scholarly journals A Prospective Study Comparing Three-Dimensional Rectal Water Contrast Transvaginal Ultrasonography and Computed Tomographic Colonography in the Diagnosis of Rectosigmoid Endometriosis

Diagnostics ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 252 ◽  
Author(s):  
Fabio Barra ◽  
Ennio Biscaldi ◽  
Carolina Scala ◽  
Antonio Simone Laganà ◽  
Valerio Gaetano Vellone ◽  
...  
Keyword(s):  
Prospective Study ◽  
Imaging Techniques ◽  
Anal Verge ◽  
Three Dimensional ◽  
Transvaginal Ultrasonography ◽  
Computed Tomographic Colonography ◽  
Lower Margin ◽  
Bowel Lumen ◽  
Computed Tomographic ◽  
Significant Difference

(1) Objectives: In patients with symptoms suggestive of rectosigmoid endometriosis, imaging techniques are required to confirm the presence and establish the extent of the disease. The objective of the current study was to compare the performance of three-dimensional rectal water contrast transvaginal ultrasonography (3D-RWC-TVS) and computed tomographic colonography (CTC) in predicting the presence and characteristics of rectosigmoid endometriosis. (2) Methods: This prospective study included patients with suspicion of rectosigmoid endometriosis who underwent both 3D-RWC-TVS and CTC and subsequently were surgically treated. The findings of imaging techniques were compared with surgical and histological results. (3) Results: Out of 68 women included in the study, 37 (48.9; 95% C.I. 38.2–59.7%) had rectosigmoid nodules and underwent bowel surgery. There was no significant difference in the accuracy of 3D-RWC-TVS and CTC in diagnosing the presence of rectosigmoid endometriotic nodules (p = 0.118), although CTC was more precise in diagnosing endometriosis located in the sigmoid (p = 0.016). 3D-RWC-TVS and CTC had similar precision in estimating the largest diameter of the main endometriotic nodule (p = 0.099) and, in patients undergoing segmental resection, the degree of the stenosis of the bowel lumen (p = 0.293). CTC was more accurate in estimating the distance between the lower margin of the intestinal nodule and the anal verge (p = 0.030) but was less tolerated than 3D-RWC-TVS (p < 0.001). (4) Conclusion: This was the first study comparing the performance of 3D-RWC-TVS and CTC in the diagnosis of rectosigmoid endometriosis. Both techniques allowed for the evaluation of the profile of the bowel lumen in a pseudoendoscopic fashion and had a similar performance for the diagnosis of rectosigmoid endometriosis, although CTC was more accurate in diagnosing and characterizing sigmoid nodules.

Primary three-dimensional analysis with perspective-filet view versus primary two-dimensional analysis: Evaluation of lesion detection by inexperienced readers at computed tomographic colonography in symptomatic patients

2009 ◽  
Vol 50 (3) ◽  
pp. 244-255 ◽  
Author(s):  
V. A. Fisichella ◽  
F. Jäderling ◽  
S. Horvath ◽  
P.-O. Stotzer ◽  
A. Kilander ◽  
...  
Keyword(s):  
Dimensional Analysis ◽  
Reading Time ◽  
Three Dimensional ◽  
Lesion Detection ◽  
3D Analysis ◽  
Two Dimensional ◽  
Computed Tomographic Colonography ◽  
Experienced Reader ◽  
Computed Tomographic ◽  
Significant Difference

