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To develop a novel method of detecting rectal cancer, we assessed relationships between intra-abdominal fat distribution and rectal cancer in Japanese patients. Subjects comprised 38 patients with rectal cancer apparent on CT-colonography and 110 other cases. The intra-abdominal fat area was determined by calculating pixel distribution with attenuation values from -140 HU to -40 HU. The area of intra-abdominal fat was measured on axial images using an interslice gap of 10 mm. Profile curves of intra-abdominal fat were in the plane direction from diaphragm to anus. Of note is the fact that Ogura's peak, a secondary small peak around the rectal cancer, was apparent on the profile of intra-abdominal fat, with 73.7% of rectal cancers displaying Ogura's peak. In comparison, only 19.1% of other cases displayed Ogura's peak on this profile. The relationship between fat and rectal cancer is difficult to explain. However, making good use of these results showing intra-abdominal fat distribution, a computer-aided diagnosis (CAD) system for detecting rectal cancer according to the presence of Ogura's peak has potential as a method of mass screening. As only 148 cases were investigated in the present study, the accumulation of additional data is needed. More detailed studies with larger patient populations are warranted.

Evaluation of Intra-abdominal Fat Distribution Using X-ray CT Data for Detection of Rectal Cancer