Exploring the interior of 3D endoluminal lesions in the air spaces by a novel electronic biopsy technique: A preliminary study of endoluminal colon lesions.

To explore the interior of a lesion in a 3D endoluminal view, this study investigates the application of an 'electronic biopsy' (EB) technique to computed tomographic colonography (CTC) for further differentiation and 2D image correlation of endoluminal lesions in the air spaces. A retrospective study of sixty-two various endoluminal lesions from thirty patients (13 males, 17 females; age range, 31 to 90 years) was approved by our institutional review board and evaluated. The endoluminal lesions were segmented using gray-level threshold and reconstructed into isosurfaces using a marching cube algorithm. EB allows users to interactively erode and apply grey-level mapping (GM) to the surface of the region of interest (ROI) in 3D CTC. Radiologists conducted the clinical evaluation, and the resulting data were analyzed. EB significantly improves 3D gray-level presentation for evaluating the surface and inside of endoluminal lesions over that of SR, GM or target GM (TGM) (P < 0.01) with preservation of the 3D spatial effect. Moreover, 3D to 2D image correlation were achieved in any layer of the lesion using EB as did GM/TGM on the surface. The specificity and diagnostic accuracy of EB are significantly greater than those of SR (P < 0.01). These performance can be better further with GM/TGM and reach the best with EB (specificity, 89.3-92.9%; accuracy, 95.2-96.8%). EB can be used in CTC to improve the differentiation of endoluminal lesions. EB increases 3D to 2D image correlations of the lesions on or beneath the lesion surface.

A case-control study of airborne dissemination of bacteria during CT colonography.

OBJECTIVES: The COVID-19 pandemic has highlighted the importance of aerosol spread of infection. We have conducted a study to detect bacterial contamination of room surfaces and room air during CT colonography and confirm the efficacy of room disinfection procedures carried out between examinations. METHODS: Systematic sampling of the CT examination couch and horizontal surfaces 1 m and 3 m from the couch was performed before and after patient examinations. A 1 m3 sample of room air was obtained during patient examinations. Samples were processed using routine laboratory methods. A case-control study design was used (30 CT colonography and 30 routine body CT scans). RESULTS: Evidence of airborne dissemination of bacteria was detected in >30% of CT colonography examinations and <10% of control examinations (p = 0.01). No pathogenic bacteria were detected in surface samples taken before patient examinations. CONCLUSION: The room disinfection policy in use in our CT department is effective in eliminating pathogenic bacteria from surfaces in the patient environment. CT colonography causes contamination of room air with enteric bacteria in a significant proportion of cases. ADVANCES IN KNOWLEDGE: CT colonography may possibly be an aerosol-generating procedure. Larger-scale investigation is needed to fully evaluate this potential infection risk.

CT colonography's role in the COVID-19 pandemic: a safe(r), socially distanced total colon examination.

PURPOSE: To describe the favorable procedural profile of CT colonography (CTC) during the COVID-19 pandemic. CONCLUSION: Postponement of cancer screening due to COVID-19 has resulted in a backlog of individuals needing to undergo structural examination of the colon. The experience during the initial COVID-19 surge with urgent evaluation of the colon for transplant patients prior to transplant suggests that CTC can be done in a lower risk manner as compared to other structural examinations. The procedural profile of CTC is advantageous during this pandemic as maintaining social distancing and preserving healthcare supplies including PPE are of paramount importance. CTC is an important option to utilize in the screening armamentarium to allow effective screening of average risk asymptomatic individuals in the COVID-19 era.