter com balão foi introduzido no reto com insuflação dos cólons e do reto com ar ambiente até que fosse obtida distensão satisfatória dos mesmos. Para otimizar a distensão colônica, minimizar artefatos decorrentes da peristalse e diminuir o espasmo, foram administrados 20 mg de hioscina intravenosa imediatamente antes do exame radiológico. RESULTADOS: A imagem radiológica do cólon foi considerada de qualidade satisfatória em todos os casos. A colonoscopia detectou o total de 85 pólipos em 19 dos 20 pacientes (95%. Todos os pólipos observados foram removidos e encaminhados para exame anatomopatológico. A colonografia tomográfica computadorizada identificou 8 dos 10 pólipos com diâmetros > 10 mm (80%, 2 dos 19 com diâmetro entre 5 e 9 mm (18,2%, e apenas 1 dos 53 5 mm. Destes, 8 (47% foram corretamente identificados pela colonografia tomográfica computadorizada. Nenhuma das neoplasias com diâmetros BACKGROUND: Computed tomographic colonography has been proposed for detection of colorectal polyps instead of colonoscopy in colorectal cancer screening programs. AIM: To evaluate the performance of computed tomographic colonography in the detection of colorectal polyps with colonoscopy used as the gold standard. METHODS: We prospectively studied 20 patients at high risk for colorectal neoplasia (14 men and 6

  1. Circulating Tumor Cells (CTC) and Cell-Free DNA (cfDNA) Workshop 2016: Scientific Opportunities and Logistics for Cancer Clinical Trial Incorporation.

    Science.gov (United States)

    Lowes, Lori E; Bratman, Scott V; Dittamore, Ryan; Done, Susan; Kelley, Shana O; Mai, Sabine; Morin, Ryan D; Wyatt, Alexander W; Allan, Alison L

    2016-09-08

    Despite the identification of circulating tumor cells (CTCs) and cell-free DNA (cfDNA) as potential blood-based biomarkers capable of providing prognostic and predictive information in cancer, they have not been incorporated into routine clinical practice. This resistance is due in part to technological limitations hampering CTC and cfDNA analysis, as well as a limited understanding of precisely how to interpret emergent biomarkers across various disease stages and tumor types. In recognition of these challenges, a group of researchers and clinicians focused on blood-based biomarker development met at the Canadian Cancer Trials Group (CCTG) Spring Meeting in Toronto, Canada on 29 April 2016 for a workshop discussing novel CTC/cfDNA technologies, interpretation of data obtained from CTCs versus cfDNA, challenges regarding disease evolution and heterogeneity, and logistical considerations for incorporation of CTCs/cfDNA into clinical trials, and ultimately into routine clinical use. The objectives of this workshop included discussion of the current barriers to clinical implementation and recent progress made in the field, as well as fueling meaningful collaborations and partnerships between researchers and clinicians. We anticipate that the considerations highlighted at this workshop will lead to advances in both basic and translational research and will ultimately impact patient management strategies and patient outcomes.

  2. The kinetics of the arginine deiminase pathway in the meat starter culture Lactobacillus sakei CTC 494 are pH-dependent.

    Science.gov (United States)

    Rimaux, T; Vrancken, G; Pothakos, V; Maes, D; De Vuyst, L; Leroy, F

    2011-05-01

    Lactobacillus sakei is frequently present as the dominant lactic acid bacterium in spontaneously fermented meat products, demonstrating its competitiveness in and adaptation to the meat environment. Since meat is generally low in carbohydrate content, the ability to utilize other energy sources to generate ATP, such as arginine via the arginine deiminase (ADI) pathway, represents a competitive benefit. In this study, the kinetics of growth and arginine conversion capabilities of Lb. sakei CTC 494 were analyzed, and a model was set up to describe the influence of pH on growth and arginine conversion. A series of in vitro batch fermentations using reconstituted MRS medium at different constant pH values (pH 4.50-pH 7.75) was performed. Arginine conversion through the ADI pathway, which was activated from the stationary growth phase on, resulted in the production of both citrulline and ornithine for all pH conditions tested. However, the pattern and the ratio of the end-products of the ADI pathway were influenced by pH. For certain pH values (between pH 5.0 and 6.5), a further conversion of citrulline into ornithine was found when all arginine was depleted. Characterization of responses of the ADI pathway in Lb. sakei CTC 494 to environmental conditions will allow a better understanding and control of this important starter culture in meat fermentations.

