Abstract
The purpose of this study is to describe our experience with cases of false negative findings at conventional colonoscopy (CC) that were identified by CT colonography (CTC). Conventional colonoscopy (CC) is the universally accepted gold-standard technique for the diagnosis of colonic polyps and cancers, however occasionally this method can generate false negative findings. We present examples of false negatives at CC, correctly identified by CT colonography (CTC), and later confirmed at a second endoscopy, describing the reasons of false negative, when possible.
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Pickhardt PJ, Hassan C, Halligan S, Marmo R (2011) Colorectal cancer: CT colonography and colonoscopy for detection-systematic review and meta-analysis. Radiology 259:393–405
Johnson CD, Chen MH, Toledano AY, et al. (2008) Accuracy of CT colonography for detection of large adenomas and cancers. N Engl J Med 359:1207–1217
Regge D, Laudi C, Galatola G, et al. (2009) Diagnostic accuracy of computed tomographic colonography for the detection of advanced neoplasia in individuals at increased risk of colorectal cancer. JAMA 301:2453–2461
Graser A, Stieber P, Nagel D, et al. (2009) Comparison of CT colonography, colonoscopy, sigmoidoscopy and faecal occult blood tests for the detection of advanced adenoma in an average risk population. Gut 58:241–248
Baxter NN, Goldwasser MA, Paszat LF, et al. (2009) Association of colonoscopy and death from colorectal cancer. Ann Intern Med 150(1):1–8
Fidler J, et al. (2009) Flat polyps of the colon: accuracy of detection by CT colonography and histologic significance. Abdom Imaging 34:157–171
Togashi K, et al. (2003) Flat and depressed lesions of the colon and rectum: pathogenesis and clinical management. Ann Acad Med Singapore 32:152–158
Taylor SA, et al. (2009) Flat neoplasia of the colon: CT colonography with CAD. Abdom Imaging 34:173–181
Suzuki N, et al. (2004) The prevalence of small flat colorectal cancers in a western population. Colorectal Dis 6:15–20
Han Dongsoo, et al. (1997) Flat depressed early colon cancer: a case report. JKMS 12:465–468
Hurlstone P, et al. (2003) A prospective clinicopathological and endoscopic evaluation of flat and depressed colorectal lesions in the United Kingdom. Am J Gastroenterol 98:2543–2549
Lostumbo A, et al. (2010) Flat lesions in CT colonography. Abdom Imaging 35:578–583
Rembacken BJ, et al. (2000) Flat and depressed colonic neoplasms: a prospective study of 1000 colonoscopies in the UK. Lancet 355:1211–1214
Park SH, et al. (2006) Flat polyps of the colon: detection with 16-MDCT colonography—preliminary results. AJR 186:1611–1617
Gluecker TM, et al. (2004) Characterization of lesions missed on interpretation of CT colonography using a 2D search method. AJR 182:881–889
Fidler JL, et al. (2002) Detection of flat lesions in the colon with CT colonography. Abdom Imaging 27:292–300
Park SH, et al. (2009) Sensitivity of CT colonography for nonpolypoid colorectal lesions interpreted by human readers and with computer-aided detection. AJR 193:1–9
Pickhardt PJ, et al. (2004) Flat colorectal lesions in asymptomatic adults: implications for screening with CT virtual colonoscopy. AJR 183:1343–1347
Suzuki N, et al. (2006) Flat colorectal neoplasms and the impact of the revised Vienna classification on their reporting: a case–control study in UK and Japanese patients. Scand J Gastroenterol 41:812–819
Taylor S, et al. (2008) CT colonography: computer-aided detection of morphologically flat T1 colonic carcinoma. Eur Radiol 18:1666–1673
Soetikno R, et al. (2006) Nonpolypoid (flat and depressed) colorectal neoplasms. Gastroenterology 130:566–576
The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon: November 30 to December 1, 2002. Gastrointest Endosc 58:S3–S43 (2003)
Compton CC, et al. (2004) The staging of colorectal cancer: 2004 and beyond. CA Cancer J Clin 54:295–308
Ross AS, Waxman I (2006) Flat and depressed neoplasms of the colon in western populations. Am J Gastroenterol 101:172–180
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Coppola, F., Regge, D., Flor, N. et al. Flat lesions missed at conventional colonoscopy (CC) and visualized by CT colonography (CTC): a pictorial essay. Abdom Imaging 39, 25–32 (2014). https://doi.org/10.1007/s00261-013-0052-2
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DOI: https://doi.org/10.1007/s00261-013-0052-2