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Review
. 2015 Mar;60(3):647-59.
doi: 10.1007/s10620-014-3454-2. Epub 2014 Dec 10.

CT colonography for population screening: ready for prime time?

Perry J Pickhardt  1
Affiliations
Review

CT colonography for population screening: ready for prime time?

Perry J Pickhardt. Dig Dis Sci. 2015 Mar.
No abstract available

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Figures

Figure 1
Figure 1. Detection of advanced neoplasia at CTC screening with same-day polypectomy in asymptomatic 67-year-old man
3D colon map from CTC (A) shows two red dots that pinpoint the location of two sigmoid polyps. Note associated diverticular disease. 3D endoluminal (B) and confirmatory 2D transverse (C) CTC images show a large 1.6 cm pedunculated polyp (arrow), corresponding to the more proximal lesion. Additional 3D (D) and 2D (E) CTC images show a 9-mmm pedunculated polyp in the distal sigmoid. Both lesions were removed at same-day colonoscopy, avoiding the need for a second bowel prep. The larger polyp proved to be a tubulovillous adenoma (advanced lesion), whereas the smaller polyp was a tubular adenoma.
Figure 2
Figure 2. Asymptomatic colon cancer found at routine CTC screening
Colon map (A) shows the location of the mass seen at 3D (B) and 2D (C) CTC evaluation (arrows). The semi-annular morphology is compatible with an asymptomatic cancer, which was proven by biopsy at same-day colonoscopy (not shown).
Figure 3
Figure 3. Unsuspected extracolonic cancers identified at CTC screening in three different individuals
A. Bronchogenic adenocarcinoma at the right lung base (arrow). B. Non-Hodgkin’s lymphoma manifesting with bulky retroperitoneal lymphadenopathy (arrows). C. Peritoneal implant (arrow) representing unsuspected metastatic disease from a stage 1 endometrial cancer diagnosed previously.
Figure 4
Figure 4. Large flat serrated polyp identified at screening CTC
3D endoluminal CTC image (A) shows a relatively flat, large lobulated lesion that was confirmed (B) and removed (C) at subsequent same-day colonoscopy. The lesion proved to be a serrated serrated adenoma.
See this image and copyright information in PMC

References

    1. Johnson CD, Chen MH, Toledano AY, et al. Accuracy of CT colonography for detection of large adenomas and cancers. New England Journal of Medicine. 2008;359:1207–1217. - PMC - PubMed
    1. Kim DH, Pickhardt PJ, Taylor AJ, et al. CT colonography versus colonoscopy for the detection of advanced neoplasia. New England Journal of Medicine. 2007;357:1403–1412. - PubMed
    1. Pickhardt PJ, Choi JR, Hwang I, et al. Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. New England Journal of Medicine. 2003;349:2191–2200. - PubMed
    1. Hanson ME, Pickhardt PJ, Kim DH, Pfau PR. Anatomic factors predictive of incomplete colonoscopy based on findings at CT colonography. AJR Am J Roentgenol. 2007;189:774–779. - PubMed
    1. Macari M, Berman P, Dicker M, Milano A, Megibow AJ. Usefulness of CT colonography in patients with incomplete colonoscopy. American Journal of Roentgenology. 1999;173:561–564. - PubMed

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