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Adnan Qureshi, Saira BiBi, Ravi Madhotra
Aim: The aim of this study was to determine common factors leading to incomplete colonoscopy with a special interest in patient body mass index (BMI), and also to determine most common second line investigation, its pick up rates for cancer and the success rate of re-scoping. Background: Wide availability of scope guide in all procedures may decrease failure rate. Methods: We retrospectively reviewed 2891 colonoscopies performed at our institution from August 2015 to July 2016...
2018: Gastroenterology and Hepatology From Bed to Bench
Fredrik Thorén, Åse A Johnsson, John Brandberg, Mikael Hellström
Background Computed tomography colonography (CTC) is an accepted complement or alternative to optical colonoscopy (OC) but its implementation is incompletely analyzed, and technical performance varies between centers. Purpose To evaluate implementation, indications, and technical performance of CTC in Sweden and to evaluate compliance to international guidelines. Material and Methods A structured, self-assessed questionnaire regarding implementation and technical performance of CTC was sent to all eligible radiology departments in Sweden...
January 1, 2018: Acta Radiologica
D J Meiklejohn, L J Ridley, M C Ngu, J L Cowlishaw, A Duller, W Ridley
Colorectal cancers result in substantial morbidity and mortality to Australian society each year. The usual investigation for bowel malignancyis optical colonoscopy (OC), withcomputed tomographic colonography (CTC) used as an alternative investigation. The catharsis and colon insufflation associated with these investigations pose a higher risk in the elderly and frail. Risks include perforation, serum electrolyte disturbance, and anaesthesia/sedation risks.Minimal preparation computed tomographic colonography (MPCTC) eliminates these risks...
June 11, 2018: Internal Medicine Journal
Antonio Tursi
Diverticulosis of the colon is a common condition, and about one fourth of those people develop symptoms, which is called "diverticular disease" (DD). Since there are still some concerns about the diagnosis of diverticular disease, the aim of this review was to analyse current and evolving advances in its diagnosis. Area covered: Analysis of clinical, radiology, laboratory and endoscopic tools to pose a correct diagnosis of DD was performed according to current PubMed literature. Expert commentary: A combination of clinical characteristic of the abdominal pain and fecal calprotectin expression may help to differentiate between Symptomatic Uncomplicated Diverticular Disease (SUDD) and Irritable Bowel Syndrome (IBS)...
June 9, 2018: Expert Review of Gastroenterology & Hepatology
Shuangyan Sun, Changliang Yang, Zhicheng Huang, Wen Jiang, Yan Liu, Hongfen Wu, Jihong Zhao
BACKGROUND: Advanced colorectal cancers were associated with poor prognosis, and early diagnosis was important for high-risk patients. Colonography is commonly used for diagnosing colorectal cancer. However, a few studies reported the diagnostic value of magnetic resonance colonography (MRC) versus computed tomography colonography (CTC). This study aimed to compare the diagnostic value of MRC versus CTC for colorectal cancer. METHODS: Twenty-three studies on the diagnosis of colorectal cancer using MRC or CTC were obtained from PubMed, Embase, and the Cochrane Library databases until July 2017...
June 2018: Medicine (Baltimore)
Andrew M D Wolf, Elizabeth T H Fontham, Timothy R Church, Christopher R Flowers, Carmen E Guerra, Samuel J LaMonte, Ruth Etzioni, Matthew T McKenna, Kevin C Oeffinger, Ya-Chen Tina Shih, Louise C Walter, Kimberly S Andrews, Otis W Brawley, Durado Brooks, Stacey A Fedewa, Deana Manassaram-Baptiste, Rebecca L Siegel, Richard C Wender, Robert A Smith
In the United States, colorectal cancer (CRC) is the fourth most common cancer diagnosed among adults and the second leading cause of death from cancer. For this guideline update, the American Cancer Society (ACS) used an existing systematic evidence review of the CRC screening literature and microsimulation modeling analyses, including a new evaluation of the age to begin screening by race and sex and additional modeling that incorporates changes in US CRC incidence. Screening with any one of multiple options is associated with a significant reduction in CRC incidence through the detection and removal of adenomatous polyps and other precancerous lesions and with a reduction in mortality through incidence reduction and early detection of CRC...
May 30, 2018: CA: a Cancer Journal for Clinicians
Reinier G S Meester, Elisabeth F P Peterse, Amy B Knudsen, Anne C de Weerdt, Jennifer C Chen, Anna P Lietz, Andrea Dwyer, Dennis J Ahnen, Rebecca L Siegel, Robert A Smith, Ann G Zauber, Iris Lansdorp-Vogelaar
BACKGROUND: Colorectal cancer (CRC) risk varies by race and sex. This study, 1 of 2 microsimulation analyses to inform the 2018 American Cancer Society CRC screening guideline, explored the influence of race and sex on optimal CRC screening strategies. METHODS: Two Cancer Intervention and Surveillance Modeling Network microsimulation models, informed by US incidence data, were used to evaluate a variety of screening methods, ages to start and stop, and intervals for 4 demographic subgroups (black and white males and females) under 2 scenarios for the projected lifetime CRC risk for 40-year-olds: 1) assuming that risk had remained stable since the early screening era and 2) assuming that risk had increased proportionally to observed incidence trends under the age of 40 years...
