I happen to be old enough to have had a screening colonoscopy on two occasions. As anyone who has had this procedure performed will know, the exam itself isn’t nearly as bad as the preparation for it. With good sedation, one hardly remembers the procedure. However, drinking a gallon or so of go-litely bowel prep and then waiting for your gut to evacuate has never been high on this doctor’s list of favorite things to do. For that reason alone, many people avoid having a screening colonoscopy even though it is a test that can save lives by detecting cancer early.
Avoiding the nasty prep and the invasive (some would say embarrassing) test are reasons why many people are attracted to an alternate test called “virtual” screening colonoscopy. In this test, a CT scanner replaces the colonoscope, but unfortunately the gut-cleaning prep is still required. The American Cancer Society has added virtual colonoscopy to its list of recommended screenings and studies have shown that the virtual exam is as reliable as the scope method in finding polyps or cancer (New England Journal of Medicine).
Now, clinicians at the Massachusetts General Hospital are testing a concept that could make virtual colonoscopy faster, less expensive and even easier for the patient. Using the magic of computers and software, it is possible to digitally remove the normal contents of the gut and make the inside of the gut appear just as if the patient had done the usual bowel evacuation prep. However, one issue with the virtual “cleaning” has been the amount of time needed to process the CT images so they can be interpreted by clinicians. The time needed to run the necessary computer algorithms can take up to 60 minutes for each exam, far too long to be practical. So Dr. Hiro Yoshida, a researcher with Massachusetts General who developed the datagram transport layer security (DTLS) algorithm used to electronically clean virtual colonoscopy images, knew it needed to be done faster. Using Microsoft’s high performance computing (HPC) platform, Microsoft .Net 4.0, and the Intel Parallel Studio 2011 developer tool suite, researchers were able to reduce the time needed to run the algorithms from 60 minutes to just 3 minutes. This might very well lead to faster, less expensive virtual exams that are also much more pleasant for patients because no bowel prep is required.
The collaboration also:
- demonstrates advanced visualization capabilities with 2D to 3D conversion, gesture-based (multi-touch) navigation and computer-aided diagnostics on Windows 7 powered devices, including a Slate device, Windows Phone 7, or desktop PC
- leverages Intel’s multi-core processor technologies, enabling programmers to make performance and reliability improvements to applications
- uses a fully parallelized GPU-based volume rendering engine developed by Microsoft Research
- demonstrates the capability to do high performance CPU and GPU-based computing with Windows HPC and .NET for colon cancer screening
One disadvantage of virtual colonoscopy is that if a polyp or cancer is discovered with the CT scan, a patient must undergo a standard colonoscopy for final diagnosis and treatment. However, as a screening test the virtual exam is likely to be favored by many patients who would rather avoid the prep and inconvenience associated with traditional colonoscopy. By working together, computer scientists and clinicians may be finding ways to make virtual colonoscopy even better and more attractive to patients. If so, many more lives could be saved.
Bill Crounse, MD Senior Director, Worldwide Health Microsoft