A balance of clinical assessment and use of diagnostic imaging: A CT colonography comparative case report
Computer tomography colonography (CTC) is a non-invasive procedure which has replaced barium enema. CTC uses helical images of a cleansed and gas-distended colon for the diagnosis and treatment of colonic neoplasms. This case study compares 2 patients: one with positive pathology (patient A) and ano...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-07-01
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| Series: | Radiology Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1930043324002747 |
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| author | Justin A. Clarke, BSc (Hons), PGCert (CTC), MPM, MSc Jeevon Benning, MRCP, FRCR John Isaacs, PhD Sheree Angell-Clarke, BSc (Hons), MPM |
| author_facet | Justin A. Clarke, BSc (Hons), PGCert (CTC), MPM, MSc Jeevon Benning, MRCP, FRCR John Isaacs, PhD Sheree Angell-Clarke, BSc (Hons), MPM |
| author_sort | Justin A. Clarke, BSc (Hons), PGCert (CTC), MPM, MSc |
| collection | DOAJ |
| description | Computer tomography colonography (CTC) is a non-invasive procedure which has replaced barium enema. CTC uses helical images of a cleansed and gas-distended colon for the diagnosis and treatment of colonic neoplasms. This case study compares 2 patients: one with positive pathology (patient A) and another as comparator (patient B) with a similar pathology to discuss and debate possible treatment pathways. Patient (A) CTC showed 2 polyps: 6 mm and 10 mm, which the colorectal surgeons thought only needed follow-up. Our comparator (patient B) displayed a similar pathology which measured 9 mm. In this case (patient B), there was mutual agreement with the surgeons for polypectomy but without haematology involvement which was atypical of the usual pathway. The surgeons did not see the 9 mm polyp at polypectomy which could be due to observer error or radiology reporter error. Given that conventional colonoscopy is more sensitive in detecting polyps; a repeat of both tests could confirm the presence of polyp, however, the surgeons gave patient (B) a virtual appointment and requested a repeat CTC in 12 months. In colorectal medicine there can be variations in the treatment of patients with polyps. While a repeat of both tests could confirm the presence of polyp in patient (B), the surgeons’ decisions regarding the patient's treatment reflected a balance of confidence in clinical assessment and use of diagnostic imaging which can reduce unnecessary requests and use of diagnostic tests. |
| first_indexed | 2024-04-24T07:38:46Z |
| format | Article |
| id | doaj.art-81721efd10434f70b4ea82814f56aa63 |
| institution | Directory Open Access Journal |
| issn | 1930-0433 |
| language | English |
| last_indexed | 2024-04-24T07:38:46Z |
| publishDate | 2024-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Radiology Case Reports |
| spelling | doaj.art-81721efd10434f70b4ea82814f56aa632024-04-20T04:17:18ZengElsevierRadiology Case Reports1930-04332024-07-0119727512755A balance of clinical assessment and use of diagnostic imaging: A CT colonography comparative case reportJustin A. Clarke, BSc (Hons), PGCert (CTC), MPM, MSc0Jeevon Benning, MRCP, FRCR1John Isaacs, PhD2Sheree Angell-Clarke, BSc (Hons), MPM3Ashford and St. Peter's Hospitals Radiology Department, Guilford Road, Chertsey, Surrey, UK; Corresponding author.Ashford and St. Peter's Hospitals Radiology Department, Guilford Road, Chertsey, Surrey, UKAshford and St. Peter's Hospitals Research and Development Department, Guilford Road, Chertsey, Surrey, UKRamsay Healthcare, UKComputer tomography colonography (CTC) is a non-invasive procedure which has replaced barium enema. CTC uses helical images of a cleansed and gas-distended colon for the diagnosis and treatment of colonic neoplasms. This case study compares 2 patients: one with positive pathology (patient A) and another as comparator (patient B) with a similar pathology to discuss and debate possible treatment pathways. Patient (A) CTC showed 2 polyps: 6 mm and 10 mm, which the colorectal surgeons thought only needed follow-up. Our comparator (patient B) displayed a similar pathology which measured 9 mm. In this case (patient B), there was mutual agreement with the surgeons for polypectomy but without haematology involvement which was atypical of the usual pathway. The surgeons did not see the 9 mm polyp at polypectomy which could be due to observer error or radiology reporter error. Given that conventional colonoscopy is more sensitive in detecting polyps; a repeat of both tests could confirm the presence of polyp, however, the surgeons gave patient (B) a virtual appointment and requested a repeat CTC in 12 months. In colorectal medicine there can be variations in the treatment of patients with polyps. While a repeat of both tests could confirm the presence of polyp in patient (B), the surgeons’ decisions regarding the patient's treatment reflected a balance of confidence in clinical assessment and use of diagnostic imaging which can reduce unnecessary requests and use of diagnostic tests.http://www.sciencedirect.com/science/article/pii/S1930043324002747Computed tomography colonoscopyUse of diagnostic imaging |
| spellingShingle | Justin A. Clarke, BSc (Hons), PGCert (CTC), MPM, MSc Jeevon Benning, MRCP, FRCR John Isaacs, PhD Sheree Angell-Clarke, BSc (Hons), MPM A balance of clinical assessment and use of diagnostic imaging: A CT colonography comparative case report Radiology Case Reports Computed tomography colonoscopy Use of diagnostic imaging |
| title | A balance of clinical assessment and use of diagnostic imaging: A CT colonography comparative case report |
| title_full | A balance of clinical assessment and use of diagnostic imaging: A CT colonography comparative case report |
| title_fullStr | A balance of clinical assessment and use of diagnostic imaging: A CT colonography comparative case report |
| title_full_unstemmed | A balance of clinical assessment and use of diagnostic imaging: A CT colonography comparative case report |
| title_short | A balance of clinical assessment and use of diagnostic imaging: A CT colonography comparative case report |
| title_sort | balance of clinical assessment and use of diagnostic imaging a ct colonography comparative case report |
| topic | Computed tomography colonoscopy Use of diagnostic imaging |
| url | http://www.sciencedirect.com/science/article/pii/S1930043324002747 |
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