Skip to main content

Advertisement

SpringerLink
Log in

State-of-the-art CT colonography: Update on technique and performance

  • Published:
Current Colorectal Cancer Reports

Abstract

CT colonography, also called virtual colonoscopy, was introduced about a decade ago, has made great progress over the years, and is becoming more popular. With the advent of CT scanners and computer software, the examination is performed more quickly and with less patient radiation exposure providing the radiologist with data that allow for accurate polyp detection using both two-and three-dimensional imaging. In this article we will review the technical basics of CT colonography, its current indications, and performance.

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

Similar content being viewed by others

References and Recommended Reading

  1. Ransohoff DF, Sandler RS: Clinical practice: screening for colorectal cancer. N Engl J Med 2002, 346:40–44.

    Article  PubMed  Google Scholar 

  2. Jemal A, Tiwari RC, Murray T, et al.: Cancer statistics, 2004. CA Cancer J Clin 2004, 54:8–29.

    PubMed  Google Scholar 

  3. Parker SL, Tong T, Bolden S, Wingo PA: Cancer statistics, 1996. CA Cancer J Clin 1996, 46:5–27.

    PubMed  CAS  Google Scholar 

  4. Pignone M, Saha S, Hoerger T, Mandelblatt J: Cost-effectiveness analyses of colorectal cancer screening: a system atic review for the US Preventive Services Task Force. Ann Intern Med 2002, 137:96–104.

    PubMed  Google Scholar 

  5. Walsh JME, Terdiman JP: Colorectal cancer screening, scientific review. JAMA 2003, 289:1288–1295.

    Article  PubMed  Google Scholar 

  6. Rex DK, Cutler CS, Lemmel GT, et al.: Colonoscopic miss rates of adenomas determined by back-to-back colonoscopies. Gastroenterology 1997, 112:24–28.

    Article  PubMed  CAS  Google Scholar 

  7. Winawer SJ, Stewart ET, Zauber AG et al. A comparison of colonoscopy and double-contrast barium enem a for surveillance after polypectomy. National Polyp Study Work Group. N Engl J Med 2000, 342:1766–1772.

    Article  PubMed  CAS  Google Scholar 

  8. Vining DJ, Gelfand DW, Bechtold RE, et al.: Technical feasibility of colon imaging with helical CT and virtual reality. AJR Am J Roentgenol 1994, 162:S104.

    Google Scholar 

  9. Macari M, Lavelle M, Pedrosa I, et al.: Effect of different bowel preparations on residual fluid at CT colonography. Radiology 2001, 218:274–277.

    PubMed  CAS  Google Scholar 

  10. Yee J, Akerkar GA, Hung RK, et al.: Colonic distension and colorectal polyp detection with and without glucagon on virtual colonoscopy Presented at the 28th Postgraduate Course of the Society of Gastrointestinal Radiologists. Palm Beach, FL; 1999.

  11. Zalis ME, Hahn PF: Digital subtraction bowel cleansing in CT colonography. AJR Am J Roentgenol 2001, 176:646–648.

    PubMed  CAS  Google Scholar 

  12. Callstrom M, Johnson C, Fletcher J, et al.: CT colonography without cathartic preparation: feasibility study. Radiology 2001, 219:693–698.

    PubMed  CAS  Google Scholar 

  13. Lefere PA, Gryspeerdt SS, Dewyspelaere J, et al.: Dietary fecal tagging as a cleansing method before CT colonography: initial results polyp detection and patient acceptance. Radiology 2002, 224:393–403.

    Article  PubMed  Google Scholar 

  14. Macari MM, Bini EJ: CT colonography: where have we been and where are we going? Radiology 2005, 237:819–833.

    Article  PubMed  Google Scholar 

  15. Yee J: CT colonography: examination prerequisites. Abdom Imaging 2002, 27:244–252.

    PubMed  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  17. Stevenson GW, Wilson JA, Wilkinson J, et al.: Pain following colonoscopy: elimination with carbon dioxide. Gastrointest Endosc 1992, 38:564–567.

    Article  PubMed  CAS  Google Scholar 

  18. Morrin MM, Farrell RJ, Keogan MT, et al.: CT colonography: colonic distention improved by dual positioning but not intravenous glucagon. Eur Radiol 2002, 12:525–530.

    PubMed  Google Scholar 

  19. Chen SC, Lu DS, Hecht JR, Kadell BM: CT colonography: value of scanning in both the supine and prone positions. AJR Am J Roentgenol 1999, 172:595–599.

