Virtual colonoscopy: Utility, impact and overview
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摘要
Computed tomography (CT) colonoscopy is a well-established technique for evaluation of colorectal cancer. Significant advances have been made in the technique of CT colonoscopy since its inception. Excellent results can be achieved in detecting both colorectal cancer and significant sized polyps as long as a meticulous technique is adopted while performing CT colonoscopy. Furthermore, it is important to realize that there is a learning curve involved in interpreting these studies and adequate experience is essential to achieve high sensitivity and specificity with this technique. Indications, contraindications, technique and interpretation, including potential pitfalls in CT colonoscopy imaging, are reviewed in this article. Recent advances and the current role of CT colonoscopy in colorectal cancer screening are also discussed.
Computed tomography (CT) colonoscopy is a well-established technique for evaluation of colorectal cancer. Significant advances have been made in the technique of CT colonoscopy since its inception. Excellent results can be achieved in detecting both colorectal cancer and significant sized polyps as long as a meticulous technique is adopted while performing CT colonoscopy. Furthermore, it is important to realize that there is a learning curve involved in interpreting these studies and adequate experience is essential to achieve high sensitivity and specificity with this technique. Indications, contraindications, technique and interpretation, including potential pitfalls in CT colonoscopy imaging, are reviewed in this article. Recent advances and the current role of CT colonoscopy in colorectal cancer screening are also discussed.
Computed tomography (CT) colonoscopy is a well-established technique for evaluation of colorectal cancer. Significant advances have been made in the technique of CT colonoscopy since its inception. Excellent results can be achieved in detecting both colorectal cancer and significant sized polyps as long as a meticulous technique is adopted while performing CT colonoscopy. Furthermore, it is important to realize that there is a learning curve involved in interpreting these studies and adequate experience is essential to achieve high sensitivity and specificity with this technique. Indications, contraindications, technique and interpretation, including potential pitfalls in CT colonoscopy imaging, are reviewed in this article. Recent advances and the current role of CT colonoscopy in colorectal cancer screening are also discussed.
引文
1 http://www.cancer.org/Cancer/ColonandRectumCancer/De- tailedGuide/colorectal-cancer-key-statistics
2 Howlader N, Noone AM, Krapcho M, Neyman N, Aminou R, Waldron W, Altekruse SF, Kosary CL, Ruhl J, Tatalov- ich Z, Cho H, Mariotto A, Eisner MP, Lewis DR, Chen HS, Feuer EJ, Cronin KA, Edwards BK, editors. SEER Cancer Statistics Review, 1975-2008. National Cancer Institute. Bethesda, MD. Available from: URL: http://seer.cancer. gov/csr/1975_2008/. Based on November 2010 SEER data submission, posted to the SEER web site, 2011
3 Day DW, Morson BC. The adenoma-carcinoma sequence. Major Probl Pathol 1978; 10: 58-71 [PMID: 359943]
4 Morson BC. The evolution of colorectal carcinoma. Clin Radiol 1984; 35: 425-431 [PMID: 6499378 DOI: 10.1016/ S0009-9260(84)80033-1]
5 Muto T, Bussey HJ, Morson BC. The evolution of cancer of the colon and rectum. Cancer 1975; 36: 2251-2270 [PMID: 1203876 DOI: 10.1002/cncr.2820360944]
6 Toribara NW, Sleisenger MH. Screening for colorectal can- cer. N Engl J Med 1995; 332: 861-867 [PMID: 7870142 DOI:10.1056/NEJM199503303321306]
7 Vogelstein B, Fearon ER, Hamilton SR, Kern SE, Preisinger AC, Leppert M, Nakamura Y, White R, Smits AM, Bos JL. Genetic alterations during colorectal-tumor development. N Engl J Med 1988; 319: 525-532 [PMID: 2841597 DOI: 10.1056/ NEJM198809013190901]
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10 Vining DJ. Virtual endoscopy: is it reality/ Radiology 1996; 200: 30-31 [PMID: 8657938]
11 Pickhardt PJ, Hassan C, Halligan S, Marmo R. Colorectal cancer: CT colonography and colonoscopy for detection- -systematic review and meta-analysis. Radiology 2011; 259: 393-405 [PMID: 21415247 DOI: 10.1148/radiol.11101887]
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13 Halligan S, Altman DG, Taylor SA, Mallett S, Deeks JJ, Bartram CI, Atkin W. CT colonography in the detection of colorectal polyps and cancer: systematic review, meta- analysis, and proposed minimum data set for study level reporting. Radiology 2005; 237: 893-904 [PMID: 16304111 DOI:10.1148/radiol.2373050176]
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15 Kimberly JR, Phillips KC, Santago P, Perumpillichira J, Bechtold R, Pineau B, Vining D, Bloomfeld RS. Extracolonic findings at virtual colonoscopy: an important consider- ation in asymptomatic colorectal cancer screening. J Gen Intern Med 2009; 24: 69-73 [PMID: 18958531 DOI: 10.1007/ s11606-008-0835-2]
