Early-stage colorectal carcinoma has been conventionally diagnosed mainly on the basis of colono-scopy and barium enema study. Particularly in Japan, where colonoscopic technique is remarkably advanced, colonoscopy is the principal modality for early detection of colorectal carcinomas. A detailed investigation on superficial type of lesions, so called “flatlesion,” has been conducted with the development of electronic video colonoscopy(Kudo 1996). More recently, detecting colorectal lesions by electronic video colon-oscopy also became possible with narrow band imaging (NBI) of mucosal capillary blood flow(Sano et al. 2006). Moreover, with the advancements of therapeutic techniques, including endoscopic submucosal dissection (ESD), simultaneous diagnosis and treatment of superficial type of lesions has been made possible(Saito et al. 2005).
The recent proliferation of multi-detector row computed tomography (MDCT) has revolutionized the efficiency of CT scanning and image enhancement (Nakajima et al. 2008). In addition, digital imaging technology has enabled three-dimensional (3D) imaging of various organs that can also be used for diagnosing gastrointestinal tract. Especially, 3D imaging of the large intestine is globally referred to as computed tomography colonography CTC. This modality has been thoroughly inves tigated with regard to its application in colorectal screening in Western countries and is now accepted worldwide for diagnosing colorectal lesions(Johnson et al. 2008). Also in Japan, CTC has been gradually admitted as an option for evaluation of colorectum in preoperative staging. For future proliferation of CTC in colorectal screening, the diagnosis of superficial type of lesions should be scrutinized and established based on Japanese experiences in the advanced colonoscopic diagnosis.
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The works were supported by Grants for Scientific Research Expens es for Health and Welfare Programs and the Foundation for the Promotion of Cancer Research, and by the 3rd-term Comprehensive 10-year Strategy for Cancer Control from the Ministry of Health, Labor and Welfare.
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Iinuma, G., Miyake, M., Uchida, K., Arai, Y., Muramatsu, Y., Moriyama, N. (2010). The Challenge: Detection of Early-Stage Superficial Colorectal Lesions. In: Lefere, P., Gryspeerdt, S. (eds) Virtual Colonoscopy. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-79886-6_12
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