Skip to main content
SpringerLink
Log in

CT colonography: over two decades from discovery to practice

  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Since the introduction of CT colonography (CTC) in the mid-1990s, there have been continuous advancements in the examination technique and advanced visualization software for interpretation. This review will cover the origins of CTC as a natural extension of abdominal CT imaging, and discuss the evolution of CTC through the subsequent clinical phases of feasibility, validation, and implementation.

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

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

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

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Explore related subjects

Discover the latest articles, news and stories from top researchers in related subjects.

References

  1. Coin CG (1994) Inventor computed tomographic colonoscopy patent US5458111 A

  2. Vining DJ, Gelfand DW, Bechtold RE, et al. (1994) Technical feasibility of colon imaging with helical CT and virtual reality (abstr). Am J Roentgenol 162:104

    Google Scholar 

  3. Balthazar EJ, Megibow AJ, Hulnick D, Naidich DP (1988) Carcinoma of the colon: detection and preoperative staging by Ct. Am J Roentgenol 150:301–306

    Article  CAS  Google Scholar 

  4. Balthazar EJ (1991) CT of the gastrointestinal-tract: principles and interpretation. Am J Roentgenol 156:23–32

    Article  CAS  Google Scholar 

  5. Halligan S, Altman DG, Taylor SA, et al. (2006) CT colonography in the detection of colorectal polyps and cancer: systematic review meta-analysis and proposed minimum data set for study level reporting. Radiology 238:893–904

    Article  Google Scholar 

  6. Vining DJ (1996) Virtual endoscopy: is it reality? Radiology 200:30–31

    Article  CAS  PubMed  Google Scholar 

  7. Vining DJ, Teigen EL, Stelts D, et al. (1995) Experience with virtual colonoscopy in 20 patients. Radiology 197:514

    Google Scholar 

  8. Lees WR, Amin Z, Boulos P (1996) Spiral CT pneumocolon for suspected colonic neoplasm: Is virtual colonoscopy helpful? Radiology 201:1047

    Google Scholar 

  9. Hara AK, Johnson CD, MacCarty RL, et al. (2001) CT colonography: single-versus multi-detector row imaging. Radiology 219:461–465

    Article  CAS  PubMed  Google Scholar 

  10. Levin B, Lieberman DA, McFarland B, et al. (2008) 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 58:130–160

    Article  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  12. Vining DJ (2005) Virtual colonoscopy: the inside story. In: Dachman A (ed) Fundamentals of virtula colonoscopy. New York: Springer, pp 1–3

    Google Scholar 

  13. Barish MA, Soto JA, Ferrucci JT (2005) Consensus on current clinical practice of virtual colonoscopy. Am J Roentgenol 184:786–792

    Article  Google Scholar 

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

    Article  PubMed  Google Scholar 

  15. Fenlon HM, Nunes DP, Schroy PC, et al. (1999) A comparison of virtual and conventional colonoscopy for the detection of colorectal polyps. N Engl J Med 341:1496–1503

    Article  CAS  PubMed  Google Scholar 

  16. Fletcher JG, Johnson CD, Welch TJ, et al. (2000) Optimization of CT colonography technique: prospective trial in 180 patients. Radiology 216:704–711

    Article  CAS  PubMed  Google Scholar 

  17. Hara AK, Johnson CD, Reed JE, et al. (1997) Detection of colorectal polyps with CT colography: initial assessment of sensitivity and specificity. Radiology 205:59–65

    Article  CAS  PubMed  Google Scholar 

  18. Morrin MM, Farrell RJ, Kruskal JB, et al. (2000) Utility of intravenously administered contrast material at CT colonography. Radiology 217:765–771

    Article  CAS  PubMed  Google Scholar 

  19. Pineau BC, Paskett ED, Chen GJ, et al. (2003) Virtual colonoscopy using oral contrast compared with colonoscopy for the detection of patients with colorectal polyps. Gastroenterology 125:304–310

    Article  PubMed  Google Scholar 

  20. Yee J, Akerkar GA, Hung RK, et al. (2001) Colorectal neoplasia: Performance characteristics of CT colonography for detection in 300 patients. Radiology 219:685–692

    Article  CAS  PubMed  Google Scholar 

  21. Rex DK, Vining D, Kopecky KK (1999) An initial experience with screening for colon polyps using spiral CT with and without CT colography (virtual colonoscopy). Gastrointest Endosc 50:309–313

    Article  CAS  PubMed  Google Scholar 

  22. McFarland EG, Pilgram TK, Brink JA, et al. (2002) CT colonography: multiobserver diagnostic performance. Radiology 225:380–390

    Article  PubMed  Google Scholar 

  23. Lefere PA, Gryspeerdt SS, Dewyspelaere J, Baekelandt M, Van Holsbeeck BG (2002) Dietary fecal tagging as a cleansing method before CT colonography: initial results-polyp detection and patient acceptance. Radiology 224:393–403

    Article  PubMed  Google Scholar 

  24. Fenlon HM, McAneny DB, Nunes DP, Clarke PD, Ferrucci JT (1999) Occlusive colon carcinoma: virtual colonoscopy in the preoperative evaluation of the proximal colon. Radiology 210:423–428