  3. Virtual colonoscopy

    Science.gov (United States)

    Colonoscopy - virtual; CT colonography; Computed tomographic colonography; Colography - virtual ... Differences between virtual and conventional colonoscopy include: VC can view the colon from many different angles. This is not as easy ...

  4. PET/CT Artifacts

    OpenAIRE

    Blodgett, Todd M.; Mehta, Ajeet S.; Mehta, Amar S.; Laymon, Charles M; Carney, Jonathan; Townsend, David W.

    2011-01-01

    There are several artifacts encountered in PET/CT imaging, including attenuation correction (AC) artifacts associated with using CT for attenuation correction. Several artifacts can mimic a 2-deoxy-2-[18F] fluoro-D-glucose (FDG) avid malignant lesions and therefore recognition of these artifacts is clinically relevant. Our goal was to identify and characterize these artifacts and also discuss some protocol variables that may affect image quality in PET/CT.

  5. TCC系统与CTC系统的接口仿真研究%Study on Interface Simulation Between TCC and CTC

    Institute of Scientific and Technical Information of China (English)

    林海香

    2013-01-01

    高速铁路列控中心(TCC,train control center system)子系统作为安全系统,其与非安全系统调度集中(CTC,centralized traffic control)系统的接口是影响高速铁路安全高效运营的关键接口.结合TCC系统的特点和CTC系统对通道的要求,对该接口进行软、硬件仿真,给出了报文交换过程,并对接口通信故障处理进行了说明.实验结果表明,对这种安全系统与非安全系统的接口,因其仅进行信息交互,采用串行接口是方便可行的.同时,硬件上采用交叉连接冗余配置,保证可靠连接;软件上采用查询方式通信,可以实现较好的接口通信效果.%As a safety-criteria computer system,high-speed railway TCC(train control center) system has an interface with the CTC(centralized traffic control) system that is nonsafety-criteria computer system,which can affect the safe and efficient operation of the high-speed railway.According to the characteristics of high-speed railway TCC and the communication channel standard of CTC,this kind of interface is simulated in hardware and software,while its message-exchange process is presented,and its communication fault processing is explained.The experimental result shows that it is convenient and feasible to adopt serial interface only for information exchange.And if the hardware interface adopts the cross-connect redundant configuration and the software design uses query communication,it can achieve better communication effect.

  6. CT of Gastric Emergencies.

    Science.gov (United States)

    Guniganti, Preethi; Bradenham, Courtney H; Raptis, Constantine; Menias, Christine O; Mellnick, Vincent M

    2015-01-01

    Abdominal pain, nausea, and vomiting are common presenting symptoms among adult patients seeking care in the emergency department, and, with the increased use of computed tomography (CT) to image patients with these complaints, radiologists will more frequently encounter a variety of emergent gastric pathologic conditions on CT studies. Familiarity with the CT appearance of emergent gastric conditions is important, as the clinical presentation is often nonspecific and the radiologist may be the first to recognize gastric disease as the cause of a patient's symptoms. Although endoscopy and barium fluoroscopy remain important tools for evaluating patients with suspected gastric disease in the outpatient setting, compared with CT these modalities enable less comprehensive evaluation of patients with nonspecific complaints and are less readily available in the acute setting. Endoscopy is also more invasive than CT and has greater potential risks. Although the mucosal detail of CT is relatively poor compared with barium fluoroscopy or endoscopy, CT can be used with the appropriate imaging protocols to identify inflammatory conditions of the stomach ranging from gastritis to peptic ulcer disease. In addition, CT can readily demonstrate the various complications of gastric disease, including perforation, obstruction, and hemorrhage, which may direct further clinical, endoscopic, or surgical management. We will review the normal anatomy of the stomach and discuss emergent gastric disease with a focus on the usual clinical presentation, typical imaging appearance, and differentiating features, as well as potential imaging pitfalls.

  7. Computed Tomography (CT) -- Head

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    Full Text Available ... images or pictures of the inside of the body. The cross-sectional images generated during a CT scan can be reformatted ... of data to create two-dimensional cross-sectional images of your body, which are then displayed on a monitor. CT ...

  8. Abdominal and Pelvic CT

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    Full Text Available ... images or pictures of the inside of the body. The cross-sectional images generated during a CT scan can be reformatted ... of data to create two-dimensional cross-sectional images of your body, which are then displayed on a monitor. CT ...

