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KMID : 0614720070500010033
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Journal of Korean Medical Association
2007 Volume.50 No. 1 p.33 ~ p.50
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CT Colonography
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Kim Se-Hyung
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Abstract
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CT colonography is a recent radiologic technique enabling detection of tumoral lesions in the colon. Since double contrast barium enema has lost most of its adherents, CT colonography gives a great opportunity for radiologists to play a predominant role in the diagnosis and treatment of colorectal cancer and adenoma. CT colonography has dramatically evolved by the refinement of the existing techniques and the introduction of new techniques such as fecal tagging, the use of carbon dioxide to inflate the colon, multi-detector row CT scanners, the use of ultra-low dose scan protocols, and computer-aided detection. These technical improvements are helpful both to the radiologists and to the patients. Several technical factors should be considered for the successful performance of CT colonography. Fecal tagging improves patients’ compliance by allowing for reduced bowel preparation. It facilitates the differentiation of true polyp from residual feces, resulting in the improvement of diagnostic accuracy. Automated carbon dioxide insufflation is more efficient and safer in colonic distention compared to manual room air insufflation. CT colonography should be performed by using a thin collimation of ≤3mm with a reconstruction increment of ≤3 mm and a low radiation dose of 30mAs to 50mAs. There are two strategies to interpret CT colonography dataset; primary 2D and 3D interpretation. There is not a single correct method for interpretation of CTC; therefore, the radiologists should be well-versed with both methods of interpretation. Finally, radiologists should also be familiar with potential diagnostic pitfalls, false positive and false negative findings. In experienced hands, CT colonography seems to be ripe for prime-time colorectal cancer screening. However, it is not yet ready for widespread application of screening due to various drawbacks. Therefore, considerable efforts should be undertaken to take it to the level of being a widely accepted screening method for colorectal cancer.
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KEYWORD
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Colon, CT, Neoplasm, Technique
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