virtuelle endoskopie...

[ilo]

Hallo, ich hätte mal gerne gewusst, ob in der Krebsfrüherkennung - z. B. Darm - schon die neue Methode "virtuelle Endoskopie" angewendet wird und wo man das mit dieser Methode machen lassen kann. Ich wohne im Ruhrgebiet. Wo kann man so etwas denn erfahren? Viele Grüße und vielen Dank - ilo

[Prof. Wust]

RE: virtuelle endoskopie...


Die virtuelle Endoskopie ist eine radiologische Methode der Dick- und Dünndarmuntersuchung. Diese Methode ist noch nicht so validiert, daß sie uneingeschränkt die normale Endoskopie er-setzen kann, zumal in der „richtigen“ Endoskopie auch Eingriffe (Polypenabtragung und Biopsien) vorgenommen werden können. Dieses Verfahren wird zur Zeit von einigen Universitätskliniken (Radiologie) eingeführt (natürlich auch an der Charité). Im Ruhrgebiet gibt es eine Reihe von Universitäten, z.B. Bonn, Köln oder Düsseldorf, wo Sie mal anfragen sollten.

Virtual endoscopy of the small bowel: phantom study and preliminary clinical results.
AU: Rogalla,-P; Werner-Rustner,-M; Huitema,-A; van-Est,-A; Meiri,-N; Hamm,-B
AD: Department of Radiology, Charite Hospital, Humboldt-Universitat zu Berlin, Schumannstrasse 20/21, D-10098 Berlin, Germany.
SO: Eur-Radiol. 1998; 8(4): 563-7
AB: The purpose of this study was to determine the optimal scanning technique for lesion detec-tion in a small bowel phantom and to evaluate the virtual endoscopy (VE) technique in patients. A small bowel phantom with a fold thickness of 7 mm and length of 115 cm was prepared with nine round lesions (3 x 1 mm, 2 x 2 mm, 2 x 3 mm, 2 x 4 mm). Spiral CT parameters were 7/7/4, 3/5/2, 3/5/1, 1.5/3/1 (slice thickness/table feed/reconstruction interval). VE was done using volume rendering technique with 1 cm distance between images and 120 degrees viewing angle. Two masked readers were asked to determine the number and location of the lesions. Seven patients underwent an abdominal CT during one breathhold after placement of a duodenal tube and filling of the small bowel with methyl cellulose contrast solution. VE images were compared with the axial slices with respect to detectability of pathology. With the 7/7/4 protocol only the 4-mm lesions were visualised with fuzzy contours. The 3/5/2 protocol showed both 4-mm lesions, one 3-mm lesion and one false positive lesion. The 3/5/1 protocol showed both 4-mm and both 3-mm (one uncertain) lesions with improved sharpness, and no false positive lesions. One 2-mm and one 1-mm lesion were additionally seen with the 1.5/3/1 protocol. Path definition was difficult in sharp turns or kinks in the lumen. In all patients, no difference was found between VE and axial slices for bowel pathology; however, axial slices showed 'outside' information that was not included in VE. We conclude that the 3/5/2 protocol may be regarded as an optimal compromise between lesion detection, coverage during one breathhold, and number of reconstructed images in patients; round lesions of 4 mm in diameter can be detected with high certainty.