nach oben

Abdominal Radiology

Erschienen in:

01.01.2004 | INVITED UPDATE

Colorectal cancer screening and surveillance with CT colonography: current controversies and obstacles

verfasst von: R. E. van Gelder, J. Florie, J. Stoker

Erschienen in: Abdominal Radiology | Ausgabe 1/2004

Einloggen, um Zugang zu erhalten

Abstract

Computed tomographic (CT) colonography has been advocated as an alternative colorectal screening method because studies in populations with a high prevalence of polyps have demonstrated that sensitivity for patients with large (≥10 mm) polyps is generally high (∼90%). In three recent studies in low-prevalence populations, however, these values vary from 55% to 94%.

Many questions have been raised as to the cause of this remarkable variability, which hampers the implementation of CT colonography in colorectal cancer screening and surveillance. We provide an overview of some potential causes and discuss the available, often indirect, evidence. In addition, several other obstacles that may influence implementation are discussed. Many differences between the study with high sensitivity (94%) and the two studies with low sensitivity (55% and 64%) exist: the primary method to review the data (two or three dimensional), bowel preparation (with or without oral contrast agents), study design (verification method and analysis of adenomas only), reader’s experience, and scanning technique (single vs. multislice, thin vs. thick sections). Additional obstacles for implementation in prevention of colorectal cancer may be controversial results concerning patient acceptance, the large-scale use of ionizing radiation, difficulties in detecting flat adenomas, and extracolonic findings.

Use of primary three-dimensional review methods, addition of oral contrast agents to bowel preparation, and endoscopic verification of false-positive results on CT colonography are speculated to have a positive influence on sensitivity. Future investigations should demonstrate the influence of these potential factors on sensitivity of CT colonography. Despite a growing body of evidence, it remains uncertain to what extent patient acceptance, radiation issues, flat lesions, and extracolonic findings will be a stumbling block to using CT colonography for colorectal cancer screening.

Smith, RA, Cokkinides, V, Eyre, HJ 2003American Cancer Society guidelines for the early detection of cancer, 2003CA Cancer J Clin532743PubMedCrossRef

Winawer, S, Fletcher, R, Rex, D, et al. 2003Colorectal cancer screening and surveillance: clinical guidelines and rationale—update based on new evidenceGastroenterology124544560PubMedCrossRef

Pariente, A, Milan, C, Lafon, J, Faivre, J 1998Colonoscopic screening in first-degree relatives of patients with ‘sporadic’ colorectal cancer: a case-control study. The Association Nationale des Gastroenterologues des Hopitaux and Registre Bourguignon des Cancers Digestifs (INSERM CRI 9505)Gastroenterology115712PubMedCrossRef

Cooper, GS, Yuan, Z, Chak, A, Rimm, AA 2000Patterns of endoscopic follow-up after surgery for nonmetastatic colorectal cancerGastrointest Endosc523338PubMedCrossRef

Hackelsberger, A, Fruhmorgen, P, Weiler, H, et al. 1995Endoscopic polypectomy and management of colorectal adenomas with invasive carcinomaEndoscopy27153158PubMedCrossRef

Rex, DK, Johnson, DA, Lieberman, DA, et al. 2000Colorectal cancer prevention 2000: screening recommendations of the American College of GastroenterologyAm J Gastroenterol95868877PubMed

Harewood, GC, Wiersema, MJ, Melton, LJ,III 2002A prospective, controlled assessment of factors influencing acceptance of screening colonoscopyAm J Gastroenterol9731863194PubMedCrossRef

Dominitz, JA, Eisen, GM, Baron, TH, et al. 2003Complications of colonoscopyGastrointest Endosc57441445PubMedCrossRef

Yee, J, Akerkar, GA, Hung, RK, et al. 2001Colorectal neoplasia: performance characteristics of CT colonography for detection in 300 patientsRadiology219685692PubMed

10.

Fenlon, HM, Nunes, DP, Schroy, PC,III, et al. 1999A comparison of virtual and conventional colonoscopy for the detection of colorectal polypsN Engl J Med34114961503PubMedCrossRef

11.

