Computed tomographic colonography without cathartic preparation for the detection of colorectal polyps
| Autor: | Antonietta Lamazza, Riccardo Iannaccone, Francesca Piacentini, Alberto Schillaci, Giovanni Sinibaldi, Filippo Mangiapane, Carlo Catalano, V. Stipa, Takamichi Murakami, Masatoshi Hori, Roberto Passariello, Paolo Sammartino, Andrea Laghi, Italo Nofroni |
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| Jazyk: | angličtina |
| Rok vydání: | 2004 |
| Předmět: |
Adult
Male medicine.medical_specialty Colorectal cancer education Colonic Polyps Cathartic Colonoscopy Sensitivity and Specificity Surveys and Questionnaires medicine Humans Computed Tomographic Colonography neoplasms Aged Hepatology medicine.diagnostic_test Cathartics business.industry Gastroenterology Middle Aged Sodium Diatrizoate medicine.disease Predictive value digestive system diseases Confidence interval Colonic Neoplasms Diatrizoate Meglumine Female Radiology Nuclear medicine business Colonography Computed Tomographic |
| Popis: | Background & Aims: We prospectively compared the performance of low-dose multidetector computed tomographic colonography (CTC) without cathartic preparation with that of colonoscopy for the detection of colorectal polyps. Methods: A total of 203 patients underwent low-dose CTC without cathartic preparation followed by colonoscopy. Before CTC, fecal tagging was achieved by adding diatrizoate meglumine and diatrizoate sodium to regular meals. No subtraction of tagged feces was performed. Colonoscopy was performed 3–7 days after CTC. Three readers interpreted the CTC examinations separately and independently using a primary 2-dimensional approach using multiplanar reconstructions and 3-dimensional images for further characterization. Colonoscopy with segmental unblinding was used as reference standard. The sensitivity of CTC was calculated both on a per-polyp and a per-patient basis. For the latter, specificity, positive predictive values, and negative predictive values were also calculated. Results: CTC had an average sensitivity of 95.5% (95% confidence interval [CI], 92.1%–99%) for the identification of colorectal polyps ≥8 mm. With regard to per-patient analysis, CTC yielded an average sensitivity of 89.9% (95% CI, 86%–93.7%), an average specificity of 92.2% (95% CI, 89.5%–94.9%), an average positive predictive value of 88% (95% CI, 83.3%–91.5%), and an average negative predictive value of 93.5% (95% CI, 90.9%–96%). Interobserver agreement was high on a per-polyp basis (κ statistic range, .61–.74) and high to excellent on a per-patient basis (κ statistic range, .79–.91). Conclusions: Low-dose multidetector CTC without cathartic preparation compares favorably with colonoscopy for the detection of colorectal polyps. |
| Databáze: | OpenAIRE |
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