Dose Reduction in Screening Programs: Colon Cancer Screening

  • Thierry N. Boellaard
  • Henk W. Venema
  • Jaap Stoker
Part of the Medical Radiology book series (MEDRAD)


Colorectal cancer is one of the most common causes of cancer-related death in the Western world and screening is the most feasible option to reduce this mortality. Screening is performed by detection of the precursor lesions (adenoma) and early colorectal cancer, followed by appropriate treatment. CT colonography is a multi-detector-row CT technique with high accuracy for the detection of adenomas and colorectal cancer and is therefore an option for screening. It has replaced barium enema as the preferred imaging technique for screening. Although CT colonography has several advantages compared to other screening options, ionizing radiation remains an important drawback. Dose reduction is important to prevent unnecessary radiation exposure and thereby improves the benefit-risk ratio and acceptance of CT colonography as a screening tool. Whether dose reduction is possible depends on several factors, including subject characteristics, the target lesions (intracolonic/extracolonic) and type of oral bowel preparation. Dose reduction can be achieved by adjusting the CT scanner parameters (tube current, tube voltage, pitch and rotation time). Additionally, technical specifications of the CT scanner affect the radiation dose (e.g. number of detector rows and filter type). Newer functionality such as automatic current selection, advanced noise reduction filters and improved reconstruction techniques even enable radiation dose reduction without visual loss of image quality. This chapter gives an overview of CT colonography, factors that influence radiation dose and reviews the current literature on dose reduction in CT colonography.


Bowel Preparation Fecal Occult Blood Test Compute Tomography Colonography Compute Tomography Number Tube Current Modulation 



Adaptive statistical iterative reconstruction


Computer-aided detection


CT Colonography Reporting and Data System


Prior image constrained compressed sensing


Kilo voltage






Multi-detector-row CT


Multiplanar reformatting





Thierry Boellaard and Jaap Stoker pay tribute to our co-author Henk Venema who deceased after finalizing this chapter. Henk Venema was pivotal for this work and to our work in general on radiation dose in CT colonography.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Thierry N. Boellaard
    • 1
  • Henk W. Venema
    • 2
  • Jaap Stoker
    • 1
  1. 1.Department of RadiologyAcademic Medical Center, University of AmsterdamAmsterdamThe Netherlands
  2. 2.Departments of Radiology and Medical PhysicsAcademic Medical Center, University of AmsterdamAmsterdamThe Netherlands

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