Pineau, BC, Paskett, ED, Chen, GJ, et al. 2003Virtual colonoscopy using oral contrast compared with colonoscopy for the detection of patients with colorectal polypsGastroenterology125304310PubMedCrossRef

12.

Johnson, CD, Toledano, AY, Herman, BA, et al. 2003Computerized tomographic colonography: performance evaluation in a retrospective multicenter settingGastroenterology125688695PubMedCrossRef

13.

Cotton, PB, Durhalski, VL, Finean, CK, et al. 2004Computed tomographic colonography (virtual colonoscopy): a multicenter comparison with standard colonoscopy for detection of colorectal neoplasmJAMA29117131719PubMedCrossRef

14.

15.

Johnson, CD, Harmsen, WS, Wilson, LA, et al. 2003Prospective blinded evaluation of computed tomographic colonography for screen detection of colorectal polypsGastroenterology125311319PubMedCrossRef

16.

Pickhardt, PJ, Choi, JR, Hwang, I, et al. 2003Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adultsN Engl J Med34921912200PubMedCrossRef

17.

Tursi, A 2004Computed tomographic colonography or conventional colonoscopy in detecting small colonic lesions in clinical practice?Gastroenterology126937938PubMedCrossRef

18.

Pescatore, P, Glucker, T, Delarive, J, et al. 2000Diagnostic accuracy and interobserver agreement of CT colonography (virtual colonoscopy)Gut47126130PubMedCrossRef

19.

Rex, DK, Vining, D, Kopecky, KK 1999An initial experience with screening for colon polyps using spiral CT with and without CT colography (virtual colonoscopy)Gastrointest Endosc50309313PubMedCrossRef

20.

Macari, M, Milano, A, Lavelle, M, et al. 2000Comparison of time-efficient CT colonography with two- and three-dimensional colonic evaluation for detecting colorectal polypsAJR17415431549PubMedCrossRef

21.

Vos, FM, Gelder, RE, Serlie, IW, et al. 2003Three-dimensional display modes for CT colonography: conventional 3D virtual colonoscopy versus unfolded cube projectionRadiology228878885PubMedCrossRef

22.

Beaulieu, CF, Jeffrey, RB,Jr, Karadi, C, et al. 1999Display modes for CT colonography. Part II. Blinded comparison of axial CT and virtual endoscopic and panoramic endoscopic volume-rendered studiesRadiology212203212PubMed

23.

Fletcher, JG, Johnson, CD, Reed, JE, Garry, J 2001Feasibility of planar virtual pathology: a new paradigm in volume-rendered CT colonographyJ Comput Assist Tomogr25864869PubMedCrossRef

24.

Paik, DS, Beaulieu, CF, Jeffrey, RB, et al. 2000Visualization modes for CT colonography using cylindrical and planar map projectionsJ Comput Assist Tomogr24179188PubMedCrossRef

25.

McFarland, E, Brink, J, Pilgram, T, et al. 2001Spiral CT colonography: reader agreement and diagnostic performance with two- and three-dimensional image-display techniquesRadiology218375383PubMed

26.

Yoshida, H, Masutani, Y, MacEneaney, P, et al. 2002Computerized detection of colonic polyps at CT colonography on the basis of volumetric features: pilot studyRadiology222327336PubMedCrossRef

27.

Summers, RM, Jerebko, AK, Franaszek, M, et al. 2002Colonic polyps: complementary role of computer-aided detection in CT colonographyRadiology225391399PubMedCrossRef

28.

Macari, M, Lavelle, M, Pedrosa, I, et al. 2001Effect of different bowel preparations on residual fluid at CT colonographyRadiology218274277PubMed

29.

Zalis, ME, Perumpillichira, J, Frate, C, Hahn, PF 2003CT colonography: digital subtraction bowel cleansing with mucosal reconstruction initial observationsRadiology226911917PubMedCrossRef

30.

