Understanding the contribution of family history to colorectal cancer risk and its clinical implications: A state-of-the-science review.

Persons with a family history (FH) of colorectal cancer (CRC) or adenomas that are not due to known hereditary syndromes have an increased risk for CRC. An understanding of these risks, screening recommendations, and screening behaviors can inform strategies for reducing the CRC burden in these families. A comprehensive review of the literature published within the past 10 years has been performed to assess what is known about cancer risk, screening guidelines, adherence and barriers to screening, and effective interventions in persons with an FH of CRC and to identify FH tools used to identify these individuals and inform care.

Clinical use of CT colonography for colorectal cancer screening in military training facilities and potential impact on HEDIS measures.

Purpose: The National Committee for Quality Assurance developed the Healthcare Effectiveness Data and Information Set(®) (HEDIS(®)) to provide quality measures for the evaluation of standards of medical care across health plans. Screening for colorectal cancer (CRC) has been shown to increase the detection of early-stage disease and reduce mortality. Current HEDIS measures for CRC screening include fecal occult blood testing, flexible sigmoidoscopy, and colonoscopy.

Rescreening of persons with a negative colonoscopy result: results from a microsimulation model.

Background: Persons with a negative result on screening colonoscopy are recommended to repeat the procedure in 10 years.

Objective: To assess the effectiveness and costs of colonoscopy versus other rescreening strategies after an initial negative colonoscopy result.

Design: Microsimulation model.

Incidental findings in imaging research: evaluating incidence, benefit, and burden.

Background: Little information exists concerning the frequency and medical significance of incidental findings (IFs) in imaging research.

Methods: Medical records of research participants undergoing a research imaging examination interpreted by a radiologist during January through March 2004 were reviewed, with 3-year clinical follow-up. An expert panel reviewed all IFs generating clinical action to determine medical benefit/burden on the basis of predefined criteria.

ACR Colon Cancer Committee white paper: status of CT colonography 2009.

Purpose: To review the current status and rationale of the updated ACR practice guidelines for CT colonography (CTC).

Methods: Clinical validation trials in both the United States and Europe are reviewed. Key technical aspects of the CTC examination are emphasized, including low-dose protocols, proper insufflation, and bowel preparation.

Managing incidental findings in human subjects research: analysis and recommendations.

No consensus yet exists on how to handle incidental findings (IFs) in human subjects research. Yet empirical studies document IFs in a wide range of research studies, where IFs are findings beyond the aims of the study that are of potential health or reproductive importance to the individual research participant. This paper reports recommendations of a two-year project group funded by NIH to study how to manage IFs in genetic and genomic research, as well as imaging research.

CT colonography: investigation of the optimum reader paradigm by using computer-aided detection software.

Purpose: To prospectively compare the diagnostic performance and time efficiency of both second and concurrent computer-aided detection (CAD) reading paradigms for retrospectively obtained computed tomographic (CT) colonography data sets by using consensus reading (three radiologists) of colonoscopic findings as a reference standard.

Materials And Methods: Ethical permission, HIPAA compliance (for U.S.

Linear polyp measurement at CT colonography: in vitro and in vivo comparison of two-dimensional and three-dimensional displays.

Purpose: To compare the accuracy of polyp measurement at computed tomographic (CT) colonography by using two-dimensional (2D) multiplanar reformation (MPR) and three-dimensional (3D) endoluminal displays obtained both in a colon phantom and at clinical examinations.

Materials And Methods: This HIPAA-compliant study had institutional review board approval, and all patients provided signed informed consent, both of which allowed for additional retrospective evaluation. Two-dimensional and 3D CT colonography displays were generated from data obtained in an in vitro colon phantom that contained 10 6-13-mm synthetic polyps and from data obtained at in vivo clinical CT colonography examinations performed in 10 patients (five men, five women; mean age, 56.

Computed tomography colonography: automated diameter and volume measurement of colonic polyps compared with a manual technique--in vitro study.

Objective: To investigate inter- and intraobserver agreement of automated measurement of polyp diameter in vitro.

Methods: Two phantoms ("QRM" and "Whiting") containing simulated polyps of known diameter and volume were scanned using 16-detector row computed tomography. Two observers estimated polyp diameter using 3 methods: software calipers ("manual"), freehand boundary identification ("semiautomatic"), and automated software segmentation ("fully automatic").

Computerized tomographic colonography: performance evaluation in a retrospective multicenter setting.

Background & Aims: No multicenter study has been reported evaluating the performance and interobserver variability of computerized tomographic colonography. The aim of this study was to assess the accuracy of computerized tomographic colonography for detecting clinically important colorectal neoplasia (polyps >or=10 mm in diameter) in a multi-institutional study.

Methods: A retrospective study was developed from 341 patients who had computerized tomographic colonography and colonoscopy among 8 medical centers.

Patient preferences for CT colonography, conventional colonoscopy, and bowel preparation.

Objectives: The aim of this study was to determine patient pre-examination expectations and postexamination appraisals for CT colonography, conventional colonoscopy and bowel preparation.

Methods: Prospective evaluation of 120 patients at defined risk for colorectal neoplasia was performed with CT colonography followed by colonoscopy on the same day. Subjects were stratified by age and sex (67 women and 53 men) and were randomized to receive either manual air (n = 61) or CO(2) (n = 59) insufflation during CT colonography.

Detection of primary hepatic malignancy in liver transplant candidates: prospective comparison of CT, MR imaging, US, and PET.

Purpose: To determine and compare the diagnostic performance of computed tomography (CT), magnetic resonance (MR) imaging, ultrasonography (US), and positron emission tomography (PET) in the detection of hepatocellular carcinoma (HCC) or cholangiocarcinoma in liver transplant candidates and to determine interobserver variability between the readers.

Materials And Methods: Twenty-five patients were examined prospectively with CT, MR imaging, US, and PET. Each test result was interpreted independently by two radiologists.

CT colonography: multiobserver diagnostic performance.

Purpose: To prospectively evaluate multiobserver diagnostic performance and reader agreement for colorectal polyp detection in a well-characterized cohort of patients with increased number of polyps, compared with an average-risk patient, with colonoscopy as the reference standard.

Materials And Methods: A cohort of 70 patients suspected of having polyps was examined with spiral computed tomographic (CT) colonography, with colonoscopy performed the same day. After air insufflation per rectum, supine and prone images were obtained with single-detector row CT (5-mm collimation, 8-mm table increment, 2-mm reconstruction interval).