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Incidental Findings in CT Colonography: Literature Review and Survey of Current Research Practice

Published online by Cambridge University Press:  01 January 2021

Extract

Just over ten years ago, the first human trials of virtual colonoscopy, or computed tomography (CT) colonography, were performed. CT colonography (CTC), as it is now called, is a low radiation dose CT examination of the abdomen and pelvis following bowel purgation cleansing and insuflation (inflation) of the colon and rectum. High spatial resolution CT datasets of the abdomen and pelvis are obtained while the patient is lying in the prone and supine positions, with the entire procedure lasting about ten minutes. The resulting images are interactively reviewed on a dedicated computer workstation using 2D multiplanar images and 3D endoluminal displays of the colon. Over the past decade, rapid technological advancements in image acquisition, 3D display techniques, colonic insuflation, and stool tagging (i.e., labeling of stool with ingested radio-opaque contrast) have occurred, which have greatly improved the ability of CT colonography to detect colorectal polyps and cancer.

Type
Symposium
Copyright
Copyright © American Society of Law, Medicine and Ethics 2008

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References

Johnson, C. D. and Dachman, A. H., “CT Colonography: The Next Colon Screening Examination?” Radiology 216, no. 2 (2000): 331341.CrossRefGoogle Scholar
Gluecker, T. M. et al., “Extracolonic Findings at CT Colonography: Evaluation of Prevalence and Cost in a Screening Population,” Gastroenterology 124, no. 4 (2003): 911916; Hara, A. K. et al., “Incidental Extracolonic Findings at CT Colonography,” Radiology 215, no. 2 (2000): 353–357.CrossRefGoogle Scholar
Id. (Gluecker); see Pickhardt, P. J. and Taylor, A. J., “Extracolonic Findings Identified in Asymptomatic Adults at Screening CT Colonography,” American Journal of Roentgenology 186, no. 3 (2006): 718728.CrossRefGoogle Scholar
Id. (Gluecker); Hara, et al., supra note 2; Casarella, W. J., “A Patient's Viewpoint on a Current Controversy,” Radiology 224, no. 3 (2002): 927; Chin, M. et al., “Computed Tomographic Colonography: Prevalence, Nature, and Clinical Significance of Extracolonic Findings in a Community Screening Program,” American Journal of Gastroenterology 100, no. 12 (2005): 2771–2776; Yee, J. et al., “Extracolonic Abnormalities Discovered Incidentally at CT Colonography in a Male Population,” Radiology 236, no. 2 (2005): 519–526.Google Scholar
Wolf, S. M. et al., “Managing Incidental Findings in Human Subjects Research: Analysis and Recommendations,” Journal of Law, Medicine & Ethics 36, no. 2 (2008): 219248.CrossRefGoogle Scholar
See Gluecker, et al., supra note 2; Hara, et al., supra note 2; Yee, et al., supra note 4.Google Scholar
Hellstrom, M. et al., “Extracolonic and Incidental Findings on CT Colonography (Virtual Colonoscopy),” American Journal of Roentgenology 182, no. 3 (2004): 631638.CrossRefGoogle Scholar
See Gluecker, et al., supra note 2; Hara, et al., supra note 2; Chin, et al., supra note 4; Yee, et al., supra note 4; Pickhardt, P. J. et al., “CT Colonography Reporting and Data System (C-RADS): Prospective Categorization for Screening in 2501 Patients,” presentation at the Radiological Society of North America Scientific Assembly and Annual Meeting, Radiological Society of North America, Chicago, 2006, at 537. The largest study referred to in text is Pickhardt, et al.Google Scholar
