Skip to main content
Erschienen in: International Journal of Colorectal Disease 8/2011

01.08.2011 | Review

Role of CT colonography in symptomatic assessment, surveillance and screening

verfasst von: L. Maximilian Almond, Douglas M. Bowley, Sharad S. Karandikar, Shuvro H. Roy-Choudhury

Erschienen in: International Journal of Colorectal Disease | Ausgabe 8/2011

Einloggen, um Zugang zu erhalten

Abstract

Introduction

When ‘whole colonic imaging’ is indicated, clinicians must decide between optical colonoscopy, barium enema and CT colonography (CTC). CTC is a relatively new technique which has become increasingly accessible in the UK over the past 5 years. As radiologists have gained experience and scanning parameters have standardised, there have been substantial improvements in both the accuracy and safety of CTC.

Methods

We review evidence from observational studies and randomised trials, and draw on expert opinion, to provide a comprehensive discussion of the current role of CTC in both symptomatic and asymptomatic individuals.

Conclusions

The emergence of CTC could soon entirely obviate the need for barium enema. CTC now has a complementary role alongside colonoscopy in symptomatic patients and a possible future role in colorectal cancer screening in the UK.
Literatur
1.
Zurück zum Zitat Vining DJ, Shifrin RY et al (1994) Virtual colonoscopy. Radiology 193:446 Vining DJ, Shifrin RY et al (1994) Virtual colonoscopy. Radiology 193:446
2.
Zurück zum Zitat Johnson CD, Chen MS, Toledano AY et al (2008) Accuracy of CT colonography for colorectal cancer screening. NEJM 359(12):1207–1217PubMedCrossRef Johnson CD, Chen MS, Toledano AY et al (2008) Accuracy of CT colonography for colorectal cancer screening. NEJM 359(12):1207–1217PubMedCrossRef
3.
Zurück zum Zitat Halligan S, Altman DG, Taylor SA, Mallett S, Deeks JJ, Bartram CI, Atkin W (2005) CT colonography in the detection of colorectal polyps and cancer: systematic review, meta-analysis, and proposed minimum data set for study level reporting. Radiology 237(3):893–904PubMedCrossRef Halligan S, Altman DG, Taylor SA, Mallett S, Deeks JJ, Bartram CI, Atkin W (2005) CT colonography in the detection of colorectal polyps and cancer: systematic review, meta-analysis, and proposed minimum data set for study level reporting. Radiology 237(3):893–904PubMedCrossRef
4.
Zurück zum Zitat Sosna J, Morrin MM, Kruskal JB et al (2003) CT colonography of colorectal polyps: a meta-analysis. AJR Am J Roentgenol 181:1593–1598PubMed Sosna J, Morrin MM, Kruskal JB et al (2003) CT colonography of colorectal polyps: a meta-analysis. AJR Am J Roentgenol 181:1593–1598PubMed
5.
Zurück zum Zitat Stevenson G (2008) Colon imaging in radiology departments in 2008: goodbye to the routine double contrast barium enema. Can Assoc Radiol J 59(4):174–182PubMed Stevenson G (2008) Colon imaging in radiology departments in 2008: goodbye to the routine double contrast barium enema. Can Assoc Radiol J 59(4):174–182PubMed
6.
Zurück zum Zitat Taylor SA, Halligan S, Saunders BP, Bassett P, Vance M, Bartram CI (2003) Acceptance by patients of multidetector CT colonography compared with barium enema examinations, flexible sigmoidoscopy, and colonoscopy. AJR Am J Roentgenol 181:913–921PubMed Taylor SA, Halligan S, Saunders BP, Bassett P, Vance M, Bartram CI (2003) Acceptance by patients of multidetector CT colonography compared with barium enema examinations, flexible sigmoidoscopy, and colonoscopy. AJR Am J Roentgenol 181:913–921PubMed
7.
Zurück zum Zitat East JE, Saunders BP, Boone D, Halligan S, Taylor SA (2006) Comprehensive mucosal visualization at optical colonoscopy. Gastroenterology 131(3):975–976PubMedCrossRef East JE, Saunders BP, Boone D, Halligan S, Taylor SA (2006) Comprehensive mucosal visualization at optical colonoscopy. Gastroenterology 131(3):975–976PubMedCrossRef
8.
