Skip to main content
SpringerLink
Log in

CT Colonography for Population Screening: Ready for Prime Time?

  • Review
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. Johnson CD, Chen MH, Toledano AY, et al. Accuracy of CT colonography for detection of large adenomas and cancers. N Engl J Med. 2008;359:1207–1217.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  2. Kim DH, Pickhardt PJ, Taylor AJ, et al. CT colonography versus colonoscopy for the detection of advanced neoplasia. N Engl J Med. 2007;357:1403–1412.

    Article  CAS  PubMed  Google Scholar 

  3. Pickhardt PJ, Choi JR, Hwang I, et al. Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. N Engl J Med. 2003;349:2191–2200.

    Article  CAS  PubMed  Google Scholar 

  4. Hanson ME, Pickhardt PJ, Kim DH, Pfau PR. Anatomic factors predictive of incomplete colonoscopy based on findings at CT colonography. AJR Am J Roentgenol. 2007;189:774–779.

    Article  PubMed  Google Scholar 

  5. Macari M, Berman P, Dicker M, Milano A, Megibow AJ. Usefulness of CT colonography in patients with incomplete colonoscopy. Am J Roentgenol. 1999;173:561–564.

    Article  CAS  Google Scholar 

  6. Morrin MM, Kruskal JB, Farrell RJ, Goldberg SN, McGee JB, Raptopoulos V. Endoluminal CT colonography after an incomplete endoscopic colonoscopy. Am J Roentgenol. 1999;172:913–918.

    Article  CAS  Google Scholar 

  7. Yucel C, Lev-Toaff AS, Moussa N, Durrani H. CT colonography for incomplete or contraindicated optical colonoscopy in older patients. Am J Roentgenol. 2008;190:145–150.

    Article  Google Scholar 

  8. Copel L, Sosna J, Kruskal JB, Raptopoulos V, Farrell RJ, Morrin MM. CT colonography in 546 patients with incomplete colonoscopy. Radiology. 2007;244:471–478.

    Article  PubMed  Google Scholar 

  9. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. Ca-a Cancer J Clin. 2013;63:11–30.

    Article  Google Scholar 

  10. Pickhardt PJ. Computed tomography colonography: emerging evidence to further support clinical effectiveness. Curr Opin Gastroenterol. 2013;29:55–59.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Pickhardt PJ. CT colonography: time for clinical implementation. Nat Rev Clin Oncol. 2009;6:187–188.

    Article  PubMed  Google Scholar 

  12. Pickhardt PJ. CT colonography: does it satisfy the necessary criteria for a colorectal screening test? Expert Rev Gastroenterol Hepatol. 2014;8:211–213.

    Article  CAS  PubMed  Google Scholar 

  13. Rex DK. Is virtual colonoscopy ready for widespread application? Gastroenterology. 2003;125:608–610.

    Article  PubMed  Google Scholar 

  14. Levin B, Lieberman DA, McFarland B, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. CA Cancer J Clin. 2008;58:130–160.

    Article  PubMed  Google Scholar 

  15. Kim DH, Pickhardt PJ. CT colonography versus colonoscopy for the detection of advanced neoplasia—reply. New Engl J Med. 2008;358:90.

  16. Kim DH, Pickhardt PJ, Taylor AJ. Characteristics of advanced adenomas detected at CT colonographic screening: implications for appropriate polyp size thresholds for polypectomy versus surveillance. Am J Roentgenol. 2007;188:940–944.

    Article  Google Scholar 

  17. Pickhardt PJ, Kim DH. Colorectal cancer screening with CT colonography: key concepts regarding polyp prevalence, size, histology, morphology, and natural history. Am J Roentgenol. 2009;193:40–46.

    Article  Google Scholar 

  18. Winawer SJ, Zauber AG. The advanced adenoma as the primary target of screening. Gastrointest Endosc Clin N Am 2002;12:1–9, v.

  19. Pickhardt PJ, Kim DH, Pooler BD, et al. Assessment of volumetric growth rates of small colorectal polyps with CT colonography: a longitudinal study of natural history. Lancet Oncol. 2013;14:711–720.

