Sali L, Falchini M, Taddei A, Mascalchi M. Role of preoperative CT colonography in patients with colorectal cancer.
World J Gastroenterol 2014;
20:3795-3803. [PMID:
24744573 PMCID:
PMC3983437 DOI:
10.3748/wjg.v20.i14.3795]
[Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 01/01/2014] [Accepted: 01/20/2014] [Indexed: 02/06/2023] Open
Abstract
In patients with colorectal cancer (CRC), accurate preoperative evaluation is essential for a correct therapeutic plan. Colonoscopy and intravenous contrast-enhanced computed tomography (CT) are currently recommended in the preoperative work-up for CRC. Preoperative colonoscopy has some limitations such as misdiagnosis of synchronous cancers in cases of incomplete exploration of the colon and inaccurate tumor localization. Intravenous contrast-enhanced CT successfully documents distant metastases although it sometimes enables unsatisfactory locoregional staging. Computed tomography colonography (CTC) is obtained after gas insufflation of the colon and offers a comprehensive preoperative evaluation in patients with CRC, including a definition of the segmental location of the tumor, presence of synchronous lesions or lack thereof, and fairly accurate locoregional staging. CTC has some limitations, including a lack of biopsy capability, suboptimal sensitivity for synchronous small polyps, and unsatisfactory nodal staging. Bearing in mind these limitations, CTC could be employed as a “one-stop-shop” examination for preoperative assessment in patients with CRC.
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