A novel semi-automatic segmentation method for volumetric assessment of the colon based on magnetic resonance imaging

Sandberg, Thomas Holm; Nilsson, Matias; Poulsen, Jakob Lykke; Gram, Mikkel; Frøkjær, Jens Brøndum; Østergaard, Lasse Riis; Drewes, Asbjørn Mohr

doi:10.1007/s00261-015-0475-z

Cited by 37 publications

(28 citation statements)

References 31 publications

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“…The 'large bowel' hypothesis proposes that rapid colonic fermentation of unabsorbed carbohydrates generates gas, distending the colon and causing flatulence, bloating and discomfort. Reports that some IBS patients have different microbiota to non-sufferers 10,11 , and that the microbiota changes with diet, 12,13 20,21 . Luminal gas has been assessed in both the small bowel 22 and colon 23 .…”

Section: Discussionmentioning

confidence: 99%

Colon Hypersensitivity to Distension, Rather Than Excessive Gas Production, Produces Carbohydrate-Related Symptoms in Individuals With Irritable Bowel Syndrome

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Colon Hypersensitivity to Distension, Rather Than Excessive Gas Production, Produces Carbohydrate-Related Symptoms in Individuals With Irritable Bowel Syndrome

et al. 2017

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“…16 The present study will not elaborate on software (Colometry v.1.0, MechSense, Aalborg University Hospital, 2015, Aalborg, Denmark) details, but merely explain that the method is based on manually placed regions of interest on the T2-weighted scans. These regions of interest are used to outline the four colon segments in each of the 35-40 coronal slices per scan.…”

Section: Colorectal Volumesmentioning

confidence: 99%

“…On the other hand, our recent study with this method found that it exhibits negligible intra-observer bias. 16 Currently, the MRI-based method is not able to discern between the volume of the colon wall itself, fecal volume and or gas within the colon. Therefore, the colorectal volumes reported here are the total combined volume of the colon itself and all content (gas, fluid mass, solid mass).…”

Section: Study Limitationsmentioning

confidence: 99%

“…[13][14][15] We have recently presented a novel MRI-based semi-automatic technique that allows determination of segmental colorectal volumes without the use of contrast-enhancing agents. 16 By repeating the investigation just after defecation, the method may also allow description of changes in colorectal volume distribution resulting from defecation. We hypothesize that segmental colorectal volumes in healthy subjects exhibit low variability between observations with a significant change after defecation.…”

Section: Introductionmentioning

confidence: 99%

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Quantification and variability in colonic volume with a novel magnetic resonance imaging method

Nilsson

Sandberg

Poulsen

et al. 2015

Neurogastroenterology Motil

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Key Messages• The aim of this study was to describe the inter-individual and intra-individual variability in segmental volume of the undisturbed colon between two observations and the effect of defecation on the segmental volumes.• Variability of segmental colorectal volumes was assessed with a novel semi-automatic MRI-based technique in healthy males in a controlled fasting state.• Despite being a highly dynamic organ, the colon displays low intra-individual variability and the technique is sensitive to the changes in segmental colorectal volume that occur from defecation. AbstractBackground Segmental distribution of colorectal volume is relevant in a number of diseases, but clinical and experimental use demands robust reliability and validity. Using a novel semi-automatic magnetic resonance imaging-based technique, the aims of this study were to describe: (i) inter-individual and intra-individual variability of segmental colorectal volumes between two observations in healthy subjects and (ii) the change in segmental colorectal volume distribution before and after defecation. Methods The inter-individual and intra-individual variability of four colorectal volumes (cecum/ ascending colon, transverse, descending, and rectosigmoid colon) between two observations (separated by 52 AE 10) days was assessed in 25 healthy males and the effect of defecation on segmental colorectal volumes was studied in another seven healthy males. Key Results No significant differences between the two observations were detected for any segments (All p > 0.05). Inter-individual variability varied across segments from low correlation in cecum/ascending colon (intra-class correlation coefficient [ICC] = 0.44) to moderate correlation in the descending colon (ICC = 0.61) and high correlation in the transverse (ICC = 0.78), rectosigmoid (ICC = 0.82), and total volume (ICC = 0.85). Overall intra-individual variability was low (coefficient of variance = 9%). After defecation the volume of the rectosigmoid decreased by 44% (p = 0.003). The change in rectosigmoid volume was associated with the true fecal volume (p = 0.02). Conclusions & Inferences Imaging of segmental colorectal volume, morphology, and fecal accumulation is advantageous to conventional methods in its low variability, high spatial resolution, and its absence of contrast-enhancing agents and irradiation. Hence, the method is suitable for future clinical and interventional studies and for characterization of defecation physiology.

