Skip to main content

Overview of CTC in Imaging the Colon

  • Chapter
  • First Online:
CT Colonography for Radiographers

Abstract

The transition of a new technique into clinical practice involves review of the practice, audit and the development of standards and guidelines to support the introduction of the technique. CTC has been developed by gastrointestinal-focused radiologists throughout the globe, with guidelines issued to aid implementation and to establish best practice for centres performing CTC. This chapter reviews the development of CTC and discusses current guidance and where CTC may be heading in the future.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F. GLOBOCAN 2012 v1.0, cancer incidence and mortality worldwide: IARC Cancer Base No. 11 [Internet]. Lyon: International Agency for Research on Cancer; 2013. http://globocan.iarc.fr. Accessed 05 July 2015.

  2. American Cancer Society. Cancer facts and figures: what are the key statistics about colorectal cancer? http://www.cancer.org/cancer/colonandrectumcancer/detailedguide/colorectal-cancer-key-statistics. Accessed 13 Oct 2015.

  3. World Health Organisation: International Agency for research on Cancer. World Cancer fact sheet: world cancer burden 2012; 2014. http://publications.cancerresearchuk.org/downloads/product/CS_REPORT_WORLD.pdf. Accessed 05 Aug 2015.

  4. Felsen CB, Piasecki A, Ferrante JM, Ohman-Strickland PA, Crabtree BF. Colorectal cancer screening among primary care patients: does risk affect screening behavior? J Community Health. 2011;36:605–11. doi:10.1007/s10900-010-9348-0.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Atkin WS, Edwards R, Kralj-Hans I, Wooldrage K, Hart AR, Northover JM, et al. UK flexible sigmoidoscopy trial investigators. Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial. Lancet. 2010;375:1624–33.

    Article  PubMed  Google Scholar 

  6. Levin B, Lieberman DA, McFarland B, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. CA Cancer J Clin. 2008;58:130–60.

    Article  PubMed  Google Scholar 

  7. American Cancer Society. Colorectal cancer: early detection, diagnosis and staging topics. Revised 13th August 2015. http://www.cancer.org/cancer/colonandrectumcancer/detailedguide/colorectal-cancer-survival-rates. Accessed 13 Oct 2015.

  8. Cancer Research UK. Bowel cancer survival statistics: bowel cancer survival by stage at diagnosis. http://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/bowel-cancer/survival#heading-Three. Accessed 13 Oct 2015.

  9. Halligan S, Wooldrage K, Dadswell E, Kralj-Han I, von Wagner C, Edwards R, Atkin W. Computed tomographic colonography versus barium enema for diagnosis of colorectal cancer or large polyps in symptomatic patients (SIGGAR): a multicentre randomised trial. Lancet. 2013;381:1185–93.

    Article  PubMed  Google Scholar 

  10. Pickhardt PJ, Hassan C, Halligan S, Marmo R. Colorectal cancer: CT colonography and colonoscopy for detection—systematic review and meta-analysis. Radiology. 2011;259:393–405.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Hara AK, Johnson CD, Reed JE, et al. Detection of colorectal polyps with CT colonography: Initial assessment of sensitivity and specificity. Radiology. 1997;205:59–65.

    Article  CAS  PubMed  Google Scholar 

  12. 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;169:1237–42.

    Article  CAS  PubMed  Google Scholar 

  13. Plumb AA, Halligan S, Pendsé DA, Taylor SA, Mallett S, Sensitivity and specificity of CT colonography for the detection of colonic neoplasia after positive faecal occult blood testing: systematic review and meta-analysis. Eur Radiol. 2014;24:1049–58. http://www.ncbi.nlm.nih.gov/pubmed/24519111. Accessed 01 July 2015.

    Google Scholar 

  14. Laghi A. Computed tomography colonography in 2014: an update on technique and indications. World J Gastroenterol. 2014;20:16858–67. doi:10.3748/wjg.v20.i45.16858.

