1. Automatic Virtual Colonoscopy Based Diagnostic Decision Support System for Colorectal Cancer Screening Project IKTA5-058/2002 Infocommunications Technologies and Applications Research & Development Division, Ministry of Education, Hungary http://www.om.hu/ikta Project Duration: March 2003 – Sept 2004

2. Participants Co-ordinator: Semmelweis University, Department of Diagnostic Radiology and Onkotherapy, Budapest Semmelweis University, Department of Diagnostic Radiology and Onkotherapy, Budapest Home page: http://www.sote.hu Address: H-1082 Budapest, Üllői út 78/a Tel.: (36-1)-2100307 Project leader: Tarján Zsolt Dr. Consortium members: Budapest University of Technology and Economics, Department of Control Engineering and Information Technology, Budapest Budapest University of Technology and Economics, Department of Control Engineering and Information Technology, Budapest Home page: http://www.iit.bme.hu Team leader: Szirmay-Kalos László Prof. KDBR Consulting Kft., Budapest KDBR Consulting Kft., Budapest Home page: http://www.kdbr.hu Team leader: Kuhár János

3. Scientific Background Keywords: Endoscopy, Colonoscopy, Cancer Screening, Radiology, Computer Tomography, Virtual Endoscopy, Virtual Colonoscopy, Computer Graphics, Volume Rendering, Image Processing, Decision Support Endoscopy, Colonoscopy, Cancer Screening, Radiology, Computer Tomography, Virtual Endoscopy, Virtual Colonoscopy, Computer Graphics, Volume Rendering, Image Processing, Decision Support Related publications by the participants at: European Congress of Radiology, Wien, 2001 3rd National Conference on Image Processing and Shape Recognition, Domaszék, Hungary, 2002 First Hungarian Computer Graphics and Geometry Conference, Budapest, 2002 Winter School on Computer Graphics, 2003 3 rd Conference on 3D Imaging and Virtual Endoscopy, Rome, 2002

4. Motivation 6000 people die yearly because of colorectal cancer in Hungary. Early detection could reduce fatalities to one third. Because of associated discomfort only few asymptomatic patients would undergo traditional screening by colonoscopy.

5. Traditional Colonoscopy Video colonoscopy Endoscopic treatment

6. Virtual Colonoscopy CT scan Axial cross-sectional images set Volumetric dataset (voxel array) Virtual colonoscopy view Visualization algorithms

7. Goals The aim of the project is to develop a complex alternative screening method for colorectal cancer and preceding conditions. Research focuses on: less burdening patient preparation, suitable CT protocol, automated virtual colonoscopy software, fecal tagging algorithm, handling noisy, low dosage CT data, computer aided semi-automated decision support.

8. Software Engineering Problems Processing large volumetric datasets at interactive speed Direct volume visualization Efficient user friendly interface Semi-automated navigation Fecal tagging Automated polyp detection Diagnostic decision support

9. Virtual Colonoscopy Software

10. Challenges in Radiology Fast patient preparation Efficient and comfortable cleansing, contrasting and inflation CT protocol to minimize X-ray dosage Ensuring high diagnostic sensitivity