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“…Additionally, chyme heterogeneity in the ascending colon has been assessed with subjective observer scores, and more objectively with imaging‐based feature analysis . Colonic segmental volumes can be quantified from T 2 ‐weighted MRI sequences, where the colon wall shows high contrast to surrounding fat tissue, a method with high reliability between observers . T 2 ‐weighted MRI has also been used to quantify the amount of free water pockets in the small bowel and colon after drinking water, due to the images' high signal strength corresponding to free water .…”

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confidence: 99%

MRI analysis of fecal volume and dryness: Validation study using an experimental oxycodone‐induced constipation model

Mark

Bodker

Grønlund

et al. 2019

Magnetic Resonance Imaging

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Background Opioids are known to affect gastrointestinal motility, but their effect on fluid absorption and secretion is poorly understood in humans. Purpose To investigate the effect of oxycodone on colonic fecal volume and stool dryness by using a novel MRI‐based technique. Study Type Prospective, randomized, double‐blinded, crossover study. Subjects Twenty‐five healthy male volunteers (median age: 24 years [range: 21–56]; mean body mass index [BMI]: 23.9 kg/m2 [range: 22.9–25.0]) without known gastrointestinal disease. Field Strength/Sequence T2‐weighted and two‐point Dixon MRI scans of the abdomen at 1.5 T. Assessment Subjects were treated for 5 days with prolonged‐release oxycodone or a placebo. Imaging was performed on the first and last study day in each period. Images of the colon were analyzed with semiautomatic k‐means‐based segmentation software. Regional colonic fecal volumes were quantified excluding gas volume and colon wall. Two‐point Dixon and T2‐weighted MRI signal intensity were assessed as a proxy of colonic stool dryness. Data were obtained in a previously reported study. Statistical Tests Intraclass correlation coefficients were used to test the reliability of measurements between days, while repeated measures mixed models were applied to test treatment effects. Results After oxycodone treatment, total colonic fecal volume was significantly increased compared with placebo (mean change 100 mL vs. –13 mL; P = 0.001), with the largest increase (24%) observed in the ascending colon/cecum (P = 0.001). Dixon signal increased (less water in colon content) after oxycodone treatment compared with placebo (mean 0.09 vs. –0.02; P < 0.001). T2‐weighted signal decreased (less water in colon content) after oxycodone treatment compared with placebo (mean –0.03 vs. 0.03; P = 0.002). Data Conclusion The 5‐day oxycodone treatment increased colonic fecal volume and increased stool dryness compared with placebo. This imaging‐based method for noninvasive analysis of colon content has the potential to characterize gastrointestinal symptoms in general, such as in constipation. Level of Evidence: 2 Technical Efficacy Stage: 1 J. Magn. Reson. Imaging 2019;50:733–745.

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A novel semi-automatic segmentation method for volumetric assessment of the colon based on magnetic resonance imaging

Cited by 37 publications

References 31 publications

Colon Hypersensitivity to Distension, Rather Than Excessive Gas Production, Produces Carbohydrate-Related Symptoms in Individuals With Irritable Bowel Syndrome

Colon Hypersensitivity to Distension, Rather Than Excessive Gas Production, Produces Carbohydrate-Related Symptoms in Individuals With Irritable Bowel Syndrome

Quantification and variability in colonic volume with a novel magnetic resonance imaging method

MRI analysis of fecal volume and dryness: Validation study using an experimental oxycodone‐induced constipation model

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