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Polyp measurement with CT colonography: multiple-reader, multiple-workstation comparison.

Brett M Young1, J G Fletcher, Scott R Paulsen

  • 1Mayo Clinic College of Medicine, Rochester, MN 55905, USA.

AJR. American Journal of Roentgenology
|December 21, 2006
PubMed
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Accurate colorectal polyp measurement using CT colonography (CTC) is crucial for assessing cancer risk. Lung window settings on 2D axial or MPR images (Wizard, Advantage) or 3D images (Vitrea) provide the most precise polyp size measurements.

Area of Science:

  • Radiology
  • Medical Imaging
  • Gastroenterology

Background:

  • Colorectal polyp size is a key indicator for invasive colorectal cancer risk.
  • Accurate measurement of polyp size is essential for risk stratification.

Purpose of the Study:

  • To determine the most accurate methods for measuring polyp size using CT colonography (CTC).
  • To compare polyp size measurement accuracy across three different workstation models and multiple observers.

Main Methods:

  • Six reviewers measured 24 polyps of known sizes, shapes, and locations in a colonic phantom model.
  • Measurements were performed using CT colonography data sets at two dose levels (5 mAs and 65 mAs).
  • Polyp diameters were measured on three workstations using axial, 2D multiplanar reconstruction (MPR), and 3D imaging with lung and soft-tissue windows.

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Main Results:

  • Significant differences in measurements were observed across workstation settings (p < 0.0001).
  • Lung window settings on 2D images yielded more accurate measurements than soft-tissue windows (p < 0.0001).
  • Optimal methods varied by workstation, but generally involved lung windows on axial, 2D MPR, or 3D images, with mean errors ranging from 0.48 mm to 0.76 mm.

Conclusions:

  • CT colonography workstations enable accurate polyp size measurement.
  • For routine CTC, use lung window settings on 2D axial/MPR (Wizard, Advantage) or 3D (Vitrea) images.
  • At routine doses, these workstations show no significant difference in measurement accuracy when optimal methods are employed.