[CT colonography in daily practice]

The sensitivity of computed tomography (CT) colonography for colorectal carcinoma and large polyps (≥ 10 mm) is comparable with that of colonoscopy. Acceptance in symptomatic patients is higher than for colonoscopy. The accuracy of CT colonography for polyps of 6-9 mm, for flat polyps and in particular for polyps < 6 mm is lower than for colonoscopy. Indication for CT colonography depends on the a prior chance of finding something relevant, as colonoscopy is necessary in the case of relevant findings. CT colonography can be an alternative to colonoscopy in patients with symptoms consistent with colorectal cancer when colonoscopy is not possible or appears incomplete. It can be used as primary technique in older patients with comorbidity and low a prior chance of relevant findings. CT colonography is less appropriate for surveillance as the accuracy for flat polyps is lower. CT colonography is not suitable in hereditary syndromes due to the lower accuracy for polyps < 10 mm. CT colonography can be a good alternative in patients with irritable bowel syndrome in the case of a low suspicion of colorectal cancer.