  9. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... images or pictures of the inside of the body. The cross-sectional images generated during a CT scan can be reformatted ... of data to create two-dimensional cross-sectional images of your body, which are then displayed on a monitor. CT ...

  10. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... the best way to see if treatment is working or if a finding is stable or changed over time. top of page What are the benefits vs. risks? Benefits A CT scan is one of the safest means of studying the sinuses. CT is the most reliable imaging ...

  11. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... you have a hard time staying still, are claustrophobic or have chronic pain, you may find a CT exam to be stressful. The technologist or nurse, under the direction of a physician, may offer you some medication to help you tolerate the CT scanning procedure. If an ...

  12. Computed Tomography (CT) -- Head

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    Full Text Available ... you have a hard time staying still, are claustrophobic or have chronic pain, you may find a CT exam to be stressful. The technologist or nurse, under the direction of a physician, may offer you some medication to help you tolerate the CT scanning procedure. If an ...

  13. Computed Tomography (CT) -- Head

    Science.gov (United States)

    ... of a stroke. a stroke, especially with a new technique called Perfusion CT. brain tumors. enlarged brain ... be asked to remove hearing aids and removable dental work. Women will be asked to remove bras ... does the equipment look like? The CT scanner is typically a ...

  14. CT of tracheal agenesis

    Energy Technology Data Exchange (ETDEWEB)

    Strouse, Peter J.; Hernandez, Ramiro J. [C.S. Mott Children' s Hospital, Department of Radiology, Ann Arbor, MI (United States); Newman, Beverley [Children' s Hospital of Pittsburgh, PA (United States). Department of Pediatric Radiology; Afshani, Ehsan [Children' s Hospital of Buffalo, NY (United States). Departments of Radiology and Pediatrics; Bommaraju, Mahesh [Women' s and Children' s Hospital of Buffalo, Division of Neonatology, University Pediatrics Associates, Buffalo, NY (United States)

    2006-09-15

    Tracheal agenesis is a rare and usually lethal anomaly. In the past, opaque contrast medium was injected via the esophagus to demonstrate the anatomy. To demonstrate the utility of helical and multidetector CT in delineating the aberrant anatomy in newborns with tracheal agenesis. Four newborns with tracheal agenesis were identified from three institutions. Imaging studies and medical records were reviewed. Each child was imaged with chest radiography. One child was imaged on a single-detector helical CT scanner and the other three on multidetector scanners. Helical and multidetector CT with 2D and 3D reconstructions clearly delineated the aberrant tracheobronchial and esophageal anatomy in each infant. Minimum intensity projection reformatted CT images were particularly helpful. One infant each had type I and type II tracheal agenesis. Two infants had type III tracheal agenesis. All four infants died. CT is a useful tool for delineating the aberrant anatomy of newborns with tracheal agenesis and thus helps in making rational clinical decisions. (orig.)

  15. Children's (Pediatric) CT (Computed Tomography)

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    Full Text Available ... CT is less sensitive to patient movement than MRI. CT can be performed if you have an implanted medical device of any kind, unlike MRI. CT imaging provides real-time imaging, making it ...

  16. Children's (Pediatric) CT (Computed Tomography)

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    Full Text Available ... Physician Resources Professions Site Index A-Z Children's (Pediatric) CT (Computed Tomography) Pediatric computed tomography (CT) is ... a CT scan. View full size with caption Pediatric Content Some imaging tests and treatments have special ...

  17. Children's (Pediatric) CT (Computed Tomography)

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    Full Text Available ... of page What are some common uses of the procedure? CT is used to help diagnose a ... the CT examination. top of page What does the equipment look like? The CT scanner is typically ...

  18. Children's (Pediatric) CT (Computed Tomography)

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Children's (Pediatric) CT (Computed Tomography) Pediatric computed tomography (CT) is ... a CT scan. View full size with caption Pediatric Content Some imaging tests and treatments have special ...

  19. Children's (Pediatric) CT (Computed Tomography)

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    Full Text Available ... scanner. top of page How does the procedure work? In many ways, CT scanning is like other ... scanners to obtain multiple slices in a single rotation. These scanners, called "multislice CT" or "multidetector CT," ...

