Synchronous Navigation for CT Colonography

We present a synchronous navigation module for CT colonography (CTC) reading. The need for such a system arises because most CTC protocols require a patient to be scanned in both supine and prone positions to increase sensitivity in detecting colonic polyps. However, existing clinical practices are limited to reading one scan at a time. Such limitation is due to the fact that building a reference system between scans for the highly flexible colon is a nontrivial task. The conventional centerline approach, generating only the longitudinal distance along the colon, falls short in providing the necessary orientation information to synchronize the virtual navigation cameras in both scanned positions. In this paper we describe a synchronous navigation system by using the teniae coli as anatomical references. Teniae coli are three parallel bands of longitudinal smooth muscle on the surface of the colon. They are morphologically distinguishable and form a piecewise triple helix structure from the appendix to the sigmoid colon. Because of these characteristics, they are ideal references to synchronize virtual cameras in both scanned positions. Our new navigation system consists of two side-by-side virtual colonoscopic view panels (for the supine and prone data sets respectively) and one single camera control unit (which controls both the supine and prone virtual cameras). The capability to examine the same colonic region simultaneously in both scanned images can raise an observer’s confidence in polyp identification and potentially improve the performance of CT colonography.