CT Colonography Research Articles

Trends in pathology diagnoses during 10 years of a colorectal cancer screening programme.

We report pathology findings from the first 10 years of the faecal-occult blood-based Northern Ireland Bowel Cancer Screening Programme, presenting summary data and trends in pathology diagnoses and clinicopathological features of screen-detected cancers. Data were analysed from a comprehensive polyp-level pathology database representing all endoscopy specimens from programme inception in 2010 until 2021. A total of 9800 individuals underwent 13 472 endoscopy procedures, yielding 25 967 pathology specimens and 32 119 diagnoses. Index specimen diagnoses (4.1%) and index colonoscopies (10.4%) yielded a diagnosis of colorectal cancer, representing 1045 cancers from 1020 individuals (25 with synchronous cancers). A further 13 index cancers were identified via computed tomography colonography; 65.3% of cancer diagnoses were in males; 41.7% were stage I, 23.1% stage II, 25.8% stage III and 1.8% stage IV (7.6% unstaged). Of 233 pT1 cancers diagnosed within local excision specimens, 79 (33.9%) had completion surgery. Ten-year trends showed a steady decline in the proportion of index colonoscopies that yielded a diagnosis of cancer (14.7% in year 1; 4.8% in year 11) or advanced colorectal polyp. There was a strong upward trend in diagnoses of sessile serrated lesions, which overtook hyperplastic polyps in proportions of total index diagnoses by the end of the study time-frame (8.7% compared to 8.5%). Over the first 10 years of a population colorectal cancer screening programme, 'real world' pathology data demonstrate success in the form of reduced diagnoses of cancer and advanced colorectal polyp with passage of successive screening rounds. Interesting trends with respect to serrated polyp diagnoses are also evident, probably related to pathologist and endoscopist behaviour.

Is It Worth Considering Colonic Evaluation After Appendicectomy?

Introduction The association of acute appendicitis with caecal or colorectal cancer is known. One of the proposed theories for acute appendicitis is luminal blockage by mass at the base of the appendix. There have been no national recommendations or guidelines for follow-up with patients aged 40 and older after an emergency appendicectomy. The purpose of this study was to evaluate the prevalence of caecal and colonic cancer or polyps in patients over the age of 40 who have undergone an appendicectomy. This shall enable us to develop the necessary strategies to investigate and diagnose associated caecal and colonic pathology in acute appendicitis to prevent delayed diagnosis of colon cancer. Methods All patients who underwent appendicectomy between October 2011 and October 31, 2021, and who were 40 years of age or older were included in this retrospective cohort study. Patients aged 40 to 54 years old and patients 55 years or older underwent subgroup analyses. We looked at any investigations of the colon (CT pneumocolon or colonoscopy) within three years before the appendicectomy or three years after an appendicectomy. All colorectal cancers diagnosed within five years of the index episode of appendicitis were included in the analysis. Results A total of 1076 appendicectomies were performed on patients aged 40 and older during the study period of 10 years. A total of 769 patients were confirmed to have appendicitis on histology. One hundred and fifty-seven patients had colonic investigations within three years of the diagnosis of acute appendicitis. In our study, 51 of the 769 patients (6.63%) were found to have colorectal neoplasms. Eight patients (8/769, 1.04%) were diagnosed with colorectal cancers, and the occurrence of caecal cancer was 0.26% (2/769). The mortality rate was 75% (6/8) in these patients diagnosed with colorectal cancer. Four out of six died due to advanced metastatic colonic cancer. In comparison to patients aged 40 to 54, patients over the age of 55 had a statistically significant increased risk of caecal pathology (polyp and cancer) (p = 0.07). Conclusion There seems to be an increased risk of significant colorectal neoplasm in patients over the age of 55 who are admitted with acute appendicitis, and there appears to be an increased severity with a poor prognosis of cancer in these individuals. We recommend the use of routine colonoscopy or CT pneumocolon, particularly for those over the age of 55 who present with acute appendicitis or the histology of appendicular neoplasms.

Comparison of Diatrizoate and Iohexol for Patient Acceptance and Fecal-Tagging Performance in Noncathartic CT Colonography.