    Article  CAS  PubMed  Google Scholar 

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

    Article  CAS  Google Scholar 

  26. Morrin MM, Kruskal JB, Farrell RJ, et al. (1999) Endoluminal CT colonography after an incomplete endoscopic colonoscopy. Am J Roentgenol 172:913–918

    Article  CAS  Google Scholar 

  27. Neri E, Giusti P, Battolla L, et al. (2002) Colorectal cancer: role of CT colonography in preoperative evaluation after incomplete colonoscopy. Radiology 223:615–619

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  29. MacCarty RL, Johnson CD, Fletcher JG, Wilson LA (2006) Occult colorectal polyps on CT colonography: implications for surveillance. Am J Roentgenol 186:1380–1383

    Article  Google Scholar 

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

    Article  CAS  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

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

    Article  Google Scholar 

  33. Pickhardt PJ (2004) Differential diagnosis of polypoid lesions seen at CT colonography (virtual colonoscopy): author’s response. Radiographics 24:1558–1559

    Article  Google Scholar 

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

    Article  Google Scholar 

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

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Fletcher JG, Chen MH, Herman BA, et al. (2010) Can radiologist training and testing ensure high performance in CT colonography? lessons from the National CT Colonography Trial. Am J Roentgenol 195:117–125

    Article  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  39. Halligan S, Wooldrage K, Dadswell E, et al. (2013) Computed tomographic colonography versus barium enema for diagnosis of colorectal cancer or large polyps in symptomatic patients (SIGGAR): a multicentre randomised trial. Lancet 381:1185–1193

    Article  PubMed  Google Scholar 

  40. Cash BD, Riddle MS, Bhattacharya I, et al. (2012) CT colonography of a medicare-aged population: outcomes observed in an analysis of more than 1400 patients. Am J Roentgenol 199:W27–W34

    Article  Google Scholar 

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

    Article  PubMed  Google Scholar 

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

    Article  Google Scholar 

  43. Pooler BD, Kim DH, Hassan C, et al. (2013) Variation in diagnostic performance among radiologists at screening CT colonography. Radiology 268:127–134

    Article  PubMed  PubMed Central  Google Scholar 

  44. Hassan C, Pickhardt PJ, Laghi A, et al. (2008) Computed tomographic colonography to screen for colorectal cancer, extracolonic cancer, and aortic aneurysm: model simulation with cost-effectiveness analysis. Arch Intern Med 168:696–705

    Article  PubMed  Google Scholar 

  45. Kim DH, Pickhardt PJ, Hanson ME, Hinshaw JL (2010) CT colonography: performance and program outcome measures in an older screening population. Radiology 254:493–500

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  47. Pickhardt PJ, Hain KS, Kim DH, Hassan C (2010) Low rates of cancer or high-grade dysplasia in colorectal polyps collected from computed tomography colonography screening. Clin Gastroenterol Hepatol 8:610–615

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

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

    Article  PubMed  PubMed Central  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  53. Pooler BD, Kim DH, Weiss JM, Matkowskyj KA, Pickhardt PJ (2015) Colorectal polyps missed with optical colonoscopy despite previous detection and localization with CT colonography. Radiology 278(2):422–429

    Article  PubMed  PubMed Central  Google Scholar 

  54. Pickhardt PJ, Pooler BD, Mbah I, Weiss JM, Kim DH (2017) Colorectal findings at repeat ct colonography screening after initial CT colonography screening negative for polyps larger than 5 mm. Radiology 282:139–148

    Article  PubMed  Google Scholar 

  55. Kim DH, Matkowskyj KA, Lubner MG, et al. (2016) Serrated polyps at ct colonography: prevalence and characteristics of the serrated polyp spectrum. Radiology 280(2):455–463

    Article  PubMed  PubMed Central  Google Scholar 

  56. Smith MA, Weiss JM, Potvien A, et al. (2017) Insurance coverage for CT colonography screening: impact on overall colorectal cancer screening rates. Radiology 284(3):717–724

    Article  PubMed  Google Scholar 

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

    Article  PubMed  PubMed Central  Google Scholar 

  58. Bibbins-Domingo K, Grossman DC, Curry SJ, et al. (2016) Screening for colorectal cancer: us preventive services task force recommendation statement. JAMA 315:2564–2575

    Article  CAS  PubMed  Google Scholar 

  59. Screening for colorectal cancer (2008) U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 149:627–637

    Article  Google Scholar 

Download references

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 Avenue, Madison, WI, 53792-3252, USA

    Perry J. Pickhardt

  2. Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, 210 East 111 Street, Bronx, NY, 10467, USA

    Judy Yee

  3. Department of Radiology, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ, 85259-5452, USA

    C. Daniel Johnson

Authors
  1. Perry J. Pickhardt
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Judy Yee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. Daniel Johnson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Perry J. Pickhardt.

Ethics declarations

Conflict of interest

Dr. Pickhardt: Co-founder of VirtuoCTC, shareholder in SHINE, Elucent, and Cellectar Biosciences; consultant to Bracco and Check-Cap. Dr. Yee: Grant funding from Echopixel. Dr. Johnson: Software license, GE Medical Systems.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pickhardt, P.J., Yee, J. & Johnson, C.D. CT colonography: over two decades from discovery to practice. Abdom Radiol 43, 517–522 (2018). https://doi.org/10.1007/s00261-018-1501-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-018-1501-8

Keywords

Search

Navigation