Polyp size and advanced adenoma: the dilemma of CT colonography

Perspective by A. Laghi


The CTC dilemma
The inherent limitations of CT colonography (CTC) in the detection and characterization of diminutive polyps (i.e. ≤5 mm) has raised some concern among clinicians about the efficacy of this technique in preventing colorectal cancer (CRC).  In other words, clinicians are threatened by the possibility of missing a cancer or a cancer precursor (advanced adenoma) if a lesion ≤5 mm is not detected. On the other hand, radiologists are not willing  to report lesions ≤5 mm, because of the fears of reducing the specificity of CTC and increasing the number of referrals to polypectomy, which could diminish the cost-effectiveness of the imaging technique.

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