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Colorectal Polyps and Cancers in Asymptomatic Average-Risk Patients: Evaluation with CT Colonography¹

¹ From the Department of Radiology, Abdominal Imaging (M.M., S.L.J., Y.W.L., J.B., A.J.M.) and Department of Medicine, Gastroenterology (E.J.B., S.N., A.M.), Tisch Hospital, NYU Medical Center, 560 First Ave, Suite HW 207, New York, NY 10016; and the Department of Medicine, NYU School of Medicine, New York (R.R.). Received November 27, 2002; revision requested January 30, 2003; final revision received June 17; accepted July 31. Address correspondence to M.M. (e-mail: michael.macari@med.nyu.edu).

View larger version (117K): [in a new window]   Figure 1a.  CT images of a 7-mm false-positive finding in a 54-year-old man. (a) Transverse image shows a lesion (arrow) on the dependent wall of the ascending colon. (b) Endoluminal image shows the pedunculated morphology (arrow) of a lesion thought to be a polyp. At colonoscopy, no polyp was seen. The finding is believed to represent fecal residue.

View larger version (130K): [in a new window]   Figure 1b.  CT images of a 7-mm false-positive finding in a 54-year-old man. (a) Transverse image shows a lesion (arrow) on the dependent wall of the ascending colon. (b) Endoluminal image shows the pedunculated morphology (arrow) of a lesion thought to be a polyp. At colonoscopy, no polyp was seen. The finding is believed to represent fecal residue.

View larger version (143K): [in a new window]   Figure 2a.  CT images of a 16-mm false-positive finding in a 62-year-old man. (a) Transverse image shows a lesion (arrow) on a haustral fold in the splenic flexure. (b) Endoluminal image shows the sessile morphology (arrow) of a lesion thought to be a polyp. At colonoscopy, no polyp was seen. The finding is believed to represent a bulbous fold.

View larger version (133K): [in a new window]   Figure 2b.  CT images of a 16-mm false-positive finding in a 62-year-old man. (a) Transverse image shows a lesion (arrow) on a haustral fold in the splenic flexure. (b) Endoluminal image shows the sessile morphology (arrow) of a lesion thought to be a polyp. At colonoscopy, no polyp was seen. The finding is believed to represent a bulbous fold.

View larger version (156K): [in a new window]   Figure 3a.  Images of a 5-mm true-positive finding in a 65-year-old man. (a) Transverse CT image shows a lesion (arrow) on a haustral fold in the splenic flexure. (b) Endoluminal CT image shows the raised morphology (arrow) of the lesion. (c) Conventional colonoscopic image shows the same lesion (arrow). Histologic evaluation showed this to be a hyperplastic polyp.

View larger version (105K): [in a new window]   Figure 3b.  Images of a 5-mm true-positive finding in a 65-year-old man. (a) Transverse CT image shows a lesion (arrow) on a haustral fold in the splenic flexure. (b) Endoluminal CT image shows the raised morphology (arrow) of the lesion. (c) Conventional colonoscopic image shows the same lesion (arrow). Histologic evaluation showed this to be a hyperplastic polyp.

View larger version (171K): [in a new window]   Figure 3c.  Images of a 5-mm true-positive finding in a 65-year-old man. (a) Transverse CT image shows a lesion (arrow) on a haustral fold in the splenic flexure. (b) Endoluminal CT image shows the raised morphology (arrow) of the lesion. (c) Conventional colonoscopic image shows the same lesion (arrow). Histologic evaluation showed this to be a hyperplastic polyp.

View larger version (158K): [in a new window]   Figure 4a.  Images of a 24-mm true-positive finding in a 58-year-old man. (a) Transverse CT image shows a large lesion (arrow) in the distal sigmoid colon. (b) Endoluminal CT image shows the rounded morphology (arrow) of the lesion. Note the tip of a rectal tube (arrowhead). (c) Conventional colonoscopic image shows same lesion (arrow). Histologic evaluation showed this to be a tubular adenoma.

View larger version (145K): [in a new window]   Figure 4b.  Images of a 24-mm true-positive finding in a 58-year-old man. (a) Transverse CT image shows a large lesion (arrow) in the distal sigmoid colon. (b) Endoluminal CT image shows the rounded morphology (arrow) of the lesion. Note the tip of a rectal tube (arrowhead). (c) Conventional colonoscopic image shows same lesion (arrow). Histologic evaluation showed this to be a tubular adenoma.

View larger version (179K): [in a new window]   Figure 4c.  Images of a 24-mm true-positive finding in a 58-year-old man. (a) Transverse CT image shows a large lesion (arrow) in the distal sigmoid colon. (b) Endoluminal CT image shows the rounded morphology (arrow) of the lesion. Note the tip of a rectal tube (arrowhead). (c) Conventional colonoscopic image shows same lesion (arrow). Histologic evaluation showed this to be a tubular adenoma.

View larger version (140K): [in a new window]   Figure 5a.  Images of a 16-mm true-positive finding in a 55-year-old man. (a) Transverse CT image shows a large lesion (arrow) in the splenic flexure. (b) Endoluminal CT image shows the rounded morphology (arrow) of the lesion. (c) Conventional colonoscopic image shows the same lesion (arrow). Histologic evaluation showed this to be a tubular adenoma.

View larger version (130K): [in a new window]   Figure 5b.  Images of a 16-mm true-positive finding in a 55-year-old man. (a) Transverse CT image shows a large lesion (arrow) in the splenic flexure. (b) Endoluminal CT image shows the rounded morphology (arrow) of the lesion. (c) Conventional colonoscopic image shows the same lesion (arrow). Histologic evaluation showed this to be a tubular adenoma.

View larger version (159K): [in a new window]   Figure 5c.  Images of a 16-mm true-positive finding in a 55-year-old man. (a) Transverse CT image shows a large lesion (arrow) in the splenic flexure. (b) Endoluminal CT image shows the rounded morphology (arrow) of the lesion. (c) Conventional colonoscopic image shows the same lesion (arrow). Histologic evaluation showed this to be a tubular adenoma.