Imaging alternatives to colonoscopy: CT colonography and colon capsule. European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) Guideline - Update 2020.

1: ESGE/ESGAR recommend computed tomographic colonography (CTC) as the radiological examination of choice for the diagnosis of colorectal neoplasia.Strong recommendation, high quality evidence.ESGE/ESGAR do not recommend barium enema in this setting.

Imaging alternatives to colonoscopy: CT colonography and colon capsule. European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) Guideline - Update 2020.

1. ESGE/ESGAR recommend computed tomographic colonography (CTC) as the radiological examination of choice for the diagnosis of colorectal neoplasia. Strong recommendation, high quality evidence.

Electronic cleansing of tagged residue in CT colonography: what radiologists need to know.

CT colonography (CTC) is the radiological examination of choice for the diagnosis of colorectal neoplasia. Faecal tagging is considered a mandatory part of bowel preparation. However, the colonic mucosa, obscured by tagged residue, is not accessible to endoluminal 3D views and requires time-consuming 2D evaluation.

Pearls and Pitfalls of Interpretation in CT Colonography.

The accuracy of computed tomography (CT) colonography (CTC) requires that the radiologist be well trained in the recognition of pitfalls of interpretation. In order to achieve a high sensitivity and specificity, the interpreting radiologist must be well versed in the causes of both false-positive and false-negative results. In this article, we review the common and uncommon pitfalls of interpretation in CTC.

CT colonography: size reduction of submerged colorectal polyps due to electronic cleansing and CT-window settings.

Objectives: To assess whether electronic cleansing (EC) of tagged residue and different computed tomography (CT) windows influence the size of colorectal polyps in CT colonography (CTC).

Methods: A database of 894 colonoscopy-validated CTC datasets of a low-prevalence cohort was retrospectively reviewed to identify patients with polyps ≥6 mm that were entirely submerged in tagged residue. Ten radiologists independently measured the largest diameter of each polyp, two-dimensionally, before and after EC in colon, bone, and soft-tissue-windows, in randomised order.

Clinical indications for computed tomographic colonography: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) Guideline.

This is an official guideline of the European Society of Gastrointestinal Endoscopy (ESGE) and the European Society of Gastrointestinal and Abdominal Radiology (ESGAR). It addresses the clinical indications for the use of computed tomographic colonography (CTC). A targeted literature search was performed to evaluate the evidence supporting the use of CTC.

Image quality improvement in submillisievert computed tomographic colonography using a fast 3-dimensional noise reduction method.

Objective: The objective of this study was to evaluate the image quality in submillisievert computed tomographic colonography (CTC) images using a structure preserving diffusion denoising method.

Methods: Image quality was compared before and after denoising in 31 patients. One hundred twenty-kilovolt, 30-mAs prone CTC scans were used as reference and compared with submillisievert 140-kV, 10-mAs supine scans.

Comparison of the diagnostic performance of CT colonography interpreted by radiologists and radiographers.

Objective: To compare computed tomographic colonography (CTC) performance of four trained radiographers with the CTC performance of two experienced radiologists.

Methods: Four radiographers and two radiologists interpreted 87 cases with 40 polyps ≥6 mm. Sensitivity, specificity, and positive predictive value (PPV) were assessed on a per-patient basis.

Bowel preparation for CT colonography.

Bowel preparation represents an essential part of CT colonography, as the accuracy of the exam is strongly related to the adequacy of colonic cleansing, and a poor bowel preparation may compromise the diagnostic quality even despite optimization of all other acquisition parameters. Residual stool and fluid in the large bowel may affect the interpretation of the exam and may increase the number of false positives and false negatives. In this regard, the majority of patients having undergone CT colonography state that bowel preparation is the most unpleasant part.

Teleradiology based CT colonography to screen a population group of a remote island; at average risk for colorectal cancer.

Purpose: To prospectively assess the performance of teleradiology-based CT colonography to screen a population group of an island, at average risk for colorectal cancer.

Materials And Methods: A cohort of 514 patients living in Madeira, Portugal, was enrolled in the study. Institutional review board approval was obtained and all patients signed an informed consent.

The second ESGAR consensus statement on CT colonography.

Objective: To update quality standards for CT colonography based on consensus among opinion leaders within the European Society of Gastrointestinal and Abdominal Radiology (ESGAR).

Material And Methods: A multinational European panel of nine members of the ESGAR CT colonography Working Group (representing six EU countries) used a modified Delphi process to rate their level of agreement on a variety of statements pertaining to the acquisition, interpretation and implementation of CT colonography. Four Delphi rounds were conducted, each at 2 months interval.