Background: “Perspective-filet view” is a novel three-dimensional (3D) viewing technique for computed tomography colonography (CTC). Studies with experienced readers have shown a sensitivity for perspective-filet view similar to that of 2D or 3D endoluminal fly-through in detection of colorectal lesions. It is not known whether perspective-filet view, compared to axial images, improves lesion detection by inexperienced readers. Purpose: To compare primary 3D analysis using perspective-filet view (3D Filet) with primary 2D analysis, as used by inexperienced CTC readers. Secondary aims were to compare lesion detection by 3D Filet when used by experienced and inexperienced readers, and to evaluate the effect of combined 3D Filet + 2D analysis. Material and Methods: Fifty symptomatic patients were prospectively enrolled. An experienced reader performed 3D Filet analysis followed by complete 2D analysis (3D Filet + 2D), before colonoscopy with segmental unblinding. Two inexperienced readers (readers 2 and 3), blinded to CTC and colonoscopy findings, retrospectively performed 3D Filet analysis and, after 5 weeks, 2D analysis. True positives ≥6 mm detected by the inexperienced readers with 3D Filet and/or 2D were combined to obtain 3D Filet + 2D. Results: Colonoscopy revealed 116 lesions: 16 lesions ≥10 mm, 19 lesions 6–9 mm, and 81 lesions ≤5 mm. For the experienced reader, sensitivities for lesions ≥6 mm with 3D Filet and 3D Filet + 2D were 77% and 83%, respectively. For the inexperienced readers, sensitivities for lesions ≥6 mm with 3D Filet and 2D were 51% and 57% (reader 2) and 40% and 43% (reader 3), respectively. There was no significant difference between 3D Filet and 2D regarding sensitivity and reading time. For lesions ≥6 mm, 3D Filet + 2D improved the sensitivity of reader 2 to 63% and of reader 3 to 51%. Conclusion: Lesion detection by inexperienced readers using perspective-filet view is comparable to that obtained by 2D. Lesion detection improves by combining 3D Filet + 2D, but not to the level of an experienced reader.

scholarly journals Performance of computed tomographic colonography for the screening of colorectal polyp in acromegalic patients: a prospective study

2009 ◽  
Vol 46 (2) ◽  
pp. 90-96 ◽  
Author(s):  
Odery Ramos Jr. ◽  
César Luiz Boguszewski ◽  
Sandra Teixeira ◽  
Ricardo De Bem ◽  
Benito Parolim ◽  
...  
Keyword(s):  
Prospective Study ◽  
Virtual Colonoscopy ◽  
Colorectal Polyp ◽  
Colorectal Polyps ◽  
High Risk Group ◽  
Conventional Colonoscopy ◽  
Intestinal Loop ◽  
Computed Tomographic Colonography ◽  
Computed Tomographic ◽  
A Prospective Study

CONTEXT: Acromegalic patients have better chances to develop colorectal polyps and cancer and, considered a high-risk group, need to undergo frequent screening examinations. Moreover, in acromegalia, the increased bowel length and the intestinal loop complexity can lead to higher levels of technical difficulties and increase the risks of complications at conventional colonoscopy. Computed tomographic colonography, also known as virtual colonoscopy, is an innovative and secure technology which is revolutionizing the diagnosis of colon and rectum neoplasias. OBJECTIVE: To analyze computed tomographic colonography performance for the screening of colorectal polyps in acromegalic patients. METHODS: A prospective study of 21 asymptomatic acromegalic patients, 12 male and 9 female, average age 49, who underwent computed tomographic colonography and conventional colonoscopy. Computed tomographic colonography was performed with a GE Helical Multislice Computed Tomography Apparatus. Conventional colonoscopy was performed in the same day, without previous knowledge of the computed tomographic colonography diagnostics. The study evaluated the capacity of computed tomographic colonography to detect patients with colorectal polyps and identify each colorectal lesion described by the colonoscopy. RESULTS: In two patients (2/21), conventional colonoscopy was incomplete. However, in all patients computed tomographic colonography was complete. In Phase I ("per patient"), computed tomographic colonography diagnosed eight of the nine patients with colorectal polyps and showed 88% sensitivity, 75% specificity and 81% accuracy. In Phase II ("per polyp"), out of the 21 acromegalic patients included in this study, 12 presented normal findings at conventional colonoscopy. A total of 19 polyps were identified in 9 patients. Ten of the 19 polyps were smaller than 10 mm, and 9 were equal to or larger than 10 mm. Computed tomographic colonography identified 7 of the 9 polyps >10 mm described by conventional colonoscopy and only 6 of the 10 small polyps identified at conventional colonoscopy were detected by computed tomographic colonography. The histological analysis of resected lesions revealed 12 tubular adenomas, 6 hyperplastic polyps and 1 colonic tubulo-villous adenoma with an adenocarcinoma focus. CONCLUSION: The authors present the first reports of computed tomographic colonography in the screening of colorectal polyps in acromegalic patients. In this study, computed tomographic colonography was performed without complications and a complete and safe colorectal evaluation was possible in all acromegalic patients. Moreover, computed tomographic colonography presented good sensitivity, specificity and accuracy for the identification of acromegalic patients with polyps of any size and better results in the diagnosis of large polyps, when they were compared to small polypoid lesions.

