| 特集名 | CT colonography | |
|---|---|---|
| 題名 | CT colonographyによる大腸腫瘍性病変の診断 (3) 大腸癌スクリーニングの可能性 | |
| 発刊年月 | 2008年 03月 | |
| 著者 | 野崎 良一 | 大腸肛門病センター高野病院消化器内科 |
| 著者 | 松本 徹也 | 大腸肛門病センター高野病院放射線科 |
| 著者 | 前崎 孝之 | 大腸肛門病センター高野病院放射線科 |
| 著者 | 山田 一隆 | 大腸肛門病センター高野病院消化器外科 |
| 著者 | 高野 正博 | 大腸肛門病センター高野病院消化器外科 |
| 【 要旨 】 | 要旨はありません。 | |
| Theme | CT colonography | |
|---|---|---|
| Title | Possibilities for colorectal cancer screening with CT colonography in Japan | |
| Author | Ryoichi Nozaki | Department of Gastroenterology, Takano Hospital |
| Author | Tetsuya Matsumoto | Department of Radiology, Takano Hospital |
| Author | Takayuki Maezaki | Department of Radiology, Takano Hospital |
| Author | Kazutaka Yamada | Department of Surgery, Coloproctology Center, Takano Hospital |
| Author | Masahiro Takano | Department of Surgery, Coloproctology Center, Takano Hospital |
| [ Summary ] | Multi-center collaborative studies from Western countries have shown that the diagnostic accuracy of CT colonography (CTC) for colorectal tumors is comparable to that of total colonoscopy (TCS) in terms of sensitivity, specificity, and positive predictive rates. Unlike TCS, CTC is advantageous in terms of non-invasiveness, lack of need for skillful techniques, and ability to examine the bowel lumen and adjacent organs at the same time, based on CT information. There is a possibility that CTC will become a powerful modality for colorectal cancer (CRC) screening in addition to preoperative examinations. Colonic preparation, low detection rates for superficial type tumors, difficulty in evaluating CTC images, exposure to radiation, standardization of diagnostic procedures and lack of accuracy are future challenges to overcome in the wide spread acceptance of CRC screening in Japan. In terms of the establishment of CTC for CRC screening, it is important to establish the prevalence of digital preparation (fecal tagging or residual fluid tagging), make further improvements in images by upgrading multi-detector row CT, develop new software, standardize diagnostic accuracy and to increase the prevalence of CAD (computer-aided detection). Reductions in radiation exposure and arrangements for training systems to develop gastroenterologists as well as radiologists in charge of accurate diagnosis are also needed. |
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