https://www.medpagetoday.com/upload/2008/3/6/CRC.pdf

Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology.

https://louisville.edu/medicine/departments/medicine/divisions/gimedicine/physician-resources/lectures/gi-neoplasms/surveillance-colonoscopy

Colorectal cancer screening and surveillance: clinical guidelines and rationale-update based on new evidence

background We evaluated the performance characteristics of computed tomographic (CT) virtual colonoscopy for the detection of colorectal neoplasia in an average-risk screening population. methods A total of 1233 asymptomatic adults (mean age, 57.8 years) underwent same-day virtual and optical colonoscopy. Radiologists used the three-dimensional endoluminal display for the initial detection of polyps on CT virtual colonoscopy. For the initial examination of each colonic segment, the colonoscopists were unaware of the findings on virtual colonoscopy, which were revealed to them before any subsequent reexamination. The sensitivity and specificity of virtual colonoscopy and the sensitivity of optical colonoscopy were calculated with the use of the findings of the final, unblinded optical colonoscopy as the reference standard. results The sensitivity of virtual colonoscopy for adenomatous polyps was 93.8 percent for polyps at least 10 mm in diameter, 93.9 percent for polyps at least 8 mm in diameter, and 88.7 percent for polyps at least 6 mm in diameter. The sensitivity of optical colonoscopy for adenomatous polyps was 87.5 percent, 91.5 percent, and 92.3 percent for the three sizes of polyps, respectively. The specificity of virtual colonoscopy for adenomatous polyps was 96.0 percent for polyps at least 10 mm in diameter, 92.2 percent for polyps at least 8 mm in diameter, and 79.6 percent for polyps at least 6 mm in diameter. Two polyps were malignant; both were detected on virtual colonoscopy, and one of them was missed on optical colonoscopy before the results on virtual colonoscopy were revealed. conclusions CT virtual colonoscopy with the use of a three-dimensional approach is an accurate screening method for the detection of colorectal neoplasia in asymptomatic averagerisk adults and compares favorably with optical colonoscopy in terms of the detection of clinically relevant lesions.

https://www.nejm.org/doi/pdf/10.1056/NEJMoa031618

Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults.

Task Group 101 of the AAPM has prepared this report for medical physicists, clinicians, and therapists in order to outline the best practice guidelines for the external-beam radiation therapy technique referred to as stereotactic body radiation therapy (SBRT). The task group report includes a review of the literature to identify reported clinical findings and expected outcomes for this treatment modality. Information is provided for establishing a SBRT program, including protocols, equipment, resources, and QA procedures. Additionally, suggestions for developing consistent documentation for prescribing, reporting, and recording SBRT treatment delivery is provided.

https://aapm.onlinelibrary.wiley.com/doi/pdf/10.1118/1.3438081

Stereotactic body radiation therapy: The report of AAPM Task Group 101

In the United States, colorectal cancer (CRC) is the third most common cancer diagnosed among men and women and the second leading cause of death from cancer CRC largely can be prevented by the detection and removal of adenomatous polyps, and survival is significantly better when CRC is diagnosed while still localized In 2006 to 2007, the American Cancer Society, the US Multi Society Task Force on Colorectal Cancer, and the American College of Radiology came together to develop consensus guidelines for the detection of adenomatous polyps and CRC in asymptomatic average-risk adults In this update of each organization's guidelines, screening tests are grouped into those that primarily detect cancer early and those that can detect cancer early and also can detect adenomatous polyps, thus providing a greater potential for prevention through polypectomy When possible, clinicians should make patients aware of the full range of screening options, but at a minimum they should be prepared to offer patients a choice between a screening test that is effective at both early cancer detection and cancer prevention through the detection and removal of polyps and a screening test that primarily is effective at early cancer detection It is the strong opinion of these 3 organizations that colon cancer prevention should be the primary goal of screening

https://onlinelibrary.wiley.com/doi/pdf/10.3322/CA.2007.0018

Screening and Surveillance for the Early Detection of Colorectal Cancer and Adenomatous Polyps, 2008: A Joint Guideline from the American Cancer Society, the US Multi‐Society Task Force on Colorectal Cancer, and the American College of Radiology*†

Background Virtual colonoscopy is a new method of imaging the colon in which thin-section, helical computed tomography (CT) is used to generate high-resolution, two-dimensional axial images. Three-dimensional images of the colon simulating those obtained with conventional colonoscopy are then reconstructed off-line. We compared the performance of virtual and conventional colonoscopy for the detection of colorectal polyps. Methods We prospectively studied 100 patients at high risk for colorectal neoplasia (60 men and 40 women; mean age, 62 years). We performed virtual colonoscopy immediately before conventional colonoscopy. We inserted a rectal tube and insufflated the colon with air to the maximal level that the patient could tolerate. We administered 1 mg of glucagon intravenously immediately before CT scanning to minimize the degree of smooth-muscle spasm and peristalsis and to reduce the patient's discomfort. Results The entire colon was clearly seen by virtual colonoscopy in 87 patients and by convent...

