Spiral CT pneumocolon: applications, status and limitations.
CT pneumocolon is a promising new technique in the diagnosis and management of colon pathology. CT pneumocolon can detect (sensitivity >95%) and stage (accuracy 79%) colorectal cancer and is very accurate in the differentiation of malignant from benign colonic pathologies. It has excellent detection rates for polyps >10 mm in diameter. Several studies using 3D virtual colonoscopy have already proven its high sensitivity and specificity in polyp detection making this technique robust as a screening tool. The combined results for virtual colonoscopy, from all centres, show a sensitivity of >85% in the detection of polyps 10 mm or greater in size, 70-80% for 5-9 mm polyps and an overall specificity of 90%. CT pneumocolon is a safe, non-invasive and cost-effective method for detecting colonic carcinomas and adenomas and correctly identifying which patients need further colonoscopy. The technique is quick, well tolerated and non-operator dependent. It can also image the proximal colon when distal stenoses prevent endoscopic and barium examination. CT pneumocolon is able to identify the features and complications of inflammatory bowel disease. Further research is warranted to fully assess its impact in terms of a screening tool, acceptability, availability and cost benefit.
Harvey
C J
CJ
Department of Academic Imaging, University College London Hospitals Trust, The Middlesex Hospital, Mortimer Street, London W1N 8AA, UK. charvey_99@yahoo.com
Renfrew
I
I
Taylor
S
S
Gillams
A R
AR
Lees
W R
WR
D000388:Air; D003108:Colonic Diseases / Q000000981:diagnostic imaging / Q000473:pathology; D003111:Colonic Polyps / Q000000981:diagnostic imaging* / Q000473:pathology; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D009367:Neoplasm Staging; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*