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Computed Tomography Colonography in Acromegaly

Departments of Radiology "R" Department of Integrated Surgery, Anaesthesiology, and Radiology (A.T.) and Endocrinological and Medical Sciences and Center of Excellence for Biomedical Research (E.R., A.R., F.M., D.F.), University of Genoa, and Department of Radiology, Galliera Hospital (L.B., G.G., E.M., G.A.R.), 16132 Genoa, Italy

Address all correspondence and requests for reprints to: Diego Ferone, M.D., Ph.D., Department of Endocrine and Medical Sciences, University of Genova, Viale Benedetto XV, 6, 16132 Genova. E-mail: ferone{at}unige.it.

Introduction and Aim: Acromegalic patients have an increased risk for the development of colorectal cancer. For this reason, since 1996, screening colonoscopy has been recommended in all patients with acromegaly. The aim of our study was to assess the feasibility and to evaluate the results of computed tomography (CT)-colonography in acromegaly.

Patients and Methods: We examined 23 acromegalic patients with no history of colorectal cancer (11 females and 12 males; age range 18–79 yr; disease duration range 1–15 yr) with CT-colonography. Twenty of them underwent traditional colonoscopy after the CT-colonography.

Results: CT-colonography examination results were adequate in 17 of 23 cases (73%). CT-colonography found 12 polyps in eight patients, 95% confirmed by traditional colonoscopy. One polyp was a sigmoid cancer, and the diagnosis was confirmed at surgery. There were no polyps found by traditional colonoscopy that CT-colonography was not able to identify. The lesions were located in right colon (two), transversum (three), left colon (five), and sigmoid colon (two). Patient acceptance of the technique was good in 65%, medium in 20%, and poor in 15%.

Conclusion: For the first time we have demonstrated that CT-colonography has the potential ability to replace traditional colonoscopy in acromegalic patients. CT-colonography could be used as a screening modality for colon cancer in acromegaly.