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. 2003 Dec;52(12):1744-7.
doi: 10.1136/gut.52.12.1744.

Extracolonic findings at computed tomography colonography are a challenge

B Ginnerup Pedersen  1 , M Rosenkilde, T E M Christiansen, S Laurberg
Affiliations

Extracolonic findings at computed tomography colonography are a challenge

B Ginnerup Pedersen et al. Gut. 2003 Dec.

Abstract

Aim: Our aim was to perform a prospective evaluation of the frequency and diagnostic consequences of extracolonic findings at multidetector array computed tomography colonography (MDCTC) in asymptomatic patients undergoing surveillance for former colorectal polyps or cancer.

Patients and methods: Seventy five consecutive patients undergoing surveillance for former colorectal cancer (CRC) or large bowel adenoma were examined with MDCTC. Two independent observers evaluated the images with regard to extracolonic findings. Patient records and radiological information systems were reviewed to determine the results and consequences of the workup derived from MDCTC.

Results: Sixty five per cent (95% confidence interval (CI) 55-73%) of patients had extracolonic abnormalities and in 12% (CI 7-18%) of patients additional workup was indicated. Two patients (3% (CI 1-6%)) underwent surgery because of the findings (one) or because of complications of the workup (one).

Conclusion: MDCTC identifies a large number of extracolonic findings. Approximately 12% of asymptomatic patients undergo additional workup, of benefit to only a few. The high prevalence of extracolonic findings may make MDCTC a problematic colorectal screening tool for both ethical and economic reasons.

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Figures

Figure 1
Figure 1
Axial computed tomographic image of a 74 year old male showing a 20 mm lung tumour in the most distal part of the left lung (white arrow). The colonic lumen corresponding to part of the left flexure is seen (black).
Figure 2
Figure 2
Axial computed tomographic (CT) image of a 65 year old female showing a 10 mm focal process in the left adrenal gland (white arrow). No hormonal abnormalities were found and the size of the lesion was unchanged at the follow up CT scan performed six months after CT colonography. The patient was eventually diagnosed with “incidentaloma”.
See this image and copyright information in PMC

Comment in

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