The aim of this study was to compare diatrizoate and iohexol regarding patient acceptance and fecal-tagging performance in noncathartic computed tomography colonography. This study enrolled 284 volunteers with fecal tagging by either diatrizoate or iohexol at an iodine concentration of 13.33 mg/mL and an iodine load of 24 g. Patient acceptance was rated on a 4-point scale of gastrointestinal discomfort. Two gastrointestinal radiologists jointly analyzed image quality, fecal-tagging density and homogeneity, and residual contrast agent in the small intestine. The results were compared by the generalized estimating equation method. Patient acceptance was comparable between the 2 groups (3.95 ± 0.22 vs 3.96 ± 0.20, P = 0.777). The diatrizoate group had less residual fluid and stool than the iohexol group ( P = 0.019, P = 0.004, respectively). There was no significant difference in colorectal distention, residual fluid, and stool tagging quality between the 2 groups (all P 's > 0.05). The mean 2-dimensional image quality score was 4.59 ± 0.68 with diatrizoate and 3.60 ± 1.14 with iohexol ( P < 0.001). The attenuation of tagged feces was 581 ± 66 HU with diatrizoate and 1038 ± 117 HU with iohexol ( P < 0.001). Residual contrast agent in the small intestine was assessed at 55.3% and 62.3% for the diatrizoate group and iohexol group, respectively ( P = 0.003). Compared with iohexol, diatrizoate had better image quality, proper fecal-tagging density, and more homogeneous tagging along with comparable excellent patient acceptance, and might be more suitable for fecal tagging in noncathartic computed tomography colonography.

Screening for Colorectal Cancer in Asymptomatic Average-Risk Adults: A Guidance Statement From the American College of Physicians (Version 2).

The purpose of this updated guidance statement is to guide clinicians on screening for colorectal cancer (CRC) in asymptomatic average-risk adults. The intended audience is all clinicians. The population is asymptomatic adults at average risk for CRC. This updated guidance statement was developed using recently published and critically appraised clinical guidelines from national guideline developers since the publication of the American College of Physicians' 2019 guidance statement, "Screening for Colorectal Cancer in Asymptomatic Average-Risk Adults." The authors searched for national guidelines from the United States and other countries published in English using PubMed and the Guidelines International Network library from 1 January 2018 to 24 April 2023. The authors also searched for updates of guidelines included in the first version of our guidance statement. The Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument was used to assess the quality of eligible guidelines. Two guidelines were selected for adoption and adaptation by raters on the basis of the highest average overall AGREE II quality scores. The evidence reviews and modeling studies for these 2 guidelines were also used to synthesize the evidence of diagnostic test accuracy, effectiveness, and harms of CRC screening interventions and to develop our guidance statements. Clinicians should start screening for colorectal cancer in asymptomatic average-risk adults at age 50 years. Clinicians should consider not screening asymptomatic average-risk adults between the ages of 45 to 49 years. Clinicians should discuss the uncertainty around benefits and harms of screening in this population. Clinicians should stop screening for colorectal cancer in asymptomatic average-risk adults older than 75 years or in asymptomatic average-risk adults with a life expectancy of 10 years or less. Clinicians should select a screening test for colorectal cancer in consultation with their patient based on a discussion of benefits, harms, costs, availability, frequency, and patient values and preferences. Clinicians should select among a fecal immunochemical or high-sensitivity guaiac fecal occult blood test every 2 years, colonoscopy every 10 years, or flexible sigmoidoscopy every 10 years plus a fecal immunochemical test every 2 years as a screening test for colorectal cancer. Clinicians should not use stool DNA, computed tomography colonography, capsule endoscopy, urine, or serum screening tests for colorectal cancer.

Growth rates and histopathological outcomes of small (6–9 mm) colorectal polyps based on CT colonography surveillance and endoscopic removal

Background and aimsThe natural history of small polyps is not well established and rests on limited evidence from barium enema studies decades ago. Patients with one or two small polyps...

Implications of Public Interest in Colonoscopy: Analysis of Google Trends Data From 12 European Countries.

Colorectal cancer (CRC) is one of the deadliest diseases in the European Union. Colonoscopy remains the gold standard of CRC screening. Analysis of colonoscopy-related Google Trends (GT; Google LLC, Mountain View, California, United States) data could provide useful information regarding interest in colonoscopy and potential barriers making patients unwilling to attend screening programs. Data were collected using GT for the main search term "colonoscopy" and the two most related queries. Colonoscopy volumes were extracted from the Eurostat database. Due to limited Eurostat data availability, analysis was performed from January 2004 to December 2015 for each of the 12 included countries. Univariate linear regression analysis demonstrated statistically significant correlations between annual search volumes of "colonoscopy" and the annual number of colonoscopies performed in included countries (R2 = 0.923, P<.001). Trend analysis showed that the cumulative search volumes for "colonoscopy" gradually increased through the analyzed period. The spectrum of the most related queries encompassed "preparation for colonoscopy", "endoscopy", "after endoscopy", "colon", "colonoscopy diet", "virtual colonoscopy", "colonoscopy under anesthesia", "waiting times for colonoscopy" and "colonoscopy price". For eight out of nine queries, statistically significant correlations with procedure volumes were revealed. GT could be a useful tool in assessing public interest in colonoscopy. Potential barriers that prevent people from attending CRC screening programs were identified. The study demonstrated that the internet has become an important field for CRC screening promotion. GT utility for colonoscopy and CRC screening providers was highlighted. This was the first analysis of GT data in colonoscopy focused on European countries.