Evaluation of colonic lesions and pitfalls in CT colonography: a systematic approach based on morphology, attenuation and mobility.

Computed tomographic colonography is a reliable technique for the detection and classification of neoplastic and non-neoplastic lesions of the colon. It is based on a thin-section CT dataset of the cleansed and air-distended colon, acquired in prone and supine position. Two-dimensional and 3D projections are used in combination for image interpretation.

Chronic diverticulitis vs. colorectal cancer: findings on CT colonography.

Purpose: The purpose of this update article is to evaluate findings on CT colonography in patients with chronic diverticulitis and to compare the findings in patients with colorectal carcinoma.

Materials And Methods: Different morphological criteria retrieved from a literature review were retrospectively analyzed in a series of 13 patients with proven chronic diverticulitis. The findings were compared with a series of 10 patients with colorectal carcinoma.

CT colonography: avoiding traps and pitfalls.

Computed tomographic colonography (CTC) is a reliable technique for detecting tumoral lesions in the colon. However, good performance of polyp detection is only achieved if experienced CTC radiologists combine meticulous interpretation with state-of-the-art CTC technique. To reach this experience level, CTC training is mandatory.

Effect of a tele-training programme on radiographers in the interpretation of CT colonography.

Objective: To assess the performance of radiographers in CT colonography (CTC) after a tele-training programme, supervised by 2 experienced radiologists.

Materials And Methods: Five radiographers underwent training in CTC using a tele-training programme mainly based on the interpretation of 75 training cases performed in the novice department. To evaluate the educational performance, each radiographer was tested on 20 test cases with 27 lesions >6mm (12: 6-9 mm; 15: >10mm).

CT colonography: who attends training? A survey of participants at educational workshops.

Aim: To obtain information regarding the demographics of attendees of computed tomography colonography (CTC) training workshops organized by the European Society of Gastrointestinal and Abdominal Radiology (ESGAR), in particular their prior expertise and current practice.

Materials And Methods: Attendees at five CTC training workshops conducted in Edinburgh (UK), Malmo (Sweden), Amsterdam (Netherlands), Pisa and Stresa (Italy) between February 2007 and April 2010 completed an online questionnaire. Responses were collated and descriptive statistics produced.

[CT colonography: patient preparation and examination technique].

An examination technique adapted to comply with the demands of CT colonography is not only a basic requirement for a high-quality examination and correct ascertainment of the findings; it is also essential for far-reaching applications of this method of examination. The technique of CT colonography is based on good patient preparation with the aid of fecal tagging, adequate distension of the colon with CO(2) and acquisition of data with the patient both prone and supine in a thin-slice technique using a low-dose protocol. The different technical aspects of CT colonography are explained in this paper.

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.

Computer-aided detection of colonic polyps at CT colonography using a Hessian matrix-based algorithm: preliminary study.

Objective: The purpose of our study was to develop a Hessian matrix-based computer-aided detection (CAD) algorithm for polyp detection on CT colonography (CTC) and to analyze its performance in a high-risk population.

Subjects And Methods: The CTC data sets of 35 patients with at least one colonoscopically proven polyp were interpreted with a Hessian matrix-based CAD algorithm, which was designed to depict bloblike structures protruding into the lumen. Our gold standard was a combination of segmental unblinded optical colonoscopy and retrospective unblinded consensus review by two radiologists.

Computed tomographic colonography: clinical value.

Computed tomographic colonography (CTC) has the potential to reliably detect polyps in the colon. Its clinical value is accepted for several indications. The main target is screening asymptomatic people for colorectal cancer (CRC).

CT colonography: visualization methods, interpretation, and pitfalls.

Virtual colonoscopy interpretation is improving rapidly with the development of efficient software using two-dimensional, three-dimensional (3D) endoluminal, and 3D novel views such as those that seem to cut the colon open and lay it flat for interpretation. Comparison of these various views, comparisons of supine and prone positioning, and comparisons of lung and soft tissue windows aid in the recognition of various pitfalls of interpretation.

Comparison of routine and unprepped CT colonography augmented by low fiber diet and stool tagging: a pilot study.

Background: We performed a pilot study examining the feasibility of a new unprepped CT colonography (CTC) strategy: low fiber diet and tagging (unprepped) vs. low fiber diet, tagging and a magnesium citrate cleansing preparation (prepped). Prior reports of tagging were limited in that the residual stool was neither measured and stratified by size nor did prior reports subjectively evaluate the ease of interpretation by a reader experienced in interpreting CTC examinations.