The Time Has Arrived for National Reimbursement of Screening CT Colonography

1 Department of Radiology and Biomedical Imaging, San Francisco VA Medical Center, 4150 Clement St, San Francisco, CA 94121.
American Journal of Roentgenology (Impact Factor: 2.74). 07/2013; 201(1):73-9. DOI: 10.2214/AJR.13.10656
Source: PubMed

ABSTRACT OBJECTIVE. CT colonography (CTC) has been fully validated as an accurate screening test for colorectal carcinoma and is being disseminated globally. There is an abundance of new literature addressing the prior concerns of the U.S. Preventive Services Task Force and the Centers for Medicare & Medicaid Services. Specific areas related to radiation dose, extracolonic findings, and generalizability of CTC to senior patients are discussed. CONCLUSION. The time has arrived for national reimbursement of CTC in the United States.

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  • Journal of the American College of Radiology: JACR 03/2015; 12(3):211-2. DOI:10.1016/j.jacr.2015.01.018 · 2.28 Impact Factor
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    ABSTRACT: Objective To prospectively evaluate the radiation dose and image quality comparing low-dose CT colonography (CTC) reconstructed using different levels of iterative reconstruction techniques with routine-dose CTC reconstructed with filtered back projection. Methods Following institutional ethics clearance and informed consent procedures, 210 patients underwent screening CTC using automatic tube current modulation for dual positions. Examinations were performed in the supine position with a routine-dose protocol and in the prone position, randomly applying four different low-dose protocols. Supine images were reconstructed with filtered back projection and prone images with iterative reconstruction. Two blinded observers assessed the image quality of endoluminal images. Image noise was quantitatively assessed by region-of-interest measurements. Results The mean effective dose in the supine series was 1.88 mSv using routine-dose CTC, compared to 0.92, 0.69, 0.57, and 0.46 mSv at four different low doses in the prone series (p Conclusions Low-dose CTC with iterative reconstruction reduces the radiation dose by 48.5 to 75.1 % without image quality degradation compared to routine-dose CTC with filtered back projection. Key Points • Low-dose CTC reduces radiation dose ≥48.5 % compared to routine-dose CTC. • Iterative reconstruction improves overall CTC image quality compared with FBP. • Iterative reconstruction reduces overall CTC image noise compared with FBP. • Automated exposure control with iterative reconstruction is useful for low-dose CTC.
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