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CT Colonography: Where Have We Been and Where Are We Going?¹

¹ From the Department of Radiology, Division of Abdominal Imaging, NYU Medical Center, NYU School of Medicine, 560 First Ave, Suite HW 207, New York, NY 10016 (M.M.); and Department of Medicine, Division of Gastroenterology, VA New York Harbor Healthcare System, New York, NY; and NYU School of Medicine (E.J.B.). Received October 5, 2004; revision requested December 13; revision received December 29; accepted February 7, 2005. Address correspondence to M.M. (e-mail: michael.macari{at}med.nyu.edu).

Over the past decade, computed tomographic (CT) colonography (also known as virtual colonoscopy) has been used to investigate the colon for colorectal neoplasia. Numerous clinical and technical advances have allowed CT colonography to advance slowly from a research tool to a viable option for colorectal cancer screening. However, substantial controversy remains among radiologists, gastroenterologists, and other clinicians with regard to the current role of CT colonography in clinical practice. On the one hand, all agree there is much excitement about a noninvasive imaging examination that can reliably depict clinically important colorectal lesions. However, this is tempered by results from several recent studies that show the sensitivity of CT colonography may not be as great when performed and the images interpreted by radiologists without expertise and training. The potential to miss important lesions exists; moreover, if polyps cannot be differentiated from folds and residual fecal matter, unnecessary colonoscopy will be performed. In this review, current issues will be discussed regarding colon cancer and the established and reimbursed strategies to screen for it and the past, current, and potential future role of CT colonography.

© RSNA, 2005

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