Zurück zum Zitat Yee J, Sadda S, Aslam R, Yeh B (2010) Extracolonic findings at CT colonography. Gastrointest Endosc Clin N Am 20(2):305–322PubMedCrossRef Yee J, Sadda S, Aslam R, Yeh B (2010) Extracolonic findings at CT colonography. Gastrointest Endosc Clin N Am 20(2):305–322PubMedCrossRef
9.
Zurück zum Zitat Hellström M, Svensson MH, Lasson A (2004) Extracolonic and incidental findings on CT colonography (virtual colonoscopy). AJR Am J Roentgenol 182:631–638PubMed Hellström M, Svensson MH, Lasson A (2004) Extracolonic and incidental findings on CT colonography (virtual colonoscopy). AJR Am J Roentgenol 182:631–638PubMed
10.
Zurück zum Zitat Tolan DJ, Armstrong EM, Chapman AH (2007) Replacing barium enema with CT colonography in patients older than 70 years: the importance of detecting extracolonic abnormalities. AJR Am J Roentgenol 189(5):1104–1111PubMedCrossRef Tolan DJ, Armstrong EM, Chapman AH (2007) Replacing barium enema with CT colonography in patients older than 70 years: the importance of detecting extracolonic abnormalities. AJR Am J Roentgenol 189(5):1104–1111PubMedCrossRef
11.
Zurück zum Zitat Macari M, Lavelle M et al (2001) Effect of different bowel preparations on residual fluid at CT colonography. Radiology 218:274–277PubMed Macari M, Lavelle M et al (2001) Effect of different bowel preparations on residual fluid at CT colonography. Radiology 218:274–277PubMed
12.
Zurück zum Zitat Lefere PA, Gryspeerdt SS et al (2002) Dietary fecal tagging as a cleansing method before CT colonography: initial results polyp detection and patient acceptance. Radiology 224:393–403PubMedCrossRef Lefere PA, Gryspeerdt SS et al (2002) Dietary fecal tagging as a cleansing method before CT colonography: initial results polyp detection and patient acceptance. Radiology 224:393–403PubMedCrossRef
13.
Zurück zum Zitat Kim MJ, Seong HP et al (2009) Efficacy of barium-based fecal tagging for CT colonography: a comparison between the use of high and low density barium suspensions in a Korean population—a preliminary study. Korean J Radiol 10(1):25–33PubMedCrossRef Kim MJ, Seong HP et al (2009) Efficacy of barium-based fecal tagging for CT colonography: a comparison between the use of high and low density barium suspensions in a Korean population—a preliminary study. Korean J Radiol 10(1):25–33PubMedCrossRef
14.
Zurück zum Zitat Bruzzi JF, Moss AC, Brennan DD et al (2003) Efficacy of IV Buscopan as a muscle relaxant in CT colonography. Eur Radiol 13:2264–2270PubMedCrossRef Bruzzi JF, Moss AC, Brennan DD et al (2003) Efficacy of IV Buscopan as a muscle relaxant in CT colonography. Eur Radiol 13:2264–2270PubMedCrossRef
15.
Zurück zum Zitat Taylor SA, Halligan S, Goh V et al (2003) Optimizing colonic distension for multi-detector row CT colonography: effect of hyoscine butylbromide and rectal balloon catheter. Radiology 229:99–108PubMedCrossRef Taylor SA, Halligan S, Goh V et al (2003) Optimizing colonic distension for multi-detector row CT colonography: effect of hyoscine butylbromide and rectal balloon catheter. Radiology 229:99–108PubMedCrossRef
16.
Zurück zum Zitat Yee J (2002) CT colonography examination prerequisites. Abdom Imaging 27:244–252PubMed Yee J (2002) CT colonography examination prerequisites. Abdom Imaging 27:244–252PubMed
17.
Zurück zum Zitat Shinners TJ, Pickhardt PJ, Taylor AJ, Jones DA, Olsen CH (2006) Patient-controlled room air insufflation versus automated carbon dioxide delivery for CT colonography. AJR Am J Roentgenol 186:1491–1496PubMedCrossRef Shinners TJ, Pickhardt PJ, Taylor AJ, Jones DA, Olsen CH (2006) Patient-controlled room air insufflation versus automated carbon dioxide delivery for CT colonography. AJR Am J Roentgenol 186:1491–1496PubMedCrossRef
18.
Zurück zum Zitat Pickhardt PJ, Barish MA, Barlow DS, et al. (2005) Significant complications at CT colonography: survey results from the working group on virtual colonoscopy. Sixth international symposium on virtual colonoscopy, Boston, 17–18 October 2005 Pickhardt PJ, Barish MA, Barlow DS, et al. (2005) Significant complications at CT colonography: survey results from the working group on virtual colonoscopy. Sixth international symposium on virtual colonoscopy, Boston, 17–18 October 2005
