• Title/Summary/Keyword: Colonography

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Efficiacy of CT Colonography in the Detection of Colorectal Polypoid Lesions (대장의 폴립양 병변의 발견에 있어 CT 대장조영술의 유용성)

  • Kim, Yun-Gyeong;Lee, Ji-Eun;Lee, Jeong-Gyeong;Baek, Seung-Yeon;Song, Hyeon-Ju;Jeong, Seong-Ae
    • Journal of Korea Association of Health Promotion
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    • v.4 no.1
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    • pp.49-59
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    • 2006
  • "본 논문은 대한영상의학회지 2005년 제52권 제1호에 실렸던 논문으로 대한영상의학회의 승인을 득하고 본 협회지에 게재함. Purpose: We wished to compare CT colonography with conventional colonoscopy for the detection of colorectal poiypoid lesions, and we wanted to evaluate the role of IV contrast-enhanced CT colonography for the differentiation between benign polypoid lesions and malignant polypoid lesions. Materials and Methods: Thirty-four consecutive patients underwent CT colonography prior to conventional colonoscopy, Precontrast prone-position CT images and post contrast supine position CT images were obtained and the virtual colonoscopic images were reconstructed, Axial, sagittal and presence, size and morphologic features of colorectal polypoid lesions, and thor these findings were compared with the colonoscopic findings. The degree of enhancement of colorecralpolypoid lesions was measured by subtracting the attenuation valves obtained with precontrastand postcontrast CT images for the differentiation of benignity and malignancy of the colorectal polypoid lesions. Results. Among 75 colorectal polypoid lesions identified on conventional colonoscopy, 49neoplasms were found on CT coloaographv, and the overall detection rate was 65,3%.Detection rate of lesions smaller than l0mm was 52.1%(24/46), and the detection rate for lesions equal to or larger than 10mm was 86.2%(25/29), Morphologic features of the sessile type lesions on CT colonography were well correlated with those noted on colonoscopy, but the stalks were not identified in 6 of 13 polyps on CT colonography. There was no statistical correlation between benignity and malignancy and the degree of contrast enhancement on CT colonography, Conclusion CT colonography is a useful modality for the detection of colorectal polypoid lesionsequal to or polyps. However, CT colonography cannot differentiate benignity from malignancy.

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Feasibility of Computed Tomography Colonography as a Diagnostic Procedure in Colon Cancer Screening in India

  • Manjunath, Kanabagatte Nanjundappa;Gopalakrishna, Prabhu Karkala;Siddalingaswamy, Puttappa Chandrappa
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.13
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    • pp.5111-5116
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    • 2014
  • Computed Tomography Colonography (CTC) is a medical imaging technology used in identifying polyps and colon cancer masses in the large intestine. The technique has evolved a great deal since its invention and has become a routine diagnostic procedure in Western countries due to its non invasiveness and ease of use. The objective of our study was to explore the possibility of CTC application in Indian hospitals. This paper gives an overview of the procedure and its commercial viability. The explanation begins with the domain aspects from gastroenterologist perspective, the new way of thinking in polyp classification, the technical components of CTC procedure, and how engineering solutions have helped clinicians in solving the complexities involved in colon diagnosis. The colon cancer statistics in India and the results of single institution study we carried out with retrospective data is explained. By considering the increasing number of patients developing colon malignancies, the practicality of CTC in Indian hospitals is discussed. This paper does not reveal any technical aspects (algorithms) of engineering solutions implemented in CTC.

Review of the Radiation Risk and Clinical Efficacy Associated with Computed Tomography Cancer Screening (암의 조기발견을 위한 CT촬영에서의 임상적 효능과 방사선위해에 대한 고찰)

