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 physi-cians 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 colonogra-

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We evaluated the clinical usefulness of endoluminal CT colonography after an incomplete colonoscopy. SUBJECTS AND METHODS. We prospectively studied 40 patients in whom the cecum could not be reached endoscopically despite adequate bowel preparation. Endoluminal CT colonography (120 kVp, 120 mA, 3-mm collimation, pitch of 2, 1.5-mm interval reconstruction) was performed within 2 hr of incomplete colonoscopy. Two-dimensional multiplanar reformatted images and three-dimensional endoluminal images were analyzed. Twenty-six patients (65%) underwent barium enema immediately after endoluminal CT colonography. We analyzed colonic distention; duration of endoluminal CT colonography; patient tolerance: number of colonic segments seen at colonoscopy, endoluminal CT colonography, and barium enema; and reasons for incomplete colonoscopy as well as colonic and extracolonic findings. RESULTS. Duration of endoluminal CT colonography was 14.2 ± 4.6 mm (mean ± SD). Endoluminal CT colonography was better tolerated than colonoscopy or barium enema (p < .001). Probable causes for incomplete colonoscopy were identified at endoluminal CT colonography in 74% of 40 patients. Baseline colonic distention in the region of the transverse and right colon was considered adequate before additional air insufflation; however, the addition of air significantly enhanced colonic distention throughout the entire colon (p < .001). Endoluminal CT colonography adequately revealed 96% of all colonic segments; in comparison, barium enema adequately revealed 91 % of all segments (p < .05). CONCLUSION. In patients with incomplete colonoscopy, endoluminal CT colonography successfully showed the previously unrevealed colon in more than 90% of patients. Endoluminal CT colonography is a rapid, well-tolerated technique that provides clinically useful colonic and extraco-Ionic information and should be considered for all patients who undergo incomplete colonoscopy.

The use of intravenously administered contrast material significantly improved reader confidence in the assessment of bowel wall conspicuity and the ability of CT colonography to depict medium polyps in suboptimally prepared colons.