    Article  PubMed Central  PubMed  Google Scholar 

  20. O’Connell JB, Maggard MA, Ko CY. Colon cancer survival rates with the new American Joint Committee on cancer sixth edition staging. J Natl Cancer Inst. 2004;96:1420–1425.

    Article  PubMed  Google Scholar 

  21. Fenlon HM, Nunes DP, Schroy PC, Barish MA, Clarke PD, Ferrucci JT. A comparison of virtual and conventional colonoscopy for the detection of colorectal polyps. N Engl J Med. 1999;341:1496–1503.

    Article  CAS  PubMed  Google Scholar 

  22. Yee J, Akerkar GA, Hung RK, Steinauer-Gebauer AM, Wall SD, McQuaid KR. Colorectal neoplasia: performance characteristics of CT colonography for detection in 300 patients. Radiology. 2001;219:685–692.

    Article  CAS  PubMed  Google Scholar 

  23. Cotton PB, Durkalski VL, Benoit PC, et al. Computed tomographic colonography (virtual colonoscopy)—a multicenter comparison with standard colonoscopy for detection of colorectal neoplasia. J Am Med Assoc. 2004;291:1713–1719.

    Article  CAS  Google Scholar 

  24. Johnson CD, Harmsen WS, Wilson LA, et al. Prospective blinded evaluation of computed tomographic colonography for screen detection of colorectal polyps. Gastroenterology. 2003;125:311–319.

    Article  PubMed  Google Scholar 

  25. Rockey DC, Poulson E, Niedzwiecki D, et al. Analysis of air contrast barium enema, computed tomographic colonography, and colonoscopy: prospective comparison. Lancet. 2005;365:305–311.

    Article  CAS  PubMed  Google Scholar 

  26. Pickhardt PJ. Three-dimensional endoluminal CT colonography (virtual colonoscopy): comparison of three commercially available systems. Am J Roentgenol. 2003;181:1599–1606.

    Article  Google Scholar 

  27. Pickhardt PJ, Choi JHR. Electronic cleansing and stool tagging in CT colonography: advantages and pitfalls with primary three-dimensional evaluation. Am J Roentgenol. 2003;181:799–805.

    Article  Google Scholar 

  28. Pickhardt PJ, Nugent PA, Mysliwiec PA, Choi JR, Schindler WR. Location of adenomas missed by optical colonoscopy. Ann Intern Med. 2004;141:352–359.

    Article  PubMed  Google Scholar 

  29. Atkin W, Dadswell E, Wooldrage K, et al. Computed tomographic colonography versus colonoscopy for investigation of patients with symptoms suggestive of colorectal cancer (SIGGAR): a multicentre randomised trial. Lancet. 2013;381(9873):1194–1202.

  30. Graser A, Stieber P, Nagel D, et al. Comparison of CT colonography, colonoscopy, sigmoidoscopy and faecal occult blood tests for the detection of advanced adenoma in an average risk population. Gut. 2009;58:241–248.

    Article  CAS  PubMed  Google Scholar 

  31. Kawamura YJ, Okada S, Sasaki J, Tajima N, Tanaka O, Konishi F. Diagnostic accuracy of CT colonography and optical colonoscopy evaluated using surgically resected specimens. Abdom Imaging. 2010;35:584–588.

    Article  PubMed  Google Scholar 

  32. Pickhardt PJ, Hassan C, Halligan S, Marmo R. Colorectal cancer: CT colonography and colonoscopy for detection—systematic review and meta-analysis. Radiology. 2011;259:393–405.

    Article  PubMed Central  PubMed  Google Scholar 

  33. Baxter NN, Goldwasser MA, Paszat LF, Saskin R, Urbach DR, Rabeneck L. Association of Colonoscopy and Death From Colorectal Cancer. Ann Int Med. 2009;150:1-W.

  34. Pickhardt PJ, Taylor AJ, Gopal DV. Surface visualization at 3D endoluminal CT colonography: degree of coverage and implications for polyp detection. Gastroenterology. 2006;130:1582–1587.

    Article  PubMed  Google Scholar 

  35. Iafrate F, Hassan C, Ciolina M, et al. High positive predictive value of CT colonography in a referral centre. Eur J Radiol. 2011;80:E289–E292.

