While computer-aided detection (CADe) and diagnosis (CADx) of colonic polyps via computed tomographic colonography (CTC) have made good progress for the subtypes of pedunculated and sessile polyps, the challenge remains for the subtypes of flat and serrated adenomas polyps. Oral fecal tagging has been widely used to increase the image contrast of colonic residues and fluids against the mucosal surface so that the colonic residues and fluids can be electronically cleansed for assessment of the entire mucosal surface, where the tagging solution containing barium, diatrizoate and/or iohexol has been frequently observed adherent coating on the polyps. This observation could provide additional useful information to relieve the challenges. This study aims to analyze the adherent coating performance of the oral tagging solution for the purpose of relieving the challenge for detection of the flat polyps and characterization of the serrated adenomas polyps. Total of 334 polyps detected by CTC and confirmed by clinical colonoscopy (OC) with pathology were analyzed, among which 251 tagged with solution containing barium and diatrizoate (BD) and the remaining 83 with tagging solution containing barium and iohexol (BL). An experience radiologist scored the polyp coating performance on all the polyps. This study evaluates the tagging efficiency for different polyp morphologies and finds that the tagging rate for flat polyps is slightly higher for BL than for BD (78.9% vs. 73.0%). For the primary goal of differentiation hyperplastic from serrated adenomas, we find that BD tags hyperplastic and serrated adenomas more that BL (75.4% and 91.8% vs. 63.2% and 80.0%, respectively). Though we find a difference in coating thickness using the BD protocol, it is not statistically significant based on the data acquired.
Contrast-enhanced digital mammography (CEDM) reveals neovasculature of breast lesions in a two-dimensional contrast enhancement map. Contrast-enhanced digital breast tomosynthesis (CEDBT) provides contrast enhancement in three dimensions, which may improve lesion characterization and localization. We aim to compare CEDM and CEDBT for lesion assessment. Women with breast imaging-reporting and data system 4 or 5 suspicious breast lesion(s) were recruited in our study and were imaged with CEDM and CEDBT in succession under one breast compression. Two radiologists assessed CEDM and CEDBT with both images displayed side-by-side and compared (1) contrast enhancement of lesions and (2) lesion margin using a five-point scale ranging from −2 (CEDM much better) to +2 (CEDBT much better). Biopsy identified 19 malignant lesions with contrast enhancement. Our results show that CEDBT provides better lesion margins than CEDM with limited reduction in contrast enhancement. CEDBT delivers less radiation dose compared to CEDM + DBT. Synthetic CEDM can be generated from CEDBT data and provides lesion contrast enhancement comparable to CEDM. CEDBT has potential for clinical applications, such as treatment response monitoring and guidance for biopsy.
Contrast-Enhanced Digital Breast Tomosynthesis (CEDBT) provides a three-dimensional (3D) contrast-enhancement map with co-registered anatomical information from low-energy DBT. It combines the benefits from Contrast-Enhanced Digital Mammography (CEDM) and Digital Breast Tomosynthesis (DBT), and may improve breast cancer detection and assessment of lesion morphology. We investigate the efficacy of CEDBT in the assessment of lesion contrast enhancement and margin identification, and evaluate the dose efficiency. We generate synthetic CEDM images from CEDBT data, similar to synthesis of 2D mammograms from DBT data, which may facilitate overall lesion assessment without additional radiation dose. Preliminary results from a patient study show that CEDBT depicts lesion margins better compared to CEDM, while the contrast-enhancement level for in-plane slice is not as high as in CEDM. CEDBT delivers less radiation dose compared to CEDM + DBT. Synthetic CEDM is able to provide lesion contrast-enhancement level comparable to CEDM.