Editorial Reviews. Review. Master virtual colonoscopy. About the Author. University of Wisconsin School of Medicine and Public Health Madison, WI USA. Request PDF on ResearchGate | On May 1, , Ged R. Avery and others published CT Colonography: Principles and Practice of Virtual Colonoscopy. In CT Colonography, Perry Pickhardt and David Kim present techniques for quicker evaluation and diagnosis of colon cancer through the.

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CT Colonography: Pitfalls in Interpretation

Supine A and B and decubitus C CTC images show an area of persistent wall thickening and luminal narrowing arrowheads in the setting of advanced sigmoid diverticular disease. Prone transverse 2D CTC image with polyp windowing A shows a flat cecal polyp arrowheadwhich is submerged under opacified fluid but is nonetheless detectable. Interventional Cardiology, Second Edition. Although this is of particular concern with the use of large-caliber catheters with large retention cuffs, it remains an issue with the CTC-specific small flexible balloon catheters.

The manuscript will undergo copyediting, typesetting, and review practic the resulting proof before it is published in its final citable form. On the soft tissue window setting Bhowever, the lesion is obscured by the dense surrounding fluid.

In many ways, the anorectal region represents the most important source of pitfalls at CTC, since common incidental findings virrtual distract the reader from important underlying pathology, which may be relatively subtle due its specific location.

Subsequent CTC trials adding primary 3D detection alongside 2D review showed markedly improved sensitivity for polyps.

CT Colonography: Pitfalls in Interpretation

Evaluation of patient comfort and image readability. However, because relevant colorectal lesions require detection on just pracrice view, confirmation on the lesser quality view is generally achievable even in cases of inadequate distention Fig. Clinical Gastroenterology and Hepatology.


The larger concern stems from potential interpretation by non-radiologists with minimal CTC training and little or no familiarity with either general CT interpretation or the basic physics of medical imaging. Image noise is much better tolerated on the wider 2D polyp windows.

Spectrum of normal findings, anatomic variants and ivrtual of ileocecal valve: How to write a great colonosco;y. Note the mass effect upon the lesion from the adjacent balloon on the rectal catheter. As such, we continue to employ both of these contrast agents in our CTC bowel preparation.

National Center for Biotechnology InformationU. Unless the lesion is at or near a critical size threshold i.

Of greatest concern among anorectal pitfalls if the possibility of missing a low rectal tumor or anal cancer. Confirmation of polyp on poorly-distended colonic segment Supine 2D CTC images A and B show long-segment collapse of the sigmoid colon, largely obscuring a mm polyp arrowswhich is easily identified on the alternate position C and D.

Beam-hardening artifact from bilateral total hip arthroplasties 2D CTC images through the pelvis A and B show marked beam-hardening artifact, which appears more severe on the soft tissue windows. Complementary shifting of luminal fluid between supine and prone positioning at CT colonography: A rare diagnostic pitfall. For suspected polyps approaching 5—6 mm or greater detected at CTC, we recommend performing a careful combined 2D and 3D size assessment. American Journal of Gastroenterology.

A mass involving or replacing the valve itself can present a more challenging problem Fig. From reference 5with permission. A-Z of Abdominal Practcie. With our current bowel preparation, the fluid level almost never colonograph between supine and prone positioning. Injuries to the Chest Wall.

Nondiagnostic luminal distention related to a diverticular stricture Supine Coponography and B and decubitus C CTC images show an area of persistent wall thickening and luminal narrowing arrowheads in the setting of advanced sigmoid diverticular disease.


Nonetheless, the sensitivity of combined 3D-2D polyp detection with contrast tagging appears to be satisfactory. A focal soft tissue protuberance on or adjacent to a fatty valve is suspicious for a true polyp Fig. Positive predictive value for polyps ptactice at screening CT colonography. Prcatice abnormalities arrows were also noted at the ileocecal valve F and G and the appendiceal orifice F and H.

These can largely be divided into two main categories: Polyp measurement on the 3D endoluminal view can also be problematic if care is not taken to optimize the vantage point. Luminal distention on the decubitus view Chowever, was excellent and allowed for a diagnostic examination.

September 1, Imprint: Note the lack of motion or artifacts elsewhere on the image.

With proper awareness, these potential pitfalls can be effectively managed so as to minimize any negative impact on diagnostic performance. Abdominal Ultrasound for Surgeons.

The Intensive Care Unit Manual. PickhardtMD and David H. A Guide for Clinical Practice. For most polyps, the 2D and 3D measurements colonographj be within 1 mm of each other. Handbook of Endovascular Interventions. Emergency Cardiac Care This underscores the critical need for oral contrast tagging, which is highly effective for internally labeling otherwise nonspecific residual adherent stool Figs. Polyp measurement on soft tissue windows could collonoscopy to inappropriate management.

Radiologic spectrum of disease with pathologic correlation.