    Article  PubMed  PubMed Central  Google Scholar 

  15. ACR-SAR-SCBT-MR Practice parameter for the performance of computed tomography (CT) colonography in adults – revised 2014. http://www.acr.org/~/media/ACR/Documents/PGTS/guidelines/CT_Colonography.pdf. Accessed 03 June 2015.

  16. Guittet L, Bouvier V, Mariotte N, et al. Comparison of a guaiac based and an immunochemical faecal occult blood test in screening for colorectal cancer in a general average risk population. Gut. 2007;56:210–4.

    Article  CAS  PubMed  Google Scholar 

  17. Imperiale TF, Ransohoff DF, Itzkowitz SH, Levin TR, Lavin P, Lidgard GP, et al. Multitarget stool DNA testing for colorectal-cancer screening. N Engl J Med. 2014;370:1287–97.

    Article  CAS  PubMed  Google Scholar 

  18. Allison JE, Fraser CG, Halloran SP, Young GP. Population screening for colorectal cancer means getting FIT: the past, present, and future of colorectal cancer screening using the fecal immunochemical test for hemoglobin (FIT). Gut Liver. 2014;8:117–30. doi:10.5009/gnl.2014.8.2.117.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Benson VS, Patnick J, Davies AK, Nadel MR, Smith RA, Atkin WS. Colorectal cancer screening: a comparison of 35 initiatives in 17 countries. Int J Cancer. 2008;122:1357–67. http://onlinelibrary.wiley.com/doi/10.1002/ijc.23273/pdf. Accessed 01 July 2015.

    Google Scholar 

  20. Sewitch MJ, Fournier C, Ciampi A, Dyachenko A. Adherence to colorectal cancer screening guidelines in Canada. BMC Ggastroenterol. 2007;7:39–48.

    Article  Google Scholar 

  21. Center MM, Jemal A, Smith RA, Ward E. Worldwide variations in colorectal cancer. CA Cancer J Clin. 2009;59:366–78. http://onlinelibrary.wiley.com/doi/10.3322/caac.20038/full#bib32. Accessed 01 July 2015.

    Google Scholar 

  22. de Haan MC, van Gelder RE, Graser A, Bipat S, Stoker J. Diagnostic value of CT-colonography as compared to colonoscopy in an asymptomatic screening population: a meta-analysis. Eur Radiol. 2011;21:1747–63.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Sosna J, Morrin MM, Kruskal JB, Lavin PT, Rosen MP, Raptopoulos V. CT colonography of colorectal polyps: a meta-analysis. AJR Am J Roentgenol. 2003;181:1593–8.

    Article  PubMed  Google Scholar 

  24. Mulhall BP, Veerappan GR, Jackson JL. Meta-analysis: computed tomographic colonography. Ann Intern Med. 2005;142:635–50.

    Article  PubMed  Google Scholar 

  25. Halligan S, Altman DG, Taylor SA, Mallett S, Deeks JJ, Bartram CI, Atkin W. CT colonography in the detection of colorectal polyps and cancer: systematic review, meta-analysis, and proposed minimum data set for study level reporting. Radiology. 2005;237:893–904.

    Article  PubMed  Google Scholar 

  26. Chaparro M, Gisbert JP, Del Campo L, Cantero J, Maté J. Accuracy of computed tomographic colonography for the detection of polyps and colorectal tumors: a systematic review and meta-analysis. Digestion. 2009;80:1–17.

    Article  PubMed  Google Scholar 

  27. Atkin W, Dadswell E, Wooldrage K, Kralj-Hans I, von Wagner C, Edwards R, Halligan S. Computed tomographic colonography versus colonoscopy for investigation of patients with symptoms suggestive of colorectal cancer (SIGGAR): a multicentre randomised trial. Lancet. 2013;381:1194–202.

    Article  PubMed  Google Scholar 

  28. Rex DK, Rahmani EY, Haseman JH, Lemmel GT, Kaster S, Buckley JS. Relative sensitivity of colonoscopy and barium enema for detection of colorectal cancer in clinical practice. Gastroenterology. 1997;112:17–23.

