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Positive predictive value for polyps detected at screening CT colonography

  • Gastrointestinal
  • Published:
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Abstract

Purpose

To determine the positive predictive value (PPV) for polyps detected at CT colonography (CTC).

Methods

Assessment of 739 colorectal lesions ≥6 mm detected prospectively at CTC screening in 479 patients was performed. By-polyp PPV was analyzed according to small (6–9 mm) versus large (≥10 mm) size; morphology (sessile/pedunculated/flat); diagnostic confidence level (3 = most confident, 1 = least confident); and histology. By-patient PPV was analyzed at various polyp size thresholds.

Results

By-polyp PPV for CTC-detected lesions ≥6 mm, 6–9 mm, and ≥10 mm was 91.6% (677/739), 90.1% (410/451), and 92.7% (267/288), respectively (p = 0.4). By-polyp PPV according to sessile, pedunculated, flat, and mass-like morphology was 92.5% (441/477), 96.5% (139/144), 77.7% (73/94), and 97.6% (40/41), respectively (p < 0.0001 for flat versus polypoid morphology). By-polyp PPV according to diagnostic confidence level was 94.7% (554/585) for highest (= level 3), 83.5% (106/127) for intermediate (= level 2), and 63.0% (17/27) for lowest (= level 1) confidence (p < 0.0001 for levels-2/3 versus level-1). By-patient PPV at 6-mm, 8-mm, 10-mm, and 30-mm polyp size thresholds was 92.3% (442/479), 93.0% (306/329), 93.1% (228/245), and 97.4% (38/39), respectively.

Conclusion

The overall per-polyp and per-patient PPV for lesions ≥6 mm was 92% for CTC screening. Increased diagnostic confidence and polypoid (non-flat) morphology correlated with a higher PPV, whereas small versus large polyp size had very little effect.

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Acknowledgements

Dr. Pickhardt and Dr. Kim are consultants for Medicsight and Viatrox and are co-founders of VirtuoCTC.

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Authors and Affiliations

  1. Department of Radiology, University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Science Center, 600 Highland Ave., Madison, WI, 53792-3252, USA

    Perry J. Pickhardt, Steven M. Wise & David H. Kim

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  1. Perry J. Pickhardt
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  2. Steven M. Wise
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  3. David H. Kim
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Corresponding author

Correspondence to Perry J. Pickhardt.

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Pickhardt, P.J., Wise, S.M. & Kim, D.H. Positive predictive value for polyps detected at screening CT colonography. Eur Radiol 20, 1651–1656 (2010). https://doi.org/10.1007/s00330-009-1704-z

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  • DOI: https://doi.org/10.1007/s00330-009-1704-z

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