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Teniae Coli–based Circumferential Localization System for CT Colonography: Feasibility Study¹

¹ From the Diagnostic Radiology Department, Clinical Center, National Institutes of Health, 10 Center Dr, MSC 1182, Bldg 10, Room 1C351, Bethesda, MD 20892-1182 (A.H., D.A.R., R.M.S., M.F.); NIBIB/CDRH, Joint Laboratory for the Assessment of Medical Imaging Systems, U.S. Food and Drug Administration, Rockville, Md (N.P.); Uniformed Services University of the Health Sciences, Bethesda, Md (J.R.C., P.J.P.); Walter Reed Army Medical Center, Washington, DC (J.R.C.); and National Naval Medical Center, Bethesda, Md (P.J.P.). Received February 24, 2006; revision requested April 25; revision received May 19; accepted June 8; final version accepted September 1. Supported by intramural programs of the Diagnostic Radiology Department of the Clinical Center, National Institutes of Health. D.A.R. supported by a fellowship through the Clinical Research Training Program, a public-private partnership supported jointly by the National Institutes of Health and a grant to the Foundation for the National Institutes of Health from Pfizer Pharmaceuticals Group. Address correspondence to R.M.S. (e-mail: rms{at}nih.gov).

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.

Supplemental material: http://radiology.rsnajnls.org/cgi/content/full/243/2/551/DC1

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