  20. CTcP市场商机涌动——访Punch集团贝斯印公司副总裁Wim Deblauwe先生

    Institute of Scientific and Technical Information of China (English)

    晓筠

    2005-01-01

    Punch集团继2002年4月收购了Xeikon以后,又在2004年7月收购了贝斯印,在业内引起不小反响。经过此次重组.贝斯印的CTcP技术与Punch集团下Strobbe公司的CTP技术形成一种互补。同时,重组也给贝斯印公司注入了新鲜的血液,令贝斯印能够有更充足的资金投入新技术、新产品的研发,并进一步拓展国际市场,寻求更宽广的市场空间。

  1. Dark-lumen MR colonography with fecal tagging: a comparison of water enema and air methods of colonic distension for detecting colonic neoplasms

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez Gomez, Sonia; Pages Llinas, Mario; Juan Garcia, Carmen de; Rimola Gibert, Jordi; Ayuso Colella, Juan R.; Ayuso Colella, Carmen [Hospital Clinico of Barcelona, Department of Radiology, Barcelona (Spain); Castells Garangou, Antoni; Bordas Alsina, Josep M. [Hospital Clinico of Barcelona, Department of Gastroenterology, Barcelona (Spain)

    2008-07-15

    The purpose was to evaluate MR colonography (MRC) with barium fecal tagging in detecting colorectal pathology and to determine how air-based and water-based colonic distension influences MRC. We studied 83 patients with high risk of colonic neoplasms. All received oral barium sulfate for colonic preparation before unenhanced and enhanced T1-weighted gradient-echo MRC using either water (n=54) or air (n=29) for colonic distension. Fecal tagging, distension, and artifacts were recorded. All patients underwent conventional colonoscopy within 2 weeks of MRC; the techniques were compared for detection of malignant neoplasms and polyps {>=}1 cm, 6-9 mm, and {<=}5 mm. Fecal tagging was ''good'' in 76% of the colonic segments in water-distended patients and 46% of air-distended patients. The degree of distension was ''good'' in 90.7% of water-distended patients and 44% of air-distended patients. Severe artifacts were present in 15% air-distended patients and 0.3% of water-distended patients. Both water-distended and air-distended MRC detected all malignant neoplasms and polyps {>=}1 cm, but more air-distended MRC were excluded for poor quality. MRC with fecal tagging is useful for detecting lesions {>=}1 cm. Air distension was inferior to water distension in most aspects. Water-based colonic distension should be used for barium-tagging MRC. (orig.)

  2. Características da bacteriocina produzida por Lactococcus lactis ssp. hordniae CTC 484 e seu efeito sobre Listeria monocytogenes em carne bovina Characterisation of the bacteriocin produced by Lactococcus lactis ssp. hordniae CTC 484 and the effect of this compound on Listeria monocytogenes in beef

    Directory of Open Access Journals (Sweden)

    Renata Bromberg

    2006-03-01

    Full Text Available O isolamento de linhagens de bactérias lácticas produtoras de bacteriocinas em carnes e seus produtos derivados resultou na detecção de Lactococcus lactis ssp. hordniae CTC 484, proveniente de frango. A bacteriocina inibiu não apenas uma outra bactéria láctica (Lactobacillus helveticus, mas também microorganismos patogênicos (Staphylococcus aureus, Listeria monocytogenes, Bacillus cereus, Clostridium perfringens e Enterococcus faecalis. Ela foi inativada por causa de enzimas como: alfa-quimotripsina, tripsina, pronase E, ficina, pepsina, papaína e lipase. Além disso, a bacteriocina mostrou-se termoestável, mesmo a temperaturas de autoclavagem (121°C/10 min e foi produzida em condições de armazenamento sob refrigeração. A bacteriocina mostrou-se ativa dentro de uma ampla faixa de valores de pH (2-10, porém a maior atividade ocorreu em valores menores de pH. A eficiência da linhagem CTC 484, assim como a de sua bacteriocina na redução e inibição do crescimento de Listeria monocytogenes em carne bovina estéril, foram avaliadas. Os resultados indicaram que o tratamento da carne por meio da inoculação desta bactéria contribuiu para o aumento da segurança e extensão da vida útil deste alimento.Screening for the bacteriocin production of strains of lactic acid bacteria from various meat and meat products resulted in the detection of a bacteriocin-producing Lactococcus lactis ssp. hordniae CTC 484, isolated from chicken. The bacteriocin inhibited not only closely related lactic acid bacterium (Lactobacillus helveticus, but also pathogenic microorganisms (Staphylococcus aureus, Listeria monocytogenes, Bacillus cereus, Clostridium perfringens, and Enterococcus faecalis. This compound was inactivated by alpha-chymotrypsin, trypsin, pronase E, ficin, pepsin, papain, and also by lipase. It was heat stable even at autoclaving temperature (121°C/10 min and was produced under refrigerated storage. It was also active over a wide

  3. CT scan of choristoma

    Energy Technology Data Exchange (ETDEWEB)

    Moriki, A.; Morimoto, M.; Sada, Y.; Kurisaka, M.; Mori, K.

