Since its introduction (in 1994) , clinical implementation of computed tomography (CT) colonography has been governed by advances in CT technology, improvements in dedicated analysis software, development of patient preparation regimens and local diagnostic policies.
Objective To update quality standards for CT colonography based on consensus among opinion leaders within the European Society of Gastrointestinal and Abdominal Radiology (ESGAR).
Material and methods A multinational European panel of nine members of the ESGAR CT colonography Working Group (representing six EU countries) used a modified Delphi process to rate their level of agreement on a variety of statements pertaining to the acquisition, interpretation and implementation of CT colonography. Four Delphi rounds were conducted, each at 2 months interval.
Results The panel elaborated 86 statements.
In the final round the panelists achieved complete consensus in 71 of 86 statements (82 %). Categories including the highest proportion of statements with excellent Cronbach’s internal reliability were colon distension, scan parameters, use of intravenous contrast agents, general guidelines on patient preparation, role of CAD and lesion measurement.
Lower internal reliability was achieved for the use of a rectal tube, spasmolytics, decubitus positioning and number of CT data acquisitions, faecal tagging, 2D vs. 3D reading, and reporting.
Conclusion The recommendations of the consensus should be useful for both the radiologist who is starting a CTC service and for those who have already implemented the technique but whose practice may need updating.
Key Points • Computed tomographic colonography is the optimal radiological method of assessing the colon • This article reviews ESGAR quality standards for CT colonography • This article is aimed to provide CT-colonography guidelines for practising radiologists • The recommendations should help radiologists who are starting/updating their CTC services
Emanuele Neri1, Steve Halligan2, Mikael Hellström3, Philippe Lefere4, Thomas Mang5, Daniele Regge6, Jaap Stoker7, Stuart Taylor8, Andrea Laghi9 and ESGAR CT Colonography Working Group10
1 Diagnostic and Interventional Radiology, University of Pisa, Pisa, Italy.
2 University College London, Centre for Medical Imaging, University College Hospital, London, UK.
3 Department of Radiology, Sahlgrenska University Hospital and Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
4 Virtual Colonoscopy Teaching Centre, Hooglede, Belgium.
5 Department of Radiology, Medical University of Vienna, Vienna, Austria.
6 Institute for Cancer Research and Treatment, Candiolo-Torino, Italy.
7 Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, NL, The Netherlands.
8 Department of Medical Imaging, University College London, London, UK.
9 Department of Radiological Sciences, Oncology and Pathology, Sapienza – Università di Roma, Rome, Italy.
10 Department of Translational Research, and Advanced Technologies in Medicine and Surgery, University of Pisa, Nuovo Ospedale S. Chiara, UO Radiodiagnostica 1, Via Paradisa 2, 56100 Pisa, Italy.