A Fully Automatic CAD-CTC System Based on Curvature Analysis for Standard and Low-Dose CT Data

Computed tomography colonography (CTC) is a rapidly evolving noninvasive medical investigation that is viewed by radiologists as a potential screening technique for the detection of colorectal polyps. Due to the technical advances in CT system design, the volume of data required to be processed by radiologists has increased significantly, and as a consequence the manual analysis of this information has become an increasingly time consuming process whose results can be affected by inter- and intrauser variability. The aim of this paper is to detail the implementation of a fully integrated CAD-CTC system that is able to robustly identify the clinically significant polyps in the CT data. The CAD-CTC system described in this paper is a multistage implementation whose main system components are: 1) automatic colon segmentation; 2) candidate surface extraction; 3) feature extraction; and 4) classification. Our CAD-CTC system performs at 100% sensitivity for polyps larger than 10 mm, 92% sensitivity for polyps in the range 5 to 10 mm, and 57.14% sensitivity for polyps smaller than 5 mm with an average of 3.38 false positives per dataset. The developed system has been evaluated on synthetic and real patient CT data acquired with standard and low-dose radiation levels.