Colonic lipomas revisited on CT colonography

Area of Science:

• Gastroenterology
• Radiology
• Oncology

Background:

• Colonic lipomas are the second most common colonic lesions after polyps.
• Accurate and rapid recognition of colonic lipomas is crucial for diagnosis and management.
• CT colonography (CTC) is an increasingly utilized, nationally approved colorectal cancer screening test.

Purpose of the Study:

• To evaluate the characteristics of colonic lipomas detected via CT colonography.
• To determine the incidence, location, morphology, and size of colonic lipomas.
• To compare the detection capabilities of CTC for colonic lipomas.

Main Methods:

• Retrospective study at two academic institutions involving 2138 patients who underwent CTC.
• Evaluation of 47 CTC examinations revealing 59 colonic lipomas by fellowship-trained abdominal radiologists.
• Analysis of lipoma characteristics including segmental location, morphology, multiplicity, attenuation, and size.

Main Results:

• Colonic lipomas detected in 2.2% of women and 2.3% of men, with a mean age of 66.9 years.
• Most common location was the ascending colon (39%), followed by transverse colon (19%).
• 9% were multiple, 42% pedunculated, 58% sessile; mean size was 19 mm, mean attenuation -132 HU.

Conclusions:

• Colonic lipomas predominantly occur in the ascending colon.
• While often solitary and sessile, a significant proportion can be multiple or pedunculated, mimicking polyps.
• CT colonography demonstrates efficacy in detecting colonic lipomas, including smaller lesions than optical colonoscopy.