Dirix Hl

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Luc de Witte

Erasmus MC

Peulen Jj

VieCuri Medisch Centrum

Pascal Friederich

Karlsruhe Institute of Technology

Simons Pc

Richard de Visser

University of Sussex

van Langen H

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Erasmus MC

The Hague University of Applied Sciences

Argentine Antarctic Institute

University of Sheffield

Tilburg University

Maastricht University

Zuyd University of Applied Sciences

Maastricht University Medical Centre

Health & Life (Taiwan)

Centre Eugène Marquis

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[CT colonography as first-line diagnostic procedure in patients with bowel symptoms].

Peulen Jj Luc de Witte Pascal Friederich Dirix Hl Richard de Visser

OBJECTIVE To investigate in how many patients with bowel or abdominal complaints, referred by the primary care physician (PCP) for exclusion of colorectal carcinoma (CRC), the more invasive colonoscopy could be avoided on the basis of the findings of CT colonography. DESIGN Retrospective, descriptive. METHODS All consecutive patients who underwent CT colonography in our centre on the request of their PCP from December 2006 to June 2009 were included. Demographic and referral data were collected. CT colonography results were described according to the 'CT Colonography Reporting and Data System'. We also investigated how many patients had to undergo colonoscopy in the 6 months following CT colonography. RESULTS 398 patients (154 men and 244 women) with a median age of 61 years (range: 22-91) were included. Follow-up colonoscopy was indicated by CT colonography in 30 patients (7.5%) for suspected colorectal carcinoma, polyps > 10 mm, or 3 or more polyps 6-9 mm in size. In 33 patients (8.3%) follow-up colonoscopy or CT colonography was indicated for 1 or 2 polyps 6-9 mm in size, or suspicious lesions. 11 of these patients (2.8%) underwent colonoscopy. In 335 patients (84.2%) polyps > 6 mm or malignancies could be excluded. 18 of these patients (4.5%) still had a colonoscopy. In total, colonoscopy was spared in 341 patients (85.7%). Significant or potentially significant extra-colonic pathological abnormalities were found in 63 patients (15.8%). CONCLUSION Our results support the theory that in the vast majority of patients with low or moderate suspicion of CRC referred by their PCP, invasive colonoscopy could be avoided, because CRC and polyps could be excluded by CT colonography. CT colonography could be a valuable additional diagnostic tool in primary care.

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