Computed tomographic colonography for diagnosis of early cancer and polyps

Computed tomographic (CT) colonography comprises thin-section CT scanning of the prepared, gas-distended colon, acquired in more than one patient position. The test is widely available internationally and is highly sensitive for colorectal cancer, including significant polyps and early colorectal cancers (SPECC). In this article, we will discuss the basic technique of CT colonography, its diagnostic performance, the challenge of detecting serrated polyps and handling of diminutive polyps. Since CT colonography permits a detailed assessment of polyp morphology, radiologists must communicate their descriptions of the CT appearances of larger polyps accurately and using widely-accepted terminology. This allows services to plan their resection strategy for these larger lesions in timely fashion and ensure availability of appropriate staff and equipment for that patient. Close collaboration between all members of the multi-disciplinary team will ensure that all patients have access to high-quality colonic imaging services.