    1987-02-01

    Choristoma is a rare tumor that occurs in the pituitary gland. The case presented here is a 44-year-old male. A plain CT scan demonstrated a slight high-density mass near the posterior clinoid of the sella turcica, while a moderate and homogeneous enhancing effect and a clear borderline were shown by an enhanced CT scan. A cornal CT scan study showed that the tumor extended from the intrasellar to the suprasellar region. The diagnosis of choristoma was made by means of histology.

  4. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... is done because a potential abnormality needs further evaluation with additional views or a special imaging technique. ... need for exploratory surgery and surgical biopsy. No radiation remains in a patient's body after a CT ...

  5. Computed Tomography (CT) -- Head

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    Full Text Available ... is done because a potential abnormality needs further evaluation with additional views or a special imaging technique. ... need for exploratory surgery and surgical biopsy. No radiation remains in a patient's body after a CT ...

  6. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... view of the body's interior. Refinements in detector technology allow nearly all CT scanners to obtain multiple ... for guiding minimally invasive procedures such as needle biopsies and needle aspirations of many areas of the ...

  7. Computed Tomography (CT) -- Head

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    Full Text Available ... view of the body's interior. Refinements in detector technology allow nearly all CT scanners to obtain multiple ... eliminate the need for exploratory surgery and surgical biopsy. No radiation remains in a patient's body after ...

  8. Abdominal and Pelvic CT

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    Full Text Available ... view of the body's interior. Refinements in detector technology allow nearly all CT scanners to obtain multiple ... for guiding minimally invasive procedures such as needle biopsies and needle aspirations of many areas of the ...

  9. Abdominal and Pelvic CT

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    Full Text Available ... CT scanning procedure. For exams (excluding head and neck) your head will remain outside the hole in ... type your comment or suggestion into the following text box: Comment: E-mail: Area code: Phone no: ...

  10. Abdominal and Pelvic CT

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    Full Text Available ... liver, shows up in shades of gray, and air appears black. With CT scanning, numerous x-ray ... injected into a vein) to help evaluate blood vessels and organs such as the liver, kidneys and ...

  11. Computed Tomography (CT) -- Head

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    Full Text Available ... liver, shows up in shades of gray, and air appears black. With CT scanning, numerous x-ray ... ability to image bone, soft tissue and blood vessels all at the same time. Unlike conventional x- ...

  12. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... is painless, noninvasive and accurate. It’s also the most reliable imaging technique for determining if the sinuses ... CT scan of the sinuses, the patient is most commonly positioned lying flat on the back. The ...

  13. CT Angiography (CTA)

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    ... during the procedure. Metal objects, including jewelry, eyeglasses, dentures and hairpins, may affect the CT images and ... of the procedure, you may be asked to complete a questionnaire to ensure your safety during this ...

  14. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... visibility of certain tissues or blood vessels. A nurse or technologist will insert an intravenous (IV) line ... CT exam to be stressful. The technologist or nurse, under the direction of a physician, may offer ...

  15. Abdominal and Pelvic CT

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    Full Text Available ... CT exam to be stressful. The technologist or nurse, under the direction of a physician, may offer ... to you, revolve around you during the imaging process. You will be alone in the exam room ...

  16. Computed Tomography (CT) -- Head

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    Full Text Available ... CT exam to be stressful. The technologist or nurse, under the direction of a physician, may offer ... to you, revolve around you during the imaging process. You will be alone in the exam room ...

  17. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... The teddy bear denotes child-specific content. Related Articles and Media Magnetic Resonance Imaging (MRI) - Head Head and Neck Cancer Treatment Radiation Dose in X-Ray and CT ...

  18. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... time staying still, are claustrophobic or have chronic pain, you may find a CT exam to be stressful. The technologist or nurse, under the direction of a physician, may offer ...

  19. Computed Tomography (CT) -- Head

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    Full Text Available ... time staying still, are claustrophobic or have chronic pain, you may find a CT exam to be stressful. The technologist or nurse, under the direction of a physician, may offer ...

