Noninvasive radiologic imaging of the large intestine: a valuable complement to optical colonoscopy.
OBJECTIVE
Radiologic imaging of the large intestine continues to evolve and expand the potential for noninvasive diagnosis. The aim of this review is to provide an update on current and emerging clinical capabilities for a variety of radiologic diagnostic imaging tools for evaluating the colon and rectum.


RESULTS
The utility of computed tomography for the evaluation of symptomatic inflammatory and neoplastic conditions of the colon is well established, but the clinical role of computed tomography colonography is rapidly evolving. In addition to a number of diagnostic indications, computed tomography colonography is emerging as a potential frontline colorectal screening test for cancer prevention. MRI has become increasingly valuable for rectal cancer staging and inflammatory bowel disease but has yet to gain momentum for polyp evaluation. PET imaging has been primarily utilized for oncologic indications, but also holds considerable potential for inflammatory conditions. Other imaging modalities, such as the barium enema, conventional radiography, and ultrasound, play a much more limited role.


CONCLUSIONS
Advances in radiologic imaging of the colorectum will continue to expand the capabilities and clinical indications for noninvasive diagnosis, allowing for a greater emphasis on the complementary roles of tissue sampling and therapy with optical colonoscopy.
Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792-3252, USA. ppickhardt2@uwhealth.org
Perry J
PJ
Pickhardt
D023881:Colonography, Computed Tomographic / Q000379:methods* / Q000639:trends; D003113:Colonoscopy / Q000379:methods / Q000639:trends; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000473:pathology; D003952:Diagnostic Imaging / Q000379:methods / Q000639:trends; D005260:Female; D005544:Forecasting; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis* / Q000473:pathology; D007420:Intestine, Large / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D049268:Positron-Emission Tomography / Q000379:methods* / Q000639:trends; D012680:Sensitivity and Specificity