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Perfetti S, Mugnai M, Citi S, Marconato L, Foglia A, Sabattini S, Linta N, Diana A. Role of CT in the Staging of Colorectal Tumors: A Preliminary Study on 10 Dogs. Animals (Basel) 2024; 14:1521. [PMID: 38891567 PMCID: PMC11171116 DOI: 10.3390/ani14111521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 05/17/2024] [Accepted: 05/18/2024] [Indexed: 06/21/2024] Open
Abstract
This study aimed to define the CT features of colorectal tumors in dogs and assess CT's role in tumor staging. It was a retrospective, multicenter, descriptive study involving dogs with a cyto-histopathological diagnosis of colorectal tumors and high-quality pre- and post-contrast CT scans of the abdomen. CT successfully identified colorectal lesions in all cases, showing variations such as wall thickening, presence of masses, and luminal stenosis. It also detected lymph node involvement. Overall, this study helps us to understand the CT features of both epithelial and mesenchymal colorectal tumors, emphasizing CT's importance in staging and surgical planning for affected dogs. Larger studies are needed to identify specific CT findings for different colorectal neoplasms.
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Affiliation(s)
- Simone Perfetti
- Department of Veterinary Clinical Science, University of Bologna, 40064 Ozzano dell’Emilia, Italy; (L.M.); (A.F.); (S.S.); (N.L.); (A.D.)
| | - Martina Mugnai
- AniCura Istituto Veterinario di Novara, 28060 Granozzo con Monticello, Italy;
| | - Simonetta Citi
- Department of Veterinary Clinical Science, University of Pisa, 56100 Pisa, Italy;
| | - Laura Marconato
- Department of Veterinary Clinical Science, University of Bologna, 40064 Ozzano dell’Emilia, Italy; (L.M.); (A.F.); (S.S.); (N.L.); (A.D.)
| | - Armando Foglia
- Department of Veterinary Clinical Science, University of Bologna, 40064 Ozzano dell’Emilia, Italy; (L.M.); (A.F.); (S.S.); (N.L.); (A.D.)
| | - Silvia Sabattini
- Department of Veterinary Clinical Science, University of Bologna, 40064 Ozzano dell’Emilia, Italy; (L.M.); (A.F.); (S.S.); (N.L.); (A.D.)
| | - Nikolina Linta
- Department of Veterinary Clinical Science, University of Bologna, 40064 Ozzano dell’Emilia, Italy; (L.M.); (A.F.); (S.S.); (N.L.); (A.D.)
| | - Alessia Diana
- Department of Veterinary Clinical Science, University of Bologna, 40064 Ozzano dell’Emilia, Italy; (L.M.); (A.F.); (S.S.); (N.L.); (A.D.)
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Zamanian MY, Golmohammadi M, Abdullaev B, García MO, Alazbjee AAA, Kumar A, Mohaamed SS, Hussien BM, Khalaj F, Hodaei SM, Shirsalimi N, Moriasi G. A narrative review on therapeutic potential of naringenin in colorectal cancer: Focusing on molecular and biochemical processes. Cell Biochem Funct 2024; 42:e4011. [PMID: 38583080 DOI: 10.1002/cbf.4011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 03/24/2024] [Accepted: 03/31/2024] [Indexed: 04/08/2024]
Abstract
Colorectal cancer (CRC) is a common and highly metastatic cancer affecting people worldwide. Drug resistance and unwanted side effects are some of the limitations of current treatments for CRC. Naringenin (NAR) is a naturally occurring compound found in abundance in various citrus fruits such as oranges, grapefruits, and tomatoes. It possesses a diverse range of pharmacological and biological properties that are beneficial for human health. Numerous studies have highlighted its antioxidant, anticancer, and anti-inflammatory activities, making it a subject of interest in scientific research. This review provides a comprehensive overview of the effects of NAR on CRC. The study's findings indicated that NAR: (1) interacts with estrogen receptors, (2) regulates the expression of genes related to the p53 signaling pathway, (3) promotes apoptosis by increasing the expression of proapoptotic genes (Bax, caspase9, and p53) and downregulation of the antiapoptotic gene Bcl2, (4) inhibits the activity of enzymes involved in cell survival and proliferation, (5) decreases cyclin D1 levels, (6) reduces the expression of cyclin-dependent kinases (Cdk4, Cdk6, and Cdk7) and antiapoptotic genes (Bcl2, x-IAP, and c-IAP-2) in CRC cells. In vitro CDK2 binding assay was also performed, showing that the NAR derivatives had better inhibitory activities on CDK2 than NAR. Based on the findings of this study, NAR is a potential therapeutic agent for CRC. Additional pharmacology and pharmacokinetics studies are required to fully elucidate the mechanisms of action of NAR and establish the most suitable dose for subsequent clinical investigations.
