Assessment of polyp and mass histopathology by intravenous contrast-enhanced CT colonography
| Autor: | Danny S. Brickman, Nicholas Petrick, Marek Franaszek, Ronald M. Summers, Adam Huang, Amy K. Hara, Shannon R. Campbell, Jennifer E. Dempsey, Ingmar Bitter, Andrew J. Dwyer, Jianhua Yao |
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| Rok vydání: | 2006 |
| Předmět: |
Adenoma
Adult Male medicine.medical_specialty Supine position Enhanced ct Colorectal cancer Colonoscopy Colonic Polyps Contrast Media medicine Carcinoma Humans Radiology Nuclear Medicine and imaging Aged Intravenous contrast Aged 80 and over medicine.diagnostic_test business.industry Middle Aged medicine.disease digestive system diseases Confidence interval ROC Curve Area Under Curve Colonic Neoplasms Injections Intravenous Histopathology Female Radiology business Colonography Computed Tomographic |
| Zdroj: | Academic radiology. 13(12) |
| ISSN: | 1076-6332 |
| Popis: | Rationale and Objectives We sought to demonstrate that intravenous contrast–enhanced CT colonography (CTC) can distinguish colonic adenomas from carcinomas. Methods Supine intravenous contrast–enhanced CTC with colonoscopic and/or surgical correlation was performed on 25 patients with colonic adenomas or carcinomas. Standard deviation of mean polyp CT attenuation was computed and assessed using ANOVA and receiver-operating characteristic analyses. Results Colonoscopy confirmed 32 polyps or masses 1 to 8 cm in size. The standard deviations of CT attenuation were carcinomas (n = 13; 36 ± 6 HU; range 28–48 HU) and adenomas (n = 19; 49 ± 14 HU; range 31–100 HU) (P = 0.005). At a standard deviation threshold of 42 HU, the sensitivity and specificity for classifying a polyp or mass as a carcinoma were 92% and 79%, respectively. The area under the receiver-operating characteristic curve was 0.89 ± 0.06 (95% confidence interval 0.73–0.96). Conclusions Measurement of the standard deviation of CT attenuation on intravenous contrast–enhanced CTC permits histopathologic classification of polyps 1 cm or larger as carcinomas versus adenomas. The presence of ulceration or absence of muscular invasion in carcinomas creates overlap with adenomas, reducing the specificity of carcinoma classification. |
| Databáze: | OpenAIRE |
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