  • Kim, Hyun Ja
    • Journal of Radiation Protection and Research
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    • v.38 no.4
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    • pp.214-227
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    • 2013
  • Computed tomographic scan as a screening procedures in asymptomatic individuals has seen a steady increase with the introduction of multiple-raw detector CT scanners. This report provides a brief review of the current controversy surrounding CT cancer screening, with a focus on the radiation induced cancer risks and clinical efficacy. 1. A large study of patients at high risk of lung cancer(the National Lung Screening Trial[NLST]) showed that CT screening reduced cancer deaths by 20%(1.33% in those screened compared with 1.67% in those not screened). The rate of positive screening tests was 24.2% and 96.4% of the positive screening results in the low-dose CT group were false-positive. Radiation induced lung cancer risk was estimated the most important in screening population because ERR of radiation induced lung cancer does not show the decrease with increasing age and synergistic connection between smoking and radiation risk. Therefore, the radiation risk may be on the same order of magnitude as the benefit observed in the NLST. Optimal screening strategy remain uncertain, CT lung cancer screening is not yet ready for implementation. 2. Computed tomographic colonography is as good as colonoscopy for detecting colon cancer and is almost as good as colonoscopy for detecting advanced adenomas, but significantly less sensitive and specific for smaller lesions and disadvantageous for subsequent therapeutic optical colonoscopy if polyps are detected. The average effective dose from CT colonography was estimated 8-10 $mS{\nu}$, which could be a significant dose if administered routinely within the population over many years. CT colonography should a) achieve at least 90% sensitivity and specificity in the size category from 6 and 10 mm, b) offer non-cathartic bowl preparation and c) be optimized and standardized CT parameters if it is to be used for mass screening. 3. There is little evidence that demonstrates, for whole-body scanning, the benefit outweighs the detriment. This test found large portion of patient(86~90.8%) had at least one abnormal finding, whereas only 2% were estimated to have clinically significant disease. Annual scans from ages 45 to 75 years would accrue an estimated lifetime cancer mortality risk of 1.9%. There is no group within the medical community that recommends whole-body CT. No good studies indicate the accuracy of screening CT, at this time. The benefit/risk balance for any of the commonly suggested CT screening techniques has yet to be established. These areas need further research. Therefore wild screening should be avoided.

Automatic Electronic Cleansing in Computed Tomography Colonography Images using Domain Knowledge

  • Manjunath, KN;Siddalingaswamy, PC;Prabhu, GK
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8351-8358
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    • 2016
  • Electronic cleansing is an image post processing technique in which the tagged colonic content is subtracted from colon using CTC images. There are post processing artefacts, like: 1) soft tissue degradation; 2) incomplete cleansing; 3) misclassification of polyp due to pseudo enhanced voxels; and 4) pseudo soft tissue structures. The objective of the study was to subtract the tagged colonic content without losing the soft tissue structures. This paper proposes a novel adaptive method to solve the first three problems using a multi-step algorithm. It uses a new edge model-based method which involves colon segmentation, priori information of Hounsfield units (HU) of different colonic contents at specific tube voltages, subtracting the tagging materials, restoring the soft tissue structures based on selective HU, removing boundary between air-contrast, and applying a filter to clean minute particles due to improperly tagged endoluminal fluids which appear as noise. The main finding of the study was submerged soft tissue structures were absolutely preserved and the pseudo enhanced intensities were corrected without any artifact. The method was implemented with multithreading for parallel processing in a high performance computer. The technique was applied on a fecal tagged dataset (30 patients) where the tagging agent was not completely removed from colon. The results were then qualitatively validated by radiologists for any image processing artifacts.

The Guideline for Colorectal Cancer Screening (대장암 선별검사 권고안)

  • Dong Il Park
    • Journal of Digestive Cancer Research
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    • v.4 no.1
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    • pp.17-20
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    • 2016
  • Colorectal cancer is the 2nd most common cancer in men, and the 3rd most common cancer in women in Korea. This incidence has been increasing steadily since the data analysis began in 1999. Guidelines from many countries including Korea recommend annual or biennial fecal occult blood test as a national colorectal cancer screening program, however, colonoscopy, stool DNA test, double contrast barium enema, and sigmoidoscopy are recommended in some countries. I will summarize the Korean National Screening Guideline for colorectal cancer revised by multi-society expert committee in Korea last year. They recommend annual or biennial fecal immunochemical test between 45 and 80 year-old asymptomatic average risk people. Selective use of colonoscopy is recommended, taking into consideration of individual preference and the risk of colorectal cancer. There is no evidence for the risks or benefits of double contrast barium enema or computed tomographic colonography for colorectal cancer screening.

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