    Article  CAS  PubMed  Google Scholar 

  29. Levine MS, Rubesin SE, Laufer I. Barium studies in modern radiology: do they have a role? Radiology. 2009;250:18–22.

    Article  PubMed  Google Scholar 

  30. Tawn DJ, Squire CJ, Mohammed MA, Adam EJ. National audit of the sensitivity of double-contrast barium enema for colorectal carcinoma, using control charts: for the royal college of radiologists clinical radiology audit sub-committee. Clin Radiol. 2005;60:558–64.

    Article  CAS  PubMed  Google Scholar 

  31. Blakeborough A, Sheridan MB, Chapman AH. Complications of barium enema examinations: a survey of consultant radiologists 1992–1994. Clin Radiol. 1997;52:142–8.

    Article  CAS  PubMed  Google Scholar 

  32. Coin CG, Wollett FC, Coin JT, et al. Computerized radiology of the colon: a potential screening technique. Comput Radiol. 1987;7:215–21.

    Article  Google Scholar 

  33. Vining DJ, Gelfand DW, Bechtold RE, et al. Technical feasibility of colon imaging with helical CT and virtual reality (abstr). AJR Am J Roentgenol. 1994;162:104.

    Google Scholar 

  34. Vining DJ. Virtual endoscopy: is it reality? Radiology. 1996;200:30–1.

    Article  CAS  PubMed  Google Scholar 

  35. Pickhardt PJ, Choi JR, Hwang I, et al. Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. N Engl J Med. 2003;349:2191–200.

    Article  CAS  PubMed  Google Scholar 

  36. Halligan S, Fenlon HM. Virtual colonoscopy. BMJ. 1999;319:1249–52.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Yee J, Weinstein S, Morgan T, Alore P, Aslam R. Advances in CT colonography for colorectal cancer screening and diagnosis. J Cancer. 2013;4:200–9. doi:10.7150/jca.5858.

    Article  PubMed  PubMed Central  Google Scholar 

  38. British Society of Gastrointestinal and Abdominal Radiology (BSGAR) and The Royal College of Radiologists. BFCR (14)9. Guidance on the use of CT colonography for suspected colorectal cancer. London: The Royal College of Radiologists; 2014. https://www.rcr.ac.uk/sites/default/files/publication/BFCR[14]9_COLON.pdf . Accessed 13 Sept 2015.

  39. Yoon MA, Kim SH, Lee JM, Woo HS, Lee ES, Ahn SJ, Han JK. Adaptive statistical iterative reconstruction and Veo: assessment of image quality and diagnostic performance in CT colonography at various radiation doses. J Comput Assist Tomogr. 2012;36:596–601.

    Article  PubMed  Google Scholar 

  40. Bortz JH. An approach for performing a successful computed tomography colonography. S Afr J Rad. 2014;18(1):Art. #607, 11. http://www.sajr.org.za/index.php/sajr/article/viewFile/607/pdf. Accessed 13 Oct 2015.

  41. Heresbach D, Djabbari M, Riou F, et al. Accuracy of computed tomographic colonography in a nationwide multicentre trial, and its relation to radiologist expertise. Gut. 2011;60:658–65.

    Article  CAS  PubMed  Google Scholar 

  42. NHS Bowel Cancer Screening Imaging guidelines. No 5: guidelines for the use of imaging in the NHS Bowel Cancer Screening Programme. 2nd ed. Sheffield: NHS Cancer Screening Programmes; 2012. http://www.cancerscreening.nhs.uk/bowel/publications/. Accessed 01 June 2015.

  43. Pickhardt PJ, Lee AD, Taylor AJ, et al. Primary 2D versus primary 3D polyp detection at screening CT colonography. AJR Am J Roentgenol. 2007;189:1451–6.

    Article  PubMed  Google Scholar 

  44. Burling D. International collaboration for CT colonography standards. CT colonography standards. Clin Radiol. 2010;65:474–80. doi:10.1016/j.crad.2009.12.003.

    Article  PubMed  Google Scholar 

  45. Neri E, Mang T, Hellstrom M, Mantarro A, Faggioni L, Bartolozzi C. How to read and report CTC. Eur J Radiol. 2013;82:1166–70.

