Low-dose CT colonography in children: initial experience, technical feasibility, and utility.
BACKGROUND
CT colonography (CTC) is utilized as a diagnostic tool in the detection of colon polyps and early colorectal cancer in adults. Large studies in the literature, although focused on adult populations, have shown CTC to be a safe, accurate, non-invasive technique.


OBJECTIVE
We evaluated the technical feasibility of CTC in children using a low-dose technique.


METHODS
From November 2001 to April 2004 we evaluated eight patients (3-17 years) with non-contrast CTC. Seven of the patients had CTC, followed by standard colonoscopy (SC) the same day; in one patient, CTC followed a failed SC. CTC results were compared to results of SC. The estimated effective dose from each CTC was calculated and compared to that of standard barium enema.


RESULTS
CTC results were consistent with those of SC. Sensitivity for polyps 5-10 mm was 100%, and sensitivity for polyps 10 mm and larger was 66.7%. The estimated mean effective dose was 2.17 mSv for CTC, compared to the 5-6 mSv for a standard air-contrast barium enema in a small child.


CONCLUSIONS
Our initial experience shows CTC in children is well-tolerated, safe, and useful. The procedure can be performed successfully with a low radiation dose, and preliminary results compare well with SC.
Anupindi
Sudha
S
Department of Radiology, Massachusetts General Hospital, 55 Fruit St., White 246, Boston, MA 02115, USA. sanupindi@partners.org
Perumpillichira
James
J
Jaramillo
Diego
D
Zalis
Michael E
ME
Israel
Esther J
EJ
D011125:Adenomatous Polyposis Coli / Q000000981:diagnostic imaging; D000293:Adolescent; D001466:Barium Sulfate; D002648:Child; D002675:Child, Preschool; D003111:Colonic Polyps / Q000000981:diagnostic imaging; D023881:Colonography, Computed Tomographic / Q000379:methods*; D003113:Colonoscopy; D003287:Contrast Media; D004733:Enema; D005240:Feasibility Studies; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008297:Male; D011829:Radiation Dosage; D012007:Rectum; D012449:Safety; D012680:Sensitivity and Specificity
D003287:Contrast Media; D001466:Barium Sulfate