Skip to main content
. Author manuscript; available in PMC: 2019 Sep 1.
Published in final edited form as: Gastroenterol Clin North Am. 2018 Jun 29;47(3):515–536. doi: 10.1016/j.gtc.2018.04.004

Figure 9. Large advanced tubular adenoma missed at initial non-blinded OC after prospective detection at initial CT colonography screening.

Figure 9

A, Three-dimensional (3D) endoluminal CTC view shows a 2-cm sessile polyp (arrow) detected behind a cecal fold adjacent to the ileocecal (IC) valve. B, Coronal two-dimensional (2D) CTC image confirms a true mucosal-based polyp (arrow). A diminutive rectal lesion (not shown) was also detected and incidentally noted in the CT colonography report. C, D, Retroflexed images from same-day OC referral show the (C) cecum and ascending colon and (D) dedicated evaluation of the ileocecal valve fold (arrow in D). The polyp was not found despite previous knowledge of specific location and thorough inspection. The diminutive rectal lesion was confirmed and proved to be a hyperplastic polyp. The OC report recommended follow-up OC in 5 years. E, Because of the standard expert discordant review process, repeat CT colonography with same-day OC, if needed, was recommended, and repeat CT colonography 9 months later shows the 2-cm polyp (arrow). F, Repeat OC performed by a different gastroenterologist confirms the large polyp behind a fold, which was resected and proved to be a tubular adenoma, advanced according to size criteria (10 mm).

From Pooler BD, Kim DH, Weiss JM, et al. Colorectal Polyps Missed with Optical Colonoscopy Despite Previous Detection and Localization with CT Colonography. Radiology 2016;278:422-429; with permission.