Computed tomography colonography: current issues.
OBJECTIVE
Direct and indirect evidence supports the concept of screening for adenomas and early stage colorectal cancer in reducing the incidence and disease-specific mortality. Controversy remains as to the appropriateness of and preferred methods for screening an asymptomatic population.


METHODS
Review of computed tomography (CT) colonography based on the literature and personal experience.


CONCLUSIONS
Current discrepancies in the data on accuracy and patient acceptance of CT colonography reflect differences in the performance and evaluation of this examination. Before CT colonography can be implemented in colorectal cancer screening, factors that cause this variability must be elucidated. Studies in which high-resolution scanning, three-dimensional review methods and an enhanced colonoscopic reference are used achieve an accuracy that is similar to colonoscopy. At the same time the evidence that ultra-low radiation dose CT colonography is feasible is mounting, a development that dramatically reduces one of the largest obstacles for large-scale application of this technique.
Nio
Yung
Y
Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. c.y.nio@amc.uva.nl
Van Gelder
Rogier E
RE
Stoker
Jaap
J
D000236:Adenoma / Q000000981:diagnostic imaging; D023881:Colonography, Computed Tomographic; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology / Q000517:prevention & control; D005062:European Union; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008403:Mass Screening; D009367:Neoplasm Staging; D010342:Patient Acceptance of Health Care; D011829:Radiation Dosage; D012680:Sensitivity and Specificity