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(Radiology. 2001;219:51-59.)
© RSNA, 2001

Computer Applications

Automated Polyp Detection at CT Colonography: Feasibility Assessment in a Human Population1

Ronald M. Summers, MD, PhD, C. Daniel Johnson, MD, Lynne M. Pusanik, MEng, James D. Malley, PhD, Ashraf M. Youssef and Judd E. Reed, BS

1 From the Diagnostic Radiology Department, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bldg 10, Rm 1C660, 10 Center Dr, MSC 1182, Bethesda, MD 20892-1182 (R.M.S., L.M.P., J.D.M., A.M.Y.); and the Department of Radiology, Mayo Clinic, Rochester, Minn (C.D.J., J.E.R.). Received May 5, 2000; revision requested June 13; revision received August 1; accepted September 12. Supported by the intramural research programs of the Diagnostic Radiology Department, Magnuson Clinical Center. Supported in part by NIH grant RO1CA75333. Address correspondence to R.M.S. (e-mail: rms@nih.gov).

PURPOSE: To test the feasibility of and improve a computer algorithm to automatically detect colonic polyps in real human computed tomographic (CT) colonographic data sets.

MATERIALS AND METHODS: Twenty patients with known polyps underwent CT colonography in the supine position. CT colonographic data were processed by using a shape-based algorithm that depicts masses that protrude into the lumen. We studied nine shape criteria and three isosurface threshold settings. Results were compared with those of conventional colonoscopy performed the same day.

RESULTS: There were 50 polyps (28 were >=10 mm in size; 12, 5–9 mm; 10, <5 mm). The sensitivity with optimal settings for detecting polyps 10 mm or greater was 64% (18 of 28). Sensitivity improved to 71% (10 of 14) for polyps 10 mm or greater in well-distended colonic segments. Performance decreased for polyps less than 10 mm, poorly distended colonic segments, and other shape algorithms. There was a mean of six false-positive lesion sites per colon. These sites were reduced 39% to 3.5 per colon by sampling CT attenuation at the lesion site and discarding sites having attenuation less than a threshold.

CONCLUSION: Automated detection of colonic polyps, especially clinically important large polyps, is feasible. Colonic distention is an important determinant of sensitivity. Further increases in sensitivity may be achieved by adding prone CT colonography.

Index terms: Colon, CT, 75.12115, 75.12119, 75.1282 • Colon neoplasms, diagnosis, 75.12115, 75.12119, 75.1282, 75.311 • Computed tomography (CT), computer programs • Computed tomography (CT), image processing • Computed tomography (CT), three-dimensional, 75.12117




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