    Article  PubMed  Google Scholar 

  46. Bielen D, Kiss G. Computer-aided detection for CT colonography: update 2007. Abdom Imaging. 2007;32:571–81.

    Article  PubMed  Google Scholar 

  47. Yoshida H, Dachman AH. CAD techniques, challenges, and controversies in computed tomographic colonography. Abdom Imaging. 2004;30:26–41.

    Article  Google Scholar 

  48. Nasirudin RA, Tachibana R, Näppi JJ, Mei K, Kopp FK, Rummeny EJ, Yoshida H, Noël PB. A comparison of material decomposition techniques for dual-energy CT colonography. Proc. SPIE 9412, Medical Imaging 2015: Physics of Medical Imaging. 2015;9412. doi:10.1117/12.2081982. http://proceedings.spiedigitallibrary.org/proceeding.aspx?articleid=2210265. Accessed 01 Aug 2015.

  49. Burling D, Moore A, Marshall M, et al. Virtual colonoscopy: effect of computer-assisted detection (CAD) on radiographer performance. Clin Radiol. 2008;63:549–56.

    Article  CAS  PubMed  Google Scholar 

  50. Helbren E, Fanshawe TR, Phillips P, Mallett S, Boone D, Gale A, Altman DG, Taylor SA, Manning D, Halligan S. The effect of computer-aided detection markers on visual search and reader performance during concurrent reading of CT colonography. Eur Radiol. 2015;25:1570–8.

    Article  PubMed  Google Scholar 

  51. Plumb AA, Halligan S, Taylor SA, Burling D, Nickerson C, Patnick J. CT colonography in the english bowel cancer screening programme: national survey of current practice. Clin Radiol. 2013;68:479–87.

    Article  CAS  PubMed  Google Scholar 

  52. Jensch S, van Gelder RE, Florie J, Thomassen-de Graaf MA, Lobé JV, Bossuyt PMM, Bipat S, Nio CY, Stoker J. Performance of radiographers in the evaluation of CT colonographic image. Gastrointest Imaging. 2007;188:249–55.

    Google Scholar 

  53. Lauridsen C, Lefere P, Gerke O, Hageman S, Karstoft J, Gryspeerdt S. Comparison of the diagnostic performance of CT colonography interpreted by radiologists and radiographers. Insights Imaging. 2013;4:491–7.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Yee J, Akerkar GA, Hung RK, Steinauer-Gebauer AM, Wall SD, McQuaid KR. Colorectal neoplasia: performance characteristics of CT colonography for detection in 300 patients. Radiology. 2001;219:685–92.

    Article  CAS  PubMed  Google Scholar 

  55. Lung P, Burling D, Kallarackel L, Muckian J, Ilangovan R, Gupta A, Marshall M, Shorvon P, Halligan S, Bhatnagar G, et al. Implementation of a new CT colonography service: 5 year experience. Clin Radiol. 2014;69:597–605.

    Article  CAS  PubMed  Google Scholar 

  56. Ristvedt SL, McFarland EG, Weinstock LB, Thyssen EP. Patient preferences for CT colonography, conventional colonoscopy, and bowel preparation. Am J Gastroenterol. 2003;98:578–85.

    Article  PubMed  Google Scholar 

  57. Park SH, Yee J, Kim SH, Kim YH. Fundamental elements for successful performance of CT colonography [Virtual Colonoscopy]. Korean J Radiol. 2007;8:264–75. doi:10.3348/kjr.2007.8.4.264.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Spada C, Stoker J, Alarcon O, Barbaro F, Bellini D, Bretthauer M, et al. Clinical indications for computed tomographic colonography: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) Guideline. European Radiology. 2015;25:331–45. http://doi.org/10.1007/s00330-014-3435-z. Accessed 01 Oct 2015.

    Google Scholar 

  59. Levin B, Brooks D, Smith RA, Stone A. Emerging technologies in screening for colorectal cancer: CT colonography, immunochemical fecal occult blood tests, and stool screening using molecular markers. CA Cancer J Clin. 2003;53:44–55.