Robotic Colonoscopy and Beyond: Insights into Modern Lower Gastrointestinal Endoscopy.

Lower gastrointestinal endoscopy is considered the gold standard for the diagnosis and removal of colonic polyps. Delays in colonoscopy following a positive fecal immunochemical test increase the likelihood of advanced adenomas and colorectal cancer (CRC) occurrence. However, patients may refuse to undergo conventional colonoscopy (CC) due to fear of possible risks and pain or discomfort. In this regard, patients undergoing CC frequently require sedation to better tolerate the procedure, increasing the risk of deep sedation or other complications related to sedation. Accordingly, the use of CC as a first-line screening strategy for CRC is hampered by patients' reluctance due to its invasiveness and anxiety about possible discomfort. To overcome the limitations of CC and improve patients' compliance, several studies have investigated the use of robotic colonoscopy (RC) both in experimental models and in vivo. Self-propelling robotic colonoscopes have proven to be promising thanks to their peculiar dexterity and adaptability to the shape of the lower gastrointestinal tract, allowing a virtually painless examination of the colon. In some instances, when alternatives to CC and RC are required, barium enema (BE), computed tomographic colonography (CTC), and colon capsule endoscopy (CCE) may be options. However, BE and CTC are limited by the need for subsequent investigations whenever suspicious lesions are found. In this narrative review, we discussed the current clinical applications of RC, CTC, and CCE, as well as the advantages and disadvantages of different endoscopic procedures, with a particular focus on RC.

Canadian Association of Radiologists Practice Guidelines for Computed Tomography Colonography.

Colon cancer is the third most common malignancy in Canada. Computed tomography colonography (CTC) provides a creditable and validated option for colon screening and assessment of known pathology in patients for whom conventional colonoscopy is contraindicated or where patients self-select to use imaging as their primary modality for initial colonic assessment. This updated guideline aims to provide a toolkit for both experienced imagers (and technologists) and for those considering launching this examination in their practice. There is guidance for reporting, optimal exam preparation, tips for problem solving to attain high quality examinations in challenging scenarios as well as suggestions for ongoing maintenance of competence. We also provide insight into the role of artificial intelligence and the utility of CTC in tumour staging of colorectal cancer. The appendices provide more detailed guidance into bowel preparation and reporting templates as well as useful information on polyp stratification and management strategies. Reading this guideline should equip the reader with the knowledge base to perform colonography but also provide an unbiased overview of its role in colon screening compared with other screening options.

Improving the quality and standardisation of the technique of automated insufflation for Computed Tomography Colonography

Improving the quality and standardisation of the technique of automated insufflation for Computed Tomography Colonography

A Comprehensive Analysis of the Radiation Exposure and the Diagnostic Benefit of PanCT in Pediatric Cases with Multiple Trauma.

Background and Objectives: The primary objective of this study was to obtain quantitative data, taking into account the amount of radiation exposure, about the clinical and diagnostic benefit obtained from panCT in pediatric trauma cases. Thus, we aim to create greater awareness in all physicians and primarily emergency medicine physicians regarding correct selection in terms of the patient group where this effective radiological method is to be applied, and to protect children from the adverse effects of radiation. Materials and Methods: The computed tomography (CT) images were retrieved from the hospital radiological archive system (PACS). The effective dose (Ed) was calculated using the standardized method including the tissue weighted parameters. The radiological pathologies determined as a result of CT imaging of the cases were categorized according to clinical significance in accordance with the Modified CT Colonography Reporting and Data System (C-RADS). Results: The data for a total of 268 patients were analyzed, comprising 89 (33.2%) females and 179 (66.8%) males with a mean age of 8.81 ± 5.21 years. The mean Ed was determined to be 18.14 ± 10.44 mSv. The Ed was determined to be statistically significantly higher in the 1-5 years age group than in the 15-18 years age group (p = 0.024). A statistically significant difference was determined between the age groups in terms of the pathologies determined (p = 0.028). Conclusions: In order to prevent performing unnecessary CT imaging, trauma teams in Emergency Departments (ED) should work in harmony and individual decision-making should be based on the severity of the trauma mechanism, the severity of the predicted injury, and the clinical status of the injured child.