  20. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... Magnetic Resonance Imaging (MRI) - Head Head and Neck Cancer Treatment Radiation Dose in X-Ray and CT Exams Contrast Materials Head and Neck Cancer X-ray, Interventional Radiology and Nuclear Medicine Radiation ...

  1. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... hours prior to your exam. Leave jewelry at home and wear loose, comfortable clothing. You may be ... the CT images and should be left at home or removed prior to your exam. You may ...

  2. Computed Tomography (CT) -- Head

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    Full Text Available ... hours prior to your exam. Leave jewelry at home and wear loose, comfortable clothing. You may be ... the CT images and should be left at home or removed prior to your exam. You may ...

  3. Abdominal and Pelvic CT

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    Full Text Available ... hours prior to your exam. Leave jewelry at home and wear loose, comfortable clothing. You may be ... the CT images and should be left at home or removed prior to your exam. You may ...

  4. Abdominal and Pelvic CT

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    Full Text Available ... liver, shows up in shades of gray, and air appears black. With CT scanning, numerous x-ray ... cause blurring of the images and degrade the quality of the examination the same way that it ...

  5. Computed Tomography (CT) -- Head

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    Full Text Available ... liver, shows up in shades of gray, and air appears black. With CT scanning, numerous x-ray ... cause blurring of the images and degrade the quality of the examination the same way that it ...

  6. Abdominal and Pelvic CT

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    Full Text Available ... tomography (CT) scan View full size with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy bear denotes child-specific content. ...

  7. Computed Tomography (CT) -- Head

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    Full Text Available ... tomography (CT) scan. View full size with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy bear denotes child-specific content. ...

  8. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... tomography (CT) scan. View full size with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy bear denotes child-specific content. ...

  9. Abdominal and Pelvic CT

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    Full Text Available ... Abdomen and Pelvis? What is CT Scanning of the Abdomen/Pelvis? Computed tomography, more commonly known as ... of page What are some common uses of the procedure? This procedure is typically used to help ...

  10. Abdominal and Pelvic CT

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    Full Text Available ... your exam. You should inform your physician of all medications you are taking and if you have ... body's interior. Refinements in detector technology allow nearly all CT scanners to obtain multiple slices in a ...

  11. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... your exam. You should inform your physician of all medications you are taking and if you have ... body's interior. Refinements in detector technology allow nearly all CT scanners to obtain multiple slices in a ...

  12. Computed Tomography (CT) -- Head

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    Full Text Available ... your exam. You should inform your physician of all medications you are taking and if you have ... body's interior. Refinements in detector technology allow nearly all CT scanners to obtain multiple slices in a ...

  13. Abdominal and Pelvic CT

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    Full Text Available ... or thyroid problems. Any of these conditions may increase the risk of an unusual adverse effect. Women ... view of the body's interior. Refinements in detector technology allow nearly all CT scanners to obtain multiple ...

  14. Computed Tomography (CT) -- Head

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    Full Text Available ... or thyroid problems. Any of these conditions may increase the risk of an unusual adverse effect. The ... view of the body's interior. Refinements in detector technology allow nearly all CT scanners to obtain multiple ...

  15. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... or thyroid problems. Any of these conditions may increase the risk of an unusual adverse effect. Women ... view of the body's interior. Refinements in detector technology allow nearly all CT scanners to obtain multiple ...

  16. Computed Tomography (CT) -- Head

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    Full Text Available ... additional view capabilities. Modern CT scanners are so fast that they can scan through large sections of ... remain still during the exam. Many scanners are fast enough that children can be scanned without sedation. ...

  17. Pediatric CT Scans

    Science.gov (United States)

    The Radiation Epidemiology Branch and collaborators have initiated a retrospective cohort study to evaluate the relationship between radiation exposure from CT scans conducted during childhood and adolescence and the subsequent development of cancer.

  18. Abdominal and Pelvic CT

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    Full Text Available ... or liver cirrhosis. cancers of the liver, kidneys, pancreas, ovaries and bladder as well as lymphoma. kidney ... and organs such as the liver, kidneys and pancreas. When you enter the CT scanner, special light ...

  19. Abdominal and Pelvic CT

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    Full Text Available ... an image on a special electronic image recording plate. Bones appear white on the x-ray; soft ... which are then displayed on a monitor. CT imaging is sometimes compared to looking into a loaf ...