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Affiliation(s)
- Mohammad Yasin Zamanian
- Department of Physiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
- Department of Pharmacology and Toxicology, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran
| | | | - Bekhzod Abdullaev
- Central Asian Center of Development Studies, New Uzbekistan University, Tashkent, Uzbekistan
- School of Medicine, Central Asian University, Tashkent, Uzbekistan
- Department of Medical Oncology and Radiology, Samarkand State Medical University
| | - María Olalla García
- Universidad Estatal de Bolívar, Facultad de Ciencias de la Salud y del Ser Humano, Carrera de Enfermería, CP, Guaranda, Ecuador
| | | | - Abhinav Kumar
- Department of Nuclear and Renewable Energy, Ural Federal University Named after the First President of Russia Boris Yeltsin, Ekaterinburg, Russia
| | - Sameer S Mohaamed
- Department of Pharmacy, Al Rafidain University College, Bagdad, Iraq
| | - Beneen M Hussien
- Medical Laboratory Technique College, the Islamic University, Najaf, Iraq
- Medical Laboratory Technique College, the Islamic University of Al Diwaniyah, Al Diwaniyah, Iraq
- Medical Laboratory Technique College, the Islamic University of Babylon, Babylon, Iraq
| | - Fattaneh Khalaj
- Digestive Diseases Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Niyousha Shirsalimi
- Department of Physiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Gervason Moriasi
- Department of Medical Biochemistry, School of Medicine, College of Health Sciences, Mount Kenya University, Thika, Kenya
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Li J, Zhu J, Zou Y, Zhang G, Zhu P, Wang N, Xie P. Diagnostic CT of colorectal cancer with artificial intelligence iterative reconstruction: A clinical evaluation. Eur J Radiol 2024; 171:111301. [PMID: 38237522 DOI: 10.1016/j.ejrad.2024.111301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/26/2023] [Accepted: 01/07/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVES To investigate the clinical value of a novel deep-learning based CT reconstruction algorithm, artificial intelligence iterative reconstruction (AIIR), in diagnostic imaging of colorectal cancer (CRC). METHODS This study retrospectively enrolled 217 patients with pathologically confirmed CRC. CT images were reconstructed with the AIIR algorithm and compared with those originally obtained with hybrid iterative reconstruction (HIR). Objective image quality was evaluated in terms of the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Subjective image quality was graded on the conspicuity of tumor margin and enhancement pattern as well as the certainty in diagnosing organ invasion and regional lymphadenopathy. In patients with surgical pathology (n = 116), the performance of diagnosing visceral peritoneum invasion was characterized using receiver operating characteristic (ROC) analysis. Changes of diagnostic thinking in diagnosing hepatic metastases were assessed through lesion classification confidence. RESULTS The SNRs and CNRs on AIIR images were significantly higher than those on HIR images (all p < 0.001). The AIIR was scored higher for all subjective metrics (all p < 0.001) except for the certainty of diagnosing regional lymphadenopathy (p = 0.467). In diagnosing visceral peritoneum invasion, higher area under curve (AUC) of the ROC was found for AIIR than HIR (0.87 vs 0.77, p = 0.001). In assessing hepatic metastases, AIIR was found capable of correcting the misdiagnosis and improving the diagnostic confidence provided by HIR (p = 0.01). CONCLUSIONS Compared to HIR, AIIR offers better image quality, improves the diagnostic performance regarding CRC, and thus has the potential for application in routine abdominal CT.
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Affiliation(s)
- Jiao Li
- Department of Radiology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510655, China; Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510655, China.
| | - Junying Zhu
- Department of Radiology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510655, China; Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510655, China.
| | - Yixuan Zou
- United Imaging Healthcare, Shanghai 201800, China.
| | - Guozhi Zhang
- United Imaging Healthcare, Shanghai 201800, China.
| | - Pan Zhu
- Department of Radiology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510655, China; Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510655, China.
| | - Ning Wang
- Department of Radiology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510655, China; Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510655, China.
| | - Peiyi Xie
- Department of Radiology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510655, China; Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510655, China.
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Tan X, Yang X, Hu S, Chen X, Sun Z. Predictive modeling based on tumor spectral CT parameters and clinical features for postoperative complications in patients undergoing colon resection for cancer. Insights Imaging 2023; 14:155. [PMID: 37741813 PMCID: PMC10517912 DOI: 10.1186/s13244-023-01515-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/29/2023] [Indexed: 09/25/2023] Open
Abstract
BACKGROUND Colon cancer is a particularly prevalent malignancy that produces postoperative complications (POCs). However, limited imaging modality exists on the accurate diagnosis of POCs. The purpose of this study was therefore to construct a model combining tumor spectral CT parameters and clinical features to predict POCs before surgery in colon cancer. METHODS This retrospective study included 85 patients who had preoperative abdominal spectral CT scans and underwent radical colon cancer resection at our institution. The patients were divided into two groups based on the absence (no complication/grade I) or presence (grades II-V) of POCs according to the Clavien-Dindo grading system. The visceral fat areas (VFA) of patients were semi-automatically outlined and calculated on L3-level CT images using ImageJ software. Clinical features and tumor spectral CT parameters were statistically compared between the two groups. A combined model of spectral CT parameters and clinical features was established by stepwise regression to predict POCs in colon cancer. The diagnostic performance of the model was evaluated using the receiver operating characteristic (ROC) curve, including area under the curve (AUC), sensitivity, and specificity. RESULTS Twenty-seven patients with POCs and 58 patients without POCs were included in this study. MonoE40keV-VP and VFA were independent predictors of POCs. The combined model based on predictors yielded an AUC of 0.84 (95% CI: 0.74-0.91), with a sensitivity of 77.8% and specificity of 87.9%. CONCLUSIONS The model combining MonoE40keV-VP and VFA can predict POCs before surgery in colon cancer and provide a basis for individualized management plans. CRITICAL RELEVANCE STATEMENT The model combining MonoE40keV-VP and visceral fat area can predict postoperative complications before surgery in colon cancer and provide a basis for individualized management plans. KEY POINTS • Visceral fat area and MonoE40keV-VP were independent predictors of postoperative complications in colon cancer. • The combined model yielded a high AUC, sensitivity, and specificity in predicting postoperative complications. • The combined model was superior to the single visceral fat area or MonoE40keV-VP in predicting postoperative complications.
