Comparison of a unidirectional panoramic 3D endoluminal interpretation technique to traditional 2D and bidirectional 3D interpretation techniques at CT colonography: preliminary observations

Aim: To compare the evaluation times and accuracy of unidirectional panoramic three-dimensional (3D) endoluminal interpretation to traditional two-dimensional (2D) and bidirectional 3D endoluminal techniques. materials and methods: Sixty-nine patients underwent computed tomography colonography (CTC) after bowel cleansing. Forty-five had no polyps and 24 had at least one polyp ≥6 mm. Patients underwent same-day colonoscopy with segmental unblinding. Three experienced abdominal radiologists evaluated the data using one of three primary interpretation techniques: (1) 2D; (2) bidirectional 3D; (3) panoramic 3D. Mixed model analysis of variance and logistic regression for correlated data were used to compare techniques with respect to time and sensitivity and specificity. Results: Mean evaluation times were 8.6, 14.6, and 12.1 min, for 2D, 3D, and panoramic, respectively. 2D was faster than either 3D technique (p < 0.0001), and the panoramic technique was faster than bidirectional 3D (p = 0.0139). The overall sensitivity of each technique per polyp and per patient was 68.4 and 76.7% for 2D, 78.9 and 93.3% for 3D; and 78.9 and 86.7% for panoramic 3D. Conclusion: 2D interpretation was the fastest overall, the panoramic technique was significantly faster than the bidirectional with similar sensitivity and specificity. The sensitivity for a single reader was significantly lower using the 2D technique. Each reader should select the technique with which they are most successful.