Popic J, Tipuric S, Balen I, Mrzljak A. Computed tomography colonography and radiation risk: How low can we go? World J Gastrointest Endosc 2021; 13(3): 72-81 [PMID: 33763187 DOI: 10.4253/wjge.v13.i3.72]
Corresponding Author of This Article
Anna Mrzljak, FEBG, MD, PhD, Associate Professor, Department of Medicine, Merkur University Hospital, School of Medicine, University of Zagreb, Zajceva 19, Zagreb 10000, Croatia. anna.mrzljak@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Opinion Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Mar 16, 2021; 13(3): 72-81 Published online Mar 16, 2021. doi: 10.4253/wjge.v13.i3.72
Computed tomography colonography and radiation risk: How low can we go?
Jelena Popic, Sandra Tipuric, Ivan Balen, Anna Mrzljak
Jelena Popic, Department of Radiology, University Hospital Merkur, School of Medicine, University of Zagreb, Zagreb 10000, Croatia
Sandra Tipuric, Department of Family Medicine, Health Center Zagreb-East, Zagreb 10000, Croatia
Ivan Balen, Department of Gastroenterology and Endocrinology, General Hospital Slavonski brod “Dr. Josip Bencevic”, Slavonski Brod 35000, Croatia
Anna Mrzljak, Department of Medicine, Merkur University Hospital, School of Medicine, University of Zagreb, Zagreb 10000, Croatia
Author contributions: Popic J made contributions to the conception and design of the study, involved in drafting and revising the manuscript critically; Tipuric S, Balen I and Mrzljak A were involved in collecting data, drafting and writing the manuscript. All authors read and approved the final manuscript.
Conflict-of-interest statement: The authors declare no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Anna Mrzljak, FEBG, MD, PhD, Associate Professor, Department of Medicine, Merkur University Hospital, School of Medicine, University of Zagreb, Zajceva 19, Zagreb 10000, Croatia. anna.mrzljak@gmail.com
Received: January 8, 2021 Peer-review started: January 8, 2021 First decision: January 23, 2021 Revised: January 23, 2021 Accepted: February 18, 2021 Article in press: February 18, 2021 Published online: March 16, 2021 Processing time: 59 Days and 15.7 Hours
Abstract
Computed tomography colonography (CTC) has become a key examination in detecting colonic polyps and colorectal carcinoma (CRC). It is particularly useful after incomplete optical colonoscopy (OC) for patients with sedation risks and patients anxious about the risks or potential discomfort associated with OC. CTC's main advantages compared with OC are its non-invasive nature, better patient compliance, and the ability to assess the extracolonic disease. Despite these advantages, ionizing radiation remains the most significant burden of CTC. This opinion review comprehensively addresses the radiation risk of CTC, incorporating imaging technology refinements such as automatic tube current modulation, filtered back projections, lowering the tube voltage, and iterative reconstructions as tools for optimizing low and ultra-low dose protocols of CTC. Future perspectives arise from integrating artificial intelligence in computed tomography machines for the screening of CRC.
Core Tip: Computed tomography colonography (CTC) is an important imaging technique with significant advantages over optical colonoscopy in terms of less invasiveness, better compliance, and assessment of extracolonic structures. Ionizing radiation is the most significant burden of this technique. This opinion review comprehensively addresses the radiation risk in CTC with imaging technology refinements that should be used to lower radiation doses.
