European Radiology

, Volume 16, Issue 1, pp 68–72 | Cite as

CT colonography: comparison of a colon dissection display versus 3D endoluminal view for the detection of polyps

  • Markus S. Juchems
  • Thorsten R. Fleiter
  • Sandra Pauls
  • Stefan A. Schmidt
  • Hans-Jürgen Brambs
  • Andrik J. Aschoff


The purpose of this study was to compare sensitivity, specificity, and postprocessing time of a colon dissection approach to regular 3D-endoluminal workup of computed tomography (CT) colonography for the detection of polypoid lesions. Twenty-one patients who had received conventional colonoscopy after CT colonography were selected; 18 patients had either colon polyps or colon cancer and three had no findings. CT colonography was performed using a 4-channel multi-detector-row (MDR) CT in ten cases and a 16-channel MDR-CT in 11 cases. A blinded reader retrospectively evaluated all colonographies using both viewing methods in a randomized order. Thirty-seven polyps were identified by optical colonoscopy. An overall per-lesion sensitivity of 47.1% for lesions smaller than 5 mm, 56.3% for lesions between 5 mm and 10 mm, and 75.0% for lesion larger than 10 mm was calculated using the colon dissection approach. This compared to an overall per-lesion sensitivity of 35.3% (<5 mm), 81.5% (5–10 mm), and 100.0% (>10 mm) using the endoluminal view. The average time consumption for CT colonography evaluation with the colon dissection software was 10 min versus 38 min using the endoluminal view. A colon dissection approach may provide a significant time advantage for evaluation of CT colonography while obtaining a high sensitivity. It is especially superior in the detection of lesions smaller than 5 mm.


