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Diagnostic accuracy of CT colonography and optical colonoscopy evaluated using surgically resected specimens

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Abstract

Objective

The aim of this study was to clarify the diagnostic ability of CT colonography (CTC) using surgically resected specimens to avoid inaccuracy associated with optical colonoscopy (OC).

Subjects and methods

CTC and OC were performed in 152 consecutive patients with colorectal cancer. Forty patients had simultaneous lesions other than the ones for which the surgery was intended, and these lesions were used as the gold standard. In 24 patients without stenosis, the sensitivity and positive predictive values (PPV) of CTC and OC were evaluated. In 16 patients with stenosis, the diagnostic ability of CTC for lesions located proximal to the stenosis was assessed.

Results

Sensitivity of CTC and OC was 81% and 66% (P = 0.16), and PPV was 90% and 100% (P = 0.13), respectively. For 22 lesions larger than 5 mm, the sensitivity of CTC and OCS was 96% and 91% (P > 0.50), and PPV was 100% and 100%, respectively. In patients with stenosis, sensitivity and PPV were 89% and 80%, respectively. These results were not significantly different from those in patients without stenosis.

Conclusions

CTC is a reliable modality for the diagnosis of colorectal polyps. It is also useful to evaluate the colon proximal to severe stenosis which could not be observed by OC.

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References

  1. Kawamura YJ, Sasaki J, Okamaoto H, et al. Clinical significance of virtual colonoscopy (CT colonography) with special reference to polyp morphology. Hepatogastroenterology. 2004;51:1686-8.

    PubMed  Google Scholar 

  2. Utano K, Endo K, Togashi K, et al. (2008) Preoperative T staging of colorectal cancer by CT colonography. Dis Colon Rectum [Epub ahead of print]

  3. Kim JH, Kim WH, Kim TI, et al. Incomplete colonoscopy in patients with occlusive colorectal cancer: usefulness of CT colonography according to tumor location. Yonsei Med J. 2007;48:934-41.

    Article  CAS  PubMed  Google Scholar 

  4. Yucel C, Lev-Toaff AS, Moussa N, Durrani H. CT colonography for incomplete or contraindicated optical colonoscopy in older patients. AJR Am J Roentgenol. 2008;190:145-50.

    Article  PubMed  Google Scholar 

  5. Copel L, Sosna J, Kruskal JB, et al. CT colonography in 546 patients with incomplete colonoscopy. Radiology. 2007;244:471-8.

    Article  PubMed  Google Scholar 

  6. Sosna J, Sella T, Sy O, et al. Critical analysis of the performance of double-contrast barium enema for detecting colorectal polyps > or = 6 mm in the era of CT colonography. AJR Am J Roentgenol. 2008;190:374-85.

    Article  PubMed  Google Scholar 

  7. Rockey DC, Paulson E, Niedzwiecki D, et al. Analysis of air contrast barium enema, computed tomographic colonography, and colonoscopy: prospective comparison. Lancet. 2005;365:305-11.

    CAS  PubMed  Google Scholar 

  8. Kim DH, Pickhardt PJ, Taylor AJ, et al. CT colonography versus colonoscopy for the detection of advanced neoplasia. N Engl J Med. 2007;357:1403-12.

    Article  CAS  PubMed  Google Scholar 

  9. Chaparro Sánchez M, del Campo Val L, Maté Jiménez J, et al. Computed tomography colonography compared with conventional colonoscopy for the detection of colorectal polyps. Gastroenterol Hepatol. 2007;30:375-80.

    Article  PubMed  Google Scholar 

  10. Bensen S, Mott LA, Dain B, Rothstein R, Baron J. The colonoscopic miss rate and true one-year recurrence of colorectal neoplastic polyps. Polyp Prevention Study Group. Am J Gastroenterol. 1999;94:194-9.

    Article  CAS  PubMed  Google Scholar 

  11. Heresbach D, Barrioz T, Lapalus MG, et al. Miss rate for colorectal neoplastic polyps: a prospective multicenter study of back-to-back video colonoscopies. Endoscopy. 2008;40:284-90.

    Article  CAS  PubMed  Google Scholar 

  12. Rex DK, Cutler CS, Lemmel GT, et al. Colonoscopic miss rates of adenomas determined by back-to-back colonoscopies. Gastroenterology. 1997;112:24-8.

    Article  CAS  PubMed  Google Scholar 

  13. van Rijn JC, Reitsma JB, Stoker J, et al. Polyp miss rate determined by tandem colonoscopy: a systematic review. Am J Gastroenterol. 2006;101:343-50.

    Article  PubMed  Google Scholar 

  14. Roberts-Thomson IC, Tucker GR, Hewett PJ, et al. Single-center study comparing computed tomography colonography with conventional colonoscopy. World J Gastroenterol. 2008;14:469-73.

    Article  PubMed  Google Scholar 

  15. Arnesen RB, von Benzon E, Adamsen S, et al. Diagnostic performance of computed tomography colonography and colonoscopy: a prospective and validated analysis of 231 paired examinations. Acta Radiol. 2007;48:831-7.

    Article  CAS  PubMed  Google Scholar 

  16. Cotton PB, Durkalski VL, Pineau BC, et al. Computed tomographic colonography (virtual colonoscopy): a multicenter comparison with standard colonoscopy for detection of colorectal neoplasia. JAMA. 2004;291:1713-9.

    Article  CAS  PubMed  Google Scholar 

  17. Pickhardt PJ, Nugent PA, Mysliwiec PA, Choi JR, Schindler WR. Location of adenomas missed by optical colonoscopy. Ann Intern Med. 2004;141:352-9.

    PubMed  Google Scholar 

  18. Postic G, Lewin D, Bickerstaff C, Wallace MB. Colonoscopic miss rates determined by direct comparison of colonoscopy with colon resection specimens. Am J Gastroenterol. 2002;97:3182-5.

    Article  PubMed  Google Scholar 

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Correspondence to Yutaka J. Kawamura.

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Kawamura, Y.J., Okada, S., Sasaki, J. et al. Diagnostic accuracy of CT colonography and optical colonoscopy evaluated using surgically resected specimens. Abdom Imaging 35, 584–588 (2010). https://doi.org/10.1007/s00261-009-9558-z

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  • DOI: https://doi.org/10.1007/s00261-009-9558-z

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