Pineau BC (2002) Project: comparison of virtual colonoscopy and conventional colonoscopy in the detection of polyps/masses. In: Proceedings of the Third International Symposium on Virtual Colonoscopy, pp 26–27

31.

Lefere, PA, Gryspeerdt, SS, Dewyspelaere, J, et al. 2002Dietary fecal tagging as a cleansing method before CT colonography: initial results polyp detection and patient acceptanceRadiology224393403PubMedCrossRef

32.

Rex, DK, Cutler, CS, Lemmel, GT, et al. 1997Colonoscopic miss rates of adenomas determined by back-to-back colonoscopies [see comments]Gastroenterology1122428PubMedCrossRef

33.

Hixson, LJ, Fennerty, MB, Sampliner, RE, et al. 1990Prospective study of the frequency and size distribution of polyps missed by colonoscopyJ Natl Cancer Inst8217691772PubMedCrossRef

34.

Gelder, RE, Nio, CY, Florie, J, et al. 2004Computed tomographic colonography compared with colonoscopy in patients at increased risk for colorectal cancerGastroenterology1274148PubMedCrossRef

35.

Ginnerup, PB, Christiansen, TE, Bjerregaard, NC, et al. 2003Colonoscopy and multidetector-array computed-tomographic colonography: detection rates and feasibilityEndoscopy35736742CrossRef

36.

Pickhardt PJ, Choi JR, Hwang I, Schindler WR (2003) Nonadenomatous polyps at virtual colonoscopy: prevalence, size distribution, detection rates, and implications for colorectal cancer screening. In: Proceedings of the Fourth International Symposium on Virtual Colonoscopy [abstract], p 161

37.

Pescatore, P, Glucker, T, Delarive, J, et al. 2000Diagnostic accuracy and interobserver agreement of CT colonography (virtual colonoscopy)Gut47126130PubMedCrossRef

38.

Gluecker, T, Meuwly, JY, Pescatore, P, et al. 2002Effect of investigator experience in CT colonographyEur Radiol1214051409PubMedCrossRef

39.

Spinzi, G, Belloni, G, Martegani, A, et al. 2001Computed tomographic colonography and conventional colonoscopy for colon diseases: a prospective, blinded studyAm J Gastroenterol96394400PubMedCrossRef

40.

Hara, AK, Johnson, CD, MacCarty, RL, et al. 2001CT colonography: single- versus multi-detector row imagingRadiology219461465PubMed

41.

Taylor, SA, Halligan, S, Bartram, CI, et al. 2003Multi-detector row CT colonography: effect of collimation, pitch, and orientation on polyp detection in a human colectomy specimenRadiology229109118PubMedCrossRef

42.

Lui, YW, Macari, M, Israel, G, et al. 2003CT colonography data interpretation: effect of different section thicknesses—preliminary observationsRadiology229791797PubMedCrossRef

43.

Gluecker, TM, Johnson, CD, Harmsen, WS, et al. 2003Colorectal cancer screening with CT colonography, colonoscopy, and double-contrast barium enema examination: prospective assessment of patient perceptions and preferencesRadiology227378384PubMedCrossRef

44.

Svensson, MH, Svensson, E, Lasson, A, Hellstrom, M 2002Patient acceptance of CT colonography and conventional colonoscopy: prospective comparative study in patients with or suspected of having colorectal diseaseRadiology222337345PubMedCrossRef

45.

Thomeer, M, Bielen, D, Vanbeckevoort, D, et al. 2002Patient acceptance for CT colonography: what is the real issue?Eur Radiol1214101415PubMedCrossRef

46.

Akerkar, GA, Yee, J, Hung, R, McQuaid, K 2001Patient experience and preferences toward colon cancer screening: a comparison of virtual colonoscopy and conventional colonoscopyGastrointest Endosc54310315PubMedCrossRef

47.

Forbes, GM, Mendelson, RM 2000Patient acceptance of virtual colonoscopyEndoscopy32274275PubMed

48.

