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Bräuer, C; Lefere, P; Gryspeerdt, S; Ringl, H; Al-Mukhtar, A; Apfaltrer, P; Berzaczy, D; Füger, B; Furtner, J; Müller-Mang, C; Pones, M; Scharitzer, M; Woitek, R; Graser, A; Weber, M; Mang, T.
CT colonography: size reduction of submerged colorectal polyps due to electronic cleansing and CT-window settings.
Eur Radiol. 2018; 28(11): 4766-4774. Doi: 10.1007/s00330-018-5416-0 [OPEN ACCESS]
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Co-Autor*innen der Med Uni Graz
Apfaltrer Paul
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Abstract:
To assess whether electronic cleansing (EC) of tagged residue and different computed tomography (CT) windows influence the size of colorectal polyps in CT colonography (CTC). A database of 894 colonoscopy-validated CTC datasets of a low-prevalence cohort was retrospectively reviewed to identify patients with polyps ≥6 mm that were entirely submerged in tagged residue. Ten radiologists independently measured the largest diameter of each polyp, two-dimensionally, before and after EC in colon, bone, and soft-tissue-windows, in randomised order. Differences in size and polyp count before and after EC were calculated for size categories ≥6 mm and ≥10 mm. Statistical testing involved 95% confidence interval, intraclass correlation and mixed-model ANOVA. Thirty-seven patients with 48 polyps were included. Mean polyp size before EC was 9.8 mm in colon, 9.9 mm in bone and 8.2 mm in soft-tissue windows. After EC, the mean polyp size decreased significantly to 9.4 mm in colon, 9.1 mm in bone and 7.1 mm in soft-tissue windows. Compared to unsubtracted colon windows, EC, performed in colon, bone and soft-tissue windows, led to a shift of 6 (12,5%), 10 (20.8%) and 25 (52.1%) polyps ≥6 mm into the next smaller size category, thus affecting patient risk stratification. EC and narrow CT windows significantly reduce the size of polyps submerged in tagged residue. Polyp measurements should be performed in unsubtracted colon windows. • EC significantly reduces the size of polyps submerged in tagged residue. • Abdominal CT-window settings significantly underestimate 2D sizes of submerged polyps. • Size reduction in EC is significantly greater in narrow than wide windows. • Underestimation of polyp size due to EC may lead to inadequate treatment. • Polyp measurements should be performed in unsubtracted images using a colon window.
Find related publications in this database (using NLM MeSH Indexing)
Aged -
Algorithms -
Analysis of Variance -
Colonic Polyps - diagnostic imaging
Colonography, Computed Tomographic - methods
Colonography, Computed Tomographic - standards
Female -
Humans -
Image Processing, Computer-Assisted - methods
Male -
Middle Aged -
Reference Standards -
Retrospective Studies -
Sensitivity and Specificity -

Find related publications in this database (Keywords)
CT colonography
Virtual colonoscopy
Neoplasms, colorectal
Colonic polyps
Cancer screening
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