https://www.nejm.org/doi/pdf/10.1056/NEJM199911113412003

A Comparison of Virtual and Conventional Colonoscopy for the Detection of Colorectal Polyps

Computed tomographic (CT) colonography continues to evolve rapidly. Advances in scanning and display technologies, encouraging performance data, and increased utilization necessitate clarification and standardization of results reporting in CT colonography. There are several reasons for this. First and most important, standardized reporting can better assist patients and referring physicians in making management decisions on the basis of the results of CT colonography. The precedent of the mammography Breast Imaging Reporting and Data System, or BI-RADS, schema is a strong incentive to provide a similar structure for CT colonography. Second, as more examinations are performed, the likelihood increases that radiologists interpreting results of a CT colonography examination performed at one center will require comparison to examination results and reports generated at other sites. As has been seen with mammography, a common set of terms facilitates this kind of assessment (1). Third, as utilization of CT colonography increases, our colleagues in other medical specialties, the various third-party payers, and the general public will insist on larger-scale evaluations of examination performance, examination quality, patient outcome, and cost. Here again, a common approach to interpretation will assist us in meeting these demands. Finally, a common scheme for reporting facilitates structured reporting. The purpose of this communication is to facilitate clear and consistent communication of CT colonography results. The authors—an ad hoc group of investigators active in the area of CT colonography—have collaborated to develop a reporting scheme that is coupled to recommendations for follow-up. Our group, the Working Group on Virtual Colonoscopy, includes members of the American College of Radiology Colon Cancer Committee. On the basis of our collective experience and a review of the relevant literature, we present a practical guide to the interpretation of CT colonography results: the CT Colonography Reporting and Data System, or “C-RADS.” Future multidisciplinary collaboration and longitudinal data may lead to a refinement of the terms and concepts we present here; our effort is a starting point in which we attempt to address the needs of current practice. Adequate training and rigorous quality control of examination performance are essential elements for maximizing the potential of CT colonography; however, these related topics will not be discussed here. Instead, we will focus on the interpretation and follow-up of CT colonography results in three parts: first, a description of terms useful for reporting the size, morphologic features, and location of polyps and masses; second, a description of a classification scheme for colonic lesions and suggestions for follow-up; Published online 10.1148/radiol.2361041926 Radiology 2005; 236:3–9 1 From the Division of Abdominal Imaging and Intervention, Department of Radiology/ White 270, Massachusetts General Hospital, Boston, MA 02114 (M.E.Z.). The complete list of author affiliations is at the end of this article. Received November 12, 2004; accepted November 15. Address correspondence to M.E.Z. (e-mail: mzalis@partners.org).

CT colonography reporting and data system: a consensus proposal.

Magnetic resonance cholangiopancratography (MRCP) is a radiologic technique that produces images of the pancreaticobiliary tree that are similar in appearance to those obtained by invasive radiographic methods, such as endoscopic retrograde cholangiopancreatography (ERCP). Originally described in 1991,1 MRCP takes advantage of the inherent contrast-related properties of fluid in the biliary and pancreatic ducts. Because MRCP does not require the administration of any exogenous contrast materials, it is an ideal imaging method for patients with allergies to iodine-based contrast materials or those with a general history of atopy. The interest in MRCP on the part of surgeons, gastroenterologists, and radiologists is . . .

Magnetic Resonance Cholangiopancreatography

Magnetic resonance cholangiography: comparison with endoscopic retrograde cholangiopancreatography.

PURPOSE: To determine the role of three-dimensional fast spin-echo magnetic resonance (MR) cholangiopancreatography in the evaluation of the normal and abnormal pancreatic duct. MATERIALS AND METHODS: A non-breath-hold MR cholangiopancreatographic technique with use of a body coil was compared with direct pancreatography performed with endoscopic retrograde cholangiopancreatography in 37 patients. RESULTS: MR cholangiopancreatograms of satisfactory quality were obtained in 92% of patients. Sensitivity for detection of pancreatic duct dilatation (n = 15) was 100% and 87% (observers 1 and 2, respectively). Among patients with pancreatic duct strictures (n = 8), 75% of the strictures were detected; there was a single false-positive finding. Specificity for both observers was 69% for the maximum intensity projection reconstructions and increased to 81% with review of the source images. Four of six cases of pancreas divisum (67%) and two cases of pancreatic duct stones were demonstrated. Interobserver agreemen...

Matthew A. Barish

Papers

A Comparison of Virtual and Conventional Colonoscopy for the Detection of Colorectal Polyps

CT colonography reporting and data system: a consensus proposal.

Magnetic Resonance Cholangiopancreatography

Magnetic resonance cholangiography: comparison with endoscopic retrograde cholangiopancreatography.

Pancreatic duct: MR cholangiopancreatography with a three-dimensional fast spin-echo technique.