Contrast-enhanced computed tomographic colonography in the follow-up of colorectal cancer patients: a feasibility study

Abstract

The aim of our study was to assess whether contrast-enhanced CT colonography is a feasible alternative to both conventional colonoscopy and liver ultrasonography in the follow-up program of colorectal cancer patients. Thirty-five patients, surgically treated for colorectal cancer, underwent a follow-up program that included physical examination, carcinoembryonic antigen serum assay, conventional colonoscopy, liver ultrasonography, and chest X-ray. For these patients, we added a yearly contrast-enhanced CT colonography. All CT examinations were performed with a high-resolution protocol using a multidetector spiral CT scanner (Siemens, Erlangen, Germany) prior to and after the administration of 130 ml of i.v. contrast material. Images were directly analyzed on a dedicated workstation by two radiologists to determine colonic evalua-tion, visualization of colonic anastomosis, presence of polyps, and extracolonic findings. Colonic evaluation was judged as optimal in 91.7% of all colonic segments. All mechanical surgical anastomoses were visualized with CT colonography. There was no evidence of anastomotic recurrence. Seven polyps were detected in five different patients with CT colonography, with two false-positive and no false-negative examinations. Three liver metastases and two basal pulmonary nodules were also identified. Contrast-enhanced CT colonography is a feasible alternative to both conventional colonoscopy and liver ultrasonography in the follow-up of patients operated on for colorectal cancer.

Current status on performance of CT colonography and clinical indications

“…CTC, according to several studies in literatures [75,76], if performed using a different technical strategy (i.e. during the intravenous administration of iodinated contrast medium), combines the ability of detecting polyps and cancer with an accuracy that is similar to CC, and, at the same time, it offers the evaluation of extracolonic findings (regional and distant lymphadenopathies and liver metastases).…”

The Establishment of an Optimal Protocol for Contrast‐Enhanced Micro‐Computed Tomography in the Cloudy Catshark Scyliorhinus torazame

“…In addition, a multiphase CECT screening scan has a great advantage when diagnosing and monitoring metastatic lesions, searching for lymph nodes, or screening an acute abdomen (Laghi et al. 2003; Stoker et al. 2009; Skinner et al.…”

Fundamental Elements for Successful Performance of CT Colonography (Virtual Colonoscopy)

“…On the other hand, IV contrast enhancement is important for the detection and characterization of clinically significant extracolonic abnormalities. Therefore, it is necessary to use contrast enhancement for patients with known colorectal cancer or if they have the suspicion of it, for patients who are followed up after curative surgery for colorectal cancer and for those patients with symptoms that suggest an increased prevalence of extracolonic abnormalities (32, 42, 43). The arterial (or mucosal) phase may be appropriate for the purpose of polyp detection since bowel wall enhancement is maximized (44) and polyps are better visualized (45) at this phase.…”