Radiologic T staging of colon cancer: renewed interest for clinical practice.

Radiologic imaging, especially MRI, has long been the mainstay for rectal cancer staging and patient selection for neoadjuvant therapy prior to surgical resection. In contrast, colonoscopy and CT have been the standard for colon cancer diagnosis and metastasis staging with T and N staging often performed at the time of surgical resection. With recent clinical trials exploring the expansion of the use of neoadjuvant therapy beyond the anorectum to the remainder of the colon, the current and future state of colon cancer treatment is evolving with a renewed interest in evaluating the role radiology may play in the primary T staging of colon cancer. The performance of CT, CT colonography, MRI, and FDG PET-CT for colon cancer staging will be reviewed. N staging will also be briefly discussed. It is expected that accurate radiologic T staging will significantly impact future clinical decisions regarding the neoadjuvant versus surgical management of colon cancer.

Assessment of price variation in colorectal cancer screening procedures at US hospitals.

6652 Background: Following the 2021 Hospital Price Transparency Final Rule, US hospitals were mandated to publish their insurer-negotiated prices. We identified factors contributing to price variability of colorectal cancer (CRC) screening procedures across the US. Methods: We compared prices of colonoscopy, flexible sigmoidoscopy, CT colonography, fecal occult blood test, fecal immunochemical test, and Cologuard across U.S. hospitals using the Turquoise dataset (N = 6,378). Psychiatric, rehabilitation, and pediatric hospitals were excluded. Prices in the top and bottom 1% were also excluded to minimize the effect of outliers. Prices were adjusted by the Medicare Geographic Price Index to account for regional variability. We then compared prices across several subgroups, including National Cancer Institute (NCI) designated hospitals, teaching hospitals, and investor owned hospitals. Significance was assessed using the Kruskal-Wallis test. To quantify price variability across insurance plans within a hospital, we defined the within-center-ratio as the 90th percentile rate at a hospital divided by the 10th percentile rate. To quantify variability across hospitals, the across-center-ratio was defined as the 90th percentile median rate across all hospitals divided by the 10th percentile median rate. Results: 1,460 hospitals reported commercial prices for colonoscopy with a median commercial price of $1,867 (IQR: $1,208 - $2,689). For colonoscopy, the within center ratio was 2.5 (IQR: 1.5 – 3.8) and the across-center ratio was 6.2. Prices for other procedures are provided in the table. Compared to non-investor owned hospitals, prices of colonoscopy ($2,082 vs $1,787, P &lt;0.001) and flexible sigmoidoscopy ($2,022 vs $1,289, P &lt;0.001) were significantly higher at investor owned hospitals. Furthermore, across investor classes, hospitals with &gt;5% ownership from private equity firms had the highest median price for both colonoscopy ($2,898), and flexible sigmoidoscopy ($2,697). We did not find significant differences in price by NCI designation, academic teaching center affiliation, overall hospital mortality, overall hospital readmission rate, or urban/rural location. Conclusions: CRC screening procedure prices vary significantly both within and across hospitals. Private equity and other investor owned hospitals had significantly higher prices compared to non-investor owned hospitals. [Table: see text]

CT colonography : Technique and indications

Dedicated radiological expertise and ahigh-quality examination, performed according to current technical standards and for accepted indications, are prerequisite to achieve excellent results with CT colonography (CTC). The aim of this article is to review current standards of the examination technique as well as indications and contraindications for CTC based on recent recommendations and guidelines. Based on extensive literature research, current knowledge about the examination technique and the indications and contraindications is summarized. CTC is the radiological examination of choice for the detection of colorectal neoplasia. Beside incomplete or refused colonoscopy and contraindications to colonoscopy, CTC is also anoninvasive option for opportunistic colorectal cancer screening. The examination technique is based on aCTC-specific patient preparation scheme that includes fecal tagging, colonic distension, low-dose CT scans in two patient positions and acombined 2D and 3D data evaluation. Performing CTC according to current technical standards is prerequisite for high-quality examinations and is, thus, also akey factor to obtain acorrect diagnosis. CTC is anoninvasive examination, capable of providing clinically relevant diagnoses for awide range of indications.

