New Studies Show That Computer Aided Detection (Cad) Systems Are An Effective Aid In The Detection Of Various Stages And Types Of Colon Cancer

Main Category: IT / Internet / E-mail
Also Included In: Colorectal Cancer;  Cancer / Oncology
Article Date: 29 Nov 2007 - 1:00 PDT

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Data presented by Dr Stuart Taylor, consultant radiologist at University College Hospital, London for the first time at the annual Radiological Society of North America meeting in Chicago, USA, showed that in two different symptomatic study populations Medicsight's ColonCADTM is effective for the localisation of the often difficult to detect morphologically flat early colonic cancerous lesions, as well as later stage colorectal cancers.1,2 Previous data have supported CAD's role in highlighting areas of abnormality with CTC in asymptomatic patients3, and this new data supports ColonCAD's use in symptomatic patient populations.1,2

Dr. Stuart Taylor, study author, said, "These results are interesting because CT Colonography is well established for the detection of adenomatous polyps in asymptomatic patients and the role of CAD is becoming increasingly established, but the potential for computer aided cancer detection in symptomatic patients has been relatively neglected. The results show that ColonCADTM effectively aids the detection of colon cancer in symptomatic patients, in particular bringing the difficult to detect, morphologically flat lesions to the attention of the radiologist." Dr Taylor added, "With the rising global incidence of colorectal cancer it is essential that technology is continually improved to enable the physician to detect abnormalities accurately and in the least invasive way for the patient. The ColonCADTM technology used in the study is validated against one of the world's largest and most population diverse databases of verified CT scan data."

One of the studies involved 30 symptomatic patients who had undergone a diagnostic colonoscopy and who were undergoing cancer staging. Their tumours were all endoscopically classified as having a flat morphology and were located and characterised by 3 independent radiologists in conjunction with the endoscopic reports and imaging. Medicsight's ColonCADTM software was then applied at 3 different settings of sphericity. The analysis showed ColonCADTM detected 83.3% of the morphologically flat cancers present. This type of lesion has historically been difficult to detect with CT colonography.1

The second larger study included 59 symptomatic patients with already proven cancers. ColonCADTM was used at 4 different filter settings and results based on the sensitivity and specificity at the different settings showed ColonCADTM to be effective for the detection of these later stage cancers. In addition, results showed that as in the detection of polyps, optimal results for CAD detection of these cancers requires scans to be performed in both supine and prone CT acquisitions.2

Colorectal cancer is the second leading cause of cancer-related deaths in the United States.4 The U.S. National Institutes of Health estimates that there will be approximately 153,760 new cases of colon and rectal cancer diagnosed in 2007 with the disease leading to an estimated 52,180 deaths (26,000 men and 26,180 women) by year end.5 The occurrence of colorectal cancer is strongly related to age, with 83% of cases arising in people who are 60 years or older. Up to age 50, the incidence of colorectal cancer is similar among men and women. After age 50, men have a higher incidence than women.6

Among individuals diagnosed with colorectal cancer, survival is highly dependent on how advanced the disease is at diagnosis. Five-year survival is 90% if the disease is diagnosed while it affects only the large intestine but only 65% once it has spread to the lymph nodes and 9% if it has spread throughout the body.7 Most colorectal cancers arise from precursor lesions in the large intestine called 'adenomatous polyps'. Screening is important because it means that adenomatous polyps can be removed before they become cancerous. Screening also means that colorectal cancer can be diagnosed at an earlier stage.7

References:

1. Taylor SA, Iinuma G, Zhang J and Halligan S. CT colonography: Computer-aided detection of morphologically flat early (T1) colonic carcinoma. Abstract VG21-09 presented at the Annual Meeting of the Radiological Society of North America, Chicago, 25-30 November 2007

2. Taylor SA, Iinuma G, Halligan S, Honeyfield L, Roddie M and Costea A. CT colonography: Computer assisted detection of colorectal cancer. Abstract SSK10-01 presented at the Annual Meeting of the Radiological Society of North America, Chicago, 25-30 November 2007

3. Bogoni L, Cathier P, Dundar M et al. Computer-aided detection (CAD) for CT colonography: a tool to address a growing need. British Journal of Radiology 2005; 78:S57-S62

4. U.S. Department of Health and Human Services, Centers fro Disease Control and Prevention: Colorectal (Colon) Cancer [Internet]. Atlanta (GA). Basic Overview. 2007 March 19 [cited 2007 Nov 6]. Available here.

