The importance of CAD and DECT in CT colonography
KeywordsCT colonography, colorectal cancer, DECT, CAD
According to the American College of Radiology and the American Cancer Society, CTC has been recognized as a valuable screening method for detecting CRC in people at medium risk as an alternative to endoscopic colonoscopy. The condition for the proper interpretation of this procedure is the patient’s preparation for the examination. The evaluation of the test includes: topogram, transverse images (as reference images), multifaceted reconstructions and three-dimensional images (3D navigator).
Materials and methods
The literature on the use of CTC in the diagnosis of CRC was analyzed. A review of the scientific literature indexed in the PUBMED database from the last 10 years was carried out.
The introduction of dual energy computed tomography (DECT) clearly improved the diagnostic accuracy of CTC. The main advantage of DECT is the possibility of obtaining iodine maps and VNC (virtual non-contrast) – a ’’virtual’’ native image (without the use of contrast). DECT allows you to monitor the results and extent of iodine capture on VNC and iodine map images, respectively, without using pre-recorded tomographic images. Pilot tests showed that DECT is an effective tool in CT colonography diagnostics and electronic colon loop cleaning after barium labeling. The use of the Computer Aided Diagnosis (CAD) algorithm in high energy tomography helps in the diagnosis and detection of intestinal tumors.
The development of modern technologies used in CT colonography proves that it is a safe and acceptable technique for patients. Lack of invasiveness, low radiation dose and high diagnostic efficiency of CTC may encourage more people to undergo colorectal cancer screening in the future.
Levin B1, L. D. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. CA Cancer J Clin. 2008; 58 (3): 130-60. Available in: doi: 10.3322/CA.2007.0018.
Lebda-Wyborny T., Barczyk A., Pilch-Kowalczyk J., Wirtualna kolonoskopia CT – nowa metoda oceny patologii jelita grubego. Chirurgia Polska. 2008; 10 (2): 88-100.
Prokop Mathias. Spiralna i wielorzędowa tomografia komputerowa człowieka. Warszawa: MediPage, 2009.
Neri Emanuele, Halligan S, Hellström M, Lefere P, Mang T, Regge D, Stoker J, Taylor S, Laghi A. The second ESGAR consensus statement on CT colonography. Eur Radiol. 2013;23(3):720-9. Available in: doi: 10.1007/s00330-012-2632-x.
Laghi Andrea. (2014, December 7). Computed tomography colonography in 2014: An update on technique and indications. World J Gastroenterol. 2014; 20 (45): 16858–1686. Available in: doi: 10.3748/wjg.v20.i45.16858.
Segnan N, Armaroli P, Bonelli L, et al. Once-only sigmoidoscopy in colorectal cancer screening follow-up findings of the Italian Randomized Controlled trial-SCORE. JNCI 2011; 103 (17): 1310-22. Available in: doi: 10.1093/jnci/djr284.
Boellaard Thierry. Colon distension and scan protocol for CT colonography: an overview. European Journal of Radiology. 2013; 82(8): 1144-58. Available in: 10.1016/j.ejrad.2011.10.030.
Kalender WA. Application- and patient size-dependent optimization of x-ray spectra for CT. Med Phys. 2009; 36(3): 993-1007.
Lambert L, Danes J, Jahoda J, Masek M, Lisy J, Ourednicek P., et al. Submilisievert ultralow-dose CT colonography using iterative reconstruction technique: a feasibility study. PeerJ. 2016; 4: e1883. Available in: doi: 10.7717/peerj.1883.
Flicek Kristina T. Amy K. Hara Alvin C. Silva Qing Wu Mary B. Peter1 C. Daniel Johnson. Reducing the Radiation Dose for CT Colonography Using Adaptive Stastical Iterative Reconstruction: A Pilot Study. American Journal of Roentgenology. 2010;195: 126-131.
Zalis ME, Barish MA, Choi JR, et al. CT colonography reporting and data system: a consensus proposal. Radiology. 2005;236(1):3-9. [online]. Available in:10.1148/radiol.2361041926.
Pilch-Kowalczyk Joanna. Badanie kontrastowe dolnego odcinka przewodu pokarmowego. Medycyna praktyczna. Available in:
Tytgat GN. Hyoscine butylbromide - a review on its parenteral use in acute abdominal spasm and as an aid in abdominal diagnostic and therapeutic procedures. Curr Med Res Opin. 2008; 24(11): 3159-73.
Seuss H, Janka R, Hammon M, Cavallaro A, Uder M, Dankerl P. Virtual Computed Tomography Colonography: Evaluation of 2D and Virtual 3D Image Quality of Sub-mSv Examinations Enabled by Third-generation Dual Source Scanner Featuring Tin Filtering. Acad Radiol. 2018;25(8):1046-1051. Available in: doi: 10.1016/j.acra.2017.12.014.
Petrick N., Haider M., Summers RM., et al. CT colonography with computer-aided detection as a second reader: observer performance study. Radiology. 2008; 248(2): 704.
Yoshida H., Näppi J. CAD in CT colonography without and with oral contrast agents: progress and challenges. Comput Med Imaging Graph 2007;31(4-5):267-84.
Wójcik A., Samek I., Jańczyk M., Kurzepa J. The use of innovative technological solutions in the assessment of colorectal cancer in CT colonography. National Scientific e-Conference „e-Factory of Science” 3rd ed. [B. m.] May 9, 2020 [online]. Abstr, s. 49. Promovendi Foundation Publishing. ISBN: 978-83-955366-8-7.
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