1,483 research outputs found

    Focal Spot, Spring 2006

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    https://digitalcommons.wustl.edu/focal_spot_archives/1102/thumbnail.jp

    Focal Spot, Spring 1999

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    https://digitalcommons.wustl.edu/focal_spot_archives/1081/thumbnail.jp

    Focal Spot, Winter 2008/2009

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    https://digitalcommons.wustl.edu/focal_spot_archives/1110/thumbnail.jp

    CT Kolonografija ā€“ Osvrt na trenutnu kliničku praksu

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    CTC is a diagnostic method that has been developed for more than a decade and there is a large number of studies conducted to describe its capabilities. By using new generations of CT devices and advanced software, colon analysis is possible in a relatively short time. On the other hand, high sensitivity for detecting polyps and the possibility of detecting bowel abnormalities make CTC an interesting and desirable method. The aim of this article is to determine the advantages and disadvantages of CTC, as well as its role in colon cancer screening. Compared to colonoscopy, CTC is a less invasive technique that does not require sedation. In addition to its advantages, CTC is associated with several disadvantages. A review of research proved a very small percentage of complications that can occur during the procedure, and the main limitation is ionising radiation. Despite this, it is used for numerous indications and plays a role in detection of colorectal cancer. Due to the fact that colon cancer is a major problem in the world, its frequency and mortality are trying to be reduced by screening methods. Compared to other diagnostic methods, CTC is described as a pleasant and safe examination. Considering the available data, CTC represents an ideal balance due to minimal invasiveness and high sensitivity. With the advancement of technology, CT devices and software, the role of CTC will most probably grow significantly and secure its important place in healthcare.CTC je dijagnostička metoda koja se razvijala viÅ”e od desetljeća i postoji veliki broj provedenih studija u svrhu opisivanja njenih mogućnosti. Upotrebom CT uređaja novih generacija te softverskim napredcima omogućena je analiza debelog crijeva u relativno kratkom vremenu. S druge strane, visoka osjetljivost za detekciju polipa te mogućnost otkrivanja abnormalnosti crijeva, CTC čine zanimljivom i poželjnom metodom. Cilj ovog rada je odrediti prednosti te nedostatke CTC, a ujedno i njenu ulogu prilikom probira karcinoma debelog crijeva. U usporedbi s kolonoskopijom CTC predstavlja manje invazivnu tehniku za koju nije potrebna sedacija. Osim svojih prednosti, CTC povezana je i s nekoliko nedostataka. Pregledom istraživanja dokazan je vrlo mali postotak komplikacija koje se mogu javiti tijekom postupka, a glavno ograničenje predstavlja ionizirajuće zračenje. Unatoč tome, koristi se za brojne indikacije te ima ulogu prilikom otkrivanja kolorektalnog karcinoma. Zbog činjenice da karcinom debelog crijeva predstavlja veliki problem u svijetu, njegova učestalost i smrtnost pokuÅ”ava se smanjiti metodama probira. S obzirom na ostale dijagnostičke metode, CTC je opisana kao ugodna i sigurna pretraga. Uzimajući u obzir dostupne podatke, CTC predstavlja idealnu ravnotežu zbog minimalne invazivnosti, a visoke osjetljivosti. Napretkom tehnologije, CT uređaja i softvera, uloga CTC značajno će rasti i tako će osigurati svoje važno mjesto u zdravstvu

    Endoskopske inovacije u dijagnostici i liječenju kolorektalnog karcinoma

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    Colonoscopy is the gold standard in diagnosis of colorectal cancer that in most instances arises from precursor lesion, adenomatous polyp. However, white ligh forward viewing colonoscopy is not a pefect method, up to a quarter of adenomas are being missed during standard procedures. Therefore, new techniques and technologies are being developed in order to increase adenoma detection rate, either through better resolution and magnification of the image (highdefinition, high-magnification endoscopes) or by augmenting the overview of colonic mucosa (Full Spectrum Endoscopy colonoscope, Third-Eye Retroscope). Besides adenoma detection, new technologies allow better tissue characterisation and in vivo discrimination between nonneoplastic and neoplastic lesions (conventional chromoendoscopy, virtual chromoendoscopy, confocal laser endomicroscopy, endocytoscopy). In additon to diagnostic procedures, therapeutic techniques are also evolving. Formerly, all of the flat or depressed colorectal lesions, encountered during colonoscopy, were reffered to surgery. Today, endoscopic mucosal resection is becoming a routine method for the treatment of early gastrointestinal mucosal lesions of less than 2 cm in diameter. For larger lesions, endoscopic submucosal dissection, a state-of-the-art technique, is indicated, but currently carried out only in tertiary centres. Endoscopic innovations are leading into new era of colorectal cancer diagnosis and management, hopefully resulting in decrease of incidence, morbidity and mortality.Kolonoskopija je zlatni standard u dijagnostici kolorektalnog karcinoma koji u većini slučajeva nastaje iz prekursorske lezije, adenoma. Međutim, standardna kolonoskopija nije savrÅ”ena metoda; prema rezultatima tandem studija čak četvrtina adenoma ostaje neotkrivena. Stoga se razvijaju nove tehnike i tehnologije koje omogućuju bolju detekciju adenoma uvećanjem i boljom rezolucijom slike (ā€˜ā€™high-definitionā€™ā€™, ā€˜ā€™high-magnificationā€™ā€™ endoskopi) te boljim pregledom sluznice debelog crijeva (ā€˜ā€™Full Spectrum Endoscopyā€™ā€™ kolonoskop, ā€˜ā€™Third-Eye Retroscopeā€™ā€™). Nove tehnologije također omogućuju i napredniju karakterizaciju kolorektalnih promjena i in vivo razlikovanje ne-neoplastičnih i neoplastičnih lezija (konvencionalna kromoendoskopija, virtualna kromoendoskopija, konfokalna laserska endomikroskopija, endocitoskopija). Osim dijagnostičkih, napreduju i terapijske endoskopske metode. Do sada su sve ne-polipoidne kolorektalne promjene liječene kirurÅ”ki, a danas je endoskopska mukozna resekcija postala rutinska metoda za lezije do 2 cm u promjeru. U slučaju većih promjena inidicirana je endoskopska submukozna disekcija, state-of-the-art tehnika koja se trenutno izvodi samo u tercijarnim centrima. Inovacije u endoskopiji vode u novu eru dijagnostike i liječenja kolorektalnog karcinoma te nagovijeÅ”taju bolju prevenciju i smanjenje incidencije ove česte maligne bolesti

    Focal Spot, Winter 2005/2006

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    https://digitalcommons.wustl.edu/focal_spot_archives/1101/thumbnail.jp

    Artificial intelligence and computer-aided diagnosis in colonoscopy: current evidence and future directions

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    Computer-aided diagnosis offers a promising solution to reduce variation in colonoscopy performance. Pooled miss rates for polyps are as high as 22%, and associated interval colorectal cancers after colonoscopy are of concern. Optical biopsy, whereby in-vivo classification of polyps based on enhanced imaging replaces histopathology, has not been incorporated into routine practice because it is limited by interobserver variability and generally only meets accepted standards in expert settings. Real-time decision-support software has been developed to detect and characterise polyps, and also to offer feedback on the technical quality of inspection. Some of the current algorithms, particularly with recent advances in artificial intelligence techniques, match human expert performance for optical biopsy. In this Review, we summarise the evidence for clinical applications of computer-aided diagnosis and artificial intelligence in colonoscopy
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