CURRENT STATUS AND FUTURE PROSPECTS OF CT COLONOGRAPHY (WITH A VIDEO)

Abstract

About 20 years have passed since the emergence of computed tomography (CT) colonography. In the last two decades, great progress in the acceleration and multiplicity of the detectors in the CT apparatus has been made, leading to high-resolution CT images that were unimaginable before. CT colonography has many advantages. Neither intubation of an endoscope nor injection of barium is required in CT colonography. Subsequently, the examination time has been shortened and the physical burden has been greatly reduced. Technical expertise in colonoscopy is not required; thus, serious adverse events have rarely occurred in the clinical setting. With recent advances in CT colonographic techniques and bowel preparation methods including fecal tagging, the accuracy of CT colonography has been validated by many large-scale clinical trials. In Japan, the number of deaths from colorectal cancer is still increasing whereas the rate of colonoscopy following positive fecal immunochemical test has not increased. Therefore, CT colonography is expected to serve as an alternative to colonoscopy. CT colonography as a colon screening test has been covered by health insurance in Japan since 2012. At present, new technologies including reduction of radiation exposure dose, super-reduced-laxative volume and computer-aided diagnostic system are being developed. In the near future, CT colonography could become established as a more comfortable and more accurate colon screening test.