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Gastrointestinal Imaging |
1 From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, St Louis, MO 63110 (E.G.M., T.K.P., J.P.H., D.M.B., D.A.H.); the Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Conn (J.A.B.); the Department of Internal Medicine, Gastroenterology Division, Washington University School of Medicine, St Louis, Mo (L.W.); and the Primary Care Internal Medicine Group, Fletcher Allen Health Care, University of Vermont, Burlington (B.L.). From the 1998 RSNA scientific assembly. Received March 9, 2000; revision requested April 26; revision received June 2; accepted June 27. Supported by National Cancer Institute Prostate-Lung-Colon-Ovary Screening Trial grant N01-CN-25516 (E.G.M, J.A.B, T.K.P, J.P.H, D.M.B, L.W., B.L.), GE Medical Systems Association of University Radiologists (GERRAF; E.G.M.), Washington University Cancer Center (E.G.M.), and American Cancer Center Institutional Review Grant 36-38-04 (E.G.M.). Address correspondence to E.G.M. (e-mail: mcfarlandb@mir.wustl.edu).
PURPOSE: To assess the diagnostic performance and reader agreement with two-dimensional (2D) and three-dimensional (3D) display techniques for detecting colorectal polyps with spiral computed tomographic (CT) colonography.
MATERIALS AND METHODS: A test set of 30 colonic segments was developed from spiral CT colonographic studies (12 with polyps and 18 without). The 12 segments with polyps contained 22 lesions (11 polyps <10 mm, 11 polyps or cancers 
10 mm), with all findings verified with colonoscopy. Three specific 2D and 3D image-display techniques were tested. Three experienced abdominal radiologists independently analyzed each test case and were retested 6 weeks later.
RESULTS: The results of readings 1 and 2 were similar for all image-display techniques among the readers. Pooled segment results were sensitivity of 89%–92% and specificity of 72%–83%. Pooled polyp size results for sensitivity and positive predictive value were 77%–86% and 74%–86% (all polyps, n = 22), 91%–100% and 85%–100% (polyps or cancers >10 mm, n = 11), and 61%–73% and 61%–80% (polyps 5–9 mm, n = 11), respectively. Overall intraobserver agreement was good for the three display techniques (
, 0.60-1.00); however, interobserver agreement for 2D multiplanar reformation was lower (, 0.53–0.80).
CONCLUSION: Among experienced abdominal radiologists, similar diagnostic performance in polyp detection was found among 2D multiplanar reformation and 3D display techniques, although individual cases showed improved characterization with 3D display techniques. Evaluation of reader agreement demonstrated good intraobserver agreement, with variable interobserver agreement.
Index terms: Colon, CT, 75.12115, 75.12117 • Colon neoplasms, 75.311 • Computed tomography (CT), image processing, 75.12115, 75.12117 • Computed tomography (CT), three-dimensional, 75.12117 • Images, analysis, 75.12115, 75.12117
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