19.
Zurück zum Zitat Neri E, Faggioni L, Cerri F et al (2010) CT colonography versus double-contrast barium enema for screening of colorectal cancer: comparison of radiation burden. Abdom Imaging 35(5):596–601PubMedCrossRef Neri E, Faggioni L, Cerri F et al (2010) CT colonography versus double-contrast barium enema for screening of colorectal cancer: comparison of radiation burden. Abdom Imaging 35(5):596–601PubMedCrossRef
20.
Zurück zum Zitat Brenner DJ, Hall EJ (2007) Computed tomography—an increasing source of radiation exposure. N Engl J Med 357:2277–2284PubMedCrossRef Brenner DJ, Hall EJ (2007) Computed tomography—an increasing source of radiation exposure. N Engl J Med 357:2277–2284PubMedCrossRef
21.
Zurück zum Zitat Taylor SA, Charman SC, Lefere P et al (2008) CT colonography: investigation of the optimum reader paradigm by using computer-aided detection software. Radiology 246:463–471PubMedCrossRef Taylor SA, Charman SC, Lefere P et al (2008) CT colonography: investigation of the optimum reader paradigm by using computer-aided detection software. Radiology 246:463–471PubMedCrossRef
22.
Zurück zum Zitat Summers RM, Yao J, Pickhardt PJ et al (2005) Computed tomographic virtual colonoscopy computer-aided polyp detection in a screening population. Gastroenterology 129:1832–1844PubMedCrossRef Summers RM, Yao J, Pickhardt PJ et al (2005) Computed tomographic virtual colonoscopy computer-aided polyp detection in a screening population. Gastroenterology 129:1832–1844PubMedCrossRef
23.
Zurück zum Zitat Halligan S, Altman DG, Mallett S et al (2006) Computed tomographic colonography: assessment of radiologist performance with and without computer-aided detection. Gastroenterology 131:1690–1699PubMedCrossRef Halligan S, Altman DG, Mallett S et al (2006) Computed tomographic colonography: assessment of radiologist performance with and without computer-aided detection. Gastroenterology 131:1690–1699PubMedCrossRef
24.
Zurück zum Zitat Petrick N, Haider M, Summers RM et al (2008) CT colonography with computer-aided detection as a second reader: observer performance study. Radiology 246:148–156PubMedCrossRef Petrick N, Haider M, Summers RM et al (2008) CT colonography with computer-aided detection as a second reader: observer performance study. Radiology 246:148–156PubMedCrossRef
25.
Zurück zum Zitat Sabanli M, Balasingam A, Bailey W, Eglinton T, Hider P, Frizelle FA (2010) Computed tomographic colonography in the diagnosis of colorectal cancer. Br J Surg 97(8):1291–1294PubMedCrossRef Sabanli M, Balasingam A, Bailey W, Eglinton T, Hider P, Frizelle FA (2010) Computed tomographic colonography in the diagnosis of colorectal cancer. Br J Surg 97(8):1291–1294PubMedCrossRef
26.
Zurück zum Zitat Johnson CD, Harmsen WS, Wilson LA et al (2003) Prospective blinded evaluation of computed tomographic colonography for screen detection of colorectal polyps. Gastroenterology 125:311–319PubMedCrossRef Johnson CD, Harmsen WS, Wilson LA et al (2003) Prospective blinded evaluation of computed tomographic colonography for screen detection of colorectal polyps. Gastroenterology 125:311–319PubMedCrossRef
27.
Zurück zum Zitat Cotton PB, Durkalski VL, Pineau BC et al (2004) Computed tomographic colonography (virtual colonoscopy): a multicenter comparison with standard colonoscopy for detection of colorectal neoplasia. JAMA 291:1713–1719PubMedCrossRef Cotton PB, Durkalski VL, Pineau BC et al (2004) Computed tomographic colonography (virtual colonoscopy): a multicenter comparison with standard colonoscopy for detection of colorectal neoplasia. JAMA 291:1713–1719PubMedCrossRef
28.
Zurück zum Zitat Rockey DC, Paulsen EK, Niedzwiecki D et al (2005) Analysis of air contrast barium enema, computed tomographic colonography, and colonoscopy: prospective comparison. Lancet 365:305–311PubMed Rockey DC, Paulsen EK, Niedzwiecki D et al (2005) Analysis of air contrast barium enema, computed tomographic colonography, and colonoscopy: prospective comparison. Lancet 365:305–311PubMed
