CT colonography: size reduction of submerged colorectal polyps due to electronic cleansing and CT-window settings.
Eur Radiol
; 28(11): 4766-4774, 2018 Nov.
Article
en En
| MEDLINE
| ID: mdl-29761359
ABSTRACT
OBJECTIVES:
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).METHODS:
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.RESULTS:
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.CONCLUSIONS:
EC and narrow CT windows significantly reduce the size of polyps submerged in tagged residue. Polyp measurements should be performed in unsubtracted colon windows. KEY POINTS ⢠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.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Procesamiento de Imagen Asistido por Computador
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Pólipos del Colon
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Colonografía Tomográfica Computarizada
Tipo de estudio:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Eur Radiol
Asunto de la revista:
RADIOLOGIA
Año:
2018
Tipo del documento:
Article
País de afiliación:
Austria