  20. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... an image on a special electronic image recording plate. Bones appear white on the x-ray; soft ... which are then displayed on a monitor. CT imaging is sometimes compared to looking into a loaf ...

  1. Computed Tomography (CT) -- Head

    Science.gov (United States)

    ... an image on a special electronic image recording plate. Bones appear white on the x-ray; soft ... which are then displayed on a monitor. CT imaging is sometimes compared to looking into a loaf ...

  2. Computed Tomography (CT) -- Head

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    Full Text Available ... an image on a special electronic image recording plate. Bones appear white on the x-ray; soft ... which are then displayed on a monitor. CT imaging is sometimes compared to looking into a loaf ...

  3. Abdominal and Pelvic CT

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    ... an image on a special electronic image recording plate. Bones appear white on the x-ray; soft ... which are then displayed on a monitor. CT imaging is sometimes compared to looking into a loaf ...

  4. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... many types of tissue as well as the lungs, bones, and blood vessels. CT examinations are fast ... of many areas of the body, particularly the lungs, abdomen, pelvis and bones. A diagnosis determined by ...

  5. Abdominal and Pelvic CT

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    Full Text Available ... many types of tissue as well as the lungs, bones, and blood vessels. CT examinations are fast ... of many areas of the body, particularly the lungs, abdomen, pelvis and bones. A diagnosis determined by ...

  6. Abdominal and Pelvic CT

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    Full Text Available ... to arriving. top of page What will I experience during and after the procedure? CT exams are ... at most a minute or two. You may experience a sensation like you have to urinate; however, ...

  7. Computed Tomography (CT) -- Head

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    Full Text Available ... 10 minutes. top of page What will I experience during and after the procedure? CT exams are ... at most a minute or two. You may experience a sensation like you have to urinate; however, ...

  8. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... 10 minutes. top of page What will I experience during and after the procedure? CT exams are ... at most a minute or two. You may experience a sensation like you have to urinate; however, ...

  9. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... cavity. CT scanning is painless, noninvasive and accurate. It’s also the most reliable imaging technique for determining ... parts absorb the x-rays in varying degrees. It is this crucial difference in absorption that allows ...

  10. Computed Tomography (CT) -- Head

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    Full Text Available ... See the Safety page for more information about pregnancy and x-rays. top of page What does ... See the Safety page for more information about pregnancy and x-rays. CT scanning is, in general, ...

  11. Abdominal and Pelvic CT

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    Full Text Available ... See the Safety page for more information about pregnancy and x-rays. top of page What does ... See the Safety page for more information about pregnancy and x-rays. CT scanning is, in general, ...

  12. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... See the Safety page for more information about pregnancy and x-rays. top of page What does ... See the Safety page for more information about pregnancy and x-rays. CT scanning is, in general, ...

  13. Abdominal and Pelvic CT

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    Full Text Available ... Radiation Therapy for Bladder Cancer Radiation Therapy for Colorectal Cancer top of page This page was reviewed on ... GI Tract X-ray (Radiography) - Upper GI Tract Colorectal Cancer Images related to Computed Tomography (CT) - Abdomen and ...

  14. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... rays used in CT scans should have no immediate side effects. Risks There is always a slight ... possible charges you will incur. Web page review process: This Web page is reviewed regularly by a ...

  15. Computed Tomography (CT) -- Head

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    Full Text Available ... rays used in CT scans should have no immediate side effects. Risks There is always a slight ... possible charges you will incur. Web page review process: This Web page is reviewed regularly by a ...

  16. Abdominal and Pelvic CT

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    Full Text Available ... rays used in CT scans should have no immediate side effects. Risks There is always a slight ... possible charges you will incur. Web page review process: This Web page is reviewed regularly by a ...

  17. Computed Tomography (CT) -- Head

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    Full Text Available ... traditional x-rays, particularly of soft tissues and blood vessels. CT scanning provides more detailed information on head injuries, stroke , brain tumors and other brain diseases than ...

  18. Abdominal and Pelvic CT

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    Full Text Available ... tissue as well as the lungs, bones, and blood vessels. CT examinations are fast and simple; in emergency cases, they can reveal internal injuries and bleeding quickly enough to help save lives. ...

  19. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... tissue as well as the lungs, bones, and blood vessels. CT examinations are fast and simple; in emergency cases, they can reveal internal injuries and bleeding quickly enough to help save lives. ...

