Role of Enhanced CT Combined with CT Virtual colonoscopy Compared to Colonic Endoscopy in Detection of Colorectal Pathology

Background: Colorectal pathology is the study of diseases affecting the colon, rectum, and anus, encompassing a range of conditions from benign to malignant. It includes common disorders such as polyps, inflammatory bowel disease (IBD), diverticulosis, and colorectal cancer. The aim of this study was to assess Clinical Value of Enhanced computed tomography (CT) Combined with CT Virtual colonoscopy compared to colonic endoscopy in detection of colorectal pathology. Methods: This prospective study included 30 patients at the National Liver Institute, Menoufia, Egypt. Results: Our study showed excellent agreement between computed tomography colonography (CTC) and conventional colonoscopy (kappa = 0.792, P < 0.001), with CTC demonstrating high sensitivity (95.83%) and specificity (83.33%). CTC detected a slightly higher number of pathologies, identifying 40% of masses or suspicious thickening compared to colonoscopy&#039;s 33.33%. For IBD, CTC identified 26.66% of cases, marginally surpassing colonoscopy&#039;s 23.33%, and both methods equally detected diverticulosis in 13.33% of cases. CTC achieved 100% accuracy for rectosigmoid and sigmoid lesions, and 96.67% accuracy across other locations, with minor discrepancies overall. Additionally, CTC had a lower complication rate, with fewer patients experiencing abdominal distension (16.66%) compared to conventional colonoscopy (36.67%). Conclusion: The strong performance of Enhanced CT Combined with CT Virtual colonoscopy in this study, particularly its high sensitivity and specificity, suggests it could be a valuable tool in colorectal pathology detection, offering a less invasive alternative with fewer complications compared to conventional colonoscopy.