Low-dose CT colonography in children: initial experience, technical feasibility, and utility

Background: CT colonography (CTC) is utilized as a diagnostic tool in the detection of colon polyps and early colorectal cancer in adults. Large studies in the literature, although focused on adult populations, have shown CTC to be a safe, accurate, non-invasive technique. Objective: We evaluated the technical feasibility of CTC in children using a low-dose technique. Materials and methods: From November 2001 to April 2004 we evaluated eight patients (3–17 years) with non-contrast CTC. Seven of the patients had CTC, followed by standard colonoscopy (SC) the same day; in one patient, CTC followed a failed SC. CTC results were compared to results of SC. The estimated effective dose from each CTC was calculated and compared to that of standard barium enema. Results: CTC results were consistent with those of SC. Sensitivity for polyps 5–10 mm was 100%, and sensitivity for polyps 10 mm and larger was 66.7%. The estimated mean effective dose was 2.17 mSv for CTC, compared to the 5–6 mSv for a standard air-contrast barium enema in a small child. Conclusion: Our initial experience shows CTC in children is well-tolerated, safe, and useful. The procedure can be performed successfully with a low radiation dose, and preliminary results compare well with SC.