    Article  CAS  PubMed  Google Scholar 

  36. Pickhardt PJ, Wise SM, Kim DH. Positive predictive value for polyps detected at screening CT colonography. Eur Radiol. 2010;20:1651–1656.

    Article  PubMed  Google Scholar 

  37. Zueco Zueco C, Sobrido Sampedro C, Corroto JD, Rodriguez Fernandez P, Fontanillo Fontanillo M. CT colonography without cathartic preparation: positive predictive value and patient experience in clinical practice. Eur Radiol. 2012;22:1195–1204.

  38. Lung PF, Burling D, Kallarackel L, et al. Implementation of a new CT colonography service: 5 year experience. Clin Radiol. 2014;69:597–605.

    Article  CAS  PubMed  Google Scholar 

  39. Pickhardt PJ. Incidence of colonic perforation at CT colonography: review of existing data and implications for screening of asymptomatic adults. Radiology. 2006;239:313–316.

    Article  PubMed  Google Scholar 

  40. Gatto NM, Frucht H, Sundararajan V, Jacobson JS, Grann VR, Neugut AI. Risk of perforation after colonoscopy and sigmoidoscopy: a population-based study. J Natl Cancer Inst. 2003;95:230–236.

    Article  PubMed  Google Scholar 

  41. Iqbal CW, Cullinane DC, Schiller HJ, Sawyer MD, Zietlow SP, Farley DR. Surgical management and outcomes of 165 colonoscopic perforations from a single institution. Arch Surg. 2008;143:701–706.

    Article  PubMed  Google Scholar 

  42. Levin TR, Zhao W, Conell C, et al. Complications of colonoscopy in an integrated health care delivery system. Ann Intern Med. 2006;145:880–886.

    Article  PubMed  Google Scholar 

  43. Rabeneck L, Paszat LF, Hilsden RJ, et al. Bleeding and perforation after outpatient colonoscopy and their risk factors in usual clinical practice. Gastroenterology. 2008;135:1899–1906.

    Article  PubMed  Google Scholar 

  44. Kim DH, Pickhardt PJ, Taylor AJ, Menias CO. Imaging evaluation of complications at optical colonoscopy. Curr Probl Diagn Radiol. 2008;37:165–177.

    Article  PubMed  Google Scholar 

  45. Sharma VK, Nguyen CC, Crowell MD, Lieberman DA, de Garmo P, Fleischer DE. A national study of cardiopulmonary unplanned events after GI endoscopy. Gastrointest Endosc. 2007;66:27–34.

    Article  PubMed  Google Scholar 

  46. Fishback SJ, Pickhardt PJ, Bhalla S, Menias CO, Congdon RG, Macari M. Delayed presentation of splenic rupture following colonoscopy: clinical and CT findings. Emerg Radiol. 2011;18:539–544.

    Article  PubMed  Google Scholar 

  47. Pickhardt PJ, Durick NA, Pooler BD, Hassan C. Left-sided polyps detected at screening CT colonography: do we need complete optical colonoscopy for further evaluation? Radiology. 2011;259:429–434.

    Article  PubMed  Google Scholar 

  48. Moawad FJ, Maydonovitch CL, Cullen PA, Barlow DS, Jenson DW, Cash BD. CT colonography may improve colorectal cancer screening compliance. Am J Roentgenol. 2010;195:1118–1123.

    Article  Google Scholar 

  49. Pooler BD, Baumel MJ, Cash BD, et al. Screening CT colonography: multicenter survey of patient experience, preference, and potential impact on adherence. Am J Roentgenol. 2012;198:1361–1366.

    Article  Google Scholar 

  50. Shinners TJ, Pickhardt PJ, Taylor AJ, Jones DA, Olsen CH. Patient-controlled room air insufflation versus automated carbon dioxide delivery for CT colonography. Am J Roentgenol. 2006;186:1491–1496.

    Article  Google Scholar 

  51. Lawrence E, Pickhardt P. Comparison of high-volume PEG lavage with low-volume CT colonography bowel preparations utilizing oral contrast at optical colonoscopy. Dis Colon Rectum. 2010;53(8):1176–1181.