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Affiliation(s)
- Xiaoying Tan
- Department of Radiology, Binhu District, Affiliated Hospital of Jiangnan University, Hefeng Road 1000#, Wuxi City, 214062, Jiangsu Province, China
| | - Xiao Yang
- Department of Radiology, Binhu District, Affiliated Hospital of Jiangnan University, Hefeng Road 1000#, Wuxi City, 214062, Jiangsu Province, China
| | - Shudong Hu
- Department of Radiology, Binhu District, Affiliated Hospital of Jiangnan University, Hefeng Road 1000#, Wuxi City, 214062, Jiangsu Province, China
| | - Xingbiao Chen
- Department of Clinical Science, Philips Healthcare, Shanghai, 200233, China
| | - Zongqiong Sun
- Department of Radiology, Binhu District, Affiliated Hospital of Jiangnan University, Hefeng Road 1000#, Wuxi City, 214062, Jiangsu Province, China.
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Zhou Y, Wang L, Zhou F. Clinical Significance of MMP7 Levels in Colorectal Cancer Patients Receiving FOLFOX4 Chemotherapy Treatment. Int J Gen Med 2023; 16:2671-2678. [PMID: 37398512 PMCID: PMC10312346 DOI: 10.2147/ijgm.s416363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 06/14/2023] [Indexed: 07/04/2023] Open
Abstract
Objective Various studies have shown an association between the anti-cancer drug 5-fluorouracil and matrix metalloproteinase 7 (MMP7). The expression of MMP7 in the serum of colorectal cancer patients, as well as their sensitivity to chemotherapy, were examined using the FOLFOX4 chemotherapy treatment. Methods Serum samples were taken from 216 colorectal cancer patients who had undergone four cycles of gemcitabine and cisplatin treatment. The sera of 216 healthy persons were used as controls. MMP7 levels in the serum were measured by ELISA. Demographic and survival data were collected. Results MMP7 levels were not associated with sex, age, peritoneal dissemination, liver metastasis, lymph node metastasis, lymphatic invasion, or venous invasion in CRC patients, but were associated with histological grade, tumor size, TNM stage, and depth of tumor invasion. Patients' serum MMP7 expression reduced after treatment. MMP7 expression was significantly lower chemotherapy-sensitive patients compared with chemotherapy-resistant patients. Elevated MMP7 expression was associated with worse prognosis and chemotherapy-sensitive patients had markedly better overall survival compared with chemotherapy-resistant patients. Conclusion MMP7 expression was potentially associated with the development of colorectal cancer and elevated levels were associated with chemoresistance in CRC patients. Serum MMP7 levels can be used to screen for drug resistance during FOLFOX4 chemotherapy treatment.
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Affiliation(s)
- Yeting Zhou
- Xuzhou Medical University Jiangsu Key Laboratory of Tumor Biotherapy, Shuyang People’s Hospital, Suqian, 221000, People’s Republic of China
| | - Leiming Wang
- Xuzhou Medical University Jiangsu Key Laboratory of Tumor Biotherapy, Shuyang People’s Hospital, Suqian, 221000, People’s Republic of China
| | - Fei Zhou
- Xuzhou Medical University Jiangsu Key Laboratory of Tumor Biotherapy, Shuyang People’s Hospital, Suqian, 221000, People’s Republic of China
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Bortz JH. Introduction. CT COLONOGRAPHY FOR RADIOGRAPHERS 2023:1-9. [DOI: 10.1007/978-3-031-30866-6_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
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Zheng Y, Wang F, Zhang W, Li Y, Yang B, Yang X, Dong T. Preoperative CT-based deep learning model for predicting overall survival in patients with high-grade serous ovarian cancer. Front Oncol 2022; 12:986089. [PMID: 36158664 PMCID: PMC9504666 DOI: 10.3389/fonc.2022.986089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/18/2022] [Indexed: 11/20/2022] Open
Abstract
Purpose High-grade serous ovarian cancer (HGSOC) is aggressive and has a high mortality rate. A Vit-based deep learning model was developed to predicting overall survival in HGSOC patients based on preoperative CT images. Methods 734 patients with HGSOC were retrospectively studied at Qilu Hospital of Shandong University with preoperative CT images and clinical information. The whole dataset was randomly split into training cohort (n = 550) and validation cohort (n = 184). A Vit-based deep learning model was built to output an independent prognostic risk score, afterward, a nomogram was then established for predicting overall survival. Results Our Vit-based deep learning model showed promising results in predicting survival in the training cohort (AUC = 0.822) and the validation cohort (AUC = 0.823). The multivariate Cox regression analysis indicated that the image score was an independent prognostic factor in the training (HR = 9.03, 95% CI: 4.38, 18.65) and validation cohorts (HR = 9.59, 95% CI: 4.20, 21.92). Kaplan-Meier survival analysis indicates that the image score obtained from model yields promising prognostic significance to refine the risk stratification of patients with HGSOC, and the integrative nomogram achieved a C-index of 0.74 in the training cohort and 0.72 in the validation cohort. Conclusions Our model provides a non-invasive, simple, and feasible method to predicting overall survival in patients with HGSOC based on preoperative CT images, which could help predicting the survival prognostication and may facilitate clinical decision making in the era of individualized and precision medicine.
