German company streamlines virtual colonoscopy exam

While obvious colon cancers can be diagnosed with standard imaging methods, the detection of precancerous polyps relies on advanced virtual colonoscopy techniques. But a full examination of the colon with virtual colonoscopy is time-consuming and complex, requiring 20 to 40 minutes of a radiologist's time.

Rendoscopy AG of Gauting, Germany, has created software that may fit virtual colonoscopy into the clinical workflow of a radiologist's daily routine, cutting individual exam time down to five minutes or less, according to the company. Rendoscopy is an offshoot of the Institute for Clinical Radiology of the Grosshadern Hospital of Ludwig-Maximilian-University Munich.

Rendoscopy software is fully automated and capable of handling 900 cases in 24 hours without operator interaction, said Georg-Friedemann Rust, Ph.D., CEO and founder of the company, which appeared on the RSNA exhibit floor as part of a multicorporation German pavilion. The software presents the data obtained from cross-sectional imaging, including 2D axial, coronal, oblique, and sagittal views--as well as an overall topogram and 3D intraluminal views--simultaneously, refreshing data at every step along the track of the colon.

A unique feature is the split view, which divides the colon into two parts and provides a perpendicular view of colonic folds, Rust said.

"The advantage of this visualization technique is that you have no blind areas. You can assess not just the internal colonic mucosa but also the adjacent mesenteric fat, which is highly relevant for assessing infiltration," he said. "Spinning of the split colon gives you the option of bringing every lesion into view so you can see what is going on in the mesenteric fat and see if there is residual stool, a polyp, or cancer. This is, from a clinician's point of view, very informative as well as relevant."

The software creates surfaces that have almost no partial-volume effect, which gives 3D images high technical contrast resolution. Its Multipath Tracking System allows the colon to be examined even when parts of the colonic tube have collapsed or are filled with liquid, Rust said.

As a company created by radiologists, Rendoscopy could provide an alternative to products developed by major imaging manufactures, he said.

"One of the problems with big manufacturers is they create something in the 3D lab and then ask doctors if it is okay or not," he said. "We are radiologists who created this software because we know that to optimize our workflow, we must be able to integrate virtual colonoscopy into our clinical workflow and analyze exams in shorter time."