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Diseases of the Colon and Rectum: CT Colonography

  • C. Dan Johnson
  • Perry J. Pickhardt
Chapter

Abstract

The public health need for colorectal cancer screening is compelling. Colorectal cancer is common, accounting for approximately 50,000 deaths yearly in the USA [1]. The benign precursor, adenoma, can be detected by several different imaging techniques and removal can prevent malignant transformation. The approximately 10-year polyp dwell time allows ample opportunity for patients to be screened and polyps detected and removed. Potentially, under ideal screening circumstances, an entire class of cancers could be prevented. However, barriers exist to ideal screening, including suboptimal performance of many existing colorectal screening tests, reluctant compliance by patients to follow recommended screening guidelines, and variable insurance coverage of examination charges. In many ways, computed tomography colonography (CTC) approaches an ideal screening test by addressing issues and problems inherent with other techniques. This syllabus highlights many key issues for CTC.

Keywords

Compute Tomography Colonography Colorectal Cancer Screening Colorectal Perforation Ideal Screening Extracolonic Finding 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Siegel R, Naishadham D, Jemal A (2012) Cancer statistics, 2012. CA Cancer J Clin 62:10–29.PubMedCrossRefGoogle Scholar
  2. 2.
    Pickhardt PJ, Choi JR, Hwang I et al (2003). Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. New Engl J Med 349:2191–2200.PubMedCrossRefGoogle Scholar
  3. 3.
    Johnson CD, Chen MH, Toledano A et al (2008) Accuracy of CT colonography for detection of large adenomas and cancer. New Engl J Med 359:1207–1217.PubMedCentralPubMedCrossRefGoogle Scholar
  4. 4.
    Fletcher JG, Chen MH, Herman BA et al (2010) Can radiologist training and testing ensure high performance in CT colonography? Lessons from the National CT Colonography Trial. AJR Am J Roentgenol 195:117–125.PubMedCentralPubMedCrossRefGoogle Scholar
  5. 5.
    Robbins JB, Kim DH (2013) Computed Tomographic Colonography: evidence and techniques for screening. Seminars in Roentgenology 48:264–272.PubMedCrossRefGoogle Scholar
  6. 6.
    Centers for Disease Control and Prevention (2008) Vital signs: colorectal cancer screening among adults aged 50–75 years — United States, 2008. MMWR Morb Mortal Wkly Rep 808-812.Google Scholar
  7. 7.
    Beebe TJ, Johnson CD, Stoner SM et al (2007) Assessing attitudes toward laxative preparation in colorectal cancer screening and effects on future testing: potential receptivity to computed tomographic colonography. Mayo Clinic Proceedings 82:666–671.PubMedCrossRefGoogle Scholar
  8. 8.
    Johnson CD, Kriegshauser JS, Lund JT et al (2011) Partial preparation computed tomographic colonography: a feasibility study. Abdom Imaging 36:707–712.PubMedCrossRefGoogle Scholar
  9. 9.
    Johnson CD, Manduca A, Fletcher JG et al (2006) Noncathartic CT colonography with stool tagging: performance with and without electronic subtraction. AJR Am J Roentgenol 190:361–366.CrossRefGoogle Scholar
  10. 10.
    Pickhardt PJ (2006) Incidence of colonic perforation at CT colonography: review of existing data and implication for screening of asymptomatic adults. Radiology 239:313–316.PubMedCrossRefGoogle Scholar
  11. 11.
    Waye JD, Kahn O, Auerbach ME (1996) Complications of colonoscopy and flexible sigmoidoscopy. Gastrointest Endosc Clin N Am 6:342–377.Google Scholar
  12. 12.
    Radiation risk in perspective (2010) Position Statement of the Health Physics Society, http://hps.org/documents/risk_ps010-2.pdfGoogle Scholar
  13. 13.
    Hendee WR, O’Connor MK (2012) Radiation risks of medical imaging: separating fact from fantasy. Radiology 264:312–321.PubMedCrossRefGoogle Scholar
  14. 14.
    Gluecker TM, Johnson CD, Wilson LA et al (2003) Extracolonic findings at CT colonography: evaluation of prevalence and cost in a screening population. Gastroenterology 124:911–916.PubMedCrossRefGoogle Scholar
  15. 15.
    Pickhardt PJ, Kim DH, Meiners RJ et al (2010) Colorectal and extracolonic cancers detected at screening CT colonography in 10,286 asymptomatic adults. Radiology 255:83–88.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2014

Authors and Affiliations

  • C. Dan Johnson
    • 1
  • Perry J. Pickhardt
    • 2
  1. 1.Mayo ClinicScottsdaleUSA
  2. 2.University of WisconsinMadisonUSA

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