Bowel Cancer Imaging

Question 1

What is the imaging pathway for a patient with suspected bowel cancer

Answer 1

colonoscopy or Ct colonography

Question 2

What is the staging imaging pathway for a patient diagnosed with cancer

Answer 2

CT chest abdo pelves with contrast
MRI of pelvis

Question 3

Compare endoscopic colonoscopy and CT colonography

Answer 3

endoscopic is more sensitive for smaller polps and allows tissue samples to be taken and polyps to be removed.

However CT is faster and has a quick recovery along with no need for sedation and less risk of damage to the abdominal wall

Question 4

What is the procedure for a colonoscopy?

Answer 4

Patient bowels need to be emptied
They have to maintain a low fibre diet 1-2 days before and drink plenty fluids
After arriving they get ID checks and give consent
Change into gown and are cannulated for delivery of drugs
Patient lies down on side with knees up and colonscope is inserted into the bowel via the rectum
Gas is inserted to distend their bowel
Images are taken of the bowel lining
Biopsy taken and small polyps are removed

Question 5

What are the risks of a colonoscopy?

Answer 5

abdominal pain or cramping
bleeding
reaction to sedative
perforation of abdominal lining

Question 6

What is the procedure for a CT colonography?

Answer 6

Patient has to prepare bowel 2 days prior by drinking gastrogafin and eating a specific diet
On arrival patient is ID checked and they are talked through the procedure , changed into gown and cannulated for administration of contrast and buscopan.
Patient lies on the table on their side so catheter can be inserted into the rectum.
Gas is then inserted to distend the bowel
Supine and prone views are taken of the colon for imaging

Question 7

What are the risks of a CT colonography ?

Answer 7

radiation dose , reaction to contarst , bowel perforation