Computed tomography colonography (virtual colonoscopy): Review
Richard M Mendelson,
Geoffrey M Forbes,
Richard M Mendelson
Royal Perth Hospital, Perth, Western Australia, Australia
Search for more papers by this authorGeoffrey M Forbes
Royal Perth Hospital, Perth, Western Australia, Australia
Search for more papers by this authorRichard M Mendelson,
Geoffrey M Forbes,
Richard M Mendelson
Royal Perth Hospital, Perth, Western Australia, Australia
Search for more papers by this authorGeoffrey M Forbes
Royal Perth Hospital, Perth, Western Australia, Australia
Search for more papers by this author
Correspondence:
Dr
RM
Mendelson,
Department of Diagnostic & Interventional Radiology, Royal Perth Hospital, Box X2213 GPO, Perth, WA 6847, Australia. Email: [email protected]
RM Mendelson MRCP FRCR FRANZCR; GM Forbes MD FRACP.
SUMMARY
Computed tomography examination of the colon performed after bowel cleansing and distension of the lumen with gas goes by several different names—CT colonography (CTC) and CT colography perhaps being the most common. Strictly, the term ‘virtual colonoscopy’ (VC), should be reserved for the process of examining 3-D, simulated endoluminal images with a capability to navigate through the bowel using appropriate software. Computed tomography colonography appears to be the name that has gained favour among radiologists, although it is suspected that ‘virtual colonoscopy’ will persist as a generic term due to its attractive ‘high-tech’ connotations for non-radiological medical and lay persons. Whatever the name, the technique has been made possible through the advent of fast helical CT scanners which allow acquisition of a volume of data, and of proprietary software which enables multiplanar reformatting and 3-D endoluminal reconstructions.
It is evident that if CTC/VC can be shown to be acceptable to patients, safe, affordable and accurate, it has enormous potential as a diagnostic and screening tool for colorectal neoplasia.
REFERENCES
- 1 Vining D, Gelfand D. Noninvasive colonoscopy using helical CT scanning, 3D reconstruction, and virtual reality. Proceedings of 23rd Annual Meeting of the Society of Gastrointestinal Radiologists, Maui, Hawaii 1994; p 70.
- 2 Hara A, Johnson C, Reed J et al. Detection of colorectal polyps by computed tomographic colography: Feasibility of a novel technique. Gastroenterology 1996; 110: 284–90.
- 3 Macari M, Lavelle M, Pedrosa I et al. Effect of different bowel preparations on residual fluid at CT colonography. Radiology 2001; 218: 274–7.
- 4 Robson N, Lloyd M, Regan F. The use of carbon dioxide as an insufflation agent in barium enema—does it have a role? Br J Radiol 1993; 66: 197–8.
- 5 Yee J, Hung R, Akerkar G, Wall S. The usefulness of glucagon hydrochloride for colonic distention in CT colonography. AJR 1999; 173: 169–72.
- 6 Hara A, Johnson C, Reed J et al. Reducing data size and radiation dose for CT colonography. AJR 1997; 168: 1181–4.
- 7 Dachman A, Kuniyoshi J, Boyle C et al. CT colonography with three-dimensional problem solving for detection of colonic polyps. AJR 1998; 171: 989–95.
- 8 Macari M, Milano A, Lavelle M et al. Comparison of time-efficient CT colonography with two- and three-dimensional colonic evaluation for detecting colonic polyps. AJR 2000; 174: 1543–9.
- 9 Spinzi G, Belloni G, Martegani A et al. Computed tomographic colonography and conventional colonoscopy for colon diseases: A prospective blinded study. Am J Gastroenterology 2001; 96: 394–400.
- 10 Hara A, Johnson C, Reed J et al. Detection of colorectal polyps with CT colography: Initial assessment of sensitivity and specificity. Radiology 1997; 205: 59–65.
- 11 Pescatore P, Glucker T, Delarive J et al. Diagnostic accuracy and interobserver agreement of CT colonography (virtual colonoscopy). Gut 2000; 47: 126–130
- 12 Kay C, Kulling D, Hawes R et al. Virtual endoscopy—comparison with colonoscopy in the detection of space-occupying lesions of the colon. Endoscopy 2000; 32: 226–32.
- 13 Chen S, Lu D, Hecht J, Kadell B. CT colonography: Value of scanning in both the supine and prone positions. AJR 1999; 172: 595–9.
- 14 Fletcher J, Johnson C, Welch T et al. Optimization of CT colonography technique: Prospective trial in 180 patients. Radiology 2000; 216: 704–11.
- 15 Mendelson RM, Foster NM, Edwards JT, Woods C, Rosenberg M, Forbes GM. Virtual colonoscopy compared with conventional colonoscopy; a developing technology. Med J Aust 2000; 173: 472–5.
- 16 Fenlon HM, Nunes DP, Schroy P et al. A comparison of virtual and conventional colonoscopy for the detection of colorectal polyps. N Engl J Med 1999; 341: 1496–503.
- 17 Yee J, Akerkar G, Hung R et al. Colorectal neoplasia: Performance characteristics of CT colonography for detection in 300 patients. Radiology 2001; 219: 685–92.
- 18 Vining D. Optimizing bowel preparation. First International Symposium on Virtual Colonoscopy, Boston, Mass. Boston University Press, 1998; p 79–80.
- 19 Morrin M, Farrell R, Kruskal J et al. Utility of intravenously administered contrast material at CT colonography. Radiology 2000; 217: 765–71.
- 20 Rex D, Cutler C, Lemmel G et al. Colonoscopy miss rates of adenomas determined by back-to-back colonoscopies. Gastroenterology 1997; 112: 24–8.
