<title>Image display system for synchronous interpretaion of supine and prone computed tomographic colography</title>

Abstract

Computed tomographic colography (CTC or virtual colonoscopy) is a new technique for imaging the colon for the detection of colorectal neoplasms. Early clinical assessment of this procedure has shown that the performance of this test is acceptable for colorectal screening examinations. The current version of CTC utilizes an interactive combination of axial, reformatted 2D and 3D images (from an endoluminal perspective) that are generated in real time. Retained fluid in the lumen of the colon is a commonly encountered problem that can obscure lesions. Prone imaging in addition to standard supine views are often required to visualize obscured colonic segments. Although the colorectum is often seen optimally with combined supine and prone views, twice as much interpretation time is required with both acquisitions. The purpose of this study is to describe a novel system of synchronous display of supine and prone images of the colon. Simultaneous display of synchronized (anatomically registered) views of the colon eliminates the need for two separate readings of the colon and shortens interpretation time. This tool has all of the features of the original CTC interpretation system (presented in 1995) and includes recent innovations such as virtual pathology which is present in another paper within this Proceeding. The anatomic levels are indexed to match each other and advanced synchronously as the radiologist interprets the data set. Axial, reformatted 2D and 3D images are displayed and simultaneously updated for both prone and supine images on the same computer screen. The colon only needs to be reviewed once with the diagnostic benefit of both scans. In many cases, the two scans can be interpreted nearly as quickly as one. Conclusion: Synchronous display of prone and supine images of the colon is a new enhancement for CTC that combines with advantages of prone and supine views without the added interpretations time of reviewing two separate scans.