  52. Pickhardt PJ. Screening CT colonography: how I do it. AJR Am J Roentgenol. 2007;189:290–298.

    Article  PubMed  Google Scholar 

  53. Pickhardt PJ, Taylor AJ, Kim DH, Reichelderfer M, Gopal DV, Pfau PR. Screening for colorectal neoplasia with CT colonography: initial experience from the 1st year of coverage by third-party payers. Radiology. 2006;241:417–425.

    Article  PubMed  Google Scholar 

  54. Pickhardt PJ, Taylor AJ, Johnson GL, et al. Building a CT colonography program: necessary ingredients for reimbursement and clinical success. Radiology. 2005;235:17–20.

    Article  PubMed  Google Scholar 

  55. Cash BD, Stamps K, McFarland EG, Spiegel AR, Wade SW. Clinical use of CT colonography for colorectal cancer screening in military training facilities and potential impact on HEDIS measures. J Am College Radiol. 2013;10:30–36.

    Article  Google Scholar 

  56. Schwartz DC, Dasher KJ, Said A, et al. Impact of a CT colonography screening program on endoscopic colonoscopy in clinical practice. Am J Gastroenterol. 2008;103:346–351.

    Article  PubMed  Google Scholar 

  57. Benson M, Pier J, Kraft S, et al. Optical colonoscopy and virtual colonoscopy numbers after initiation of a CT colonography program: long term data. J Gastrointestin Liver Dis. 2012;21:391–395.

    PubMed Central  PubMed  Google Scholar 

  58. Pickhardt PJ. Randomized controlled trial evaluating participation and yield of colonoscopy versus CT colonography screening. Expert Rev Med Devices. 2012;9:107–110.

    Article  PubMed  Google Scholar 

  59. Stoop EM, de Haan MC, de Wijkerslooth TR, et al. Participation and yield of colonoscopy versus non-cathartic CT colonography in population-based screening for colorectal cancer: a randomised controlled trial. Lancet Oncol. 2012;13:55–64.

    Article  PubMed  Google Scholar 

  60. Pickhardt PJ, Hanson ME, Vanness DJ, et al. Unsuspected extracolonic findings at screening CT colonography: clinical and economic impact. Radiology. 2008;249:151–159.

    Article  PubMed  Google Scholar 

  61. Pickhardt PJ, Taylor AJ. Extracolonic findings identified in asymptomatic adults at screening CT colonography. Am J Roentgenol. 2006;186:718–728.

    Article  Google Scholar 

  62. Pickhardt PJ, Kim DH, Meiners RJ, et al. Colorectal and extracolonic cancers detected at screening CT colonography in 10,286 asymptomatic adults. Radiology. 2010;255:83–88.

    Article  PubMed  Google Scholar 

  63. Hassan C, Pickhardt P, Laghi A, et al. Computed tomographic colonography to screen for colorectal cancer, extracolonic cancer, and aortic aneurysm. Arch Intern Med. 2008;168:696–705.

    Article  PubMed  Google Scholar 

  64. Pickhardt PJ, Hassan C, Laghi A, Kim DH. CT colonography to screen for colorectal cancer and aortic aneurysm in the medicare population: cost-effectiveness analysis. Am J Roentgenol. 2009;192:1332–1340.

    Article  Google Scholar 

  65. Summers RM, Baecher N, Yao J, et al. Feasibility of simultaneous computed tomographic colonography and fully automated bone mineral densitometry in a single examination. J Comput Assist Tomogr. 2011;35:212–216.

    Article  PubMed Central  PubMed  Google Scholar 

  66. Pickhardt PJ, Lee LJ, del Rio AM, et al. Simultaneous screening for osteoporosis at CT colonography: bone mineral density assessment using MDCT attenuation techniques compared with the DXA reference standard. J Bone Miner Res. 2011;26:2194–2203.

    Article  PubMed Central  PubMed  Google Scholar 

  67. Carberry GA, Pooler BD, Binkley N, Lauder TB, Bruce RJ, Pickhardt PJ. Unreported vertebral body compression fractures at abdominal multidetector CT. Radiology. 2013;268:120–126.