Ristvedt, SL, McFarland, EG, Weinstock, LB, Thyssen, EP 2003Patient preferences for CT colonography, conventional colonoscopy, and bowel preparationAm J Gastroenterol98578585PubMedCrossRef

49.

Taylor, SA, Halligan, S, Goh, V, et al. 2003Optimizing colonic distention for multi-detector row CT colonography: effect of hyoscine butylbromide and rectal balloon catheterRadiology22999108PubMedCrossRef

50.

Yee, J, Hung, RK, Akerkar, GA, Wall, SD 1999The usefulness of glucagon hydrochloride for colonic distention in CT colonographyAJR173169172PubMedCrossRef

51.

Iannaccone, R, Laghi, A, Catalano, C, et al. 2003Role of glucagon and hyoscine butylbromide (Buscopan) in CT colonography: a placebo-controlled studyRadiology229(P)539

52.

Callstrom, MR, Johnson, CD, Fletcher, JG, et al. 2001CT colonography without cathartic preparation: feasibility studyRadiology219693698PubMed

53.

Gelder, RE, Birnie, E, Florie, J, et al. 2003Patient experience and preference of CT colonography and conventional colonoscopy: a five-week follow-up studyRadiology229(P)366

54.

Edwards, JT, Mendelson, RM, Fritschi, L, et al. 2004Colorectal neoplasia screening with CT colonography in average-risk asymptomatic subjects: community-based studyRadiology230459464PubMedCrossRef

55.

Dixon, AK, Dendy, P 1998Spiral CT: how much does radiation dose matter?Lancet35210821083PubMedCrossRef

56.

Rogers, LF 2002Dose reduction in CT: how low can we go?AJR179299PubMedCrossRef

57.

Food and Drug Administration. FDA public health notification: reducing radiation risk from computed tomography for pediatric and small adult patients. Available at: http://www.fda.gov/cdrh/safety/110201-ct.html. Accessed 2 November 2001

58.

Gelder, RE, Venema, HW, Serlie, IW, et al. 2002CT colonography at different radiation dose levels: feasibility of dose reductionRadiology2242533PubMedCrossRef

59.

1990 Recommendations of the International Commission on Radiological Protection1991.Smith, H eds. Annals of the ICRP 21 (nos. 1–3). International Commission on Radiological Protection Publication 60Pergamon Press plcOxford, UK

60.

Cohnen, M, Vogt, C, Aurich, V, et al. 2002Multi-slice CT-colonography in low-dose technique—preliminary resultsRofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr174835838PubMedCrossRef

61.

Iannaccone, R, Laghi, A, Catalano, C, et al. 2003Detection of colorectal lesions: lower-dose multi-detector row helical CT colonography compared with conventional colonoscopyRadiology229775781PubMedCrossRef

62.

Mayo, JR, Whittall, KP, Leung, AN, et al. 1997Simulated dose reduction in conventional chest CT: validation studyRadiology202453457PubMed

63.

Gelder, RE, Venema, HW, Florie, JF, et al. 2004CT colonography: feasibility of substantial dose reduction—comparison of medium to very low doses in identical patientsRadiology232611620PubMedCrossRef

64.

Tsuda, S, Veress, B, Toth, E, Fork, FT 2002Flat and depressed colorectal tumours in a southern Swedish population: a prospective chromoendoscopic and histopathological studyGut51550555PubMedCrossRef

65.

Rubio, CA, Kumagai, J, Kanamori, T, et al. 1995Flat adenomas and flat adenocarcinomas of the colorectal mucosa in Japanese and Swedish patients. Comparative histologic studyDis Colon Rectum3810751079PubMedCrossRef

66.

Rembacken, BJ, Fujii, T, Cairns, A, et al. 2000Flat and depressed colonic neoplasms: a prospective study of 1000 colonoscopies in the UKLancet35512111214PubMedCrossRef

67.

Hurlstone, DP, Cross, SS, Adam, I, et al. 2003A prospective clinicopathological and endoscopic evaluation of flat and depressed colorectal lesions in the United KingdomAm J Gastroenterol9825432549PubMedCrossRef

68.

