{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T04:55:36Z","timestamp":1781499336683,"version":"3.54.1"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"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>Background<\/jats:title>\n                    <jats:p>Although a general trend for longer colons among older adults has been observed, longitudinal demonstration of intra-patient elongation is lacking. We assessed colonic length at serial CT colonography (CTC), which allows for precise length measurement over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Longitudinal CTC evaluation (mean time interval, 12.8 years; range, 11.6\u201316.6 years) in 100 asymptomatic adults (mean age, 54.2 years at index study; 50 men, 50 women) were analyzed using a dedicated software system (V3D Colon, Viatronix). Segmental and total colonic lengths were obtained at interactive 2D and 3D review utilizing the automated luminal centerline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean total colonic length increased from 198.1\u00a0cm at index CTC to 205.7\u00a0cm at follow-up (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), corresponding to an annual increase of 0.6\u2009\u00b1\u20091.2\u00a0cm\/year. The corresponding median colonic length increased from 191.5\u00a0cm to 202.0\u00a0cm. Intraperitoneal segments suspended by a mesentery accounted for 80% (6.1\u00a0cm) of the average overall 7.6\u00a0cm elongation, including a mean increase of 2.1\u00a0cm in the sigmoid colon and 4.0\u00a0cm in the transverse colon. There was no significant net length change for the extraperitoneal segments (rectum and retroperitoneal colon). Women had a longer colon at initial CTC on average (202.1\u00a0cm vs. 194.0\u00a0cm) but mean length was similar at final CTC (205.4\u00a0cm vs. 206.1\u00a0cm) given the increased rate of interval elongation in men (0.88\u00a0cm\/year in men vs. 0.31\u00a0cm\/year in women).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Longitudinal CTC showed a mean age-related increase in colonic length of greater than 7\u00a0cm per decade in middle-age and older adults. The intraperitoneal colonic segments (transverse\u2009&gt;\u2009sigmoid) accounted for most of this elongation, whereas the more fixed extraperitoneal segments showed no significant net length increase.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00261-025-05334-8","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T12:26:27Z","timestamp":1766147187000},"page":"3308-3313","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["CT colonography for longitudinal in-vivo assessment of colonic lengthening in middle-age and older adults"],"prefix":"10.1007","volume":"51","author":[{"given":"Perry J","family":"Pickhardt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varun","family":"Razdan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,19]]},"reference":[{"key":"5334_CR1","doi-asserted-by":"crossref","unstructured":"1. Phillips M, Patel A, Meredith P, Will O, Brassett C. Segmental colonic length and mobility. Ann R Coll Surg Engl 2015;97(6):439\u2009\u2212\u200944. (In eng). DOI: 10.1308\/003588415x14181254790527.","DOI":"10.1308\/003588415X14181254790527"},{"key":"5334_CR2","doi-asserted-by":"crossref","unstructured":"2. Saunders BP, Halligan S, Jobling C, et al. Can barium enema indicate when colonoscopy will be difficult? Clin Radiol 1995;50(5):318\u2009\u2212\u200921. (In eng). DOI: 10.1016\/s0009-9260(05)83424-5.","DOI":"10.1016\/S0009-9260(05)83424-5"},{"key":"5334_CR3","doi-asserted-by":"crossref","unstructured":"3. Saunders BP, Phillips RK, Williams CB. Intraoperative measurement of colonic anatomy and attachments with relevance to colonoscopy. Br J Surg 1995;82(11):1491-3. (In eng). DOI: 10.1002\/bjs.1800821113.","DOI":"10.1002\/bjs.1800821113"},{"key":"5334_CR4","doi-asserted-by":"crossref","unstructured":"4. Duncan JE, McNally MP, Sweeney WB, et al. CT colonography predictably overestimates colonic length and distance to polyps compared with optical colonoscopy. AJR Am J Roentgenol 2009;193(5):1291-5. (In eng). DOI: 10.2214\/ajr.09.2365.","DOI":"10.2214\/AJR.09.2365"},{"key":"5334_CR5","doi-asserted-by":"crossref","unstructured":"5. Eickhoff A, Pickhardt PJ, Hartmann D, Riemann JF. Colon anatomy based on CT colonography and fluoroscopy: Impact on looping, straightening and ancillary manoeuvres in colonoscopy. Digestive and Liver Disease 2010;42(4):291\u2013296. DOI: 10.1016\/j.dld.2009.04.022.","DOI":"10.1016\/j.dld.2009.04.022"},{"key":"5334_CR6","doi-asserted-by":"crossref","unstructured":"6. Khashab M, Pickhardt PJ, Kim DH, Rex DK. Colorectal Anatomy in Adults At CT Colonography: Normal Distribution and the Effect of Age, Gender, and Body Mass index. Gastrointestinal Endoscopy 2009;69(5):AB275-AB275. (<\u2009Go to ISI>:\/\/WOS:000265865301144).","DOI":"10.1016\/j.gie.2009.03.737"},{"key":"5334_CR7","doi-asserted-by":"crossref","unstructured":"7. Hanson ME, Pickhardt PJ, Kim DH, Pfau PR. Anatomic factors predictive of incomplete colonoscopy based on findings at CT colonography. AJR Am J Roentgenol 