| 特集名 | 大腸癌画像診断の最先端 | |
|---|---|---|
| 題名 | 2. 大腸癌の存在診断 (1) 大腸3D-CT 検査による大腸癌の存在診断能と検診 | |
| 発刊年月 | 2009年 03月 | |
| 著者 | 永田 浩一 | Department of Radiology, Massachusetts General Hospital & Harvard Medical School |
| 著者 | 吉田 広行 | Department of Radiology, Massachusetts General Hospital & Harvard Medical School |
| 【 要旨 】 | 大腸癌は日本における癌死因の上位を占め，大腸癌死亡率の年次推移は年々上昇の一途をたどり，2006年の死亡数は41,000人に達している．大腸癌は早期発見が可能で早期発見により完治が見込まれる癌ではあるが，大腸癌検診受診率，精検受診率が低いことが問題となっている． 欧米では近年，低侵襲で検査時間が短く被検者の受容性が高い大腸3D-CT検査に注目が集まり，大腸癌検診への応用が開始されようとしている．米国では，大腸3D-CT検査に対する大規模多施設共同臨床試験が成功したことを受けて，2008年3月に大腸3D-CT検査が有効な大腸癌検診法として「大腸癌スクリーニングおよびサーベイランスのガイドライン」に初めて掲載された．本稿では，大腸3D-CT検査による検診について，その特質，検査手法，検診における存在診断能と有用性について解説する． |
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| Theme | Frontier of image diagnosis for colorectal carcinoma | |
|---|---|---|
| Title | Effect of screening strategies for colorectal cancer with CT colonography | |
| Author | Koichi Nagata | Department of Radiology, Massachusetts General Hospital & Harvard Medical School |
| Author | Hiroyuki Yoshida | Department of Radiology, Massachusetts General Hospital & Harvard Medical School |
| [ Summary ] | Colorectal cancer is one of the most frequent malignancies in Japan, in wihch approximately 41,000 patients die of colorectal cancer in 2006. Although prevention of colorectal cancer by means of population screening is highly effective, screening rates are low and many barriers are present that need to be overcome in order to make a major global impact on colorectal cancer incidence and mortality. Computed tomographic colonography (CTC) is one of the colon cancer screening strategies that is known to be less expensive, less time-consuming, and better tolerated for patients than is optical colonoscopy. Recent large clinical CTC trials for screening of colorectal polyps demonstrated that CTC had a diagnostic performance similar to that of optical colonoscopy for detection of clinically significant polyps. Based on the success of these clinical trials, the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology now list CTC as a viable colorectal cancer screening in its new joint guideline. In this review, the authors discuss the essential aspects of screening strategies of colorectal polyps based on CTC, including the current techniques for patient preparation, data acquisition, image display and interpretation, as well as the CTC performance for screening. |
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