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Supercomputer 'Virtual Cleanse' Aims To Ease Colonoscopy Preparation

Image processing technologies being tested by Massachusetts General Hospital intend to take the yuck factor out of colorectal cancer screenings.

Traditional colonoscopies require patients to drink large doses of heavy-duty laxatives, usually the night before the test, to cleanse their colons. Not a pleasant experience, and undoubtedly for most patients, the worst part of having the test. Massachusetts General Hospital, working with Microsoft and Intel, is improving the image processing involved with virtual colonoscopies, which are screening tests used to detect colorectal cancer.

Traditional colonoscopies involve sedating the patient while a camera-equipped device is inserted into the length of the colon as doctors look for suspicious pre-cancerous polyps or actual malignancies. Fortunately, the sedation makes the actual test bearable to most patients, but there are risks of the colon getting perforated. Also the sedation requires the patient to arrange a ride home, and for the most part, the test is a productivity-killer for the day.

But over the last 10 years, some institutions have offered virtual colonoscopies, which instead of using a tiny camera inserted into the colon, uses computerized tomography (CT) technology to take thousands of thinly sliced images. A problem with virtual colonoscopies is that they still require the laxative prep.

However, technologies being clinically tested at Mass General allow patients undergoing virtual colonoscopies to avoid the laxative prep.

Instead, patients drink a small volume of contrasting agent that allows imaging algorithms to "virtually cleanse the colon of fecal matter," allowing clinicians to see inside the colon for signs of cancer or pre-cancer, said Hiro Yoshida, director of 3D imaging research in the radiology department at Massachusetts General Hospital, which is part of Partners Healthcare in Boston.

Till now, the computer processing involved with the virtual cleansing took anywhere from 30 to 60 minutes, Yoshida said, who developed the algorithms.

But using supercomputing strength technologies, including Microsoft's high-performance computing (HPC) platform running Windows 7, Microsoft .Net 4.0, Intel Parallel Studio 2011 developer tool suite, and imaging tools from VectorForm, Mass Gen was able to reduce the processing of the laxative-free virtual colonoscopy scans to three minutes, Yoshida said, adding that the processing time will likely get whittled down even further to about 20 seconds.

This drastic reduction of time allows clinicians to identify suspicious findings in the colon while the patient is still on CT testing table, said Yoshida. If a polyp is found, clinicians can immediately help patients schedule a procedure to have the lesion removed -- which usually involves having a traditional colonoscopy.

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