Computed tomographic colonography compared with colonoscopy in patients at increased risk for colorectal cancer
| Autor: | Jasper Florie, Joep F. Bartelsman, C. Yung Nio, Rogier E. van Gelder, Patrick M.M. Bossuyt, Steven W. de Jager, P. Snel, Jaap Stoker, Johan S. Laméris, Sander J. H. van Deventer |
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| Přispěvatelé: | Radiology and Nuclear Medicine, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, CCA -Cancer Center Amsterdam, Gastroenterology and Hepatology, Extramural researchers, Epidemiology and Data Science |
| Rok vydání: | 2004 |
| Předmět: |
Male
Risk medicine.medical_specialty Colorectal cancer Colonic Polyps Colonoscopy Sensitivity and Specificity Positive predicative value medicine Humans Mass Screening In patient Prospective Studies Family history Prospective cohort study Mass screening Aged Observer Variation Hepatology medicine.diagnostic_test business.industry Gastroenterology Cancer Middle Aged medicine.disease Female Radiology Colorectal Neoplasms business Colonography Computed Tomographic |
| Zdroj: | Gastroenterology, 127(1), 41-48. W.B. Saunders Ltd |
| ISSN: | 0016-5085 |
| Popis: | Background & Aims: To date, computed tomographic (CT) colonography has been compared with an imperfect test, colonoscopy, and has been mainly assessed in patients with positive screening test results or symptoms. Therefore, the available data may not apply to screening of patients with a personal or family history of colorectal polyps or cancer (increased risk). We prospectively investigated the ability of CT colonography to identify individuals with large (greater than or equal to10 mm) colorectal polyps in consecutive patients at increased risk for colorectal cancer. Methods: A total of 249 consecutive patients at increased risk for colorectal cancer underwent CT colonography before colonoscopy. Two reviewers interpreted CT colonography examinations independently. Sensitivity, specificity, and predictive values were determined after meticulous matching of CT colonography with colonoscopy. Unexplained large false-positive findings were verified with a second-look colonoscopy. Results: In total, 31 patients (12%) had 48 large polyps at colonoscopy. This included 8 patients with 8 large polyps that were overlooked initially and detected at the second-look colonoscopy. In 6 of 8 patients, the missed polyp was the only large lesion. With CT colonography, 84% of patients (26/31) with large polyp(s) were identified, paired for a specificity of 92% (200-201/218). Positive and negative predictive values were 59%-60% (26/43-44) and 98% (200-201/205-206), respectively. CT colonography detected 75%-77% (36-37/48) of large polyps, with 9 of the missed lesions being flat. Conclusions: CT colonography and colonoscopy have a similar ability to identify individuals with large polyps in patients at increased risk for colorectal cancer. The large proportion of missed flat lesions warrants further study |
| Databáze: | OpenAIRE |
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