Semi-automatic detection of Gd-DTPA-saline filled capsules for colonic transit time assessment in MRI

Functional gastrointestinal disorders result in a significant number of consultations in primary care facilities. Chronic constipation and diarrhea are regarded as two of the most common diseases affecting between 2% and 27% of the population in western countries^1-3. Defecatory disorders are most commonly due to dysfunction of the pelvic floor or the anal sphincter. Although an exact differentiation of these pathologies is essential for adequate therapy, diagnosis is still only based on a clinical evaluation¹. Regarding quantification of constipation only the ingestion of radio-opaque markers or radioactive isotopes and the consecutive assessment of colonic transit time using X-ray or scintigraphy, respectively, has been feasible in clinical settings^4-8. However, these approaches have several drawbacks such as involving rather inconvenient, time consuming examinations and exposing the patient to ionizing radiation. Therefore, conventional assessment of colonic transit time has not been widely used. Most recently a new technique for the assessment of colonic transit time using MRI and MR-contrast media filled capsules has been introduced⁹. However, due to numerous examination dates per patient and corresponding datasets with many images, the evaluation of the image data is relatively time-consuming. The aim of our study was to develop a computer tool to facilitate the detection of the capsules in MRI datasets and thus to shorten the evaluation time. We present a semi-automatic tool which provides an intensity, size¹⁰, and shape-based ^11,12 detection of ingested Gd-DTPA-saline filled capsules. After an automatic pre-classification, radiologists may easily correct the results using the application-specific user interface, therefore decreasing the evaluation time significantly.