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Affiliation(s)
- Yawen Zheng
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, China
| | - Fang Wang
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
| | - Wenxia Zhang
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, China
| | - Yongmei Li
- Operating room, Qilu Hospital of Shandong University, Jinan, China
| | - Bo Yang
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
- Department of Radiology, Qingzhou People’s Hospital, Qingzhou, China
| | - Xingsheng Yang
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, China
- *Correspondence: Xingsheng Yang, ; Taotao Dong,
| | - Taotao Dong
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, China
- *Correspondence: Xingsheng Yang, ; Taotao Dong,
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Computed Tomography Colonography Angiography (CTC-A) prior to colectomy for cancer: A new tool for surgeons. J Visc Surg 2021; 159:136-143. [PMID: 34794900 DOI: 10.1016/j.jviscsurg.2021.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The pre-operative work-up for non-metastatic colon cancer includes colonoscopy and thoraco-abdomino-pelvic computed tomography (CT) with intravenous (IV) contrast. Colonoscopic determination of the anatomical location of the tumor may be erroneous, particularly with a long redundant colon (dolichocolon), and the search for synchronous colon neoplasms is limited when the endoscope cannot traverse the tumor-bearing segment. While computed tomography colonography angiography (CTC-A) makes it possible to assess distant tumor metastasis, it remains limited for the assessment of loco-regional extension. CTC-A requires specific colonic preparation, controlled colonic insufflation with CO2, and an injection of IV contrast. CTC-A provides a 3-D view of the overall morphology of the colon and precisely localizes the site of the colonic tumor. Merging the images of the colon with those of mesenteric and colonic vessels provides a representation of anatomical vascular variations. This information could help the surgeon to better plan the colectomy. The use of two-dimensional images of CTC-A with sections perpendicular to the major axis of the tumor-bearing colonic segment can provide precise information on the degree of parietal extension and be useful in evaluating the value of neo-adjuvant chemotherapy.
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Haraikawa M, Kudo H, Shibuya T, Kogure Y, Takase M, Inage H, Yokota T, Htun H, Tagaya E, Fan R, Houshito H, Taniguchi G, Sakamoto K, Nagahara A. Efficacy of CO₂ Infusion for Preoperative Computed Tomographic Angiography with Computed Tomographic Colonography. Med Sci Monit 2021; 27:e931055. [PMID: 33993185 PMCID: PMC8135977 DOI: 10.12659/msm.931055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Computed tomographic colonography (CTC) is useful for patients for whom colonoscopy may be difficult to perform and is widely employed to examine the vasculature prior to colorectal cancer surgery. Computed tomographic angiography (CTA) was shown to be beneficial intraoperatively to manipulate blood vessels and prevent vascular injury. Three-dimensional (3D)-CTA combined with CTC (3D-CTA with CTC) is useful for preoperative evaluations of the anatomy of mesenteric vessels, colon, and lymph nodes. We observed that when the intestine was dilated with carbon dioxide (CO₂), the arteriovenous delineation was often more pronounced than without CO₂. To clarify the effects of gas injection with and without CO₂ on hemodynamics and vascular passage, we compared the effect of contrast for blood vessels. MATERIAL AND METHODS Thirty patients with resectable colorectal cancer who underwent a preoperative CT examination at our institution from January to October 2019 were study participants. Of these, 15 underwent 3D-CTA and 15 had 3D-CTA with CTC. Three board-certified radiologists independently and blindly evaluated 18 blood vessels. CT values for each blood vessel were measured on each image. RESULTS CT values for 3D-CTA with CTC were significantly higher with CO₂ than without CO₂. The quality of 3D-CTA with CTC images for visualization of blood vessels was also significantly greater than that of 3D-CTA, especially those of arterial and intramesenteric venous systems. CONCLUSIONS Based on the higher image quality and CT values obtained by 3D-CTA with CTC for vessels, compared with by 3D-CTA imaging, 3D-CTA with CTC imaging might be useful in evaluating colorectal cancers.
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Affiliation(s)
- Mayuko Haraikawa
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
| | - Hikaru Kudo
- Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Tomoyoshi Shibuya
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
| | - Yosuke Kogure
- Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Makoto Takase
- Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Hidekazu Inage
- Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Takuya Yokota
- Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Hanni Htun
- Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Eita Tagaya
- Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Ruiheng Fan
- Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Haruyoshi Houshito
- Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Gentaro Taniguchi
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
| | - Kazuhiro Sakamoto
- Department of Coloproctological Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Akihito Nagahara
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
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Taguchi N, Oda S, Imuta M, Yamamura S, Yokota Y, Nakaura T, Nagayama Y, Kidoh M, Utsunomiya D, Funama Y, Baba H, Yamashita Y. Dual-energy computed tomography colonography using dual-layer spectral detector computed tomography: Utility of virtual monochromatic imaging for electronic cleansing. Eur J Radiol 2018; 108:7-12. [PMID: 30396674 DOI: 10.1016/j.ejrad.2018.09.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 07/31/2018] [Accepted: 09/10/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To assess the utility of virtual monochromatic imaging (VMI) using a dual-layer spectral detector CT for electronic cleansing in fecal-tagging CT colonography (CTC). METHODS This study included 35 patients who underwent fecal-tagging CTC with a dual-layer detector spectral CT scanner. Conventional images at 120 kVp and VMI at 40, 50, and 60 keV were reconstructed. Quantitative image quality parameters, i.e., tagging density and image noise, were compared and the visual image quality was scored on a four-point scale. We recorded the number of the colon segments with appropriate tagging density (≥300 HU) for each patient and used these data to compare the reconstructions. In addition, electronic cleansing performance was semi-quantitatively assessed using a four-point scale. RESULTS The mean tagging density on VMI was significantly higher than that on conventional 120 kVp images. The number of colon segments with appropriate tagging density on VMI were significantly higher than that on conventional 120 kVp images. There was no significant difference among the reconstructed images with respect to image noise. Scores for subjective image quality and electronic cleansing performance on VMI were significantly higher than those on conventional 120 kVp images. CONCLUSION With dual-layer spectral detector CT, VMI can yield significantly better fecal-tagged CTC image quality and improve electronic cleansing performance.