    Article  PubMed  Google Scholar 

  68. Pickhardt PJ, Pooler BD, Lauder T, del Rio AM, Bruce RJ, Binkley N. Opportunistic screening for osteoporosis using abdominal computed tomography scans obtained for other indications. Ann Intern Med. 2013;158:588+.

  69. Boyce CJ, Pickhardt PJ, Kim DH, et al. Hepatic steatosis (fatty liver disease) in asymptomatic adults identified by unenhanced low-dose CT. AJR Am J Roentgenol. 2010;194:623–628.

    Article  PubMed  Google Scholar 

  70. Boyce CJ, Pickhardt PJ, Lawrence EM, Kim DH, Bruce RJ. Prevalence of urolithiasis in asymptomatic adults: objective determination using low dose noncontrast computerized tomography. J Urol. 2010;183:1017–1021.

    Article  PubMed  Google Scholar 

  71. Pickhardt PJ, Hanson ME. Incidental adnexal masses detected at low-dose unenhanced CT in asymptomatic women age 50 and older : implications for clinical management and ovarian cancer screening. Radiology. 2010;257:144–150.

    Article  PubMed  Google Scholar 

  72. Pickhardt PJ, Jee Y, O’Connor SD, Munoz del Rio A. Visceral adiposity and hepatic steatosis at abdominal CT: association with the metabolic syndrome. Am J Roentgenol. 2012;198:1100–1107.

    Article  Google Scholar 

  73. Pooler BD, Kim DH, Lam VP, Burnside ES, Pickhardt PJ. CT colonography reporting and data system (C-RADS): benchmark values from a clinical screening program. AJR Am J Roentgenol. 2014;202:1232–1237.

    Article  PubMed Central  PubMed  Google Scholar 

  74. Zalis ME, Barish MA, Choi JR, et al. CT colonography reporting and data system: a consensus proposal. Radiology. 2005;236:3–9.

    Article  PubMed  Google Scholar 

  75. Hassan C, Pickhardt PJ, Pickhardt PJ, Kim DH. Cost-effectiveness of CT colonography CT colonography: pitfalls in interpretation. Radiol Clin N Am. 2013;51:89–97.

    Article  PubMed  Google Scholar 

  76. Pickhardt PJ, Hassan C, Laghi A, Zullo A, Kim DH, Morini S. Cost-effectiveness of colorectal cancer screening with computed tomography colonography—the impact of not reporting diminutive lesions. Cancer. 2007;109:2213–2221.

    Article  PubMed  Google Scholar 

  77. Sonnenberg A, Delco F, Bauerfeind P. Is virtual colonoscopy a cost-effective option to screen for colorectal cancer? Am J Gastroenterol. 1999;94:2268–2274.

    Article  CAS  PubMed  Google Scholar 

  78. Ladabaum U, Song K, Fendrick AM. Colorectal neoplasia screening with virtual colonoscopy: when, at what cost, and with what national impact? Clin Gastroenterol Hepatol. 2004;2:554–563.

    Article  PubMed  Google Scholar 

  79. Heitman SJ, Manns BJ, Hilsden RJ, Fong A, Dean S, Romagnuolo J. Cost-effectiveness of computerized tomographic colonography versus colonoscopy for colorectal cancer screening. Can Med Assoc J. 2005;173:877–881.

    Article  Google Scholar 

  80. Hassan C, Pickhardt PJ. Cost-effectiveness of CT colonography. Radiol Clin North Am. 2013;51:89–97.

    Article  PubMed  Google Scholar 

  81. Pickhardt PJ, Hassan C, Laghi A, et al. Small and diminutive polyps detected at screening CT colonography: a decision analysis for referral to colonoscopy. Am J Roentgenol. 2008;190:136–144.

    Article  Google Scholar 

  82. Pickhardt PJ, Hassan C, Laghi A, et al. Clinical management of small (6- to 9-mm) polyps detected at screening CT colonography: a cost-effectiveness analysis. AJR Am J Roentgenol. 2008;191:1509–1516.

    Article  PubMed  Google Scholar 

  83. Brenner DJ, Hall EJ. Current concepts—computed tomography—an increasing source of radiation exposure. N Engl J Med. 2007;357:2277–2284.