May 30, 2018: Cancer
Elisabeth F P Peterse, Reinier G S Meester, Rebecca L Siegel, Jennifer C Chen, Andrea Dwyer, Dennis J Ahnen, Robert A Smith, Ann G Zauber, Iris Lansdorp-Vogelaar
BACKGROUND: In 2016, the Microsimulation Screening Analysis-Colon (MISCAN-Colon) model was used to inform the US Preventive Services Task Force colorectal cancer (CRC) screening guidelines. In this study, 1 of 2 microsimulation analyses to inform the update of the American Cancer Society CRC screening guideline, the authors re-evaluated the optimal screening strategies in light of the increase in CRC diagnosed in young adults. METHODS: The authors adjusted the MISCAN-Colon model to reflect the higher CRC incidence in young adults, who were assumed to carry forward escalated disease risk as they age...
May 30, 2018: Cancer
Lapo Sali, Silvia Delsanto, Daniela Sacchetto, Loredana Correale, Massimo Falchini, Andrea Ferraris, Giovanni Gandini, Giulia Grazzini, Franco Iafrate, Gabriella Iussich, Lia Morra, Andrea Laghi, Mario Mascalchi, Daniele Regge
OBJECTIVES: To determine whether (1) computer-based self-training for CT colonography (CTC) improves interpretation performance of novice readers; (2) computer-aided detection (CAD) use during training affects learning. METHODS: Institutional review board approval and patients' informed consent were obtained for all cases included in this study. Twenty readers (17 radiology residents, 3 radiologists) with no experience in CTC interpretation were recruited in three centres...
May 23, 2018: European Radiology
Perry J Pickhardt, Loredana Correale, Lia Morra, Daniele Regge, Cesare Hassan
OBJECTIVE: The purpose of this study was to perform a systematic review and meta-analysis of published studies on CT colonography (CTC) in which extracolonic findings were assessed. MATERIALS AND METHODS: A systematic review of studies of screening CTC and of CTC to evaluate symptoms (1994-June 2017) was conducted to estimate the rate of extra-colonic findings and associated additional workup recommendations. The primary outcome was potentially important extracolonic findings, defined as CT Colonography Imaging Reporting and Data System (C-RADS) category E4 or as having high clinical importance (if C-RADS was not used)...
May 24, 2018: AJR. American Journal of Roentgenology
Thad Wilkins, Danielle McMechan, Asif Talukder
Colorectal cancer is a common cause of morbidity and mortality in the United States. Most colorectal cancers arise from preexisting adenomatous or serrated polyps. The incidence and mortality of colorectal cancer can be reduced with screening of average-risk adults 50 to 75 years of age. Randomized controlled trials show evidence of reduced colorectal cancer-specific mortality with guaiac-based fecal occult blood tests and flexible sigmoidoscopy. There are no randomized controlled trials on the effectiveness of colonoscopy to reduce colorectal cancer-specific mortality; however, several randomized controlled trials comparing colonoscopy with other strategies are in progress...
May 15, 2018: American Family Physician
Christian Bräuer, Philippe Lefere, Stefaan Gryspeerdt, Helmut Ringl, Ali Al-Mukhtar, Paul Apfaltrer, Dominik Berzaczy, Barbara Füger, Julia Furtner, Christina Müller-Mang, Matthias Pones, Martina Scharitzer, Ramona Woitek, Anno Graser, Michael Weber, Thomas Mang
OBJECTIVES: To assess whether electronic cleansing (EC) of tagged residue and different computed tomography (CT) windows influence the size of colorectal polyps in CT colonography (CTC). METHODS: A database of 894 colonoscopy-validated CTC datasets of a low-prevalence cohort was retrospectively reviewed to identify patients with polyps ≥6 mm that were entirely submerged in tagged residue. Ten radiologists independently measured the largest diameter of each polyp, two-dimensionally, before and after EC in colon, bone, and soft-tissue-windows, in randomised order...
May 14, 2018: European Radiology
Courtney Moreno, David H Kim, Twyla B Bartel, Brooks D Cash, Kevin J Chang, Barry W Feig, Kathryn J Fowler, Evelyn M Garcia, Avinash R Kambadakone, Drew L Lambert, Angela D Levy, Daniele Marin, Christine M Peterson, Christopher D Scheirey, Martin P Smith, Stefanie Weinstein, Laura R Carucci
This review summarizes the relevant literature regarding colorectal screening with imaging. For individuals at average or moderate risk for colorectal cancer, CT colonography is usually appropriate for colorectal cancer screening. After positive results on a fecal occult blood test or immunohistochemical test, CT colonography is usually appropriate for colorectal cancer detection. For individuals at high risk for colorectal cancer (eg, hereditary nonpolyposis colorectal cancer, ulcerative colitis, or Crohn colitis), optical colonoscopy is preferred because of its ability to obtain biopsies to detect dysplasia...
