Computed tomography colonography in 2014: an update on technique and indications

Area of Science:

• Radiology
• Gastroenterology
• Medical Imaging

Background:

• Computed tomographic colonography (CTC) has been available for two decades.
• Advancements in technology have improved its performance and patient experience.

Purpose of the Study:

• To evaluate the current status and diagnostic performance of CTC.
• To discuss established and emerging indications for CTC.
• To highlight contraindications for appropriate use.

Main Methods:

• Review of consolidated literature evidence.
• Comparison of diagnostic performance against colonoscopy (CS) and barium enema.
• Analysis of technological advancements in CTC imaging and interpretation.

Main Results:

• CTC demonstrates diagnostic performance for colorectal cancer (CRC) and large polyps comparable to CS.
• CTC is superior to barium enema, which should be discouraged.
• Established indications include incomplete/failed CS, symptomatic/elderly/frail patients, and diverticular disease investigation.

Conclusions:

• CTC is a mature, less invasive, and standardized radiological test for CRC and polyps.
• Appropriate use, considering established indications and contraindications, maximizes benefits.
• Further research supports debated indications like CRC screening and post-surgical surveillance.