- 21 Forbes GM, Mendelson RM. Patient acceptance of virtual colonoscopy. (Letter). Endoscopy 2000; 32: 274.
- 22 Edwards J, Foster N, Mendelson R, Forbes G. Acceptability of virtual colonoscopy as a community-based colorectal cancer screening test in asymptomatic average-risk subjects. J Gastroenterol Hepatol 2001; 16 (Suppl). A3.
- 23 Rex DK, Weddle RA, Lehman GA et al. Flexible sigmoidoscopy plus air-contrast barium enema versus colonoscopy for sus- pected lower gastrointestinal bleeding. Gastroenterology 1990; 98: 855–61.
- 24
Karasick L,
Ehrlich S,
Levin D.
Trends in the use of barium enema examination, colonoscopy and sigmoidoscopy: is use commensurate with risk of disease?
Radiology
1995; 195: 77–84.
10.1148/radiology.195.3.7754010 Google Scholar
- 25 Macari M, Berman P, Dicker M et al. Usefulness of CT colonography in patients with incomplete colonoscopy. AJR 1999; 173: 561–4.
- 26 Morrin M, Kruskal J, Farrell R et al. Endoluminal CT colonography after an incomplete colonoscopy. AJR 1999; 172: 913–18.
- 27 Fenlon H, McAneny D, Nunes D et al. Occlusive colon carcinoma: Virtual colonoscopy in the pre-operative evaluation of the proximal colon. Radiology 1999; 210: 423–8.
- 28 National Health and Medical Research Council. Guidelines for the Prevention, Early Detection and Management of Colorectal Cancer. AusInfo, Canberra, 1999.
- 29 Australian Health Technology Advisory Committee. Colorectal cancer screening. Australian Government Publishing Service, Canberra, 1997.
- 30 Allison JE, Tekawa IS, Ransom LJ, Adrain AL. A comparison of fecal occult blood tests for colorectal-cancer screening. N Engl J 1996; 334: 155–9.
- 31 Collett J, Olynyk J, Platell C. Flexible sigmoidoscopy screening for colorectal cancer in average-risk people: update of a community-based project. Med J Aust 2000; 173: 463–6.
- 32 Nicholson FB, Korman MG, Stern AI, Hansky J. Distribution of colorectal adenomas: Implications for bowel cancer screening. Med J Aust 2000; 172: 428–30.
- 33 Mendelson RM. The role of the barium enema in the diagnosis of colorectal neoplasia. Austral Radiol 1998; 42: 191–6.
- 34 Thiis-Evensen E, Hoff GS, Sauar J et al. Flexible sigmoidoscopy or colonoscopy as a screening modality for colorectal adenomas in older age groups? Findings in a cohort of normal population aged 63 to 72 years. Gut 1999; 45: 834–9.
- 35 Freeman B, Engel JJ, Fine MS, DiVita DP. Colonoscopy to the cecum: How often do we get there? Experience in a Community Hospital. Am J of Gastroenterol 1993; 88: 789.
- 36 Winawer S, Fletcher R, Midler L et al. Colorectal cancer screening: Clinical guidelines and rationale. Gastroenterology 1997; 112: 594–642.
- 37 Hoff G, Sauar J, Hofstad B, Vatn M. The Norwegian Guidelines for Surveillance after polypectomy: 10 year intervals. Scand J Gastroenterol 1996; 31: 834–6.
- 38 Edwards J, Woods C, Mendelson R, Forbes G. Extracolonic findings at virtual colonoscopy: implications for screening programs. Am J Gastroenterol 2001; 96: 3009–12.
- 39 Hara A, Johnson C, MacCary R et al. Incidental extracolonic findings at CT colography. Radiology 2000; 215: 353–7.
- 40 Hara A, Johnson C, MacCart R et al. CT colonography: single- versus multi-detector row imaging. Radiology 2001; 219: 461–5.
- 41 Zalis M, Hahn P. Digital subtraction bowel cleansing in CT colonography. AJR 2001; 176: 646–8.
- 42 Callstrom M, Johnson C, Fletcher J et al. CT colonography with- out cathartic preparation: Feasibility study. Radiology 2001; 219: 693–8.
- 43 Summers R, Johnson C, Pusanik L et al. Automated polyp detection at CT colonography: Feasibility assessment in a human population. Radiology 2001; 219: 51–9.
- 44 Hopper K, Iyriboz A, Wise S et al. Mucosal detail at CT virtual reality: Surface versus volume rendering. Radiology 2000; 214: 517–22.
- 45 Paik D, Beaulieu C, Brooke Jeffrey R et al. Visualization modes for CT colonography using cylindrical and planar map projections. J Comput Assist Tomog 2000; 24: 179–88.
- 46 Beaulieu C, Brooke Jeffrey R, Karadi C. Display modes for CT colonography. Part II. Blinded comparison of axial CT and virtual endoscopic and panoramic endoscopic volume-rendered studies. Radiology 1999; 212: 203–12.
- 47 Debatin JF, Luboldt W, Bauerfeind P. Virtual colonoscopy in 1999: Computed tomography or magnetic resonance imaging? Endoscopy 1999; 31: 174–9.
- 48 Pappalardo G, Polettini R, Frattaroli M et al. Magnetic resonance colonography versus conventional colonoscopy for the detection of colonic endoluminal lesions. Gastroenterology 2000; 119: 300–4.
- 49 Lomas D, Sood R, Graves M et al. Colon carcinoma: MR imaging with CO2 enema—pilot study. Radiology 2001; 219: 558–62.
- 50 Rex DK, Vining D, Kopecky KK. An initial experience with screening for colon polyps using spiral CT with and without CT colography (virtual colonoscopy). Gastrointest Endosc 1999; 50: 309–13.