29.
Zurück zum Zitat Rockey DC (2009) Computed tomographic colonography: current perspectives and future directions. Gastroenterology 137(1):7–14PubMedCrossRef Rockey DC (2009) Computed tomographic colonography: current perspectives and future directions. Gastroenterology 137(1):7–14PubMedCrossRef
30.
Zurück zum Zitat Hoff G, Foerster A, Vatu MH et al (1986) Epidemiology of polyps in the rectum and colon. Recovery and evaluation of unresected polyps 2 years after detection. Scand J Gastroenterol 21:853–862PubMedCrossRef Hoff G, Foerster A, Vatu MH et al (1986) Epidemiology of polyps in the rectum and colon. Recovery and evaluation of unresected polyps 2 years after detection. Scand J Gastroenterol 21:853–862PubMedCrossRef
31.
Zurück zum Zitat Kulling D, Christ AD, Karaaslan N et al (2001) Is histological investigation of polyps always necessary? Endoscopy 33:428–432PubMedCrossRef Kulling D, Christ AD, Karaaslan N et al (2001) Is histological investigation of polyps always necessary? Endoscopy 33:428–432PubMedCrossRef
32.
Zurück zum Zitat Ferrucci JT (2001) Colon cancer screening with virtual colonoscopy: promise, polyps, politics. AJR Am J Roentgenol 177:975–988PubMed Ferrucci JT (2001) Colon cancer screening with virtual colonoscopy: promise, polyps, politics. AJR Am J Roentgenol 177:975–988PubMed
33.
Zurück zum Zitat Macari M, Berman P, Dicker M et al (1999) Usefulness of CT colonography in patients with incomplete colonoscopy. AJR Am J Roentgenol 173:561–564PubMed Macari M, Berman P, Dicker M et al (1999) Usefulness of CT colonography in patients with incomplete colonoscopy. AJR Am J Roentgenol 173:561–564PubMed
34.
Zurück zum Zitat Morrin MM, Kruskal JB, Farrell RJ et al (1999) Endoluminal CT colonography after an incomplete endoscopic colonoscopy. AJR Am J Roentgenol 172:913–918PubMed Morrin MM, Kruskal JB, Farrell RJ et al (1999) Endoluminal CT colonography after an incomplete endoscopic colonoscopy. AJR Am J Roentgenol 172:913–918PubMed
35.
Zurück zum Zitat Copel L, Sosna J, Kruskal JB et al (2007) CT colonography in 546 patients with incomplete colonoscopy. Radiology 244:471–478PubMedCrossRef Copel L, Sosna J, Kruskal JB et al (2007) CT colonography in 546 patients with incomplete colonoscopy. Radiology 244:471–478PubMedCrossRef
36.
Zurück zum Zitat Hanson ME, Pickhardt PJ, Kim DH, Pfau PR (2007) Anatomic factors predictive of incomplete colonoscopy based on findings at CT colonography. AJR Am J Roentgenol 189:774–779PubMedCrossRef Hanson ME, Pickhardt PJ, Kim DH, Pfau PR (2007) Anatomic factors predictive of incomplete colonoscopy based on findings at CT colonography. AJR Am J Roentgenol 189:774–779PubMedCrossRef
37.
Zurück zum Zitat Pickhardt PJ, Kim DH, Menias CO et al (2007) Evaluation of submucosal lesions of the large intestine: part 1. Neoplasms. Radiographics 27:1681–1692PubMedCrossRef Pickhardt PJ, Kim DH, Menias CO et al (2007) Evaluation of submucosal lesions of the large intestine: part 1. Neoplasms. Radiographics 27:1681–1692PubMedCrossRef
38.
Zurück zum Zitat Pickhardt PJ, Kim DH, Menias CO et al (2007) Evaluation of submucosal lesions of the large intestine: part 2. Nonneoplastic causes. Radiographics 27:1693–1703PubMedCrossRef Pickhardt PJ, Kim DH, Menias CO et al (2007) Evaluation of submucosal lesions of the large intestine: part 2. Nonneoplastic causes. Radiographics 27:1693–1703PubMedCrossRef
39.
Zurück zum Zitat Johnson CD, Chen MH, Toledano A et al (2008) Accuracy of CT colonography for detection of large adenomas and cancer. N Engl J Med 359:1207–1217PubMedCrossRef Johnson CD, Chen MH, Toledano A et al (2008) Accuracy of CT colonography for detection of large adenomas and cancer. N Engl J Med 359:1207–1217PubMedCrossRef
40.
