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World J Gastroenterol. Apr 14, 2014; 20(14): 3795-3803
Published online Apr 14, 2014. doi: 10.3748/wjg.v20.i14.3795
Role of preoperative CT colonography in patients with colorectal cancer
Lapo Sali, Massimo Falchini, Antonio Taddei, Mario Mascalchi
Lapo Sali, Massimo Falchini, Mario Mascalchi, Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50134 Florence, Italy
Antonio Taddei, Department of Surgery and Translational Medicine, University of Florence, 50134 Florence, Italy
Author contributions: Sali L, Falchini M, Taddei A and Mascalchi M contributed equally to this work; all authors wrote the paper.
Correspondence to: Lapo Sali, MD, PhD, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134 Florence, Italy. lapo.sali@unifi.it
Telephone: +39-55-4598201 Fax: +39-55-4598900
Received: October 28, 2013
Revised: January 1, 2014
Accepted: January 20, 2014
Published online: April 14, 2014
Processing time: 167 Days and 16.3 Hours
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.

Keywords: Colorectal cancer; Colonoscopy, Computed tomography colonography; Synchronous cancer; Cancer staging

Core tip: Computed tomography colonography (CTC) can be employed as a “one-stop-shop” examination for preoperative assessment in patients with colorectal cancer (CRC). CTC is well accepted and tolerated by patients and also accurate in the detection of significant colorectal lesions. In patients with CRC, CTC defines the segmental location of the tumor and the presence of synchronous lesions or lack thereof and provides fairly accurate locoregional staging.