5. U.S. National Institutes of Health, National Cancer Institute: Colon and Rectal Cancer [Internet]. Bethesda (MD). Estimated new cases and deaths. [cited 2007 Nov 6]. Available here.

6. Cancer Research UK. UK Bowel Cancer incidence statistics. Available at here. Accessed on 12 September 2007

7. Smith RA, Mettlin CJ, Eyre H. 31. Cancer Screening and Early Detection. In: D. W. Kufe et al., eds. Cancer Medicine. 6 ed. Hamilton, London: BC Decker Inc, 2003

Medicsight PLC is a UK-headquartered, research driven, leading developer of computer-aided detection (CAD) and image analysis software for the medical imaging market. The CAD software automatically highlights suspicious areas on computerised tomography (CT) scans of the colon and lung, helping radiologists to identify, measure and analyse potential disease and early indicators of disease. Medicsight's computer-aided detection (CAD) software has been validated using one of the world's largest and most population diverse databases of verified patient CT scan data. Medicsight's ColonCAD™ and LungCAD™ software products are seamlessly integrated with the advanced 3D visualisation workstations of several industry-leading imaging equipment partners.

About Computer-Aided Detection

With increasingly sophisticated radiological imaging hardware such as Multi-Detector CT scanners, radiologists are facing a growing challenge in the amount of detailed patient image data that they must review for each patient examination. Some CT scan examinations generate as many as 1000 images per patient. Review of this data by the radiologist is not only time-consuming but also prone to error due to reader fatigue. CAD software can help the reviewing radiologist by analysing the image data and automatically highlighting suspicious regions of interest for closer inspection. Without CAD software some potential abnormalities or areas of disease may be overlooked. This is critical for diagnosis and the management of patient outcomes as early detection of disease greatly increases the probability of successful treatment and a positive therapeutic outcome.

About Medicsight's CAD software

Medicsight's ColonCAD™ and LungCAD™ software use an advanced CAD algorithm to analyse CT scans of the colon and lung and automatically highlight suspicious areas that may be indicators of disease. CAD may highlight areas easily overlooked by the reviewing radiologist, such as small lesions or regions that are hidden from view behind folds in the colon or normal structures and surrounding tissue in the lung.

Both CAD products seamlessly integrate with the advanced 3D visualisation platforms of industry-leading imaging equipment partners. The integrated systems provide sophisticated image viewing capabilities, including 3D reconstructed image data, with the added advantage of demonstrating automatic CAD findings to assist clinical end users in the detection and analysis of disease. This allows clinical end users to perform either a 'second read', where CAD findings are displayed to the user after completion of an initial review of the CT scan data, or a 'concurrent read' where CAD findings are displayed during the user's initial review of the original CT scan images.

Since inception, Medicsight has developed close and lasting relationships with some of the world's foremost clinicians in product related areas. This provides the Company with a wealth of clinical expertise and dedicated clinical research to support ongoing product development. Medicsight also collaborates with a number of leading academic institutions and clinical research programmes worldwide to develop the Company's comprehensive database of population diverse verified patient CT scan data, thus allowing Medicsight's products to be validated to the highest possible standards.

About Adenomas

An adenoma (sometimes known as a polyp) is a slow-growing benign tumour. This is the most common type of early-stage tumour found in the colon and typically projects into the colon from the wall. Adenomas are routinely removed on identification because of their tendency to become malignant.

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