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Affiliation(s)
- Narumi Taguchi
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Seitaro Oda
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto, 860-8556, Japan.
| | - Masanori Imuta
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Sadahiro Yamamura
- Department of Radiology, Kumamoto General Hospital, 10-10 Toricho, Yatsushiro, Kumamoto, 866-8660, Japan
| | - Yasuhiro Yokota
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Yasunori Nagayama
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Masafumi Kidoh
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Daisuke Utsunomiya
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Yoshinori Funama
- Department of Medical Physics, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Hideo Baba
- Department of Gastroenterological Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Yasuyuki Yamashita
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto, 860-8556, Japan
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Offermans T, Vogelaar FJ, Aquarius M, Janssen-Heijnen MLG, Simons PCG. The added clinical value of performing CT colonography in patients with obstructing colorectal carcinoma. Gastroenterol Rep (Oxf) 2018; 6:210-214. [PMID: 32537167 PMCID: PMC7282274 DOI: 10.1093/gastro/goy003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 12/20/2017] [Accepted: 12/26/2017] [Indexed: 11/30/2022] Open
Abstract
Background A small percentage of incomplete optical colonoscopies (OCs) are the result of an obstructing tumor. According to current guidelines, CT colonography (CTC) is performed to prevent missing a synchronous tumor. The aim of this study was to evaluate how frequently a synchronous tumor was found on CTC and how often this led to a change in the surgical plan. Methods In this retrospective study, a total of 267 patients underwent CTC after an incomplete OC as a result of an obstructing colorectal carcinoma (CRC). Among them, 210 patients undergoing surgery met the inclusion criteria and were included in the analysis. The OC report, CTC report and surgical report of these patients were retrospectively evaluated for the presence of synchronous tumors using surgery and post-operative colonoscopy as the gold standard. Results Six of the 210 patients (2.9%) showed signs of a synchronous CRC proximal to the obstructing tumor on CTC. In three of these patients, a synchronous CRC was confirmed during surgery. All these tumors caused a change in the surgical plan. Three out of the six tumors found on CTC were found to be large, non-malignant polyps. All these polyps were located in the same segment as the obstructing tumor and therefore did not alter the surgical plan. Conclusion In patients with obstructing CRC, the frequency of synchronous CRCs proximal to this lesion is low. Performing a CTC leads to a change in surgical plan based on the presence of these synchronous tumors in 1.4% of the cases. CTC should be employed as a one-stop shop in patients with an obstructing CRC.
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Affiliation(s)
- Tom Offermans
- Department of Radiology, VieCuri Medical Centre, Venlo, The Netherlands
| | - F Jeroen Vogelaar
- Department of Surgery, VieCuri Medical Centre, Venlo, The Netherlands
| | - Michel Aquarius
- Department of Gastroenterology, VieCuri Medical Centre, Venlo, The Netherlands
| | - Maryska L G Janssen-Heijnen
- Department of Clinical Epidemiology, VieCuri Medical Centre, Venlo, The Netherlands.,Department of Epidemiology, Maastricht University Medical Centre, GROW School for Oncology and Developmental Biology, Maastricht, The Netherlands
| | - Petra C G Simons
- Department of Radiology, VieCuri Medical Centre, Venlo, The Netherlands
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12
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Martínez-Sapiña Llanas M, Otero Muinelo S, Crespo García C. TC rectal pathology: Findings at CT-colonography. RADIOLOGIA 2018. [DOI: 10.1016/j.rxeng.2018.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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13
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Adenocarcinoma of the Colon Disguised as Abdominal Wall Abscess: Case Report and Review of the Literature. Case Rep Surg 2018; 2018:1974627. [PMID: 29623229 PMCID: PMC5829352 DOI: 10.1155/2018/1974627] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Accepted: 01/01/2018] [Indexed: 12/26/2022] Open
Abstract
Introduction Abdominal wall invasion by cancerous cells arising from the colon with an overlying secondary infection that presents as an abdominal wall abscess has been encountered previously, but such a symptom is rarely the first presentation of colon cancer. There are very few cases reported in the literature. Case Presentation In this case report, we present a case of a 66-year-old male presenting with abdominal wall abscess that was refractory to treatment. The patient later was found to have an abdominal wall invasion by an underlying colonic carcinoma. Conclusion The purpose of this review is to set forth the proper approach when encountering such cases and emphasize on the significance of keeping a high index of suspicion. We also highlight the need for utilizing proper diagnostic imaging modalities prior to invasive intervention.