Colon CT Computed tomography (CT) Colonoscopy 


  1. 1.
    Vining D, Shifrin R, Grishaw E (1994) Virtual colonoscopy. Radiology 193:446Google Scholar
  2. 2.
    Karadi C, Beaulieu CF, Jeffrey RB Jr, Paik DS, Napel S (1999) Display modes for CT colonography. Part I. Synthesis and insertion of polyps into patient CT data. Radiology 212:195–201PubMedGoogle Scholar
  3. 3.
    Beaulieu CF, Jeffrey RB Jr, Karadi C, Paik DS, Napel S (1999) Display modes for CT colonography. Part II. Blinded comparison of axial CT and virtual endoscopic and panoramic endoscopic volume-rendered studies. Radiology 212:203–212PubMedGoogle Scholar
  4. 4.
    Hoppe H, Quattropani C, Spreng A, Mattich J, Netzer P, Dinkel HP (2004) Virtual colon dissection with CT colonography compared with axial interpretation and conventional colonoscopy: preliminary results. Am J Roentgenol 182:1151–1158Google Scholar
  5. 5.
    Bruzzi JF, Moss AC, Brennan DD, MacMathuna P, Fenlon HM (2004) Colonic surveillance by CT colonography using axial images only. Eur Radiol 14(5):763–767. Epub 2004 Feb 19CrossRefPubMedGoogle Scholar
  6. 6.
    Pickhardt PJ (2003) Three-dimensional endoluminal CT colonography (virtual colonoscopy): comparison of three commercially available systems. Am J Roentgenol 181:1599–1606Google Scholar
  7. 7.
    Vos FM, van Gelder RE, Serlie IW, Florie J, Nio CY, Glas AS et al (2003) Three-dimensional display modes for CT colonography: conventional 3D virtual colonoscopy versus unfolded cube projection. Radiology 228:878–885PubMedGoogle Scholar
  8. 8.
    Macari M, Milano A, Lavelle M, Berman P, Megibow AJ (2000) Comparison of time-efficient CT colonography with two- and three-dimensional colonic evaluation for detecting colorectal polyps. Am J Roentgenol 174:1543–1549Google Scholar
  9. 9.
    Dachman AH, Kuniyoshi JK, Boyle CM, Samara Y, Hoffmann KR, Rubin DT et al (1998) CT colonography with three-dimensional problem solving for detection of colonic polyps. Am J Roentgenol 171:989–995Google Scholar
  10. 10.
    Pickhardt PJ, Choi JR, Hwang I, Butler JA, Puckett ML, Hildebrandt HA et al (2003) Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. N Engl J Med 349:2191–2200CrossRefPubMedGoogle Scholar
  11. 11.
    Paik DS, Beaulieu CF, Jeffrey RB Jr, Karadi CA, Napel S (2000) Visualization modes for CT colonography using cylindrical and planar map projections. J Comput Assist Tomogr 24:179–188CrossRefPubMedGoogle Scholar
  12. 12.
    Rottgen R, Schroder RJ, Lorenz M, Herbel A, Fischbach F, Herzog H et al (2003) CT-colonography with the 16-slice CT for the diagnostic evaluation of colorectal neoplasms and inflammatory colon diseases. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 175:1384–1391CrossRefPubMedGoogle Scholar
  13. 13.
    Pineau BC, Paskett ED, Chen GJ, Espeland MA, Phillips K, Han JP et al (2003) Virtual colonoscopy using oral contrast compared with colonoscopy for the detection of patients with colorectal polyps. Gastroenterology 125:304–310CrossRefPubMedGoogle Scholar
  14. 14.
    Hara AK, Johnson CD, Reed JE, Ehman RL, Ilstrup DM (1996) Colorectal polyp detection with CT colography: two- versus three-dimensional techniques. Work in progress. Radiology 200:49–54PubMedGoogle Scholar
  15. 15.
    Morrin MM, Farrell RJ, Kruskal JB, Reynolds K, McGee JB, Raptopoulos V (2000) Utility of intravenously administered contrast material at CT colonography. Radiology 217:765–771PubMedGoogle Scholar
  16. 16.
    Taylor SA, Halligan S, Burling D, Morley S, Bassett P, Atkin W, Bartram CI (2004) CT colonography: effect of experience and training on reader performance. Eur Radiol 14(6):1025–1033. Epub 2004 Feb 10. PMID: 14872280CrossRefPubMedGoogle Scholar
  17. 17.
    Luboldt W, Tryon C, Kroll M, Toussaint TL, Holzer K, Hoepffner N, Vogl TJ (2005) Automated mass detection in contrast-enhanced CT colonography: an approach based on contrast and volume. Eur Radiol 15(2):247–253. Epub 2004 Oct 15. PMID: 15490178CrossRefPubMedGoogle Scholar
  18. 18.
    Luboldt W, Kroll M, Wetter A, Toussaint TL, Hoepffner N, Holzer K, Kluge A, Vogl TJ (2004) Phase- and size-adjusted CT cut-off for differentiating neoplastic lesions from normal colon in contrast-enhanced CT colonography. Eur Radiol 14(12):2228–2235. Epub 2004 Sep 23. PMID: 15449012CrossRefPubMedGoogle Scholar
  19. 19.
    Bruzzi JF, Moss AC, Brennan DD, MacMathuna P, Fenlon HM (2004) Colonic surveillance by CT colonography using axial images only. Eur Radiol 14(5):763–767. Epub 2004 Feb 19. PMID: 14986051CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Markus S. Juchems
    • 1
  • Thorsten R. Fleiter
    • 2
  • Sandra Pauls
    • 1
  • Stefan A. Schmidt
    • 3
  • Hans-Jürgen Brambs
    • 1
  • Andrik J. Aschoff
    • 1
  1. 1.Department for Diagnostic RadiologyUniversity Hospital of UlmUlmGermany
  2. 2.Department of Diagnostic ImagingUniversity Hospitals of MarylandBaltimoreUSA
  3. 3.Karl-Olga-Krankenhaus StuttgartStuttgartGermany

Personalised recommendations