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Related Experiment Videos

Computed tomography colonography in routine clinical practice.

Teresa M Gallo1, Giovanni Galatola, Mario Fracchia

  • 1Radiology Unit and Gastroenterology Unit, Institute for Cancer Research and Treatment, Candiolo, Italy. teresa.gallo@ircc.it

European Journal of Gastroenterology & Hepatology
|November 19, 2003
PubMed
Summary
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Computed tomography (CT) colonography is a reliable alternative to double-contrast barium enema for patients unable to complete colonoscopy. This imaging technique accurately detects polyps and cancers, offering a valuable option when standard colonoscopy is not feasible.

Area of Science:

  • Radiology
  • Gastroenterology
  • Medical Imaging

Background:

  • Colonoscopy is the gold standard for colorectal cancer screening but can be incomplete or refused by some patients.
  • Double-contrast barium enema has traditionally been used as an alternative, but CT colonography offers a less invasive option.

Purpose of the Study:

  • To evaluate the effectiveness of open-access computed tomography (CT) colonography as a substitute for double-contrast barium enema.
  • To assess CT colonography's performance in patients who refused or had an incomplete first colonoscopy attempt.

Main Methods:

  • A retrospective review of 463 consecutive CT colonography examinations performed between December 1998 and August 2001.
  • Patients with detected intraluminal growths underwent colonoscopy, with deep sedation available for failed attempts.

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Main Results:

  • CT colonography demonstrated high positive predictive values: 90% for cancer and up to 87% for large polyps (>/= 10 mm) on a per-lesion basis.
  • On a per-patient basis, CT colonography had a 93% positive predictive value for cancer and up to 89% for large polyps.
  • Colonoscopy confirmed most CT colonography findings, identifying additional lesions in some cases.

Conclusions:

  • Open-access CT colonography is a safe and effective routine test for patients who cannot undergo total colonoscopy.
  • It serves as a confident alternative to double-contrast barium enema in specific clinical scenarios.