Computed tomography colonography and radiation risk: How low can we go?

Abstract

Computed tomography colonography (CTC) has become a key examination in detecting colonic polyps and colorectal carcinoma (CRC). It is particularly useful after incomplete optical colonoscopy (OC) for patients with sedation risks and patients anxious about the risks or potential discomfort associated with OC. CTC's main advantages compared with OC are its non-invasive nature, better patient compliance, and the ability to assess the extracolonic disease. Despite these advantages, ionizing radiation remains the most significant burden of CTC. This opinion review comprehensively addresses the radiation risk of CTC, incorporating imaging technology refinements such as automatic tube current modulation, filtered back projections, lowering the tube voltage, and iterative reconstructions as tools for optimizing low and ultra-low dose protocols of CTC. Future perspectives arise from integrating artificial intelligence in computed tomography machines for the screening of CRC.

CT Colonography – Overview of Current Clinical Practice

“…The reason lies in natural contrast between soft tissue, introduced gas and the rest of the stool. Regarding other procedures, virtual colonoscopy leads to greater exposure to radiation with respect to classic X -ray procedures [24]. Dose reduction can be achieved with the help of software and image reconstruction.…”