See Hellstrom, et al., supra note 7; Edwards, J. T. et al., “Extracolonic Findings at Virtual Colonoscopy: Implications for Screening Programs,” American Journal of Gastroenterology 96, no. 10 (2001): 30093012; Khan, K. Y. et al., “Frequency and Impact of Extracolonic Findings Detected at Computed Tomographic Colonography in a Symptomatic Population,” British Journal of Surgery 94, no. 3 (2007): 355–361; Spreng, A. et al., “Importance of Extracolonic Findings at IV Contrast Medium-Enhanced CT Colonography versus Those at Non-Enhanced CT Colonography,” European Radiology 15, no. 10 (2005): 2088–2095.Google Scholar
See Gluecker, et al., supra note 2; Hara, et al., supra note 2.Google Scholar
See Hellstrom, et al., supra note 8; Edwards, et al., supra note 9; Spreng, et al., supra note 10.Google Scholar
See Hara, et al., supra note 2; Yee, et al., supra note 4; Pickhardt, et al., supra note 9.Google Scholar
See Edwards, et al., supra note 10; Khan, et al., supra note 10; Spreng, et al., supra note 10.Google Scholar
See Casarella, , supra note 4.Google Scholar
Xiong, T. et al., “Incidental Lesions Found on CT Colonography: Their Nature and Frequency,” British Journal of Radiology 78, no. 925 (2005): 2229.CrossRefGoogle Scholar
Pickhardt, P. J. et al., “Computed Tomographic Virtual Colonoscopy to Screen for Colorectal Neoplasia in Asymptomatic Adults,” New England Journal of Medicine 349, no. 23 (2003): 21912200.CrossRefGoogle Scholar
See Gluecker, et al., supra note 2.Google Scholar
See Hara, et al., supra note 2.Google Scholar
See Spreng, et al., supra note 10.Google Scholar
See Gluecker, et al., supra note 2; Hara, et al., supra note 2.Google Scholar
See Pickhardt, and Taylor, , supra note 3.Google Scholar
See Yee, et al., supra note 4.Google Scholar
Zalis, M. E. et al., “CT Colonography Reporting and Data System: A Consensus Proposal,” Radiology 236, no. 1 (2005): 39.CrossRefGoogle Scholar
See Pickhardt, et al., supra note 9.Google Scholar
Zalis, M. E. et al., “Implementation of Structured Reporting in CT Colonography: Initial Experience with the CT Colonography Reporting and Data System,” presentation at the Radiological Society of North American Scientific Assembly and Annual Meeting, Radiological Society of North America, Chicago, 2006, at 537.Google Scholar
See Pickhardt, and Taylor, , supra note 3.Google Scholar
See Yee, et al., supra note 4.Google Scholar
See Hara, et al., supra note 2.Google Scholar
Casola, G., “Whole-Body CT Screening: Self-Referral,” in Fourth International Symposium: Virtual Colonoscopy (Boston: Boston University School of Medicine and Boston Medical Center, 2003): at 55.Google Scholar
Young, B. M. et al., “Polyp Measurement with CT Colonography: Multiple-Reader, Multiple-Workstation Comparison,” American Journal of Roentgenology 188, no. 1 (2007): 122129.CrossRefGoogle Scholar
See Wolf, et al., supra note 5.Google Scholar
See Young, et al., supra note 34.Google Scholar
Illes, J. et al., “Discovery and Disclosure of Incidental Findings in Neuroimaging Research,” Journal of Magnetic Resonance Imaging 20, no. 5 (2004): 743747.CrossRefGoogle Scholar
Kirschen, M. P. et al., “Subjects’ Expectations in Neuroimaging Research,” Journal of Magnetic Resonance Imaging 23, no. 2 (2006): 205209.CrossRefGoogle Scholar
45 C.F.R. § 46 (2007).Google Scholar
See Casola, , supra note 33.Google Scholar
See Wolf, et al., supra note 5.Google Scholar
Jonisch, A. I. et al., “Can High-Attenuation Renal Cysts Be Differentiated from Renal Cell Carcinoma at Unenhanced CT?” Radiology 243, no. 2 (2007): 445450.CrossRefGoogle Scholar
MacMahon, H. et al., “Guidelines for Management of Small Pulmonary Nodules Detected on CT Scans: A Statement from the Fleischner Society,” Radiology 237, no. 2 (2005): 395400.CrossRefGoogle Scholar
See Spreng, et al., supra note 9.Google Scholar
See Gluecker, et al., supra note 2; Hara, et al., supra note 2; Pickhardt, and Taylor, , supra note 3.Google Scholar