{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T21:21:08Z","timestamp":1790716868717,"version":"4.1.0"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Abdom Radiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Colorectal cancer (CRC) is a leading cause of cancer-related death, and timely and accurate recognition of endoluminal pathology is crucial. While CT colonography (CTC) is validated for luminal assessment with a sensitivity concordant to endoscopy, most radiology referrals to the tumor board are based on unprepared CT abdominal studies without bowel preparation or fecal tagging. The diagnostic yield of these routine unprepared CT scans and the influence of radiologist subspecialty, remain uncertain. This study evaluated the positive predictive value of CTC and unprepared CT for suspected endoluminal pathology and examined the impact of gastrointestinal (GI) subspeciality reporting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We reviewed colorectal tumor board outcomes from 2022 at St George\u2019s Hospital, London, United Kingdom. Patients referred to the tumor board by radiology were identified and analyzed through patient records. Radiological and endoscopic concordance was assessed using composite endpoints.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 106 radiology-initiated referrals to the tumor board in 2022, 61 (58%) were for suspected endoluminal pathology. Overall positive predictive value (PPV) was 79% (42 true positives and 11 false positives). The PPV was 91% for CTC and 70% for unprepared CT. GI subspecialist reporters identified 44% more endoluminal lesions on unprepared CT than non-specialist reports (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), but without a significant difference in PPV (67% vs. 78%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.543). No significant difference in colorectal cancer detection was observed between CTC and unprepared CT (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.8).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Unprepared CT demonstrates a good PPV (70%) for detecting endoluminal pathology, with over half of identified lesions being malignant. Although PPV is comparable between GI and non-GI radiologists, GI subspecialists refer significantly more cases for further evaluation, emphasizing the importance of subspeciality expertise. Radiologists should confidently raise suspicion of endoluminal pathology to ensure timely referral for direct visualization and tumor board discussion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00261-025-05255-6","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T06:31:57Z","timestamp":1766385117000},"page":"3314-3322","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The role of routine imaging in identifying endoluminal colorectal pathology, a United Kingdom clinical experience"],"prefix":"10.1007","volume":"51","author":[{"given":"Narendranath","family":"Govindarajah","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Livingstone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Mitchell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith","family":"Farrell-Dillon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Antram","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharmin","family":"Malekout","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nigel","family":"Beharry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunal","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nirav","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kesavan","family":"Kandiah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Wale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,22]]},"reference":[{"key":"5255_CR1","unstructured":"National Cancer Institute. Colorectal Cancer - Cancer Stat Facts. SEER Cancer Stat Facts: Colorectal Cancer. 