    PubMed  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  21. Beaulieu CF, Napel S, Daniel BL, et al.: Detection of colonic polyps in a phantom model: implications for virtual colonoscopy data acquisition. J Comput Assist Tomogr 1998, 22:656–663.

    Article  PubMed  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  23. International Commission on Radiological Protection: 1990 Recommendations of the International Commission on Radiological Protection. Oxford, England: Pergamon Press; 1991. [International Commission on Radiological Protection publication no 60.]

    Google Scholar 

  24. van Gelder RE, Venema HW, Serlie IWO, et al.: CT colonography at different radiation dose levels: feasibility of dose reduction. Radiology 2002, 224:25–33.

    Article  PubMed  Google Scholar 

  25. Hara AK, Johnson CD, Reed JE, et al.: Reducing data size and radiation dose for CT colonography. AJR Am J Roentgenol 1997, 168:1181–1184.

    PubMed  CAS  Google Scholar 

  26. Macari M, Bini EJ, Xue X, et al.: Colorectal neoplasms: prospective comparison of thin-section low-dose multi-detector row CT colonography and conventional colonoscopy for detection. Radiology 2002, 224:383–392.

    Article  PubMed  Google Scholar 

  27. Lannaccone R, Catalano C, Mangiapane F, et al.: Colorectal polyps: detection with low dose multi-detector row helical CT colonography versus two sequential colonoscopies. Radiology 2005, 237:927–937.

    Article  Google Scholar 

  28. Grasser A, Wintersperger BJ, Suess C, et al.: Dose reduction and image quality in MDCT colonography using tube current modulation. AJR Am J Roentgenol 2006, 187:695–670.

    Article  Google Scholar 

  29. Dachman AH, Kuniyoshi JK, Boyle CM, et al.: CT colonography with three-dimensional problem solving for detection of colonic polyps. AJR Am J Roentgenol 1998, 171:989–995.

    PubMed  CAS  Google Scholar 

  30. Macari M, Milano A, Lavelle M, et al.: Comparison of time-efficient CT colonography with two-and three-dimensional colonic evaluation for detecting colorectal polyps. AJR Am J Roentgenol 2000, 174:1543–1549.

    PubMed  CAS  Google Scholar 

  31. Summers RM, Jerebko AK, Franazek M, et al.: Colonic polyps: complementary role of computer aided detection in CT colonography. Radiology 2002, 225:391–399.

    Article  PubMed  Google Scholar 

  32. Yoshida H, Masutani Y, MacEneaney P, et al.: Computerized detection of colonic polyps at CT colonography on the basis of volumetric features: pilot study. Radiology 2002, 222:327–336.

    Article  PubMed  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  34. Fenlon HM, McAneny DB, Nunes DP, et al.: Occlusive colon carcinoma: virtual colonoscopy in the preoperative evaluation of the proximal colon. Radiology 1999, 210:423–428.

    PubMed  CAS  Google Scholar 

  35. Macari M, Berman P, Dicker M, et al.: Usefulness of CT colonography in patients with incomplete colonoscopy. AJR Am J Roentgenol 1999, 173:561–564.

    PubMed  CAS  Google Scholar 

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

    Article  PubMed  Google Scholar 

  37. Dafnis G, Granath F, Pahlman L, et al.: The impact of endoscopists’ experience and learning curves and interendoscopist variation on colonoscopy completion rates. Endoscopy 2001, 33:511–517.

    Article  PubMed  CAS  Google Scholar 

  38. Arenas RB, Fichera A, Mhoon D, Michelassi F: Incidence and therapeutic implications of synchronous colonic pathology in colorectal adenocarcinoma. Surgery 1997, 122:706–709.

    Article  PubMed  CAS  Google Scholar 

  39. Fletcher JG, Johnson CD, Krueger WR, et al.: Contrastenhanced CT colonography in recurrent colorectal carcinoma: feasibility of simultaneous evaluation for metastatic disease, local recurrence, and metachronous neoplasia in colorectal carcinoma. AJR Am J Roentgenol 2002, 178:283–290.

    PubMed  CAS  Google Scholar 

  40. Royster AP, Fenlon HM, Clarke PD, et al.: CT colonoscopy of colorectal neoplasms: two-dimensional and three-dimensional virtual-reality techniques with colonoscopic correlation. AJR Am J Roentgenol 1997, 169:1237–1242.

    PubMed  CAS  Google Scholar 

  41. Dachman AH, Kuniyoshi JK, Boyle CM et al.: CT colonography with three-dimensional problem solving for detection of colonic polyps. Am J Roentgenol 1998, 171:989–995.

    CAS  Google Scholar 

  42. Mendelson RM, Foster NM, Edwards JT, et al.: Virtual colonoscopy compared with conventional colonoscopy: a developing technology. Med J Aust 2000, 173:472–475.