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Taguchi N, Oda S, Imuta M, Yamamura S, Nakaura T, Utsunomiya D, Kidoh M, Nagayama Y, Yuki H, Hirata K, Iyama Y, Funama Y, Baba H, Yamashita Y. Model-based Iterative Reconstruction in Low-radiation-dose Computed Tomography Colonography: Preoperative Assessment in Patients with Colorectal Cancer. Acad Radiol 2018; 25:415-422. [PMID: 29191684 DOI: 10.1016/j.acra.2017.10.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 09/29/2017] [Accepted: 10/02/2017] [Indexed: 01/16/2023]
Abstract
RATIONALE AND OBJECTIVES To assess the effect of model-based iterative reconstruction (MBIR) on image quality and diagnostic performance of low-radiation-dose computed tomography colonography (CTC) in the preoperative assessment of colorectal cancer. MATERIALS AND METHODS This study included 30 patients with colorectal cancer referred for surgical treatment. All patients underwent CTC with a standard dose (SD) protocol in the supine position and a low-dose (LD; radiation dose reduction of approximately 85%) protocol in the prone position. The SD protocol images were post-processed using filtered back projection (FBP), whereas the LD protocol images were post-processed using FBP and MBIR. Objective and subjective image quality parameters were compared among the three different methods. Preoperative evaluations, including site, length, and tumor and node staging were performed, and the findings were compared to the postsurgical findings. RESULTS The mean image noise of SD-FBP, LD-FBP, and LD-MBIR images was 17.3 ± 3.2, 40.5 ± 10.9, and 11.2 ± 2.0 Hounsfield units, respectively. There were significant differences for all comparison combinations among the three methods (P < .01). For image noise, the mean visual scores were significantly higher for SD-FBP and LD-MBIR than for LD-FBP, and the scores for SD-FBP and LD-MBIR were equivalent (3.9 ± 0.3 [SD-FBP], 2.0 ± 0.5 [LD-FBP], and 3.7 ± 0.3 [LD-MBIR]). Preoperative information was more accurate under SD-FBP and LD-MBIR than under LD-FBP, and the information was comparable between SD-FBP and LD-MBIR. CONCLUSION MBIR can yield significantly improved image quality on low-radiation-dose CTC and provide preoperative information equivalent to that of standard-radiation-dose protocol.
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15
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TC Rectal Pathology: Findings at CT-Colonography. RADIOLOGIA 2017; 60:208-216. [PMID: 29169607 DOI: 10.1016/j.rx.2017.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 10/14/2017] [Accepted: 10/19/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To review the spectrum of benign and malignant rectal diseases, their findings on CT colonography, and their management. CONCLUSION Although CT colonography is not the first choice for the study of rectal disease, it is indicated in cases where optical colonoscopy is contraindicated or cannot be completed. Rectal lesions can go undetected because this anatomic area is difficult to evaluate; for this reason, it is essential to ensure optimal preparation and distension, moderate balloon insufflation, and careful 2D and 3D navigation with knowledge of the spectrum of rectal disease and its CT colonography signs.
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16
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Preoperative segmental localization of colorectal carcinoma: CT colonography vs. optical colonoscopy. Eur J Surg Oncol 2017; 43:2105-2111. [DOI: 10.1016/j.ejso.2017.09.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 08/12/2017] [Accepted: 09/13/2017] [Indexed: 12/15/2022] Open
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17
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Usefulness of preoperative CT colonography for colon cancer. Asian J Surg 2017; 40:438-443. [DOI: 10.1016/j.asjsur.2016.04.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 04/06/2016] [Accepted: 04/11/2016] [Indexed: 01/18/2023] Open
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18
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Bai RJ, Ren SH, Jiang HJ, Li JP, Liu XC, Xue LM. Accuracy of Multi-Slice Spiral Computed Tomography for Preoperative Tumor Node Metastasis (TNM) Staging of Colorectal Carcinoma. Med Sci Monit 2017; 23:3470-3479. [PMID: 28715364 PMCID: PMC5528007 DOI: 10.12659/msm.902649] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background With the advances in imaging technologies, multi-slice spiral computed tomography (MSCT) has demonstrated superiority in the diagnosis and staging of colorectal carcinoma. In the current study, preoperative TNM staging of colorectal carcinoma by using MSCT was conducted and compared with the corresponding postoperative pathological examination findings, in order to evaluate the accuracy of preoperative MSCT for TNM staging. Material/Methods Combinations of biphasic or triphasic enhanced-phase MSCT scans were obtained for 76 patients with colorectal carcinoma, and the TNM stage was determined based on imaging reconstruction from various angles and perspectives to display the size, location, and affected range of tumors. The preoperative TNM stage was compared with the postoperative pathological stage, and the consistency between the 2 methods was tested by the κ test using SPSS 17.0 software. Results Among the different combinations of enhanced-phase MSCT scanning, triphasic MSCT imaging, comprising the arterial, portal venous, and delayed phases, showed the highest accuracy rates, at 81.6% (62/76), 82.89% (63/76), and 96.1% (73/76) for T, N, and M staging, respectively, with κ values of 0.72, 0.65, and 0.56, respectively, indicating consistency with the postoperative pathological staging. Conclusions Combined MSCT scanning comprising the arterial phase, portal venous phase, and delayed phase showed satisfying consistency with the postoperative pathological analysis results for TNM staging of colorectal carcinoma. Thus, MSCT is an important clinical value for improving the accuracy of TNM staging and for planning the appropriate colorectal cancer treatment.
