| Autor: |
Ho, Amanzo A., MacLean, Kelly A., Trollip, J. Jacques, Andrews, Gordon T., Yoshida, Eric M., Harris, Alison C. |
| Předmět: |
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| Zdroj: |
British Columbia Medical Journal; Apr2015, Vol. 57 Issue 3, p106-111, 6p |
| Abstrakt: |
Background: An estimated 3000 new cases of colorectal cancer and 1210 deaths from this common malignancy occurred in British Columbia in 2014. Given the excellent diagnostic performance and superior safety record of CT colonography (CTC) compared with colonoscopy, CTC is currently underutilized as both a diagnostic test and a screening tool. Methods: To evaluate the diagnostic performance, safety, and costs of the CTC service at UBC Hospital, we conducted a retrospective review of all CTC studies completed at the hospital between 1 June 2012 and 30 June 2013 at UBC hospital. Data were collected on patient demographics, study indication, study quality, and clinically significant colonic or extracolonic findings. Medical records were reviewed for follow-up colonoscopy/surgery and extracolonic imaging. Results: A total of 220 CTC studies were reviewed. Patients had a mean age of 65.3 (SD 11.1) years. A history of failed colonoscopy was noted for 131 patients (59.5%). CTC detected 74 polyps (6 mm or greater in diameter) in 52 patients. Follow-up colonoscopy/surgery in 39 patients identified 29 colonic polyps/masses. The per-polyp sensitivity was 71.4% for intermediate polyps (6 to 9 mm) and 100% for large polyps (10 mm or greater), while the per-polyp positive predictive value was 66.7% for intermediate polyps and 83.3% for large polyps. The overall per-patient positive predictive value was 77.8%. Extracolonic findings on CTC resulted in 26 follow-up imaging investigations, amounting to an additional cost of $37.93 per CTC study. There were no cases of colonic perforation or major complication in this study. Conclusions: The CTC service at UBC Hospital demonstrates good diagnostic performance, a low rate of complication, and has the potential to play a greater role in diagnosis and screening of colorectal cancer in BC. Although the current consensus is that CTC is less accurate than colonoscopy in the diagnosis of colorectal cancer, and thus less cost-effective, advancements in imaging protocol and institution experience will continue to increase both diagnostic accuracy and cost-effectiveness. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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