Teniae coli-based circumferential localization system for CT colonography: feasibility study

This HIPAA-compliant study, with institutional review board approval and informed patient consent, was conducted to retrospectively develop a teniae coli-based circumferential localization method for guiding virtual colon navigation and colonic polyp registration. Colonic surfaces (n = 72) were depicted at computed tomographic (CT) colonography performed in 36 patients (26 men, 10 women; age range, 47-72 years) in the supine and prone positions. For 70 (97%) colonic surfaces, the tenia omentalis (TO), the most visible of the three teniae coli on a well-distended colonic surface, was manually extracted from the cecum to the descending colon. By virtually dissecting and flattening the colon along the TO, the authors developed a localization system involving 12 grid lines to estimate the circumferential positions of polyps. A sessile polyp would most likely (at 95% confidence level) be found within +/-1.2 grid lines (one grid line equals 1/12 the circumference) with use of the proposed method. By orienting and positioning the virtual cameras with use of the new localization system, synchronized prone and supine navigation was achieved. The teniae coli are extractable landmarks, and the teniae coli-based circumferential localization system helps guide virtual navigation and polyp registration at CT colonography.