Diagnosis and t-staging of gastric cancer: comparison of standard computed tomography and computed-tomographic pneumogastrography

2021 ◽  
Vol 23 (2) ◽  
pp. 99-106
Author(s):  
Inna D. Amelina ◽  
Lev N. Shevkunov ◽  
Aleksey M. Karachun ◽  
Alexander E. Mikhnin ◽  
Denis V. Nesterov
Keyword(s):  
Gastric Cancer ◽  
Computed Tomography ◽  
Three Dimensional ◽  
High Sensitivity ◽  
Subtotal Resection ◽  
Standard Protocol ◽  
Computed Tomographic ◽  
T Stage ◽  
Significant Difference ◽  
Virtual Gastroscopy

The advantages of computed tomographic pneumogastrography with the possibility of three-dimensional visualization and virtual gastroscopy in diagnosing gastric cancer are considered. The study included 479 patients with histologically diagnosed gastric cancer who were treated at the National Medical Research Center of Oncology named after N.N. Petrov from 2011 to 2018. 232 patients received preoperative chemotherapy. All patients underwent surgery: 70 in the volume of endoscopic dissection, 40 proximal subtotal resection, 166 distal subtotal resection, 203 gastrectomy. All patients at the preoperative stage underwent staging computed tomography on a 64-slice X-ray computed tomograph: 208 patients underwent computed tomography according to the standard protocol without targeted preparation of the stomach for the study, 271 patients with targeted preparation of the stomach for the study according to the computed tomographic pneumogastrography protocol. The sensitivity of the computed tomography in assessing the T-stage was assessed by comparison with pathomorphological data. Of the 208 patients who underwent computed tomography according to the standard protocol, a gastric cancer was detected in 111 (53.4%), out of 271 patients who underwent computed tomography pneumogastrography, a gastric cancer was detected in 267 (98.52%), which is a statistically significant difference in comparing computed tomography methods (Pearson, 144.223, df = 1; p 0.001). There are statistically significant differences when comparing computed tomography according to the standard protocol and computed tomographic pneumogastrography in detecting gastric cancer for all tumor categories: T/yT1 8.2 and 94.4% (Pearson, 99.205, df = 1; p 0.001), T/yT2 47.8 and 100% (Pearson, 24.681, df = 1; p 0.001), T/yT3 72.3 and 100% (Pearson, 33.114, df = 1; p 0.001), T/yT4 90.0 and 100% (Pearson, 4.789, df = 1; p = 0.029) respectively. There are also statistically significant differences when comparing the sensitivity of computed tomography according to the standard protocol and computed tomographic pneumogastrography in determining tumor invasion for all tumor categories: T/yT1 0 and 69.4% (Pearson, 67.880, df = 1; p 0.001), T/yT2 26.1 and 71.1% (Pearson, 11.666, df = 1; p 0.001), T/yT3 32.9 and 84.6% (Pearson, 54.900, df = 1; p 0.001), T/yT4 73.3 and 95.7% (Pearson, 7.916, df = 1; p = 0.005) respectively. In general, the sensitivity of the computed tomography according to the standard protocol for determining the T-stage of gastric cancer was 28.4%, computed tomographic pneumogastrography 77.1% (Pearson, 113.505, df = 1; p 0.001). Computed tomographic pneumogastrography with the possibility of three-dimensional visualization and virtual gastroscopy significantly increases the indicators of the effectiveness of diagnosing gastric cancer both early forms (category T1) and with deeper invasion (categories T2T4), demonstrates high sensitivity in determining T/yT-stages.

scholarly journals Evaluation of mandibular volume classified by vertical skeletal dimensions with cone-beam computed tomography

2016 ◽  
Vol 86 (6) ◽  
pp. 949-954 ◽  
Author(s):  
Takatoshi Nakawaki ◽  
Tetsutaro Yamaguchi ◽  
Daisuke Tomita ◽  
Yu Hikita ◽  
Mohamed Adel ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Three Dimensional ◽  
Cone Beam ◽  
Class Iii ◽  
Tomographic Images ◽  
Computed Tomographic ◽  
Significant Difference ◽  
Detailed Assessment ◽  
Lateral Cephalometry