    PubMed  CAS  Google Scholar 

  43. Pescatore P, Glucker T, Delarive J, et al.: Diagnostic accuracy and interobserver agreement of CT colonography (virtual colonoscopy). Gut 2000, 47:126–130.

    Article  PubMed  CAS  Google Scholar 

  44. Fenlon HM, Nunes DP, Schroy PC 3rd, et al.: A comparison of virtual and conventional colonoscopy for the detection of colorectal polyps. N Engl J Med 1999, 341:1496–1503.

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  47. Macari M, Milano A, Lavelle M, et al.: Comparison of time-efficient CT colonography with two-and three-dimensional colonic evaluation for detecting colorectal polyps. AJR Am J Roentgenol 2000, 174:1543–1549.

    PubMed  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  49. Spinzi G, Belloni G, Martegani A, et al.: Computed tomographic colonography and conventional colonoscopy for colon diseases: a prospective, blinded study. Am J Gastroenterol 2001, 96:394–400.

    Article  PubMed  CAS  Google Scholar 

  50. Gluecker T, Dorta G, Keller W, et al.: Performance of multidetector computed tomography colonography compared with conventional colonoscopy. Gut 2002, 51:207–211.

    Article  PubMed  Google Scholar 

  51. Miao YM, Amin Z, Healy J, et al.: A prospective single centre study comparing computed tomography pneumocolon against colonoscopy in the detection of colorectal neoplasms. Gut 2000, 47:832–837.

    Article  PubMed  CAS  Google Scholar 

  52. Laghi A, Iannaccone R, Carbone I, et al.: Detection of colorectal lesions with virtual computed tomographic colonography. Am J Surg 2002, 183:124–131.

    Article  PubMed  Google Scholar 

  53. Laghi A, Iannaccone R, Carbone I, et al.: Computed tomographic colonography (virtual colonoscopy): blinded prospective comparison with conventional colonoscopy for the detection of colorectal neoplasia. Endoscopy 2002, 34:441–446.

    Article  PubMed  CAS  Google Scholar 

  54. Sosna J, Morrin MM, Kruskal JB, et al.: CT colonography for colorectal polyps: a meta-analysis. AJR Am J Roentgenol 2003, 181:1593–1598.

    PubMed  Google Scholar 

  55. Mulhall BP, Veerappan GR, Jackson JL: Meta-analysis: computed tomographic colonography. Ann Intern Med 2005, 142:635–650.

    PubMed  Google Scholar 

  56. Halligan S, Altman DG, Taylor SA, et al.: CT colonography in the detection of colorectal polyps and cancer: system atic review, meta-analysis and proposed minimum data set for study level reporting. Radiology 2005, 237:893–904.

    Article  PubMed  Google Scholar 

  57. Ferrucci JT: Colon cancer screening with virtual colonoscopy: promise, polyps, politics. AJR Am J Roentgenol 2001, 177:975–988.

    PubMed  CAS  Google Scholar 

  58. Rex DK, Cutler CS, Lemmel GT, et al.: Colonoscopic miss rates of adenomas determined by back-to-back colonoscopies. Gastroenterology 1997, 112:24–28.

    Article  PubMed  CAS  Google Scholar 

  59. Sosna J, Kruskal JB, Bar Ziv J, et al.: Extra colonic findings at CT colonography. Abdom Imaging 2005, 30:709–713.

    Article  PubMed  CAS  Google Scholar 

  60. Hara AK, Johnson CD, MacCarty RL, Welch TJ: Incidental extracolonic findings at CT colonography. Radiology 2000, 215:353–357.

    PubMed  CAS  Google Scholar 

  61. Sosna J, Blachar A, Amitai M, et al.: Colonic perforation at CT colonography: assessment of risk in a multicenter large cohort. Radiology 2006, 239:457–463.

    Article  PubMed  Google Scholar 

  62. Burling D, Halligan S, Slater A, et al.: Potentially serious adverse events at CT colonography in symptomatic patients: National survey of the United Kingdom. Radiology 2006, 239:464–470.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Tel Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv, 64239, Israel

    Arye Blachar MD

Authors
  1. Arye Blachar MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Moshe Graif MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ada Kessler MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jacob Sosna MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Arye Blachar MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Blachar, A., Graif, M., Kessler, A. et al. State-of-the-art CT colonography: Update on technique and performance. Curr colorectal cancer rep 3, 49–54 (2007). https://doi.org/10.1007/s11888-007-0016-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11888-007-0016-4

Keywords

Search

Navigation