Computed Tomography Colonography

Mani, Aravind; Napel, Sandy; Paik, David S.; Jeffrey, R. Brooke; Yee, Judy; Olcott, Eric W.; Prokesch, Rupert; Davila, Marta; Schraedley-Desmond, Pamela; Beaulieu, Christopher F.

doi:10.1097/00004728-200405000-00003

Cited by 64 publications

(5 citation statements)

References 48 publications

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“…Systems for helping radiologists in detecting colonic lesions at CTC have been developed [Computer aided diagnosis (CAD)]. Few data ( 131 ) suggest that this strategy has a sensitivity for polyps similar to that with unassisted reading and allows for a reduction in the reading time ( 132 ).…”

Section: Ct Colonographymentioning

confidence: 99%

Colorectal Cancer Screening: Tests, Strategies, and Perspectives

Stracci

Zorzi

Grazzini

2014

Front. Public Health

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Screening has a central role in colorectal cancer (CRC) control. Different screening tests are effective in reducing CRC-specific mortality. Influence on cancer incidence depends on test sensitivity for pre-malignant lesions, ranging from almost no influence for guaiac-based fecal occult blood testing (gFOBT) to an estimated reduction of 66–90% for colonoscopy. Screening tests detect lesions indirectly in the stool [gFOBT, fecal immunochemical testing (FIT), and fecal DNA] or directly by colonic inspection [flexible sigmoidoscopy, colonoscopy, CT colonography (CTC), and capsule endoscopy]. CRC screening is cost-effective compared to no screening but no screening strategy is clearly better than the others. Stool tests are the most widely used in worldwide screening interventions. FIT will soon replace gFOBT. The use of colonoscopy as a screening test is increasing and this strategy has superseded all alternatives in the US and Germany. Despite its undisputed importance, CRC screening is under-used and participation rarely reaches 70% of target population. Strategies to increase participation include ensuring recommendation by physicians, introducing organized screening and developing new, more acceptable tests. Available evidence for DNA fecal testing, CTC, and capsule endoscopy is reviewed.

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Section: Ct Colonographymentioning

confidence: 99%

Colorectal Cancer Screening: Tests, Strategies, and Perspectives

Stracci

Zorzi

Grazzini

2014

Front. Public Health

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“…Several retrospective observer studies have been conducted to evaluate the effects of CADe on radiologists' interpretation of CTC. 185,[194][195][196] These studies indicate that radiologists reading with CADe outperformed radiologists alone. The usefulness of CADe for CTC has yet to be evaluated in prospective clinical trials.…”

Section: Iic Cade In Colon Imagingmentioning

confidence: 83%

Anniversary Paper: History and status of CAD and quantitative image analysis: The role ofMedical Physicsand AAPM

2008

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The roles of physicists in medical imaging have expanded over the years, from the study of imaging systems (sources and detectors) and dose to the assessment of image quality and perception, the development of image processing techniques, and the development of image analysis methods to assist in detection and diagnosis. The latter is a natural extension of medical physicists' goals in developing imaging techniques to help physicians acquire diagnostic information and improve clinical decisions. Studies indicate that radiologists do not detect all abnormalities on images that are visible on retrospective review, and they do not always correctly characterize abnormalities that are found. Since the 1950s, the potential use of computers had been considered for analysis of radiographic abnormalities. In the mid-1980s, however, medical physicists and radiologists began major research efforts for computer-aided detection or computer-aided diagnosis (CAD), that is, using the computer output as an aid to radiologists-as opposed to a completely automatic computer interpretation-focusing initially on methods for the detection of lesions on chest radiographs and mammograms. Since then, extensive investigations of computerized image analysis for detection or diagnosis of abnormalities in a variety of 2D and 3D medical images have been conducted. The growth of CAD over the past 20 years has been tremendous-from the early days of time-consuming film digitization and CPU-intensive computations on a limited number of cases to its current status in which developed CAD approaches are evaluated rigorously on large clinically relevant databases. CAD research by medical physicists includes many aspects-collecting relevant normal and pathological cases; developing computer algorithms appropriate for the medical interpretation task including those for segmentation, feature extraction, and classifier design; developing methodology for assessing CAD performance; validating the algorithms using appropriate cases to measure performance and robustness; conducting observer studies with which to evaluate radiologists in the diagnostic task without and with the use of the computer aid; and ultimately assessing performance with a clinical trial. Medical physicists also have an important role in quantitative imaging, by validating the quantitative integrity of scanners and developing imaging techniques, and image analysis tools that extract quantitative data in a more accurate and automated fashion. As imaging systems become more complex and the need for better quantitative information from images grows, the future includes the combined research efforts from physicists working in CAD with those working on quantitative imaging systems to readily yield information on morphology, function, molecular structure, and more-from animal imaging research to clinical patient care. A historical review of CAD and a discussion of challenges for the future are presented here, along with the extension to quantitative image analysis.