ABSTRACT Objective: To investigate the relationship between anteroposterior and vertical differences in maxillofacial morphology and mandibular volume. Materials and Methods: Subjects comprised 213 Japanese adults (84 males and 129 females) who were divided into three groups based on mandibular basal arch (ANB) and Wits, measured in a cephalometric analysis: Class I (−1° ≤ ANB &lt; 4°,−1 mm ≤ Wits &lt; 0 mm), Class II (ANB ≥ 4°, Wits ≥ 0), and Class III (ANB &lt;−1°, Wits &lt;−1 mm). Subjects were also divided into three groups based on the mandibular plane angle (Mp), as follows: hypodivergent (Mp &lt; 23°), normodivergent (Mp  =  23–30°), and hyperdivergent (Mp &gt; 30°) groups. Mandibular volume was measured from cone-beam computed tomographic images that were analyzed using Analyze™ image processing software and compared among the three groups in each classification. Results: No significant differences were noted in mandibular volume among Classes I, II, and III. An inverse relationship was found between mandibular volume and Mp, and a significant difference was noted in mandibular volume between the hypodivergent and hyperdivergent groups. Conclusions: In addition to two-dimensional analysis, such as lateral cephalometry, three-dimensional information such as volume, provided by cone-beam computed tomography, contributes to a more detailed assessment of maxillofacial morphology.

scholarly journals Predictability of myometrial, lower uterine segment and cervical invasion with 3D transvaginal ultrasonography and magnetic resonance imaging in endometrial cancer patients: a prospective cohort study

2018 ◽  
Vol 20 (3) ◽  
pp. 348 ◽  
Author(s):  
Nuri Yildirim ◽  
Bahadir Saatli ◽  
Semir Kose ◽  
Ceren Sancar ◽  
Cagnur Ulukus ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Endometrial Cancer ◽  
Magnetic Resonance ◽  
Cancer Patients ◽  
Imaging Techniques ◽  
Three Dimensional ◽  
Lower Uterine Segment ◽  
Transvaginal Ultrasonography ◽  
Resonance Imaging ◽  
Sensitivity Specificity

Aims: The objective of this study is to identify the diagnostic performance of three-dimensional transvaginal ultrasonography (3D-US) and magnetic resonance imaging (MRI) in detecting myometrial, lower uterine segment and/or cervical invasion in endometrial cancer patients.Materials and methods: In this prospective study, 40 patients diagnosed with endometrial cancer were performed 3D-US and MRI, preoperatively. Deep myometrial, lower uterine segment and cervical invasion were evaluated subjectively and results were compared with the final histology as a gold standard.Results: Diagnostic accuracy of 3D-US for detecting deep myometrial, lower uterine segment and cervical invasion were 87.5%, 80% and 85%, respectively. The same results for MRI were 75%, 65% and 70%, respectively. For deep myometrial, lower uterine segment and/or cervical invasion in endometrial cancer, 3D-US had higher sensitivity, specificity, negative and positive predictive value and accuracy than MRI. The combination of these two imaging techniques had an increased sensitivity of detecting all parameters related with tumoral invasion but decreased specificity and the accuracy.Conclusion: 3D-US had better performance in detecting myometrial, lower uterine segment and/or cervical invasion than MRI in endometrial cancer patients. Combination of these techniques was not preferred according to this study.

scholarly journals Computed tomographic colonography compared with colonoscopy or barium enema for diagnosis of colorectal cancer in older symptomatic patients: two multicentre randomised trials with economic evaluation (the SIGGAR trials)

2015 ◽  
Vol 19 (54) ◽  
pp. 1-134 ◽  
Author(s):  
Steve Halligan ◽  
Edward Dadswell ◽  
Kate Wooldrage ◽  
Jane Wardle ◽  
Christian von Wagner ◽  
...  
Keyword(s):  
Detection Rate ◽  
Primary Outcome ◽  
Health Technology ◽  
Secondary Outcome ◽  
Computed Tomographic Colonography ◽  
Randomised Trials ◽  
Detection Rates ◽  
Computed Tomographic ◽  
Significant Difference