Zurück zum Zitat Beale AL, Penney MD, Allison MC (2005) The prevalence of iron deficiency among patients presenting with colorectal cancer. Colorectal Dis 7:398–402PubMedCrossRef Beale AL, Penney MD, Allison MC (2005) The prevalence of iron deficiency among patients presenting with colorectal cancer. Colorectal Dis 7:398–402PubMedCrossRef
41.
Zurück zum Zitat Raje D, Mukhtar H, Oshowo A, Ingham CC (2007) What proportion of patients referred to secondary care with iron deficiency anaemia have colon cancer? Dis Colon Rectum 50(8):1211–1214PubMedCrossRef Raje D, Mukhtar H, Oshowo A, Ingham CC (2007) What proportion of patients referred to secondary care with iron deficiency anaemia have colon cancer? Dis Colon Rectum 50(8):1211–1214PubMedCrossRef
42.
Zurück zum Zitat Choi YJ, Park SH, Lee SS et al (2007) CT colonography for follow-up after surgery for colorectal cancer. AJR Am J Roentgenol 189:283–289PubMedCrossRef Choi YJ, Park SH, Lee SS et al (2007) CT colonography for follow-up after surgery for colorectal cancer. AJR Am J Roentgenol 189:283–289PubMedCrossRef
43.
Zurück zum Zitat Kim HJ, Park SH, Pickhardt PJ, Yoon SN, Lee SS, Yee J, Kim DH, Kim AJ, Kim JC, Yu SC, Ha HK (2010) CT colonography for combined colonic and extracolonic surveillance after curative resection of colorectal cancer. Radiology 257(3):697–704PubMedCrossRef Kim HJ, Park SH, Pickhardt PJ, Yoon SN, Lee SS, Yee J, Kim DH, Kim AJ, Kim JC, Yu SC, Ha HK (2010) CT colonography for combined colonic and extracolonic surveillance after curative resection of colorectal cancer. Radiology 257(3):697–704PubMedCrossRef
45.
Zurück zum Zitat Hewitson P, Glasziou P, Watson E, Towler B, Irwig L (2008) Cochrane systematic review of colorectal cancer screening using the faecal occult blood test (hemoccult): an update. Am J Gastroenterol 103:1541–1549PubMedCrossRef Hewitson P, Glasziou P, Watson E, Towler B, Irwig L (2008) Cochrane systematic review of colorectal cancer screening using the faecal occult blood test (hemoccult): an update. Am J Gastroenterol 103:1541–1549PubMedCrossRef
46.
Zurück zum Zitat Atkin WS, Edwards R, Kralj-Hans I et al (2010) Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial. Lancet 375(9726):1624–1633PubMedCrossRef Atkin WS, Edwards R, Kralj-Hans I et al (2010) Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial. Lancet 375(9726):1624–1633PubMedCrossRef
47.
Zurück zum Zitat McFarland EG, Fletcher JG, Pickhardt PP et al (2009) ACR Colon Cancer Committee white paper: status of CT colonography 2009. AJR Am J Roentgenol 193:1242 McFarland EG, Fletcher JG, Pickhardt PP et al (2009) ACR Colon Cancer Committee white paper: status of CT colonography 2009. AJR Am J Roentgenol 193:1242
48.
Zurück zum Zitat Levin B, Lieberman DA, McFarland B et al (2008) Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. Gastroenterology 134:1570–1595PubMedCrossRef Levin B, Lieberman DA, McFarland B et al (2008) Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. Gastroenterology 134:1570–1595PubMedCrossRef
49.
Zurück zum Zitat Pickhardt PJ, Kim DH, Meiners RJ, Wyatt KS, Hanson ME, Barlow DS, Cullen PA, Remtulla RA, Cash BD (2010) Colorectal and extracolonic cancers detected at screening CT colonography in 10,286 asymptomatic adults. Radiology 255(1):83–88PubMedCrossRef Pickhardt PJ, Kim DH, Meiners RJ, Wyatt KS, Hanson ME, Barlow DS, Cullen PA, Remtulla RA, Cash BD (2010) Colorectal and extracolonic cancers detected at screening CT colonography in 10,286 asymptomatic adults. Radiology 255(1):83–88PubMedCrossRef
50.
Zurück zum Zitat Pickhardt PJ, Hain KS, Kim DH, Hassan C (2010) Low rates of cancer or high-grade dysplasia in colorectal polyps collected from computed tomography colonography screening. Clin Gastroenterol Hepatol 8(7):610–615PubMedCrossRef Pickhardt PJ, Hain KS, Kim DH, Hassan C (2010) Low rates of cancer or high-grade dysplasia in colorectal polyps collected from computed tomography colonography screening. Clin Gastroenterol Hepatol 8(7):610–615PubMedCrossRef
51.