    Article  CAS  PubMed  Google Scholar 

  84. Radiation risk in perspective: position statement of the Health Physics Society. Health Physics Society; 2010 Adopted January 1996, revised July 2010.

  85. Liedenbaum MH, Venema HW, Stoker J. Radiation dose in CT colonography-trends in time and differences between daily practice and screening protocols. Eur Radiol. 2008;18:2222–2230.

    Article  CAS  PubMed  Google Scholar 

  86. Graser A, Wintersperger BJ, Suess C, Reiser MF, Becker CR. Dose reduction and image quality in MDCT colonography using tube current modulation. Am J Roentgenol. 2006;187:695–701.

    Article  CAS  Google Scholar 

  87. Lubner MG, Pickhardt PJ, Tang J, Chen G-H. Reduced image noise at low-dose multidetector CT of the abdomen with prior image constrained compressed sensing algorithm. Radiology. 2011;260:248–256.

    Article  PubMed  Google Scholar 

  88. Pickhardt PJ, Lubner MG, Kim DH, et al. Abdominal CT with model-based iterative reconstruction (MBIR): initial results of a prospective trial comparing ultralow-dose with standard-dose imaging. AJR Am J Roentgenol. 2012;199:1266–1274.

    Article  PubMed Central  PubMed  Google Scholar 

  89. Berland LL, Silverman SG, Gore RM, et al. Managing incidental findings on abdominal CT: white paper of the ACR incidental findings committee. J Am Coll Radiol. 2010;7:754–773.

    Article  PubMed  Google Scholar 

  90. O’Connor SD, Pickhardt PJ, Kim DH, Oliva MR, Silverman SG. Incidental finding of renal masses at unenhanced CT: prevalence and analysis of features for guiding management. Am J Roentgenol. 2011;197:139–145.

    Article  Google Scholar 

  91. Hassan C, Pickhardt PJ, Kim DH, et al. Systematic review: distribution of advanced neoplasia according to polyp size at screening colonoscopy. Aliment Pharmacol Ther. 2010;31:210–217.

    CAS  PubMed  Google Scholar 

  92. Levin B, Lieberman DA, McFarland B, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. Gastroenterology. 2008;134:1570–1595.

    Article  CAS  PubMed  Google Scholar 

  93. Soetikno RM, Kaltenbach T, Rouse RV, et al. Prevalence of nonpolypoid (flat and depressed) colorectal neoplasms in asymptomatic and symptomatic adults. J Am Med Assoc. 2008;299:1027–1035.

    Article  CAS  Google Scholar 

  94. Pickhardt PJ, Kim DH, Robbins JB. Flat (Nonpolypoid) colorectal lesions identified at CT colonography in a US screening population. Acad Radiol. 2010;17:784–790.

    Article  PubMed  Google Scholar 

  95. Pickhardt PJ, Lam VP, Weiss JM, Kennedy GD, Kim DH. Carpet lesions detected at CT colonography: clinical, imaging, and pathologic features. Radiology. 2014;270:435–443.

    Article  PubMed Central  PubMed  Google Scholar 

  96. Bond JH. Small flat adenomas appear to have little clinical importance in western countries. Gastrointest Endosc. 1995;42:184–187.

    Article  CAS  PubMed  Google Scholar 

  97. O’Brien MJ, Winawer SJ, Zauber AG, et al. Flat adenomas in the National Polyp Study: is there increased risk for high-grade dysplasia initially or during surveillance? Clin Gastroenterol Hepatol. 2004;2:905–911.

    Article  PubMed  Google Scholar 

  98. Pickhardt PJ, Levin B, Bond JH. Screening for nonpolypoid colorectal neoplasms. JAMA. 2008;299:2743; author reply-4.

  99. Park SH, Kim SY, Lee SS, et al. Sensitivity of CT colonography for nonpolypoid colorectal lesions interpreted by human readers and with computer-aided detection. Am J Roentgenol. 2009;193:70–78.

    Article  Google Scholar 

  100. Pickhardt PJ, Kim DH. Performance of CT colonography for detecting small, diminutive, and flat polyps. Gastrointest Endosc Clin N Am. 2010;20:209–226.

