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Characteristics of Advanced Adenomas Detected at CT Colonographic Screening: Implications for Appropriate Polyp Size Thresholds for Polypectomy Versus Surveillance

David H. Kim1, Perry J. Pickhardt and Andrew J. Taylor

1 All authors: Department of Radiology, University of Wisconsin Medical School, 600 Highland Ave., E3/311 Clinical Science Center, Madison, WI 53792-3252.


Figure 1
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  		Fig. 1A —63-year-old man at average risk who underwent screening CT colonography (CTC). Endoluminal 3D colonographic image shows large (22-mm) pedunculated polyp in sigmoid colon. In general, large polyps are readily detected on CTC.

 

Figure 2
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  		Fig. 1B —63-year-old man at average risk who underwent screening CT colonography (CTC). Transverse 2D image with CTC polyp windows shows large polyp (arrowhead).

 

Figure 3
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  		Fig. 1C —63-year-old man at average risk who underwent screening CT colonography (CTC). Transverse CTC image with standard abdominal windows shows soft-tissue composition of sigmoid polyp (arrowhead).

 

Figure 4
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  		Fig. 1D —63-year-old man at average risk who underwent screening CT colonography (CTC). Digital photograph from same-day optical colonoscopy shows polyp before endoscopic resection. Pathologic evaluation revealed advanced adenoma characterized by tubulovillous histologic features without high-grade dysplasia or malignant focus.

 

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