Journal of Clinical and Medical Sciences

Abstract

Enhancing Virtual Colonoscopy: Exploring Electronic Colon Cleansing Strategies and Methodologies

Mehrnaz Mostafavi*, Mahtab Shaabani

The rapid advancements in Computed Tomography (CT) technology have positioned CT Colonography (CTC), commonly known as Virtual Colonoscopy (VC), as a promising tool for early detection of colon cancer. Despite more than 57,000 annual deaths in the United States attributed to colon cancer, CTC stands out as a recommended radiological examination for diagnosing colorectal neoplasia, especially in cases of incomplete or contraindicated colonoscopies. This method involves low-dose CT scans of the cleansed and distended colon in both supine and prone positions. This paper provides a comprehensive insight into CTC procedures and discusses key aspects of Electronic Colon Cleansing (ECC), aiming to segment the colon lumen from CT images with an oral contrast agent. The study outlines various ECC algorithms, their advantages, drawbacks, and technological intricacies extracted from reviewed literature. ECC plays a pivotal role in processing CT data, particularly in cleansing the colon's interior for effective polyp identification, a crucial step in virtual colonoscopy. The paper delves into multiple ECC methodologies, including thresholding, Markov random field models, segmentation using segmentation rays, and non-linear transfer functions combined with morphological operations. These methodologies vary in their approaches, performance, and computational requirements. For instance, while thresholding offers speed, it struggles with partial voxel segmentation and sensitivity to threshold alterations. In contrast, the Markov random field model integrated into the Expectation Maximization (EM) algorithm simultaneously estimates model parameters and segments voxels. Additionally, segmentation rays accurately detect partial volume regions and allow for their removal, enhancing accuracy in colon cleansing. The paper also discusses non-linear transfer functions and morphological operations, amalgamating two techniques to boost the precision of colon cleansing. This detailed analysis aims to present a nuanced understanding of ECC techniques, providing researchers with a comprehensive overview of these methodologies. The insights derived from this paper contribute to the ongoing exploration of effective ECC strategies for optimizing virtual colonoscopy and improving colon cancer screening outcomes.

Published Date: 2025-04-10; Received Date: 2023-12-27