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European Radiology

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29-04-2022 | Computed Tomography

Comparison of the performance of conventional and spectral-based tagged stool cleansing algorithms at CT colonography

Authors: Sergio Grosu, Rafael Wiemker, Chansik An, Markus M. Obmann, Eddy Wong, Judy Yee, Benjamin M. Yeh

Published in: European Radiology | Issue 11/2022

Abstract

Objectives

To compare the performance of conventional versus spectral-based electronic stool cleansing for iodine-tagged CT colonography (CTC) using a dual-layer spectral detector scanner.

Methods

We retrospectively evaluated iodine contrast stool-tagged CTC scans of 30 consecutive patients (mean age: 69 ± 8 years) undergoing colorectal cancer screening obtained on a dual-layer spectral detector CT scanner. One reader identified locations of electronic cleansing artifacts (n = 229) on conventional and spectral cleansed images. Three additional independent readers evaluated these locations using a conventional cleansing algorithm (Intellispace Portal) and two experimental spectral cleansing algorithms (i.e., fully transparent and translucent tagged stool). For each cleansed image set, readers recorded the severity of over- and under-cleansing artifacts on a 5-point Likert scale (0 = none to 4 = severe) and readability compared to uncleansed images. Wilcoxon’s signed-rank tests were used to assess artifact severity, type, and readability (worse, unchanged, or better).

Results

Compared with conventional cleansing (66% score ≥ 2), the severity of overall cleansing artifacts was lower in transparent (60% score ≥ 2, p = 0.011) and translucent (50% score ≥ 2, p < 0.001) spectral cleansing. Under-cleansing artifact severity was lower in transparent (49% score ≥ 2, p < 0.001) and translucent (39% score ≥ 2, p < 0.001) spectral cleansing compared with conventional cleansing (60% score ≥ 2). Over-cleansing artifact severity was worse in transparent (17% score ≥ 2, p < 0.001) and translucent (14% score ≥ 2, p = 0.023) spectral cleansing compared with conventional cleansing (9% score ≥ 2). Overall readability was significantly improved in transparent (p < 0.001) and translucent (p < 0.001) spectral cleansing compared with conventional cleansing.

Conclusions

Spectral cleansing provided more robust electronic stool cleansing of iodine-tagged stool at CTC than conventional cleansing.

Key Points

• Spectral-based electronic cleansing of tagged stool at CT colonography provides higher quality images with less perception of artifacts than does conventional cleansing.

• Spectral-based electronic cleansing could potentially advance minimally cathartic approach for CT colonography. Further clinical trials are warranted.

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Title: Comparison of the performance of conventional and spectral-based tagged stool cleansing algorithms at CT colonography
Authors: Sergio Grosu
Rafael Wiemker
Chansik An
Markus M. Obmann
Eddy Wong
Judy Yee
Benjamin M. Yeh
Publication date: 29-04-2022
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 11/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-022-08831-2

At a glance: The STEP trials

Springer Medicine

Comparison of the performance of conventional and spectral-based tagged stool cleansing algorithms at CT colonography

Abstract

Objectives

Methods

Results

Conclusions

Key Points

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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