    Article  PubMed  Google Scholar 

  101. Pickhardt PJ, Nugent PA, Choi JR, Schindler WR. Flat colorectal lesions in asymptomatic adults: implications for screening with CT virtual colonoscopy. Am J Roentgenol. 2004;183:1343–1347.

    Article  Google Scholar 

  102. Kim DH, Hinshaw JL, Lubner MG, del Rio AM, Pooler BD, Pickhardt PJ. Contrast coating for the surface of flat polyps at CT colonography: a marker for detection. Eur Radiol. 2014;24:940–946.

    Article  PubMed  Google Scholar 

  103. O’Connor SD, Summers RM, Choi JR, Pickhardt PJ. Oral contrast adherence to polyps on CT colonography. J Comput Assist Tomogr. 2006;30:51–57.

    Article  PubMed  Google Scholar 

  104. Kahi CJ, Hewett DG, Norton DL, Eckert GJ, Rex DK. Prevalence and variable detection of proximal colon serrated polyps during screening colonoscopy. Clin Gastroenterol Hepatol. 2011;9:42–46.

    Article  PubMed  Google Scholar 

  105. O’Brien MJ. Hyperplastic and serrated polyps of the colorectum. Gastroenterol Clin North Am. 2007;36:947–968.

    Article  PubMed  Google Scholar 

  106. Pickhardt PJ. Missed lesions at CT colonography: lessons learned. Abdom Imaging. 2013;38:82–97.

    Article  PubMed  Google Scholar 

  107. Pickhardt PJ, Kim DH. CT Colonography: pitfalls in Interpretation. Radiol Clin North Am. 2013;51:69–88.

    Article  PubMed Central  PubMed  Google Scholar 

  108. Sanford MF, Pickhardt PJ. Diagnostic performance of primary 3-dimensional computed tomography colonography in the setting of colonic diverticular disease. Clinical Gastroenterology and Hepatology. 2006;4:1039–1047.

    Article  PubMed  Google Scholar 

  109. Gryspeerdt S, Lefere P. Chronic diverticulitis vs. colorectal cancer: findings on CT colonography. Abdom Imaging. 2012;37:1101–1109.

    Article  PubMed  Google Scholar 

  110. Flor N, Rigamonti P, Pisani Ceretti A, et al. Diverticular disease severity score based on CT colonography. Eur Radiol. 2013;23:2723–2729.

  111. Kim DH, Pickhardt PJ. Colorectal cancer: managing diminutive polyps-what is the optimal approach? Nat Rev Gastroenterol Hepatol. 2011;8:129–131.

    Article  PubMed  Google Scholar 

  112. Lieberman D, Moravec M, Holub J, Michaels L, Eisen G. Polyp size and advanced histology in patients undergoing colonoscopy screening: implications for CT colonography. Gastroenterology. 2008.

  113. Pickhardt PJ, Kim DH, Hassan C. Advanced neoplasia detection rates at colonoscopy screening: implications for CT Colonography. Gastroenterology. 2009;136:1121–1122.

    Article  PubMed  Google Scholar 

  114. Hain KS, Pickhardt PJ, Kim DH. Rate of important histology in large and small polyps detected at CT colonography screening. Annual Meeting for the Society of Gastrointestinal Radiologists; 2009.

  115. Kim DH, Pooler BD, Weiss JM, Pickhardt PJ. Five year colorectal cancer outcomes in a large negative CT colonography screening cohort. Eur Radiol. 2012;22:1488–1494.

    Article  PubMed Central  PubMed  Google Scholar 

  116. Pickhardt PJ. Strong evidence in support of CT colonography screening. Lancet Oncol. 2012;13:6–7.

    Article  PubMed  Google Scholar 

  117. Barclay RL, Vicari JJ, Doughty AS, Johanson JF, Greenlaw RL. Colonoscopic withdrawal times and adenoma detection during screening colonoscopy. N Engl J Med. 2006;355:2533–2541.

    Article  CAS  PubMed  Google Scholar 

  118. Pooler BD, Kim DH, Hassan C, Rinaldi A, Burnside ES, Pickhardt PJ. Variation in diagnostic performance among radiologists at screening CT colonography. Radiology. 2013;268:127–134.

