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Role of CT colonography in differentiating sigmoid cancer from chronic diverticular disease

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Abstract

Purpose

To evaluate the accuracy of computed tomography colonography (CTC) in differentiating chronic diverticular disease from colorectal cancer (CRC), using morphological and textural parameters.

Materials and methods

We included 95 consecutive patients with histologically proven chronic diverticular disease (n = 53) or CRC (n = 42) who underwent CTC. One radiologist, unaware of histological findings, evaluated CTC studies for the presence of potential discriminators including: maximum thickness, involved segment length, shouldering phenomenon, growth pattern, diverticula, fascia thickening, fat tissue edema, loco-regional lymph nodes, mucosal pattern. Another radiologist performed volumetric texture analysis on the involved segment.

Results

Several qualitative imaging parameters resulted to significantly correlated with colorectal cancer, including absence of diverticula in the affected segment, straightened growth pattern and shouldering phenomenon. A maximum wall thickness/involved segment length ratio < 0.1 had 98% specificity and 47% sensitivity in identifying diverticular disease. Regarding first-order texture analysis parameters, kurtosis resulted to be significantly different between the two groups.

Conclusions

Absence of diverticula, straightened growth pattern and shouldering phenomenon are significantly associated with CRC (71–91% sensitivity; 82–91%).

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Abbreviations

CTC:

Computed tomography colonography

CRC:

Colorectal cancer

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Authors and Affiliations

  1. Department of Radiology, Bolzano Regional Hospital, 5 Böhler Street, 39100, Bolzano, Italy

    Riccardo Valletta, Matteo Bonatti, Micaela Tagliamonte & Federica Ferro

  2. Department of Radiology, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy

    Riccardo Valletta & Niccolò Faccioli

  3. Department of Radiology, IRCCS Ospedale Sacro Cuore-Don Calabria, via Don Sempreboni 5, 37024, Negrar, VR, Italy

    Giovanni Foti & Fabio Lombardo

  4. Department of Radiology, Mater Salutis Hospital Legnago, Via Gianella 1, 37045, Legnago, VR, Italy

    Elena Santi

Authors
  1. Riccardo Valletta
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  2. Niccolò Faccioli
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  3. Matteo Bonatti
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  4. Giovanni Foti
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  5. Fabio Lombardo
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  6. Elena Santi
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  7. Micaela Tagliamonte
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  8. Federica Ferro
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Correspondence to Riccardo Valletta.

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All authors declare no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (include name of committee + reference number) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Retrospective study, need for informed consent was waived by the institutional review board.

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Valletta, R., Faccioli, N., Bonatti, M. et al. Role of CT colonography in differentiating sigmoid cancer from chronic diverticular disease. Jpn J Radiol 40, 48–55 (2022). https://doi.org/10.1007/s11604-021-01176-8

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  • DOI: https://doi.org/10.1007/s11604-021-01176-8

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