2007;189(4):774-9.","DOI":"10.2214\/AJR.07.2048"},{"key":"5334_CR8","doi-asserted-by":"crossref","unstructured":"8. Pickhardt PJ. Screening CT colonography: how I do it. AJR Am J Roentgenol 2007;189(2):290-8.","DOI":"10.2214\/AJR.07.2136"},{"key":"5334_CR9","doi-asserted-by":"crossref","unstructured":"9. Utano K, Nagata K, Honda T, Kato T, Lefor AK, Togashi K. Bowel habits and gender correlate with colon length measured by CT colonography. Jpn J Radiol 2021 (In eng). DOI: 10.1007\/s11604-021-01204-7.","DOI":"10.1007\/s11604-021-01204-7"},{"key":"5334_CR10","doi-asserted-by":"crossref","unstructured":"10. Pickhardt PJ, Bakke J, Kuo J, et al. Volumetric Analysis of Colonic Distention According to Patient Position at CT Colonography: Diagnostic Value of the Right Lateral Decubitus Series. American Journal of Roentgenology 2014;203(6):W623-W628. DOI: 10.2214\/ajr.13.12369.","DOI":"10.2214\/AJR.13.12369"},{"key":"5334_CR11","doi-asserted-by":"crossref","unstructured":"11. Buchach CM, Kim DH, Pickhardt PJ. Performing an additional decubitus series at CT colonography. Abdominal Imaging 2011;36(5):538\u2013544. DOI: 10.1007\/s00261-010-9666-9.","DOI":"10.1007\/s00261-010-9666-9"},{"key":"5334_CR12","doi-asserted-by":"crossref","unstructured":"12. Sadahiro S, Ohmura T, Yamada Y, Saito T, Taki Y. Analysis of length and surface area of each segment of the large intestine according to age, sex and physique. Surg Radiol Anat 1992;14(3):251-7. (In eng). DOI: 10.1007\/bf01794949.","DOI":"10.1007\/BF01794949"},{"key":"5334_CR13","doi-asserted-by":"crossref","unstructured":"13. Wald A, Scarpignato C, Kamm MA, et al. The burden of constipation on quality of life: results of a multinational survey. Aliment Pharmacol Ther 2007;26(2):227\u2009\u2212\u200936. (In eng). DOI: 10.1111\/j.1365-2036.2007.03376.x.","DOI":"10.1111\/j.1365-2036.2007.03376.x"},{"key":"5334_CR14","doi-asserted-by":"crossref","unstructured":"14. Suares NC, Ford AC. Prevalence of, and risk factors for, chronic idiopathic constipation in the community: systematic review and meta-analysis. Am J Gastroenterol 2011;106(9):1582-91; quiz 1581, 1592. (In eng). DOI: 10.1038\/ajg.2011.164.","DOI":"10.1038\/ajg.2011.164"},{"key":"5334_CR15","doi-asserted-by":"crossref","unstructured":"15. Higgins PD, Johanson JF. Epidemiology of constipation in North America: a systematic review. Am J Gastroenterol 2004;99(4):750-9. (In eng). DOI: 10.1111\/j.1572-0241.2004.04114.x.","DOI":"10.1111\/j.1572-0241.2004.04114.x"},{"key":"5334_CR16","doi-asserted-by":"crossref","unstructured":"16. Anderson JC, Gonzalez JD, Messina CR, Pollack BJ. Factors that predict incomplete colonoscopy: thinner is not always better. Am J Gastroenterol 2000;95(10):2784-7. (In eng). DOI: 10.1111\/j.1572-0241.2000.03186.x.","DOI":"10.1111\/j.1572-0241.2000.03186.x"},{"key":"5334_CR17","doi-asserted-by":"crossref","unstructured":"17. Kim DH, Pickhardt PJ, Taylor AJ, et al. CT colonography versus colonoscopy for the detection of advanced neoplasia. New England Journal of Medicine 2007;357(14):1403\u20131412. (<\u2009Go to ISI>:\/\/000249892900006 ).","DOI":"10.1056\/NEJMoa070543"},{"key":"5334_CR18","doi-asserted-by":"crossref","unstructured":"18. Pickhardt PJ, Choi JR, Hwang I, et al. Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. New England Journal of Medicine 2003;349(23):2191\u20132200. (<\u2009Go to ISI>:\/\/000186921700005 ).","DOI":"10.1056\/NEJMoa031618"},{"key":"5334_CR19","doi-asserted-by":"crossref","unstructured":"19. Pickhardt PJ, Kim DH. CT colonography (virtual colonoscopy): a practical approach for population screening. Radiol Clin North Am 2007;45(2):361\u2009\u2212\u200975.","DOI":"10.1016\/j.rcl.2007.03.011"},{"key":"5334_CR20","doi-asserted-by":"crossref","unstructured":"20. Pickhardt PJ, Golden MV, Kim DH. CT Colonography for Colorectal Cancer Screening and Prevention: 20-Year Programmatic Experience at a U.S. Academic Medical Center. AJR Am J Roentgenol 2025 (In eng). DOI: 10.2214\/ajr.25.33288.","DOI":"10.2214\/AJR.25.33288"}],"container-title":["Abdominal Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00261-025-05334-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00261-025-05334-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00261-025-05334-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T04:43:59Z","timestamp":1781498639000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00261-025-05334-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,19]]},"references-count":20,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["5334"],"URL":"https:\/\/doi.org\/10.1007\/s00261-025-05334-8","relation":{},"ISSN":["2366-0058"],"issn-type":[{"value":"2366-0058","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,19]]},"assertion":[{"value":"4 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 November 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 December 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 December 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"PJP serves as an advisor to Bracco Diagnostics, Nanox-AI, and ColoWatch; and has stock or stock options in Elucent, SHINE, and ColoWatch.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}