    Article  PubMed Central  PubMed  Google Scholar 

  119. Pickhardt PJ, Lee AD, Taylor AJ, et al. Primary 2D versus primary 3D polyp detection at screening CT colonography. Am J Roentgenol. 2007;189:1451–1456.

    Article  Google Scholar 

  120. Kim DH, Pickhardt PJ. Radiologists should read CT colonography. Gastrointest Endosc Clin N Am. 2010;20:259–269.

    Article  PubMed  Google Scholar 

  121. Pickhardt PJ. Editorial: CTC interpretation by gastroenterologists: feasible but largely impractical, undesirable, and misguided. Am J Gastroenterol. 2009;104:2932–2934.

    Article  PubMed  Google Scholar 

  122. Imperiale TF, Ransohoff DF, Itzkowitz SH, Turnbull BA, Ross ME. Fecal DNA versus fecal occult blood for colorectal-cancer screening in an average-risk population. N Engl J Med. 2004;351:2704–2714.

    Article  CAS  PubMed  Google Scholar 

  123. Imperiale TF, Ransohoff DF, Itzkowitz SH, et al. Multitarget stool DNA testing for colorectal-cancer screening. N Engl J Med. 2014;370:1287–1297.

    Article  CAS  PubMed  Google Scholar 

  124. Ahlquist DA, Taylor WR, Mahoney DW, et al. The stool DNA test is more accurate than the plasma septin 9 test in detecting colorectal neoplasia. Clin Gastroenterol Hepatol. 2012;10:272-U182.

    Article  CAS  Google Scholar 

  125. Eliakim R, Fireman Z, Gralnek IM, et al. Evaluation of the PillCam Colon capsule in the detection of colonic pathology: results of the first multicenter, prospective, comparative study. Endoscopy. 2006;38:963–970.

    Article  CAS  PubMed  Google Scholar 

  126. Yee J, Keysor KJ, Kim DH. The time has arrived for national reimbursement of screening CT colonography. AJR Am J Roentgenol. 2013;201:73–79.

    Article  PubMed  Google Scholar 

  127. McFarland EG, Levin B, Lieberman DA, et al. Revised colorectal screening guidelines: joint effort of the American Cancer Society, U.S. Multisociety Task Force on Colorectal Cancer, and American College of Radiology. Radiology. 2008;248:717–720.

    Article  PubMed  Google Scholar 

  128. Screening for colorectal cancer. U.S. preventive services task force recommendation statement. Ann Intern Med. 2008;149:627–637.

    Article  Google Scholar 

  129. Rosenthal E. The $2.7 trillion medical bill: colonoscopies explain why US leads the World in Health Expenditures. The New York Times 2013 June 1, 2013.

  130. Weiss JM, Smith MA, Pickhardt PJ, et al. Predictors of colorectal cancer screening variation among primary-care providers and clinics. Am J Gastroenterol. 2013;108:1159–1167.

    Article  PubMed Central  PubMed  Google Scholar 

  131. Pickhardt PJ, Hassan C, Laghi A, et al. Is there sufficient MDCT capacity to provide colorectal cancer screening with CT colonography for the US population? Am J Roentgenol. 2008;190:1044–1049.

    Article  Google Scholar 

Download references

Acknowledgments

Perry J. Pickhardt received Grant support from NIH 1R01CA144835, 1R01CA155347.

Conflict of interest

Dr. Pickhardt has or recently has had a financial interest and/or other relationship with VirtuoCTC, Viatronix, Braintree, Midways, and Cellectar Biosciences.

Author information

Authors and Affiliations

  1. Department of Radiology, University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Science Center, 600 Highland Ave., Madison, WI, 53792-3252, USA

    Perry J. Pickhardt

Authors
  1. Perry J. Pickhardt
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Perry J. Pickhardt.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pickhardt, P.J. CT Colonography for Population Screening: Ready for Prime Time?. Dig Dis Sci 60, 647–659 (2015). https://doi.org/10.1007/s10620-014-3454-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-014-3454-2

Keywords

Search

Navigation