BackgroundComputed tomographic colonography (CTC) is a relatively new diagnostic test that may be superior to existing alternatives to investigate the large bowel.ObjectivesTo compare the diagnostic efficacy, acceptability, safety and cost-effectiveness of CTC with barium enema (BE) or colonoscopy.DesignParallel randomised trials: BE compared with CTC and colonoscopy compared with CTC (randomisation 2 : 1, respectively).SettingA total of 21 NHS hospitals.ParticipantsPatients aged ≥ 55 years with symptoms suggestive of colorectal cancer (CRC).InterventionsCTC, BE and colonoscopy.Main outcome measuresFor the trial of CTC compared with BE, the primary outcome was the detection rate of CRC and large polyps (≥ 10 mm), with the proportion of patients referred for additional colonic investigation as a secondary outcome. For the trial of CTC compared with colonoscopy, the primary outcome was the proportion of patients referred for additional colonic investigation, with the detection rate of CRC and large polyps as a secondary outcome. Secondary outcomes for both trials were miss rates for cancer (via registry data), all-cause mortality, serious adverse events, patient acceptability, extracolonic pathology and cost-effectiveness.ResultsA total of 8484 patients were registered and 5384 were randomised and analysed (BE trial: 2527 BE, 1277 CTC; colonoscopy trial: 1047 colonoscopy, 533 CTC). Detection rates in the BE trial were 7.3% (93/1277) for CTC, compared with 5.6% (141/2527) for BE (p = 0.0390). The difference was due to better detection of large polyps by CTC (3.6% vs. 2.2%;p = 0.0098), with no significant difference for cancer (3.7% vs. 3.4%;p = 0.66). Significantly more patients having CTC underwent additional investigation (23.5% vs. 18.3%;p = 0.0003). At the 3-year follow-up, the miss rate for CRC was 6.7% for CTC (three missed cancers) and 14.1% for BE (12 missed cancers). Significantly more patients randomised to CTC than to colonoscopy underwent additional investigation (30% vs. 8.2%;p < 0.0001). There was no significant difference in detection rates for cancer or large polyps (10.7% for CTC vs. 11.4% for colonoscopy;p = 0.69), with no difference when cancers (p = 0.94) and large polyps (p = 0.53) were analysed separately. At the 3-year follow-up, the miss rate for cancer was nil for colonoscopy and 3.4% for CTC (one missed cancer). Adverse events were uncommon for all procedures. In 1042 of 1748 (59.6%) CTC examinations, at least one extracolonic finding was reported, and this proportion increased with age (p < 0.0001). A total of 149 patients (8.5%) were subsequently investigated, and extracolonic neoplasia was diagnosed in 79 patients (4.5%) and malignancy in 29 (1.7%). In the short term, CTC was significantly more acceptable to patients than BE or colonoscopy. Total costs for CTC and colonoscopy were finely balanced, but CTC was associated with higher health-care costs than BE. The cost per large polyp or cancer detected was £4235 (95% confidence interval £395 to £9656).ConclusionsCTC is superior to BE for detection of cancers and large polyps in symptomatic patients. CTC and colonoscopy detect a similar proportion of large polyps and cancers and their costs are also similar. CTC precipitates significantly more additional investigations than either BE or colonoscopy, and evidence-based referral criteria are needed. Further work is recommended to clarify the extent to which patients initially referred for colonoscopy or BE undergo subsequent abdominopelvic imaging, for example by computed tomography, which will have a significant impact on health economic estimates.Trial registrationCurrent Controlled Trials ISRCTN95152621.FundingThis project was funded by the NIHR Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 19, No. 54. See the NIHR Journals Library website for further project information. Funding was also provided by the UK Department of Health, which stipulated a randomised controlled design but had no involvement in the collection, analysis or interpretation of data, in writing the report, or in the decision to submit for publication. This was also the case for manufacturers who donated equipment for the study (Bracco UK Ltd, High Wycombe, UK; Viatronix Inc., Stony Brook, NY, USA; Medicsight plc, London, UK; Barco Ltd, Bracknell, UK).

Sign in / Sign up

Export Citation Format

Share Document