臨牀消化器内科 Vol.29 No.10(2-2)


特集名 CT colonographyの現状と将来
題名 各論 (2) 大腸CTを用いた大腸がん検診
発刊年月 2014年 09月
著者 永田 浩一 自治医科大学放射線科/国立がん研究センターがん予防・検診研究センター検診研究部
著者 木島 茂喜 自治医科大学放射線科
著者 佐々木 崇洋 自治医科大学放射線科
著者 金澤 英紀 自治医科大学放射線科
著者 歌野 健一 自治医科大学放射線科/福島県立医科大学会津医療センター小腸・大腸・肛門科
著者 杉本 英治 自治医科大学放射線科
【 要旨 】 米国では,大腸CTの精度検証であるNational CT colonography Trialが成功し,大腸CTが有効な大腸癌検査法として大腸がん検診ガイドラインに掲載された.欧州でも大腸CTの内視鏡に対する非劣性試験が相次いで実施されて成功した.大腸CTは腸管前処置の大幅な軽減が可能であり,欧米では大腸CTの普及が加速している.日本でも,専門医の内視鏡診断をゴールドスタンダードとした2つの大規模臨床試験JANCTおよびUMIN6665が成功に終わった.精度検証が完了した今,日本でも大腸CTを活用する環境が整った.今後の普及において,大腸CTの検査手技や読影方法の標準化が必要と思われる.
Theme Now and Feature of CT Colonography
Title Evidence of CT Colonography in Colorectal Cancer Screening
Author Koichi Nagata Department of Radiology, Jichi Medical University / Cancer Screening Technology Division, Research Center for Cancer Prevention and Screening, National Cancer Ceter
Author Shigeyoshi Kijima Department of Radiology, Jichi Medical University
Author Takahiro Sasaki Department of Radiology, Jichi Medical University
Author Hidenori Kanazawa Department of Radiology, Jichi Medical University
Author Kenichi Utano Department of Radiology, Jichi Medical University / Department of Coloproctology, Aizu Medical Center, Fukushima Medical University
Author Hideharu Sugimoto Department of Radiology, Jichi Medical University
[ Summary ] With the success of the National CT colonography Trial in the United States, CT colonography (CTC) has been endorsed as a valid screening test by a multisociety task force which included the American Cancer Society, the American College of Radiology, and the U. S. Multisociety Task Force on Colorectal Cancer. Also in Europe, some clinical trial results have been published proving the accuracy of CTC to be similar to that of colonoscopy. In addition, non-laxative CTC has been proven an effective screening method. CTC has become a common effective screening test for colorectal cancer and is becoming accepted in the United States and Europe. In Japan, the Japanese National CT Colonography Trial and the UMIN6665 trial, which are the gold standards concerning colonoscopic findings performed by Board Members of the Japan Gastroenterological Endoscopy Society, has been finalized. The diagnostic performance of CTC for detecting colorectal polyps is well established in Japan. Training and standardization for CTC procedures are essential for widespread clinical use.
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