MODERN SCREENING METHODS FOR EARLY DETECTION OF COLORECTAL CANCER (LITERATURE REVIEW)

Abstract. Colorectal cancer (CRC) is one of the most common malignant tumours of the human gastrointestinal tract. The development of colorectal cancer consists of several stages, starting with benign adenomatous polyps in the inner wall of the large intestine and rectum, and then gradually developing into advanced adenoma, carcinoma in situ and invasive carcinoma. The aim of this review of current literature is to consider new routine screening and diagnostic methods (e.g. endoscopy and CT colonoscopy, SEPT9 methylation analysis, faecal test) and to search for reliable molecular markers for early diagnosis of CRC.

Drainage pattern of the splenic flexure vein and its accompanying arteries using three-dimensional computed tomography angiography: a single-centre study of 600 patients.

The splenic flexure has variable vascular anatomy, and the details of the venous forms are not known. In this study, we report the flow pattern of the splenic flexure vein (SFV) and the positional relationship between the SFV and arteries such as the accessory middle colic artery (AMCA). This was a single-centre study using preoperative enhanced CT colonography images of 600 colorectal surgery patients. CT images were reconstructed into 3D angiography. SFV was defined as a vein flowing centrally from the marginal vein of the splenic flexure visible on CT. AMCA was defined as the artery feeding the left side of the transverse colon, separate from the left branch of the middle colic artery. The SFV returned to the inferior mesenteric vein (IMV) in 494 cases (82.3%), the superior mesenteric vein in 51 cases (8.5%) and the splenic vein in seven cases (1.2%). The AMCA was present in 244 cases (40.7%). The AMCA branched from the superior mesenteric artery or its branches in 227 cases (93.0% of cases with existing AMCA). In the 552 cases in which the SFV returned to the IMV, superior mesenteric vein or splenic vein, the left colic artery was the most frequent artery accompanying the SFV (42.2%), followed by the AMCA (38.1%) and the left branch of the middle colic artery (14.3%). The most common flow pattern of the vein in the splenic flexure is from the SFV to IMV. The SFV is frequently accompanied by the left colic artery or AMCA.

Exploring the interior of 3D endoluminal lesions in the air spaces by a novel electronic biopsy technique: A preliminary study of endoluminal colon lesions.

To explore the interior of a lesion in a 3D endoluminal view, this study investigates the application of an 'electronic biopsy' (EB) technique to computed tomographic colonography (CTC) for further differentiation and 2D image correlation of endoluminal lesions in the air spaces. A retrospective study of sixty-two various endoluminal lesions from thirty patients (13 males, 17 females; age range, 31 to 90 years) was approved by our institutional review board and evaluated. The endoluminal lesions were segmented using gray-level threshold and reconstructed into isosurfaces using a marching cube algorithm. EB allows users to interactively erode and apply grey-level mapping (GM) to the surface of the region of interest (ROI) in 3D CTC. Radiologists conducted the clinical evaluation, and the resulting data were analyzed. EB significantly improves 3D gray-level presentation for evaluating the surface and inside of endoluminal lesions over that of SR, GM or target GM (TGM) (P < 0.01) with preservation of the 3D spatial effect. Moreover, 3D to 2D image correlation were achieved in any layer of the lesion using EB as did GM/TGM on the surface. The specificity and diagnostic accuracy of EB are significantly greater than those of SR (P < 0.01). These performance can be better further with GM/TGM and reach the best with EB (specificity, 89.3-92.9%; accuracy, 95.2-96.8%). EB can be used in CTC to improve the differentiation of endoluminal lesions. EB increases 3D to 2D image correlations of the lesions on or beneath the lesion surface.

Trends in colorectal cancer screening in the United States, 2012 to 2020.