Zurück zum Zitat Pickhardt PJ, Hassan C, Laghi A, Zullo A, Kim DH, Iafrate F, Morini S (2008) Small and diminutive polyps detected at screening CT colonography: a decision analysis for referral to colonoscopy. AJR Am J Roentgenol 190:136–144PubMedCrossRef Pickhardt PJ, Hassan C, Laghi A, Zullo A, Kim DH, Iafrate F, Morini S (2008) Small and diminutive polyps detected at screening CT colonography: a decision analysis for referral to colonoscopy. AJR Am J Roentgenol 190:136–144PubMedCrossRef
52.
Zurück zum Zitat Bond JH (2000) Clinical evidence for the adenoma-carcinoma sequence, and the management of patients with colorectal adenomas. Semin Gastrointest Dis 11:176–184PubMed Bond JH (2000) Clinical evidence for the adenoma-carcinoma sequence, and the management of patients with colorectal adenomas. Semin Gastrointest Dis 11:176–184PubMed
53.
Zurück zum Zitat Lieberman D (2009) Debate: small (6–9 mm) and diminutive (1–5 mm) polyps noted on CTC: how should they be managed? Gastrointest Endosc Clin N Am 20(2):239–243CrossRef Lieberman D (2009) Debate: small (6–9 mm) and diminutive (1–5 mm) polyps noted on CTC: how should they be managed? Gastrointest Endosc Clin N Am 20(2):239–243CrossRef
54.
Zurück zum Zitat Lee D, Muston D, Sweet A, Cunningham C, Slater A, Lock K (2010) Cost effectiveness of CT Colonography for UK NHS colorectal cancer screening of asymptomatic adults aged 60–69 years. Appl Health Econ Health Policy 8(3):141–154PubMedCrossRef Lee D, Muston D, Sweet A, Cunningham C, Slater A, Lock K (2010) Cost effectiveness of CT Colonography for UK NHS colorectal cancer screening of asymptomatic adults aged 60–69 years. Appl Health Econ Health Policy 8(3):141–154PubMedCrossRef
55.
Zurück zum Zitat Fisichella VA, Hellstrom M (2010) Survey update on implementation, indications, and technical performance of computed tomography colonography in Sweden. Acta Radiol 51(1):4–851PubMedCrossRef Fisichella VA, Hellstrom M (2010) Survey update on implementation, indications, and technical performance of computed tomography colonography in Sweden. Acta Radiol 51(1):4–851PubMedCrossRef
56.
Zurück zum Zitat Almond LM, Bowley D, Roy-Choudhury S, Hendrickse C, Karandikar SS (2010) Trends in whole colonic imaging. Acta Radiol 51(6):708PubMedCrossRef Almond LM, Bowley D, Roy-Choudhury S, Hendrickse C, Karandikar SS (2010) Trends in whole colonic imaging. Acta Radiol 51(6):708PubMedCrossRef
57.
Zurück zum Zitat Halligan S, Lilford RJ, Wardle J, Morton D, Rogers P, Wooldrage K, Edwards R, Kanani R, Shah U, Atkin W (2007) Design of a multicentre randomized trial to evaluate CT colonography versus colonoscopy or barium enema for diagnosis of colonic cancer in older symptomatic patients: the SIGGAR study. Trials 8:32PubMedCrossRef Halligan S, Lilford RJ, Wardle J, Morton D, Rogers P, Wooldrage K, Edwards R, Kanani R, Shah U, Atkin W (2007) Design of a multicentre randomized trial to evaluate CT colonography versus colonoscopy or barium enema for diagnosis of colonic cancer in older symptomatic patients: the SIGGAR study. Trials 8:32PubMedCrossRef
58.
Zurück zum Zitat Ozel B, Pickhardt PJ, Kim DH, Schumacher C, Bhargava N, Winter TC (2010) Accuracy of routine nontargeted CT without colonography technique for the detection of large colorectal polyps and cancer. Dis Colon Rectum 53(6):911–918PubMedCrossRef Ozel B, Pickhardt PJ, Kim DH, Schumacher C, Bhargava N, Winter TC (2010) Accuracy of routine nontargeted CT without colonography technique for the detection of large colorectal polyps and cancer. Dis Colon Rectum 53(6):911–918PubMedCrossRef
Metadaten
Titel
Role of CT colonography in symptomatic assessment, surveillance and screening
verfasst von
L. Maximilian Almond
Douglas M. Bowley
Sharad S. Karandikar
Shuvro H. Roy-Choudhury
Publikationsdatum
01.08.2011
Verlag
Springer-Verlag
Erschienen in
International Journal of Colorectal Disease / Ausgabe 8/2011
Print ISSN: 0179-1958
Elektronische ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-011-1178-8