Saitoh, Y, Waxman, I, West, AB, et al. 2001Prevalence and distinctive biologic features of flat colorectal adenomas in a North American populationGastroenterology12016571665PubMedCrossRef

69.

Fidler, JL, Johnson, CD, MacCarty, RL, et al. 2002Detection of flat lesions in the colon with CT colonographyAbdom Imaging27292300PubMedCrossRef

70.

Laghi, A, Iannaccone, R, Mangiapane, F, et al. 2003Experimental colonic phantom for the evaluation of the optimal scanning technique for CT colonography using a multidetector spiral CT equipmentEur Radiol13459466PubMed

71.

Rockey, DC 2004Virtual colonoscopy to screen for colorectal cancerN Engl J Med35011481150PubMedCrossRef

72.

Hara, AK, Johnson, CD, MacCarty, RL, Welch, TJ 2000Incidental extracolonic findings at CT colonographyRadiology215353357PubMed

73.

Edwards, JT, Wood, CJ, Mendelson, RM, Forbes, GM 2001Extracolonic findings at virtual colonoscopy: implications for screening programsAm J Gastroenterol9630093012PubMedCrossRef

74.

Hellstrom, M, Svensson, MH, Lasson, A 2004Extracolonic and incidental findings on CT colonography (virtual colonoscopy)AJR182631638PubMedCrossRef

75.

Ginnerup, PB, Rosenkilde, M, Christiansen, TE, Laurberg, S 2003Extracolonic findings at computed tomography colonography are a challengeGut5217441747CrossRef

76.

Gluecker, TM, Johnson, CD, Wilson, LA, et al. 2003Extracolonic findings at CT colonography: evaluation of prevalence and cost in a screening populationGastroenterology124911916PubMedCrossRef

77.

Ashton, HA, Buxton, MJ, Day, NE, et al. 2002The Multicentre Aneurysm Screening Study (MASS) into the effect of abdominal aortic aneurysm screening on mortality in men: a randomised controlled trialLancet36015311539PubMedCrossRef

78.

Tsui, KH, Shvarts, O, Smith, RB, et al. 2000Renal cell carcinoma: prognostic significance of incidentally detected tumorsJ Urol163426430PubMedCrossRef

79.

Lerman, C, Trock, B, Rimer, BK, et al. 1991Psychological side effects of breast cancer screeningHealth Psychol10259267PubMedCrossRef

80.

McCann, J, Stockton, D, Godward, S 2002Impact of false-positive mammography on subsequent screening attendance and risk of cancerBreast Cancer Res4R11PubMedCrossRef

Titel: Colorectal cancer screening and surveillance with CT colonography: current controversies and obstacles
verfasst von: R. E. van Gelder
J. Florie
J. Stoker
Publikationsdatum: 01.01.2004
Verlag: Springer-Verlag
Erschienen in: Abdominal Radiology / Ausgabe 1/2004
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI: https://doi.org/10.1007/s00261-004-0249-5

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Colorectal cancer screening and surveillance with CT colonography: current controversies and obstacles

Abstract

Neu im Fachgebiet Radiologie

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

S3-Leitlinie zu Pankreaskrebs aktualisiert

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

„Nur wer sich gut aufgehoben fühlt, kann auch für Patientensicherheit sorgen“

Update Radiologie

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 1/2004

Vascular pathology of the spleen, part I

Randomized single blind trial of two low-volume bowel preparations for screening computed tomographic colonography

Small bowel obstruction related to left-side paraduodenal hernia: CT findings

CT diagnosis of Meckel diverticulum in a paracolic internal hernia

MRI findings of primary biliary cirrhosis: correlation with Scheuer histologic staging

Emphysematous epididymitis as presentation of unusual seminal vesicle fistula secondary to sigmoid diverticulitis: case report

Neu im Fachgebiet Radiologie

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

S3-Leitlinie zu Pankreaskrebs aktualisiert

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

„Nur wer sich gut aufgehoben fühlt, kann auch für Patientensicherheit sorgen“

Update Radiologie