Despite recommendations to increase the uptake of colorectal cancer (CRC) screening, trends in CRC screening vary with sociodemographic status. We aimed to evaluate trends in CRC screening in the US population and subpopulations. A total of 1,082,924 participants aged 50 to 75 from five cycles (2012, 2014, 2016, 2018, and 2020) of the Behavioral Risk Factor Surveillance System were involved. Multivariable logistic regression models were performed to evaluate linear trends in CRC screening utilization from 2012 to 2018. Rao-Scott chi-square tests were used to assess the differences in CRC screening utilization between 2018 and 2020. The estimated percentage reporting up-to-date with CRC screening increased significantly (P for trend <0.001), from 62.8% (95% CI, 62.4%-63.2%) in 2012 to 66.7% (95% CI, 66.3%-67.2%) in 2018 and 70.4% (95% CI, 69.8%-71.0%) in 2020, in accordance with 2008 US Preventive Services Task Force recommendations. Trends followed similar patterns in most subgroups, although with different magnitudes in several subgroups, primarily those underweight showed a stable percentage over time (P for trend = 0.170). In 2020, 72.4% of participants reported they were up to date with CRC screening, including the utilization of stool DNA tests and virtual colonoscopy. Colonoscopy was the most commonly used test in 2020 (64.5%), followed by FOBT (12.6%), stool DNA test (5.8%), sigmoidoscopy (3.8%), and virtual colonoscopy (2.7%). In this nationally representative survey of the US population from 2012 through 2020, the percentage reporting up to date with CRC screening has increased, but not equally among all subgroups.

Beyond the AJR: CT Colonography Versus Three Rounds of Fecal Immunochemical Testing for Colorectal Cancer Screening (SAVE Randomized Controlled Trial).

Beyond the AJR: CT Colonography Versus Three Rounds of Fecal Immunochemical Testing for Colorectal Cancer Screening (SAVE Randomized Controlled Trial).

A Head-to-Head Comparison of Computed Tomography Colonography, Optical Colonoscopy, and Colon Endoscopic Capsule for the Detection of Polyps After Partial Colectomy or Rectosigmoidectomy for Colorectal Cancer: A Pilot Study

Background and objective Optical colonoscopy is the gold standard method for the diagnosis of colorectal cancer (CRC) and it allows for biopsy and resection, as well as documentation of synchronous lesions. CT colonography (CTC) and colon endoscopic capsule (CEC) are also recommended as alternative minimally invasive or non-invasive procedures. Prospective studies comparing these three approaches are scarce in the current literature. In light of this, the aim of this pilot study was to compare the efficacy of polyp detection between these three methods in patients with a history of curative surgical resection of CRC. Methods Patients were consecutively recruited and all procedures were sequentially conducted on the same day. The primary endpoint was the detection rate of polyps, whereas secondary endpoints were the detection of polyps according to size and location, and theadverse events caused by these procedures. Results A total of 21 patients were consecutively included and all of them underwent all three interventions.No adverse events, local recurrences, or metachronous lesions were detected. In two cases with elevated carcinoembryonic antigen (CEA), CTC unveiled distant metastasis. Optical colonoscopy registered a mean of 0.4 polyp >6 mm and 1.3 polyps <6 mm per patient. CTC unveiled only 0.5 polyp >6 mm/patient and no smaller lesions were documented, whereas findings for the colon capsule comprised an average of 0.4 polyps >6 mm and 0.7 polyps <6 mm per patient. Statistical difference was not demonstrated, except for virtual colonoscopy in terms of the total number of polyps detected in comparison to optical colonoscopy. Conclusions Optical colonoscopy showed superior results in comparison to virtual colonoscopy while there was no statistical difference in comparison to colon capsule. Notwithstanding occasional difficulties, all three techniques were well tolerated. Hence, decisions concerning the use of each diagnostic method shouldbe based on their availability, professional expertise, contraindications, and patient preferences.

The Public Perception of CT Colonography Versus Colonoscopy via Sentiment Analysis of Social Media

PurposeThe purpose of this study was to understand the public perception of CT colonography (CTC) in comparison with optical colonoscopy as a colorectal cancer screening technique. MethodsIn this observational study, all English-language tweets from January 1, 2015, until September 1, 2021, containing terms related to CTC and terms related to optical colonoscopy were collected. The tweets were given sentiment scores using Twitter-roBERTa-base, a natural language processing model. These scores were then used to classify tweets into positive, neutral, and negative categories. The numbers of negative, positive, and neutral tweets were tabulated. ResultsA total of 4,709 tweets from 2,194 users relating to CTC were collected. Of these tweets, 9.81% were negative, 68.52% were neutral, and 21.63% were positive. In comparison, a total of 445,969 tweets from 261,209 users were collected relating to optical colonoscopy. Of these tweets, 31.8% were negative, 51.3% were neutral, and 16.9% were positive. ConclusionsThe public awareness of CTC remains limited in comparison with optical colonoscopy, with Twitter volume relating to CTC being about 1% the volume for optical colonoscopy. There was a higher proportion of negative tweets regarding colonoscopy. The lower proportion of negative tweets regarding CTC may be helpful in encouraging its use as an alternative to optical colonoscopy, with the aim of increasing uptake of colorectal cancer screening.