Weitere Artikel der Ausgabe 8/2011

International Journal of Colorectal Disease 8/2011 Zur Ausgabe

Echinokokkose medikamentös behandeln oder operieren?

06.05.2024 DCK 2024 Kongressbericht

Die Therapie von Echinokokkosen sollte immer in spezialisierten Zentren erfolgen. Eine symptomlose Echinokokkose kann – egal ob von Hunde- oder Fuchsbandwurm ausgelöst – konservativ erfolgen. Wenn eine Op. nötig ist, kann es sinnvoll sein, vorher Zysten zu leeren und zu desinfizieren. 

Wie sieht der OP der Zukunft aus?

04.05.2024 DCK 2024 Kongressbericht

Der OP in der Zukunft wird mit weniger Personal auskommen – nicht, weil die Technik das medizinische Fachpersonal verdrängt, sondern weil der Personalmangel es nötig macht.

Umsetzung der POMGAT-Leitlinie läuft

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

Recycling im OP – möglich, aber teuer

02.05.2024 DCK 2024 Kongressbericht

Auch wenn sich Krankenhäuser nachhaltig und grün geben – sie tragen aktuell erheblich zu den CO2-Emissionen bei und produzieren jede Menge Müll. Ein Pilotprojekt aus Bonn zeigt, dass viele Op.-Abfälle wiederverwertet werden können.

Update Chirurgie

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

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.