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“…This increase in reading times is generally undesirable if a large number of cases must be read sequentially, as occurs for population screening. A potentially more time-efficient paradigm is first-reader CAD, in which the reader’s interpretation is restricted to CAD prompts alone [48]. However, detection of colonic findings typically not targeted by CAD systems, such as masses or atypical lesions, poses challenges [49].…”

Section: Introductionmentioning

confidence: 99%

Population screening for colorectal cancer by flexible sigmoidoscopy or CT colonography: study protocol for a multicenter randomized trial

Regge

Iussich

Senore

et al. 2014

Trials

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BackgroundColorectal cancer (CRC) is the second most prevalent type of cancer in Europe. A single flexible sigmoidoscopy (FS) screening at around the age of 60 years prevents about one-third of CRC cases. However, FS screens only the distal colon, and thus mortality from proximal CRC is unaffected. Computed tomography colonography (CTC) is a highly accurate examination that allows assessment of the entire colon. However, the benefit of CTC testing as a CRC screening test is uncertain. We designed a randomized trial to compare participation rate, detection rates, and costs between CTC (with computer-aided detection) and FS as primary tests for population-based screening.Methods/DesignAn invitation letter to participate in a randomized screening trial comparing CTC versus FS will be mailed to a sample of 20,000 people aged 58 or 60 years, living in the Piedmont region and the Verona district of Italy. Individuals with a history of CRC, adenomas, inflammatory bowel disease, or recent colonoscopy, or with two first-degree relatives with CRC will be excluded from the study by their general practitioners. Individuals responding positively to the invitation letter will be then randomized to the intervention group (CTC) or control group (FS), and scheduled for the screening procedure. The primary outcome parameter of this part of the trial is the difference in advanced neoplasia detection between the two screening tests. Secondary outcomes are cost-effectiveness analysis, referral rates for colonoscopy induced by CTC versus FS, and the expected and perceived burden of the procedures. To compare participation rates for CTC versus FS, 2,000 additional eligible subjects will be randomly assigned to receive an invitation for screening with CTC or FS. In the CTC arm, non-responders will be offered fecal occult blood test (FOBT) as alternative screening test, while in the FS arm, non-responders will receive an invitation letter to undergo screening with either FOBT or CTC. Data on reasons for participation and non-participation will also be collected.DiscussionThis study will provide reliable information concerning benefits and risks of the adoption of CTC as a mass screening intervention in comparison with FS. The trial will also evaluate the role of computer-aided detection in a screening setting.Trial registrationClinicalTrials.gov Identifier: NCT01739608

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Computed Tomography Colonography

Abstract: : Computer-aided detection as a first reader in CTC was associated with similar per-polyp and per-patient detection sensitivity to unassisted reading. Computer-aided detection decreased interobserver variability and reduced the time required to detect the first polyp.

Cited by 64 publications

References 48 publications

Colorectal Cancer Screening: Tests, Strategies, and Perspectives

Colorectal Cancer Screening: Tests, Strategies, and Perspectives

Anniversary Paper: History and status of CAD and quantitative image analysis: The role ofMedical Physicsand AAPM

Population screening for colorectal cancer by flexible sigmoidoscopy or CT colonography: study protocol for a multicenter randomized trial

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