Studies show that chest CT scanning increases the detection rates for ILL and pulmonary metastases. The clinical benefit of the increased detection rates is not clear. There is a paucity of data assessing the optimal chest staging strategy for patients presenting with CRC.

No abstract

The sensitivity of 95 per cent for CTC in the diagnosis of colorectal cancer compares favourably with that of double-contrast barium enema (92 per cent) and colonoscopy (94 per cent).

Introduction: The Canterbury earthquake of 22 February 2011 initiated a mass casualty event for Christchurch Hospital, which suffered damage itself, and faced logistical difficulties in continued operation. Radiology was part of the hospital-wide response. This paper reviews the radiology department response and surveys opinions of emergency doctors to provide an overview of events of the day and thoughts regarding any potential future response. Methods: Two main approaches were undertaken: (i) informal data gathering and discussions with staff including radiographers, sonographers, radiologists, emergency doctors and others present on the day regarding their experiences; and (ii) survey of emergency doctors regarding their experiences and recommendations. A comparison with other similar events was also conducted. Results: (1) Diagnostic radiology services were initially constrained by a lack of power and lift access. Usual imaging and reporting pathways were interrupted. Alternative processes were initiated to ensure an ongoing radiology service with available resources. Lessons were learned and changes implemented locally.(2) Survey data confirmed several primary outcomes: (i) Ultrasound was crucial while CT was down; (ii) all available imaging modalities remain important in a disaster response; and (iii) preliminary reports from radiologists in the emergency department (ED) were useful in the immediate post-earthquake period. Conclusion: Although resources were limited, a diagnostic radiology service remained operational. The Christchurch experience reinforces the need for disaster planning and rehearsal of plans.

PET/CT remains a useful adjunct to conventional imaging in the pre-operative workup of patients with colorectal cancer.

Introduction: The aims of this study were to investigate the diagnostic performance of computed tomography colonography (CTC) performed in a rural secondary hospital, and to describe the local pattern of CTC service provision. Method: A single site, retrospective observational analysis was conducted for all patients undergoing CTC during the 12-month period from 1st of January to 31st of December 2014 with comparison to available colonoscopy. Results: There were 639 CTCs performed during the 12-months period. The average time from referral to performance of CTC scan was 21.3 days. The diagnostic yield of CTC for CRC was 5.8%; and for large polyps ≥10 mm was 8.0%. The sensitivity and specificity of CTC for detecting CRC were 97.1% and 88.2% respectively. The most predictive symptoms for finding colorectal lesions were rectal bleeding and anaemia. The referral rate from CTC to colonoscopy was 16.9%. 63 patients (9.9%) had follow up recommendations made in their reports due to extracolonic findings. Conclusion: Computed tomography colonography performed in a rural secondary hospital provided sufficient sensitivity to detect large polyps or CRC. The specificity for CRC was lower than reported figures in the literature. Technical issue of CTC performance due to poor insufflation techniques was identified as a main contributing factor reducing CTC accuracy. CTCs were performed with acceptable waiting time and showed high overall diagnostic yield for colorectal neoplasm in a rural hospital.