Virtual colonoscopy in the detection of colonic polyps and neoplasms

First introduced in 1994, CT colonography (Virtual colonoscopy) has emerged as an accurate, non-invasive test that will likely play a future role in colorectal cancer screening. Over the past 3 years, there have been dramatic improvements in both hardware and software technology relating to CT colonography resulting in shorter scan times, enhanced user-friendliness and improved performance statistics. Published results show the accuracy of CT colonography to be comparable to conventional colonoscopy for detection of polyps >6mm in size with few false-positives. While many of the technical aspects of CT colonography have now been standardised current interest focuses on the development of faecal tagging agents to avoid full bowel catharsis and the use of low dose multislice CT acquisition to reduce patient radiation exposure. This chapter will summarise the development of CT colonography to date, document its published performance in detection of colorectal polyps and cancers, and review its current and potential future uses.