Development of CT Colonography as a Screening Tool for Colorectal Cancer Gen Iinuma 1 , Mototaka Miyake 1 , Yasuaki Arai 1 , Yukio Muramatsu 2 , Noriyuki Moriyama 2 , Takahisa Matsuda 3 , Yutaka Saito 3 , Yuushi Hirano 4 , Michihiro Yamazaki 5 , Yoshiyuki Miyatani 6 , Kingo Shichinohe 7 , Kazuhiko Matsumoto 8 1Diagnostic Radiology Division, National Cancer Center Central Hospital, Tokyo 2Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo 3Endoscopy Division, National Cancer Center Hospital, Tokyo 4Department of Radiology, Otaru Ekisaikai Hospital, Otaru, Japan 5Department of Radiology, Yamashita Hospital, Ichinomiya, Japan 6Toshiba Medical Systems, Tokyo 7AMIN, Inc., Tokyo 8Ziosoft, Inc., Tokyo Keyword: CT colonography , 大腸 , スクリーニング , virtual gross pathology pp.939-954
Published Date 2008/5/25
DOI https://doi.org/10.11477/mf.1403101385
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 With the development of multi-slice CT (MSCT), CT colonography (CTC) has gradually been admitted as an effective option for colorectal cancer screening not only in western countries but in Japan. CTC in preoperative staging of colorectal cancer is now an indispensable modality in our hospital. Using CTC, we can now accurately diagnose primary tumor and its local invasion, as well as small lymph node metastases. CTC is recognized as an effective option for evaluating primary lesions replacing colonoscopy and barium enema study. Virtual endoscopy, volume rendering image, MPR (multi-planar reconstruction), and their combination views are very useful to visualize colorectal lesions more clearly. CTC, which is based on 3D digital volume data, has great potential for computer-aided detection (CAD) of colorectal polyps, and for preparatory measures before treatment. Judging from our past studies, the current CTC-CAD system is not adequate for detection of colorectal flat lesions. However, further studies will surely develop new CAD algorisms for detection of flat lesions, and CTC with CAD can be expected to improve diagnostic performance, especially in colorectal mass screening. On the other hand, digital preparation has also developed, and now is available in CTC. The preparation method will reduce the burden of candidates, and these favorable features in CTC will lead to a standardized and effective colorectal screening method in the very near future.

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