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Affiliation(s)
- Rong-Jie Bai
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China (mainland)
| | - Shao-Hua Ren
- Department of Radiology, The First Hospital of Harbin, Harbin, Heilongjiang, China (mainland)
| | - Hui-Jie Jiang
- Department of Radiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China (mainland)
| | - Jin-Ping Li
- Department of Radiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China (mainland)
| | - Xiao-Cheng Liu
- Department of Radiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China (mainland)
| | - Li-Ming Xue
- Department of Radiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China (mainland)
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19
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Huisman JF, Leicher LW, de Boer E, van Westreenen HL, de Groot JW, Holman FA, van de Meeberg PC, Sallevelt P, Peeters K, Wasser M, Vasen H, de Vos Tot Nederveen Cappel WH. Consequences of CT colonography in stenosing colorectal cancer. Int J Colorectal Dis 2017; 32:367-373. [PMID: 27783161 DOI: 10.1007/s00384-016-2683-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/11/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND In patients with stenosing colorectal cancer (CRC), visualization of the entire colon prior to surgery is recommended to exclude synchronous tumors. Therefore, most centers combine computed tomographic colonography (CTC) with staging CT. The aims of this study were to evaluate the yield and clinical implications of CTC. METHODS In this multicenter retrospective study, patients with stenosing CRC that underwent CTC and subsequent surgery between April 2013 and November 2015 were included. Result of the CTC, its influence on the surgical treatment plan, and final histology report were evaluated. RESULTS One hundred sixty-two patients with stenosing CRC were included. Nine (5.6 %) synchronous cancers proximal to the stenosing tumor were suspected with CTC. In four of nine patients, the CTC did not change the primary surgical plan because the tumors were located in the same surgical segment. In five of nine patients, CTC changed the surgical treatment plan. Three of these five patients underwent an extended resection and the presence of the tumors was confirmed. Two of these three synchronous CRCs were also visible on abdominal staging CT. In the other two patients, the result of CTC was false positive which led to an unnecessary extended resection in one patient. CONCLUSION The yield of CTC was relatively low. In only three patients (1.9 %), CTC correctly changed the primary surgical plan, but in two of them, the tumor was also visible on abdominal staging CT. Moreover, in two patients, CTC was false positive. The clinical value of CTC in stenosing CRC appears to be limited.
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Affiliation(s)
- J F Huisman
- Department of Gastroenterology and Hepatology, P.O. box 10400, Isala, 8000 GK, Zwolle, the Netherlands.
| | - L W Leicher
- Department of Gastroenterology and Hepatology, P.O. box 10400, Isala, 8000 GK, Zwolle, the Netherlands
| | - E de Boer
- Department of Radiology, Isala, Zwolle, the Netherlands
| | | | - J W de Groot
- Department of Medical Oncology, Isala, Zwolle, the Netherlands
| | - F A Holman
- Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands
| | - P C van de Meeberg
- Department of Gastroenterology and Hepatology, Slingeland hospital, Doetinchem, the Netherlands
| | - Pejm Sallevelt
- Department of Radiology, Slingeland hospital, Doetinchem, the Netherlands
| | - Kcmj Peeters
- Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands
| | - Mnjm Wasser
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Hfa Vasen
- Dept of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands
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Kniery K, Nishtala M, Steele SR. Staging, prognosis, and survivorship in colon cancer. SEMINARS IN COLON AND RECTAL SURGERY 2016. [DOI: 10.1053/j.scrs.2016.04.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Abstract
Computed tomographic colonography (CTC) is a minimally invasive, patient-friendly, safe and robust colonic imaging modality. The technique is standardized and consolidated evidence from the literature shows that the diagnostic performances for the detection of colorectal cancer and large polyps are similar to colonoscopy (CS) and largely superior to alternative radiological exams, like barium enema. A clear understanding of the exact role of CTC will be beneficial to maximize the benefits and minimize the potential sources of frustration or disappointment for both referring clinicians and patients. Incomplete, failed, or unfeasible CS; investigation of elderly, and frail patients and assessment of diverticular disease are major indications supported by evidence-based data and agreed by the endoscopists. The use of CTC for symptomatic patients, colorectal cancer screening and colonic surveillance is still under debate and, thus, recommended only if CS is unfeasible or refused by patients.
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Affiliation(s)
- Andrea Laghi
- a Department of Radiological Sciences, Oncology and Pathology , Sapienza - University of Rome, ICOT Hospital , Latina , Italy
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22
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Scalise P, Mantarro A, Pancrazi F, Neri E. Computed tomography colonography for the practicing radiologist: A review of current recommendations on methodology and clinical indications. World J Radiol 2016; 8:472-483. [PMID: 27247713 PMCID: PMC4882404 DOI: 10.4329/wjr.v8.i5.472] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 12/23/2015] [Accepted: 02/24/2016] [Indexed: 02/06/2023] Open
Abstract
Colorectal cancer (CRC) represents one of the most relevant causes of morbidity and mortality in Western societies. CRC screening is actually based on faecal occult blood testing, and optical colonoscopy still remains the gold standard screening test for cancer detection. However, computed tomography colonography (CT colonography) constitutes a reliable, minimally-invasive method to rapidly and effectively evaluate the entire colon for clinically relevant lesions. Furthermore, even if the benefits of its employment in CRC mass screening have not fully established yet, CT colonography may represent a reasonable alternative screening test in patients who cannot undergo or refuse colonoscopy. Therefore, the purpose of our review is to illustrate the most updated recommendations on methodology and the current clinical indications of CT colonography, according to the data of the existing relevant literature.