    Article  PubMed  Google Scholar 

  60. Yee J. CT colonography: techniques and applications. Radiol Clin North Am. 2009;47:133–45.

    Article  PubMed  Google Scholar 

  61. Pyenson B, Pickhardt PJ, Sawhney TG, Berrios M. Medicare cost of colorectal cancer screening: CT colonography vs. optical colonoscopy. Abdom Imaging. 2015;40:1–11. doi:10.1007/s00261-015-0538-1.

    Article  Google Scholar 

  62. GE Healthcare – Smart Metal Artifact Reduction (AMR) Date of publication: 8/21/2014 – Document ID: DOC1381483; JB23002XX http://www3.gehealthcare.com/en/products/categories/computed_tomography/radiation_therapy_planning/metal_artifact_reduction . Accessed 13 Oct 2015.

  63. Philips NetForum community – Metal Artifact Reduction for Orthopedic Implants (O-MA) 8th January 2012 http://clinical.netforum.healthcare.philips.com/us_en/Explore/White-Papers/CT/Metal-Artifact-Reduction-for-Orthopedic-Implants-(O-MAR). Accessed 13 Oct 2015.

  64. Haycock A, Burling D, Wylie P, Muckian J, Ilangovan R, Thomas-Gibson S. CT colonography training for radiographers—a formal evaluation. Clin Radiol. 2010;65:997–1004.

    Article  CAS  PubMed  Google Scholar 

  65. St Marks – CTC courses for radiographers. https://www.stmarkshospital.org.uk/shop/courses/st-marks-hands-on-ct-colonography-ctc-training-course-for-radiographers. Accessed 09 Sept 2015.

  66. British Abdominal Imaging – The CTC Northern School -Leeds – CTC courses for radiographers and radiologists http://www.britishabdominalimaging.co.uk/. Accessed 09 Sept 2015.

  67. Keele University. Key Facts: NUR-40036: advance practice in computed tomographic colonography. http://www.keele.ac.uk/health/postgraduate/individualmodules/advancedpracticeincomputedtomographycolonography/. Accessed 13 Oct 2015.

  68. Rex DK, Johnson DA, Anderson JC, Schoenfeld PS, Burke CA, Inadomi JM. American College of Gastroenterology guidelines for colorectal cancer screening 2008. Am J Gastroenterol. 2009;104:739–50.

    Article  PubMed  Google Scholar 

  69. Graser A, Stieber P, Nagel D, Schäfer C, Horst D, Becker CR, et al. Comparison of CT colonography, colonoscopy, sigmoidoscopy and faecal occult blood tests for the detection of advanced adenoma in an average risk population. Gut. 2009;58:241–8. doi:10.1136/gut.2008.156448.

    Article  CAS  PubMed  Google Scholar 

  70. Levine MS, Yee J. History, evolution, and current status of radiologic imaging tests for colorectal cancer screening. Radiology. 2014;273:S160–80. doi:10.1148/radiol.14140531.

    Article  PubMed  Google Scholar 

  71. Brenner DJ, Georgsson MA. Mass screening with CT colonography: should the radiation exposure be of concern? Gastroenterology. 2005;129:328–37.

    Article  PubMed  Google Scholar 

  72. Kim DH, Pickhardt PJ, Taylor AJ, Leung WK, Winter TC, Hinshaw JL, et al. CT colonography versus colonoscopy for the detection of advanced neoplasia. N Engl J Med. 2007;357:1403–12.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Rachel Baldwin-Cleland BSc(Hons), Pg Cert (UK) .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Baldwin-Cleland, R., Muckian, J. (2016). Overview of CTC in Imaging the Colon. In: Bortz, J., Ramlaul, A., Munro, L. (eds) CT Colonography for Radiographers. Springer, Cham. https://doi.org/10.1007/978-3-319-29379-0_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-29379-0_7

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-29377-6

  • Online ISBN: 978-3-319-29379-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics