Multislice CT colonography: current status and limitations.

Abstract

CT colonography (CTC) is a promising method for colorectal screening providing a full structural evaluation of the entire colon and gaining in popularity due to a superior safety profile, a low rate of complications, and high patient acceptance. Multislice CT (MSCT) has further improved the diagnostic potential of CTC by generating high-resolution CT images of the abdomen and pelvis in shorter acquisition times than was previously possible. Over the past year, multiple studies have been published on every aspect of CTC including techniques, image display, image reconstruction, and clinical trial results assessing the feasibility of CTC as a screening tool. Yet despite increasing clinical use, the appropriate role of CTC in colorectal cancer screening remains undefined and barriers to widespread adoption remain. In particular, though the test is generally regarded as easy to perform, accurate interpretation requires a steep learning curve. While several large studies have found high sensitivity and specificity, the accuracy of CTC in a screening population has yet to be verified and almost no health insurance plans reimburse for its use in colorectal screening. Ongoing research in computer-aided detection and new software tools, however, have the potential to increase accuracy and ease of interpretation significantly, accelerating its acceptance as a colorectal screening tool.