2022;"},{"key":"5255_CR2","doi-asserted-by":"crossref","unstructured":"Morgan E, Arnold M, Gini A, Lorenzoni V, Cabasag CJ, Laversanne M, et al. Global burden of colorectal cancer in 2020 and 2040: Incidence and mortality estimates from GLOBOCAN. Gut. 2023;72(2).","DOI":"10.1136\/gutjnl-2022-327736"},{"key":"5255_CR3","unstructured":"National Cancer Auditing Collaboration (NATCAN). NBOCA Annual Report 2019. 2019."},{"key":"5255_CR4","doi-asserted-by":"crossref","unstructured":"Miles RA, Kerr DJ. The calman report on cancer services. Curr Obstet Gynaecol. 1995;5(4).","DOI":"10.1016\/S0957-5847(95)80011-5"},{"key":"5255_CR5","doi-asserted-by":"crossref","unstructured":"MacDermid E, Hooton G, Macdonald M, Mckay G, Grose D, Mohammed N, et al. Improving patient survival with the colorectal cancer multi-disciplinary team. Colorectal Disease. 2009;11(3).","DOI":"10.1111\/j.1463-1318.2008.01580.x"},{"key":"5255_CR6","unstructured":"Academy of Royal Medical Colleges. Alerts and notification of imaging reports Recommendations [Internet]. 2022 [cited 2025 Mar 9]. Available from: https:\/\/www.aomrc.org.uk\/wpcontent\/uploads\/2022\/10\/Alerts_notification_imaging_reports_recommendations_1022.pdf"},{"key":"5255_CR7","doi-asserted-by":"crossref","unstructured":"Halligan S. CT colonography for investigation of patients with symptoms potentially suggestive of colorectal cancer: A review of the UK SIGGAR trials. Vol. 86, British Journal of Radiology. 2013.","DOI":"10.1259\/bjr.20130137"},{"key":"5255_CR8","doi-asserted-by":"crossref","unstructured":"Mangat S, Kozoriz MG, Bicknell S, Spielmann A. The Accuracy of Colorectal Cancer Detection by Computed Tomography in the Unprepared Large Bowel in a Community-Based Hospital. Canadian Association of Radiologists Journal. 2018;69(1).","DOI":"10.1016\/j.carj.2017.12.005"},{"key":"5255_CR9","doi-asserted-by":"crossref","unstructured":"Ozel B, Pickhardt PJ, Kim DH, Schumacher C, Bhargava N, Winter TC. Accuracy of routine nontargeted CT without colonography technique for the detection of large colorectal polyps and cancer. Dis Colon Rectum. 2010;53(6).","DOI":"10.1007\/DCR.0b013e3181d5de13"},{"key":"5255_CR10","doi-asserted-by":"crossref","unstructured":"Wahlig S, Hassan O, Behr S. Colorectal cancer detection on routine abdomen\/pelvis CT. The Royal College of Radiologists Open 2, 2024, 100157.","DOI":"10.1016\/j.rcro.2024.100157"},{"key":"5255_CR11","unstructured":"MedCalc Statistical Software Version 23.2.1. MedCalc [Internet]. 2024. Available from: https:\/\/www.medcalc.org\/calc\/comparison_of_proportions.php"},{"key":"5255_CR12","unstructured":"Standards of practice for computed tomography colonography (CTC). Joint guidance from the British Society of Gastrointestinal and Abdominal Radiology and The Royal College of Radiologists [Internet]. 2021. Available from: www.rcr.ac.uk"},{"key":"5255_CR13","doi-asserted-by":"crossref","unstructured":"Spreng A, Netzer P, Mattich J, Dinkel HP, Vock P, Hoppe H. Importance of extracolonic findings at IV contrast medium-enhanced CT colonography versus those at non-enhanced CT colonography. Eur Radiol. 2005;15(10).","DOI":"10.1007\/s00330-005-2798-6"},{"key":"5255_CR14","doi-asserted-by":"crossref","unstructured":"Myo K, Manda V, Qi LJ, Rawlings D, Leung E. Sensitivity of routine CT abdomen and pelvis for detecting colorectal cancer. International Journal of Surgery. 2016;36.","DOI":"10.1016\/j.ijsu.2016.08.149"},{"key":"5255_CR15","doi-asserted-by":"crossref","unstructured":"Colvin H, Lukram A, Sohail I, Chung KT, Jehangir E, Berry J, et al. The performance of routine computed tomography for the detection of colorectal cancer. Ann R Coll Surg Engl. 2013;95(7).","DOI":"10.1308\/003588413X13629960049072"},{"key":"5255_CR16","doi-asserted-by":"crossref","unstructured":"Klang E, Eifer M, Kopylov U, Belsky V, Raskin S, Konen E, et al. Pitfalls in diagnosing colon cancer on abdominal CT. Clin Radiol. 2017;72(10).","DOI":"10.1016\/j.crad.2017.06.007"},{"key":"5255_CR17","doi-asserted-by":"crossref","unstructured":"Horvat N, Raj A, Liu S, Matkowskyj KA, Knezevic A, Capanu M, et al. CT colonography in preoperative staging of colon cancer: Evaluation of FOxTROT inclusion criteria for neoadjuvant therapy. 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