Minimum-invasive early diagnosis of colorectal cancer with CT colonography: techniques and clinical value

Abstract

Computed tomographic colonography (CTC) is less expensive, less time-consuming and better tolerated for patients than is optical colonoscopy. At present, CTC has a diagnostic performance similar to that of optical colonoscopy for detection of colorectal polyps. The American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology now list CTC as a viable colorectal cancer screening option in its new joint guideline. In addition, CTC can provide accurate preoperative staging and thus can be a useful tool for navigation surgery. In this review, the authors discuss the essential aspects of minimum-invasive early diagnosis of colorectal cancer based on CTC, including the current techniques for patient preparation, data acquisition, image display and interpretation, the CTC performance for screening, preoperative staging, and navigation surgery. Increased screening by CTC is expected to result in a decrease in the incidence of and mortality due to CRC. Increased preoperative staging and navigation surgery by use of CTC is expected to secure an accurate choice of the precise therapeutic plan and a safer performance of surgery. Together, a comprehensive program for screening, preoperative staging, and navigation surgery based on CTC will ultimately reduce the mortality due to CRC.