CT colonography: clinical evaluation of a method for automatic coregistration of polyps at follow-up surveillance studies.

Purpose: To evaluate the accuracy of a method of automatic coregistration of the endoluminal surfaces at computed tomographic (CT) colonography performed on separate occasions to facilitate identification of polyps in patients undergoing polyp surveillance.
Materials and Methods: Institutional review board and HIPAA approval were obtained. A registration algorithm that was designed to coregister the coordinates of endoluminal colonic surfaces on images from prone and supine CT colonographic acquisitions was used to match polyps in sequential studies in patients undergoing polyp surveillance. Initial and follow-up CT colonographic examinations in 26 patients (35 polyps) were selected and the algorithm was tested by means of two methods, the longitudinal method (polyp coordinates from the initial prone and supine acquisitions were used to identify the expected polyp location automatically at follow-up CT colonography) and the consistency method (polyp coordinates from the initial supine acquisition were used to identify polyp location on images from the initial prone acquisition, then on those for follow-up prone and follow-up supine acquisitions). Two observers measured the Euclidean distance between true and expected polyp locations, and mean per-patient registration accuracy was calculated. Segments with and without collapse were compared by using the Kruskal-Wallace test, and the relationship between registration error and temporal separation was investigated by using the Pearson correlation.
Results: Coregistration was achieved for all 35 polyps by using both longitudinal and consistency methods. Mean ± standard deviation Euclidean registration error for the longitudinal method was 17.4 mm ± 12.1 and for the consistency method, 26.9 mm ± 20.8. There was no significant difference between these results and the registration error when prone and supine acquisitions in the same study were compared (16.9 mm ± 17.6; P = .451).
Conclusion: Automatic endoluminal coregistration by using an algorithm at initial CT colonography allowed prediction of endoluminal polyp location at subsequent CT colonography, thereby facilitating detection of known polyps in patients undergoing CT colonographic surveillance.