Medical School, Faculty of Health, University of Adelaide, Adelaide, South Australia, Australia.
IBD Service, Department of Gastroenterology, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, Australia.
Intern Med J. 2022 May;52(5):864-867. doi: 10.1111/imj.15778. Epub 2022 Apr 22.
Computed tomography colonography (CTC) is a safe and accurate tool for colorectal cancer (CRC) screening in both symptomatic and asymptomatic patients. CTC requires dedicated radiological expertise and demonstrates a high sensitivity and specificity in polyp detection, which is similar to optical colonoscopy (OC). Newer preparation techniques for CTC, such as faecal tagging without catharsis might further improve both the tolerability and accuracy of the test. While exposure to ionising radiation, lack of capacity for therapeutic intervention and potentially diminished sensitivity for flat serrated polyps are limitations of CTC, the technique has a role in select populations. CTC should be considered in frail or elderly patients at high anaesthetic risk for OC, patients with stricturing colonic lesions as well as incomplete colonoscopy, or in patients at risk of delayed access to timely OC. With an ever-growing demand for endoscopic services, increased utilisation of CTC could reduce waiting times for colonoscopy, thereby broadening access to timely and effective CRC screening. Further research is required to improve further the detection of flat lesions, including sessile serrated polyps.
计算机断层结肠成像（CTC）是一种安全且准确的结直肠癌（CRC）筛查工具，适用于有症状和无症状的患者。CTC 需要专门的放射学专业知识，在息肉检测方面具有较高的灵敏度和特异性，与光学结肠镜检查（OC）相似。CTC 的新型准备技术，如无泻药的粪便标记，可能进一步提高检测的耐受性和准确性。尽管 CTC 存在放射性辐射暴露、缺乏治疗干预能力以及对扁平锯齿状息肉的敏感性降低等局限性，但该技术在某些特定人群中具有一定作用。对于 OC 麻醉风险高的体弱或老年患者、有狭窄性结肠病变以及结肠镜检查不完全的患者，或者有延迟接受及时 OC 风险的患者，应考虑使用 CTC。随着内镜服务需求的不断增长，增加 CTC 的使用可能会减少结肠镜检查的等待时间，从而扩大及时有效的 CRC 筛查的机会。需要进一步研究来提高对扁平病变（包括平坦锯齿状息肉）的检测能力。
