AGA future trends report: CT colonography

Dam, Jacques Van; Cotton, Peter B.; Johnson, C. Daniel; McFarland, Beth; Pineau, Benoit C.; Provenzale, Dawn; Ransohoff, David F.; Rex, Douglas K.; Rockey, Don C.; Wootton, F. Taylor

doi:10.1053/j.gastro.2004.07.003

Cited by 103 publications

(36 citation statements)

References 54 publications

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“…To underscore this viewpoint, the American Gastroenterological Association has stated that, in the case of CTC, polyps measuring 5 mm are not sufficient cause to perform colonoscopy and polypectomy. 24 The current study findings showed that diminutive lesions are neither a clinically effective nor a cost-effective target for CRC screening. In fact, diminutive lesions appear to represent a heavy burden on the overall costs of screening programs, accounting for greater than half of all therapeutic OC procedures and nearly half of all OC-related complications.…”

Section: Discussionmentioning

confidence: 54%

Cost‐effectiveness of colorectal cancer screening with computed tomography colonography

Pickhardt

Hassan

Laghi³

et al. 2007

Cancer

186

114

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Endogenous acetylcholine is an important modulator of sensory processing, especially at the spinal level, where nociceptive (pain‐related) stimuli enter the central nervous system and are integrated before being relayed to the brain. To decipher the organization of the local cholinergic circuitry in the spinal dorsal horn, we used transgenic mice expressing enchanced green fluorescent protein specifically in cholinergic neurons (ChAT::EGFP) and characterized the morphology, neurochemistry, and firing properties of the sparse population of cholinergic interneurons in this area. Three‐dimensional reconstruction of lamina III ChAT::EGFP neurons based either on their intrinsic fluorescence or on intracellular labeling in live tissue demonstrated that these neurons have long and thin processes that grow preferentially in the dorsal direction. Their dendrites and axon are highly elongated in the rostrocaudal direction, beyond the limits of a single spinal segment. These unique morphological features suggest that dorsal horn cholinergic interneurons are the main contributors to the plexus of cholinergic processes located in lamina IIi, just dorsal to their cell bodies. In addition, immunostainings demonstrated that dorsal horn cholinergic interneurons in the mouse are γ‐aminobutyric acidergic and express nitric oxide synthase, as in rats. Finally, electrophysiological recordings from these neurons in spinal cord slices demonstrate that two‐thirds of them have a repetitive spiking pattern with frequent rebound spikes following hyperpolarization. Altogether our results indicate that, although they are rare, the morphological and functional features of cholinergic neurons enable them to collect segmental information in superficial layers of the dorsal horn and to modulate it over several segments. J. Comp. Neurol. 519:3139–3158, 2011. © 2011 Wiley‐Liss, Inc.

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Section: Discussionmentioning

confidence: 54%

Cost‐effectiveness of colorectal cancer screening with computed tomography colonography

Pickhardt

Hassan

Laghi³

et al. 2007

Cancer

186

114

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“…35 Whether it is ready for 'prime time' , ie for widespread community screening, is a topic of hot debate. 36 Several large multicentre studies suggest that the accuracy is less than optimal in general use. 37 As technology and training improve, and particularly if 'prep-less' examinations become a reality, CT colonography will play an important role in colorectal medicine.…”

Section: Developments In Related Fieldsmentioning

confidence: 99%

“…Estimates of its likely impact on the practice of colonoscopy vary widely. 36 Interventional radiologists also have many sophisticated techniques applicable to patients with digestive problems, notably bleeding and biliary obstruction. Thus, the interface between endoscopy and radiology (starting with arguments about the barium meal) remains in an interesting flux.…”

Section: Developments In Related Fieldsmentioning

confidence: 99%

Digestive endoscopy in five decades

Cotton

2005

Clinical Medicine

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-The world of gastroenterology changed forever when flexible endoscopes became available in the 1960s. Diagnostic and therapeutic techniques proliferated and entered the mainstream of medicine, not without some controversy. Success resulted in a huge service demand, with the need to train more endoscopists and to organise large endoscopy units and teams of staff. The British health service struggled with insufficient numbers of consultants, other staff and resources, and British endoscopy fell behind that of most other developed countries. This situation is now being addressed aggressively, with many local and national initiatives aimed at improving access and choice, and at promoting and documenting quality. Many more consultants are needed and some should be relieved of their internal medicine commitment to focus on their specialist skills. New instruments and procedures are stretching the diagnostic boundaries and changing the interface with sister disciplines like radiology, surgery and pathology. The old distinctions, particularly between gastroenterology and surgery, are increasingly irrelevant and unhelpful. The future is bright for gastroenterology and for endoscopy, but unpredictable. In this fast-changing world it will be essential to remain flexible, with our goals firmly focused on the best interests of our patients.

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“…Because CT colonography cannot evaluate polyp histology, the assessment of current and future risk for colorectal cancer (and patient management based on CT colonography findings) is fundamentally based on polyp size 21 . Indeed, management strategies have been actively debated [22][23][24][25][26] , and it is clear that it is important to understand the characteristics of the seminal measure that determines clinical management of patients, namely polyp size measurement by CT colonography.…”

Section: Introductionmentioning

confidence: 99%