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Singh K, Narula AK, Thukral CL, Singh NR, Singh A, Kaur H. Role of CT Colonography in Colonic Lesions and Its Correlation with Conventional Colonoscopic Findings. J Clin Diagn Res 2015; 9:TC14-8. [PMID: 26023619 DOI: 10.7860/jcdr/2015/12686.5853] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2014] [Accepted: 03/09/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Preoperative evaluation in patients with colorectal carcinoma is essential for a correct therapeutic plan. Conventional colonoscopy has certain limitations including its inability to detect synchronous lesions in case of distal obstructive mass and inaccurate tumour localization. CT colonography combines cross sectional imaging with virtual colonoscopic images and offers a comprehensive preoperative evaluation in patients with colorectal carcinoma including detection of synchronous lesions with accurate segmental localization and loco regional staging. AIM The objective was to determine the role of CT colonography in various colonic lesions and to correlate the findings with conventional colonoscopy and histopathological findings. SETTINGS AND DESIGN This prospective study included 50 patients with clinical symptoms suspicious of colonic pathology. MATERIALS AND METHODS All the patients underwent both CT colonography and conventional colonoscopy on the same day. CT colonography was performed in supine and prone position. Considering histopathological and/or surgical findings as gold standard, sensitivity and specificity of both the modalities were calculated. RESULTS Conventional colonoscopy missed two synchronous lesions proximal to occlusive mass and one lesion proximal to the anastomotic site; all were detected with CT colonography. One carpet lesion in rectum and one case of mild ulcerative colitis were missed by CT colonography. Sensitivity and specificity for detection of colorectal cancer were 97.56% and 100%, resp. with PPV and NPV of 100% and 93.75%, for CT colonography and 92.68% and 100%, respectively with PPV and NPV of 100% and 83.3% for conventional colonoscopy. Sensitivity for correct detection of acute and chronic ulcerative colitis of CT colonography was 66.6 % and 100 %, resp. CONCLUSION CT colonography has higher sensitivity than conventional colonoscopy for detection of colorectal carcinoma, including its ability to detect abnormalities proximal to obstructing lesion, accurate segmental localization of lesions and staging. However, some limitations of CT colonography were difficulty in detection of flat lesions and lack of information about hyperemia and superficial mucosal erosion, where conventional colonoscopy scored over CT colonography.
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Affiliation(s)
- Kunwarpal Singh
- Assistant Professor, Department of Radiodiagnosis, Sri Guru Ram Das Institute of Medical Sciences and Research , Vallah, Amritsar, India
| | - Aparna Kaur Narula
- Post Graduate, Department of Radiodiagnosis, Sri Guru Ram Das Institute of Medical Sciences and Research , Vallah, Amritsar, India
| | - Chuni Lal Thukral
- Professor and Head, Department of Radiodiagnosis, Sri Guru Ram Das Institute of Medical Sciences and Research , Vallah, Amritsar, India
| | - Neeti Rajan Singh
- Professor, Department of Surgery, Sri Guru Ram Das Institute of Medical Sciences and Research , Vallah, Amritsar, India
| | - Amandeep Singh
- Assistant Professor, Department of Radiodiagnosis, Sri Guru Ram Das Institute of Medical Sciences and Research , Vallah, Amritsar, India
| | - Harmeet Kaur
- Senior Resident, Department of Radiodiagnosis, Sri Guru Ram Das Institute of Medical Sciences and Research , Vallah, Amritsar, India
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Laghi A. Computed tomography colonography in 2014: an update on technique and indications. World J Gastroenterol 2014; 20:16858-67. [PMID: 25492999 PMCID: PMC4258555 DOI: 10.3748/wjg.v20.i45.16858] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 08/27/2014] [Accepted: 10/14/2014] [Indexed: 02/06/2023] Open
Abstract
Twenty years after its introduction, computed tomographic colonography (CTC) has reached its maturity, and it can reasonably be considered the best radiological diagnostic test for imaging colorectal cancer (CRC) and polyps. This examination technique is less invasive than colonoscopy (CS), easy to perform, and standardized. Reduced bowel preparation and colonic distention using carbon dioxide favor patient compliance. Widespread implementation of a new image reconstruction algorithm has minimized radiation exposure, and the use of dedicated software with enhanced views has enabled easier image interpretation. Integration in the routine workflow of a computer-aided detection algorithm reduces perceptual errors, particularly for small polyps. Consolidated evidence from the literature shows that the diagnostic performances for the detection of CRC and large polyps in symptomatic and asymptomatic individuals are similar to CS and are largely superior to barium enema, the latter of which should be strongly discouraged. Favorable data regarding CTC performance open the possibility for many different indications, some of which are already supported by evidence-based data: incomplete, failed, or unfeasible CS; symptomatic, elderly, and frail patients; and investigation of diverticular disease. Other indications are still being debated and, thus, are recommended only if CS is unfeasible: the use of CTC in CRC screening and in surveillance after surgery for CRC or polypectomy. In order for CTC to be used appropriately, contraindications such as acute abdominal conditions (diverticulitis or the acute phase of inflammatory bowel diseases) and surveillance in patients with a long-standing history of ulcerative colitis or Crohn's disease and in those with hereditary colonic syndromes should not be overlooked. This will maximize the benefits of the technique and minimize potential sources of frustration or disappointment for both referring clinicians and patients.
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