Current Issues in Computed Tomography Colonography

Computed tomography colonography has evolved over the past 2 decades to become the primary alternative to optical colonoscopy for detection of colonic neoplasia. With good technique in performance and reporting, accuracy is comparable to optical colonoscopy for cancers and larger polyps. This article discusses the current components of a high-quality examination including contemporary methods of bowel preparation and distension. Also described is the main trial data that have validated the examination. Finally, the use of the technique for nonneoplastic colonic pathology is discussed, and future directions are described including magnetic resonance colonography and wireless capsule colonic imaging.