May 2018: Journal of the American College of Radiology: JACR
Perry J Pickhardt, Loredana Correale, Silvia Delsanto, Daniele Regge, Cesare Hassan
OBJECTIVE: We sought to perform a systematic review and meta-analysis of published CT colonography (CTC) studies assessing lesion detection in senior-age (≥ 65 years old) cohorts. MATERIALS AND METHODS: We conducted a systematic review of CTC studies published between January 1994 and August 2017 containing data on senior-age adults. The primary endpoint was the CTC-positive rate for large colorectal polyps (≥ 10 mm) and masses. Secondary endpoints included lesions ≥ 6 mm, proven advanced neoplasia, and colorectal cancer (CRC)...
April 18, 2018: AJR. American Journal of Roentgenology
Eun Sun Lee, Byung Chang Kim, Bo Yun Hur, Min Ju Kim, Hyun Jeong Park, Sung Bin Park, Jong Beum Lee, Dae Kyung Sohn, Kyung Su Han, Chang Won Hong
OBJECTIVE: This study aimed to identify the computed tomographic colonography (CTC) findings of incomplete colonoscopy compared with those of complete colonoscopy. METHODS: The clinical data and CTC imaging data from January 2004 to December 2012 were retrospectively obtained at 2 different institutions and reviewed by the central review system. A total of 71 patients who underwent both videocolonoscopy and CTC were included in this study. The CTC findings and clinical data were evaluated for the completeness of colonoscopy...
April 13, 2018: Journal of Computer Assisted Tomography
Shabana F Pasha
PURPOSE OF REVIEW: This is a review of colon capsule endoscopy (CCE) with a focus on its recent developments, technological improvements, and current and potential future indications. RECENT FINDINGS: Based on the current literature, CCE II demonstrates comparable polyp detection rates as optical colonoscopy and CT colonography, and improved cost-effectiveness. The main limitation to patient acceptance is the requirement of a rigorous bowel preparation. Preliminary studies show good correlation between CCE and optical colonoscopy for assessment of colonic disease activity in inflammatory bowel disease (IBD)...
April 12, 2018: Current Gastroenterology Reports
Andrew Guinigundo
OBJECTIVE: To examine the viability of colon cancer screening with computed tomography colonography, also known as virtual colonoscopy. DATA SOURCES: Clinical guidelines, published medical research. CONCLUSION: Virtual colonoscopy, under the right circumstances, is an accurate viable screening tool for patients who may not otherwise desire to or are not able to participate in traditional colonoscopy. IMPLICATIONS FOR NURSING PRACTICE: Nurses should be aware that routine colon cancer screening is recommended starting at age 50...
May 2018: Seminars in Oncology Nursing
L T O Bell, S Gandhi
AIM: To directly compare the accuracy and speed of analysis of two commercially available computer-assisted detection (CAD) programs in detecting colorectal polyps. MATERIALS AND METHOD: In this retrospective single-centre study, patients who had colorectal polyps identified on computed tomography colonography (CTC) and subsequent lower gastrointestinal endoscopy, were analysed using two commercially available CAD programs (CAD1 and CAD2). Results were compared against endoscopy to ascertain sensitivity and positive predictive value (PPV) for colorectal polyps...
June 2018: Clinical Radiology
Courtney C Moreno, Todd F Fibus, Elizabeth A Krupinski, David H Kim, Perry J Pickhardt
BACKGROUND: Incidence and mortality from colorectal cancer (CRC) are higher among African Americans where CRC screening rates lag behind non-Hispanic whites. The purpose of this investigation was to evaluate CT colonography (CTC) performance and outcome measures in an African-American cohort. MATERIALS AND METHODS: This study is an institutional review board-approved and Health Insurance Portability and Accountability Act-compliant study. Retrospective evaluation of the African-American cohort from the Atlanta VA Medical Center (Decatur, Georgia) CTC screening program...
June 2018: Clinical Colorectal Cancer
B Dustin Pooler, Meghan G Lubner, Jake R Theis, Richard B Halberg, Zhengrong Liang, Perry J Pickhardt
RATIONALE AND OBJECTIVES: To (1) apply a quantitative volumetric textural analysis (VTA) to colorectal masses at CT colonography (CTC) for the differentiation of malignant and benign lesions and to (2) compare VTA with human performance. MATERIALS AND METHODS: A validated, quantitative VTA method was applied to 63 pathologically proven colorectal masses (mean size, 4.2 cm; range, 3-8 cm) at noncontrast CTC in 59 adults (mean age, 66.5 years; range, 45.9-91.6 years)...
March 19, 2018: Academic Radiology
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