Extracolonic findings at computed tomography colonography are a challenge.
OBJECTIVE
Our aim was to perform a prospective evaluation of the frequency and diagnostic consequences of extracolonic findings at multidetector array computed tomography colonography (MDCTC) in asymptomatic patients undergoing surveillance for former colorectal polyps or cancer.


METHODS
Seventy five consecutive patients undergoing surveillance for former colorectal cancer (CRC) or large bowel adenoma were examined with MDCTC. Two independent observers evaluated the images with regard to extracolonic findings. Patient records and radiological information systems were reviewed to determine the results and consequences of the workup derived from MDCTC.


RESULTS
Sixty five per cent (95% confidence interval (CI) 55-73%) of patients had extracolonic abnormalities and in 12% (CI 7-18%) of patients additional workup was indicated. Two patients (3% (CI 1-6%)) underwent surgery because of the findings (one) or because of complications of the workup (one).


CONCLUSIONS
MDCTC identifies a large number of extracolonic findings. Approximately 12% of asymptomatic patients undergo additional workup, of benefit to only a few. The high prevalence of extracolonic findings may make MDCTC a problematic colorectal screening tool for both ethical and economic reasons.
Ginnerup Pedersen
B
B
Department of Radiology, Aarhus Amtssygehus, Aarhus University Hospital, Tage Hansensgade 2, DK-8000 Aarhus C, Denmark. ginnerup-kelsen@dadlnet.dk
Rosenkilde
M
M
Christiansen
T E M
TE
Laurberg
S
S
D000236:Adenoma / Q000000981:diagnostic imaging; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging; D023881:Colonography, Computed Tomographic / Q000379:methods*; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D011446:Prospective Studies