L. Abelairas Lopez, A Coruña, ES

To present the current, under debate and promising indications of CT Colonography (CTC) and to describe technical details about patient preparation, bowel distention, data acquisition and evaluation.

Background

CTC started as a diagnostic tool for colorectal cancer (CRC) screening. Over the years, CTC is becoming a robust and minimally invasive technique to image the entire colon. Current CTC accepted indications include incomplete optical colonoscopy (OC), patients who are unfit for OC (elderly and frail patients), uncomplicated diverticular disease, accurate location of the tumour and synchronous lesions before laparoscopic surgery, surveillance after surgery for CRC, surveillance of small lesions previously detected in CTC. Besides, it allows to assess the colonic involvement and extension of bowel inflammatory diseases in chronic fibrostenosing phase. Also, submucosal lesions can be characterized with CTC. In more recent years, CTC has gained strength in improving the accuracy of CT in local staging of colon cancer. Recent studies show the effectiveness of CTC in differentiating low-moderate risk from high-risk cancer.

Imaging findings OR Procedure findings

CTC are performed with an MDCT, after a low-fibre diet usually without cathartic agents, faecal tagging, intramuscular or intravenous administration of antispasmodic agents and colonic distension with CO2. Imaging processing and interpretation are performed on a workstation equipped with dedicated software.

Conclusion

Nowadays, CTC is a reliable and robust tool to imaging the colon with well-established indications as well as promising, with an important role in the local staging of colon cancer in order to plan their treatment including or not neoadjuvant chemotherapy.

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