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72 Levin B, Lieberman DA, McFarland B, Smith RA, Brooks D, Andrews KS, Dash C, Giardiello FM, Glick S, Levin TR, Pickhardt P, Rex DK, Thorson A, Winawer SJ. 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 Radiol- ogy. CA Cancer J Clin 2008; 58: 130-160 [PMID: 18322143 DOI:10.3322/CA.2007.0018]
2 Howlader N, Noone AM, Krapcho M, Neyman N, Aminou R, Waldron W, Altekruse SF, Kosary CL, Ruhl J, Tatalov- ich Z, Cho H, Mariotto A, Eisner MP, Lewis DR, Chen HS, Feuer EJ, Cronin KA, Edwards BK, editors. SEER Cancer Statistics Review, 1975-2008. National Cancer Institute. Bethesda, MD. Available from: URL: http://seer.cancer. gov/csr/1975_2008/. Based on November 2010 SEER data submission, posted to the SEER web site, 2011
3 Day DW, Morson BC. The adenoma-carcinoma sequence. Major Probl Pathol 1978; 10: 58-71 [PMID: 359943]
4 Morson BC. The evolution of colorectal carcinoma. Clin Radiol 1984; 35: 425-431 [PMID: 6499378 DOI: 10.1016/ S0009-9260(84)80033-1]
5 Muto T, Bussey HJ, Morson BC. The evolution of cancer of the colon and rectum. Cancer 1975; 36: 2251-2270 [PMID: 1203876 DOI: 10.1002/cncr.2820360944]
6 Toribara NW, Sleisenger MH. Screening for colorectal can- cer. N Engl J Med 1995; 332: 861-867 [PMID: 7870142 DOI:10.1056/NEJM199503303321306]
7 Vogelstein B, Fearon ER, Hamilton SR, Kern SE, Preisinger AC, Leppert M, Nakamura Y, White R, Smits AM, Bos JL. Genetic alterations during colorectal-tumor development. N Engl J Med 1988; 319: 525-532 [PMID: 2841597 DOI: 10.1056/ NEJM198809013190901]
8 Winawer SJ, Zauber AG, Ho MN, O’Brien MJ, Gottlieb LS, Sternberg SS, Waye JD, Schapiro M, Bond JH, Panish JF. Prevention of colorectal cancer by colonoscopic polyp- ectomy. The National Polyp Study Workgroup. N Engl J Med 1993; 329: 1977-1981 [PMID: 8247072 DOI: 10.1056/ NEJM199312303292701]
9 Rockey DC, Paulson E, Niedzwiecki D, Davis W, Bosworth HB, Sanders L, Yee J, Henderson J, Hatten P, Burdick S, Sanyal A, Rubin DT, Sterling M, Akerkar G, Bhutani MS, Binmoeller K, Garvie J, Bini EJ, McQuaid K, Foster WL, Thompson WM, Dachman A, Halvorsen R. Analysis of air contrast barium en- ema, computed tomographic colonography, and colonoscopy: prospective comparison. Lancet 2005; 365: 305-311 [PMID: 15664225 DOI: 10.1016/S0140-6736(05)17784-8]
10 Vining DJ. Virtual endoscopy: is it reality/ Radiology 1996; 200: 30-31 [PMID: 8657938]
11 Pickhardt PJ, Hassan C, Halligan S, Marmo R. Colorectal cancer: CT colonography and colonoscopy for detection- -systematic review and meta-analysis. Radiology 2011; 259: 393-405 [PMID: 21415247 DOI: 10.1148/radiol.11101887]
12 Mang TCP, Lefere P. International implementation. In: Dachman AH, Laghi A, editors. Atlas of Virtual Colonos- copy. New York: Springer, 2010: 9-48
13 Halligan S, Altman DG, Taylor SA, Mallett S, Deeks JJ, Bartram CI, Atkin W. CT colonography in the detection of colorectal polyps and cancer: systematic review, meta- analysis, and proposed minimum data set for study level reporting. Radiology 2005; 237: 893-904 [PMID: 16304111 DOI:10.1148/radiol.2373050176]
14 Hermanek P. Dysplasia-carcinoma sequence, types of adeno- mas and early colo-rectal carcinoma. Eur J Surg Oncol 1987;13: 141-143 [PMID: 3556595]
15 Kimberly JR, Phillips KC, Santago P, Perumpillichira J, Bechtold R, Pineau B, Vining D, Bloomfeld RS. Extracolonic findings at virtual colonoscopy: an important consider- ation in asymptomatic colorectal cancer screening. J Gen Intern Med 2009; 24: 69-73 [PMID: 18958531 DOI: 10.1007/ s11606-008-0835-2]
16 Morrin MM, Farrell RJ, Kruskal JB, Reynolds K, McGee JB, Raptopoulos V. Utility of intravenously administered contrast material at CT colonography. Radiology 2000; 217: 765-771 [PMID: 11110941]
17 Rajapaksa RC, Macari M, Bini EJ. Prevalence and impact of extracolonic findings in patients undergoing CT colonogra- phy. J Clin Gastroenterol 2004; 38: 767-771 [PMID: 15365402 DOI: 10.1097/01.mcg.0000139035.38568.18]
18 Levin B, Lieberman DA, McFarland B, Andrews KS, Brooks D, Bond J, Dash C, Giardiello FM, Glick S, Johnson D, John- son CD, Levin TR, Pickhardt PJ, Rex DK, Smith RA, Thorson A, Winawer SJ. Screening and surveillance for the early de- tection 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 2008; 134: 1570-1595 [PMID: 18384785 DOI: 10.1053/j.gastro.2008.02.002]
19 McFarland EG, Fletcher JG, Pickhardt P, Dachman A, Yee J, McCollough CH, Macari M, Knechtges P, Zalis M, Barish M, Kim DH, Keysor KJ, Johnson CD. ACR Colon Cancer Com- mittee white paper: status of CT colonography 2009. J Am Coll Radiol 2009; 6: 756-772.e4 [PMID: 19878883]
20 McFarland EG, Levin B, Lieberman DA, Pickhardt PJ, John- son CD, Glick SN, Brooks D, Smith RA. Revised colorectal screening guidelines: joint effort of the American Cancer So- ciety, U.S. Multisociety Task Force on Colorectal Cancer, and American College of Radiology. Radiology 2008; 248: 717-720 [PMID: 18710970 DOI: 10.1148/radiol.2483080842]
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