  20. Abdominal and Pelvic CT

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    Full Text Available ... during the procedure. Metal objects, including jewelry, eyeglasses, dentures and hairpins, may affect the CT images and ... may increase the risk of an unusual adverse effect. Women should always inform their physician and the ...

  1. Computed Tomography (CT) -- Head

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    Full Text Available ... during the procedure. Metal objects, including jewelry, eyeglasses, dentures and hairpins, may affect the CT images and ... may increase the risk of an unusual adverse effect. The radiologist also should know if you have ...

  2. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... during the procedure. Metal objects, including jewelry, eyeglasses, dentures and hairpins, may affect the CT images and ... may increase the risk of an unusual adverse effect. Women should always inform their physician and the ...

  3. Computed Tomography (CT) -- Head

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    Full Text Available ... is reduced. Though the scanning itself causes no pain, there may be some discomfort from having to ... time staying still, are claustrophobic or have chronic pain, you may find a CT exam to be ...

  4. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... is reduced. Though the scanning itself causes no pain, there may be some discomfort from having to ... time staying still, are claustrophobic or have chronic pain, you may find a CT exam to be ...

  5. Abdominal and Pelvic CT

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    Full Text Available ... often used to determine the cause of unexplained pain. CT scanning is fast, painless, noninvasive and accurate. ... help diagnose the cause of abdominal or pelvic pain and diseases of the internal organs, small bowel ...

  6. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... generated during a CT scan can be reformatted in multiple planes, and can even generate three-dimensional ... hours beforehand, as contrast material will be used in your exam. You should inform your physician of ...

  7. Computed Tomography (CT) -- Head

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    Full Text Available ... or to plan radiation therapy for brain cancer. In emergency cases, it can reveal internal injuries and ... generated during a CT scan can be reformatted in multiple planes, and can even generate three-dimensional ...

  8. Computed Tomography (CT) -- Head

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    Full Text Available ... tomography, more commonly known as a CT or CAT scan, is a diagnostic medical test that, like ... contrast materials and a metallic taste in your mouth that lasts for at most a minute or ...

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    Full Text Available ... When the image slices are reassembled by computer software, the result is a very detailed multidimensional view of the body's interior. Refinements in detector technology allow nearly all CT scanners to obtain multiple ...

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  2. CT head in children

    Energy Technology Data Exchange (ETDEWEB)

    Rao, Padma, E-mail: padma.rao@rch.org.au [Royal Children' s Hospital and the University of Melbourne, Medical Imaging Department, Flemington Road, Parkville, Melbourne, Victoria 3052 (Australia); Bekhit, Elhamy, E-mail: elhamy.bekhit@rch.org.au [Royal Children' s Hospital and the University of Melbourne, Medical Imaging Department, Flemington Road, Parkville, Melbourne, Victoria 3052 (Australia); Ramanauskas, Fiona, E-mail: fiona.ramanauskas@rch.org.au [Royal Children' s Hospital and the University of Melbourne, Medical Imaging Department, Flemington Road, Parkville, Melbourne, Victoria 3052 (Australia); Kumbla, Surekha, E-mail: surekha.kumbla@rch.org.au [Royal Children' s Hospital and the University of Melbourne, Medical Imaging Department, Flemington Road, Parkville, Melbourne, Victoria 3052 (Australia)

    2013-07-15

    The advances in computerized technology (CT) technique over the last few decades have greatly modified imaging protocols in children. The range of pathologies that can now be demonstrated has broadened with the advent of newer techniques such as CT perfusion and the ability to perform complex reconstructions. Increasing speed of scanning and reduction in scan time have influenced the need for sedation and general anaesthetic as well as impacting on motion artefact. Additionally, concerns about radiation safety and avoidance of unnecessary radiation have further impacted on the inclusion of CT in the imaging armamentarium. Justification and image optimisation are essential. It is important to familiarize oneself with the appearances of normal variants or age related developmental changes. CT does however remain an appropriate investigation in a number of conditions.

  3. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... modality for sinusitis. CT of the sinuses is now widely available and is performed in a relatively short time, especially when compared to magnetic resonance imaging (MRI). ...

  4. Lumbosacral spine CT

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    ... More Broken bone CT scan Cyst Herniated disk Osteoarthritis Osteomalacia Tumor Review Date 9/8/2014 Updated by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, ...

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  8. Chest CT Scan

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    ... can combine these pictures to create three-dimensional (3D) models to help show the size, shape, and ... a medical imaging facility or hospital. The CT scanner is a large, tunnel-like machine that has ...

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