The role of CT Colonography in the assessment of inflammatory bowel Diseases patients

Abstract

Inflammatory bowel disease (IBD), including Crohn's disease (CD) and Ulcerative Colitis (UC), is characterized by chronic inflammation of the gastrointestinal tract, and its long-standing course significantly elevates the risk of colorectal cancer (CRC), primarily arising from dysplastic lesions. While regular surveillance by colonoscopy is well established for UC patients, guidelines for CD remain uncertain. Computed Tomographic Colonography (CTC) offers a minimally invasive alternative for evaluating the colon, particularly in cases where colonoscopy is incomplete or contraindicated. Although not commonly utilized in IBD management, CTC provides substantial advantages in identifying complications such as fistulas, strictures, and colonic neoplasms. Additionally, it offers anatomical detail, which is crucial for surgical planning and decision-making. In this review we aim to demonstrate the usefulness of CTC in selected IBD cases, particularly in patients for whom colonoscopy is not feasible, and to show how its integration into clinical practice enhances decision-making and provides crucial insights into disease complications.