Roadmap of the Small Bowel

Episode # 67
Uploaded: August 31, 2011
Running Time: 02:30

CROWN: From the National Institutes of Health in Bethesda, Maryland, this is CLINICAL CENTER RADIO.

An intramural research project at the NIH Clinical Center is working to roadmap the small bowel – an intricate organ that presents challenging imaging issues for clinicians looking for lesions, polyps, and tumors.  Dr. Ronald Summers, senior investigator and staff radiologist chief at the NIH Clinical Center’s Imaging Biomarkers and Computer-Aided Diagnosis Laboratory said they’re trying to create a better diagnostic tool.

SUMMERS: I look at these CT scans of people’s abdomens every day. There are 22 feet of small bowel all wrapped up like a ball of yarn. I try my best to find abnormalities in that bowel but it is pretty tricky. So the idea was to try to figure out how to unravel that ball of yarn.

CROWN: Currently, the standard diagnostic tool is computed tomography, or CT.  CT scans can show clinicians if there is an abnormality. Yet because of the design of the small bowel with its many loops and folds, doctors often have to wait until they get into surgery and feel a section of the small bowel to actually find the issue. However, Summers and his team found a way to map out a patient’s small bowel and create a 3-D video using the CT images. It wasn’t an easy process.

SUMMERS: It took 2 weeks to make this video because we had to identify all the small blood vessels that feed the small intestines. It’s easy to see the big blood vessels but identifying all the small blood vessels was very time-consuming.

CROWN: Down the road, the idea is that this process would be fully automated. Researchers are looking at indicators that would help identify a patient’s unique small bowel design – not entirely unlike their fingerprint. If they can identify those indicators, they may be able to create these 3-D videos in minutes, and offer a better picture for diagnosis and treatment.

SUMMERS: We’re hoping that it will shorten the surgery time, that it will reduce the amount of bowel that has to be cut out, and that it will reduce the number of times tumors are left behind.

CROWN: Watch the video created by Summers and his team online at http://www.youtube.com/NIHClinicalCenter. From America's Clinical Research Hospital, this has been CLINICAL CENTER RADIO. In Bethesda, Maryland, I'm Ellen Crown, at the National Institutes of Health, an agency of the United States Department of Health and Human Services.

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