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CT Colonography: Automated Measurement of Colonic Polyps Compared with Manual Techniques—Human in Vitro Study¹

¹ From the Department of Imaging, University College Hospital, 2F Podium, 235 Euston Rd, London NW1 2BU, England (S.A.T., S.H.); Department of Imaging, John Radcliffe Hospital, Oxford, England (A.S.); Medicsight, London, England (L.H., J.D., H.A.); Charing Cross Hospital, London, England (M.E.R.); and St Mark's and Northwick Park Hospitals, London, England (D.B.). From the 2005 RSNA Annual Meeting. Received December 19, 2005; revision requested February 13, 2006; revision received February 17; final version accepted April 7. Address correspondence to S.A.T. (e-mail: csytaylor{at}yahoo.co.uk).

View larger version (81K): [in this window] [in a new window] [Download PPT slide]   Figure 1a: Transverse images show placement of seed points by using automated measurement software. (a) A 6-mm-diameter sigmoid polyp (arrow) well seen within colectomy specimen. (b) Two software seed points that the readers placed opposite each other at the perceived junction between polyp and colonic wall prior to automated extraction and measurement by using software.

View larger version (76K): [in this window] [in a new window] [Download PPT slide]   Figure 1b: Transverse images show placement of seed points by using automated measurement software. (a) A 6-mm-diameter sigmoid polyp (arrow) well seen within colectomy specimen. (b) Two software seed points that the readers placed opposite each other at the perceived junction between polyp and colonic wall prior to automated extraction and measurement by using software.

View larger version (69K): [in this window] [in a new window] [Download PPT slide]   Figure 2a: (a–d) Transverse sequential 2D images demonstrate extent of polyp boundary as determined with the software and indicated to the reader.

View larger version (69K): [in this window] [in a new window] [Download PPT slide]   Figure 2b: (a–d) Transverse sequential 2D images demonstrate extent of polyp boundary as determined with the software and indicated to the reader.

View larger version (72K): [in this window] [in a new window] [Download PPT slide]   Figure 2c: (a–d) Transverse sequential 2D images demonstrate extent of polyp boundary as determined with the software and indicated to the reader.

View larger version (70K): [in this window] [in a new window] [Download PPT slide]   Figure 2d: (a–d) Transverse sequential 2D images demonstrate extent of polyp boundary as determined with the software and indicated to the reader.

View larger version (19K): [in this window] [in a new window] [Download PPT slide]   Figure 3: Graph shows interobserver agreement by using automated measurement software. Bland-Altman plot of difference between polyp measurements of radiologist and technician against mean measurement, with 95% limits of agreement. For most polyps, agreement was good with the automated software; differences between measurements of readers were within 0.6 mm for all but three polyps.

View larger version (20K): [in this window] [in a new window] [Download PPT slide]   Figure 4: Graph shows interobserver agreement for measurement by using manual 3D method. Bland-Altman plot of difference between polyp measurements of radiologist and technician against mean measurement, with 95% limits of agreement. In general, the scatter of measurement differences around the mean was greater than that with the automated software, although overall 95% limits of agreement were similar.

View larger version (19K): [in this window] [in a new window] [Download PPT slide]   Figure 5: Graph shows interobserver agreement by using manual 2D measurement. Bland-Altman plot of difference between polyp measurements of radiologist and technician against mean measurement, with 95% limits of agreement. In general, scatter of measurement differences around mean was greater than that with either manual 3D measurement or automated software, although overall 95% limits of agreement were similar.

View larger version (22K): [in this window] [in a new window] [Download PPT slide]   Figure 6: Graph shows intraobserver agreement by using automated measurement software. Bland-Altman plot of difference between polyp size measurement for readings 1 and 2 against mean measurement, with 95% limits of agreement (both readers). In general, intraobserver agreement was very good for all but two polyps. CAR = computer-assisted reader.

View larger version (23K): [in this window] [in a new window] [Download PPT slide]   Figure 7: Graph shows intraobserver agreement by using manual 2D measurement. Bland-Altman plot of difference between polyp size measurement for readings 1 and 2 against mean measurement, with 95% limits of agreement (both readers). In general, scatter of measurement differences around mean was greater than that with automated software.

View larger version (24K): [in this window] [in a new window] [Download PPT slide]   Figure 8: Graph shows intraobserver agreement by using manual 3D measurement. Bland-Altman plot of difference between polyp size measurement for readings 1 and 2 against mean measurement, with 95% limits of agreement (both readers). In general, scatter of measurement differences around mean was greater than that with automated software.