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Predictive value of a diagnosis of colonic polyp on the double-contrast barium enema

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Gastrointestinal Radiology Aims and scope

Abstract

The positive predictive value of a diagnosis of colonic polyp on the double-contrast barium enema was determined by analyzing 160 polypoid lesions reported in 105 patients. Of the 160 polyps, 139 were confirmed by endoscopy, surgery, or repeat barium enema for a positive predictive value of 87%. Twenty-one lesions were not confirmed despite repeat endoscopy, repeat barium enema, review of the original study, or surgery, giving a false positive rate of 13%. The individual false positive error rates of 5 radiologists ranged from 8% to 26%. False positive errors were due to stool, diverticula, air bubbles, misinterpretation of the ileocecal valve, and haustration. Many of the false positive errors appeared to have been avoidable if the original examination had been more meticulously interpreted.

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References

  1. Gelfand DW, Ott DJ: Single-vs. double-contrast gastrointestinal studies: critical analysis of reported statistics.AJR 137:523–528, 1981

    PubMed  Google Scholar 

  2. Williams CB, Hunt RH, Loose H, Riddell RH, Sakai Y, Swarbrick ET: Colonoscopy in the management of colon polyps.Br J Surg 61:673–682, 1974

    PubMed  Google Scholar 

  3. Laufer I, Smith NCW, Mullens JE: The radiological demonstration of colorectal polyps undetected by endoscopy.Gastroenterology 70:167–170, 1976

    PubMed  Google Scholar 

  4. Thoeni RF, Menuck L: Comparison of barium enema and colonoscopy in the detection of small colonic polyps.Radiology 124:631–635, 1977

    PubMed  Google Scholar 

  5. Maruyama M:Radiologic Diagnosis of Polyps and Carcinoma of the Large Bowel. Tokyo: Igaku-Shoin, 1978, pp 56–57

    Google Scholar 

  6. Bloomfield JA: Reliability of barium enema in detecting colonic neoplasia.Med J Aust 1:631–633, 1982

    Google Scholar 

  7. Fork F-T: Double contrast enema and colonoscopy in polyp detection.Gut 22:971–977, 1981

    PubMed  Google Scholar 

  8. Weyman PJ, Koehler RE, Zuckerman GR: Resolution of radiographic-endoscopic discrepancies in colon neoplasms.J Clin Gastroenterol 3(Suppl 1):89–93, 1981

    Google Scholar 

  9. Ransohoff DF, Feinstein AR: Problems of spectrum and bias in evaluating the efficacy of diagnostic tests.N Engl J Med 299:926–930, 1978

    PubMed  Google Scholar 

  10. Feinstein AR:Clinical Biostatistics. St. Louis: CV Mosby Co, 1977, pp 214–226

    Google Scholar 

  11. Metz CE: Basic principles of ROC analysis.Semin Nucl Med 8:283–298, 1978

    PubMed  Google Scholar 

  12. Lusted LB: General problems in medical decision making with comments on ROC analysis.Semin Nucl Med 8:299–306, 1978

    PubMed  Google Scholar 

  13. Leinicke JL, Dodds WJ, Hogan WJ, Stewart ET: A comparison of colonoscopy and roentgenography for detecting polypoid lesions of the colon.Gastrointest Radiol 2:125–128, 1977

    PubMed  Google Scholar 

  14. Ott DJ, Gelfand DW, Ramquist NA: Causes of error in gastrointestinal radiology. II. Barium enema examination.Gastrointest Radiol 5:99–105, 1980

    Article  PubMed  Google Scholar 

  15. Ott DJ, Gelfand DW, Wu WC, Kerr RM: Sensitivity of double-contrast barium enema: emphasis on polyp detection.AJR 135:327–330, 1980

    PubMed  Google Scholar 

  16. Miller RE: Detection of colon carcinoma and the barium enema.JAMA 230:1195–1198, 1974

    Article  PubMed  Google Scholar 

  17. Miller RE: The clean colon.Gastroenterology 70:289–290, 1976

    PubMed  Google Scholar 

  18. Laufer I: The double-contrast enema: myths and misconceptions.Gastrointest Radiol 1:19–31, 1976

    Article  PubMed  Google Scholar 

  19. Ott DJ, Gelfand DW: Colorectal tumors: pathology and detection.AJR 131:691–695, 1978

    PubMed  Google Scholar 

  20. Knutson CO, Williams HC, Max MH: Detection of intracolonic lesion by barium contrast enema. The importance of adequate colon preparation for diagnostic accuracy.JAMA 242:2206–2208, 1979

    Article  PubMed  Google Scholar 

  21. Kelvin FM, Gardiner R, Vas W, Stevenson GW: Colorectal carcinoma missed on double contrast barium enema study: a problem of perception.AJR 137:307–313, 1981

    PubMed  Google Scholar 

  22. Irwin JP, Peterson GH: Colon preparation for the barium enema: a guide for the radiologist.Gastrointest Radiol 7:75–78, 1982

    Article  PubMed  Google Scholar 

  23. Youker JE, Welin S: Differentiation of true polypoid tumors of the colon from extraneous material: a new roentgen sign.Radiology 84 610–615, 1965

    PubMed  Google Scholar 

  24. Friedland GW, Poole GJ: False-positive “eccentric target sign” on barium-air contrast enema examination.Radiology 99:67–68, 1971

    PubMed  Google Scholar 

  25. Youker JE, Dodds WJ, Welin S: Colonic polyps. In Margulis AR, Burhenne HJ (eds):Alimentary Tract Roentgenology, Vol 2, St. Louis: CV Mosby Co, 1973, pp 1037–1067

    Google Scholar 

  26. Htoo AM, Bartram CI: The radiological diagnosis of polyps in the presence of diverticular disease.Br J Radiol 52:263–267, 1979

    PubMed  Google Scholar 

  27. Dodds WJ, Stewart ET, Hogan WJ: Role of colonoscopy and roentgenology in the detection of polypoid colonic lesions.Am J Dig Dis 22:646–649, 1977

    Article  PubMed  Google Scholar 

  28. Miller RE, Lehman G: Polypoid colonic lesions undetected by endoscopy.Radiology 129:295–297, 1978

    PubMed  Google Scholar 

  29. Evers K, Laufer I, Gordon RL, Kressel HY, Herlinger H, Gohel VK: Double-contrast enema examination for detection of rectal carcinoma.Radiology 140:635–639, 1981

    PubMed  Google Scholar 

  30. Thoeni RF, Petras A: Detection of rectal and rectosigmoid lesions by double-contrast barium enema examination and sigmoidoscopy.Radiology 142:59–62, 1982

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA

    David J. Ott M.D., Deborah S. Ablin, David W. Gelfand & Isadore Meschan

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  1. David J. Ott M.D.
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  2. Deborah S. Ablin
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  3. David W. Gelfand
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  4. Isadore Meschan
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Ott, D.J., Ablin, D.S., Gelfand, D.W. et al. Predictive value of a diagnosis of colonic polyp on the double-contrast barium enema. Gastrointest Radiol 8, 75–80 (1983). https://doi.org/10.1007/BF01948093

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  • DOI: https://doi.org/10.1007/BF01948093

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