Flat colorectal lesions in asymptomatic adults: implications for screening with CT virtual colonoscopy
| Autor: | Pamela A. Nugent, Perry J. Pickhardt, J. Richard Choi, William R. Schindler |
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| Rok vydání: | 2004 |
| Předmět: |
Adenoma
Adult Male medicine.medical_specialty Virtual colonoscopy Colon Biopsy Colonoscopy Rectum Colonic Polyps Asymptomatic Sensitivity and Specificity Lesion Predictive Value of Tests medicine Humans Radiology Nuclear Medicine and imaging Clinical significance Aged medicine.diagnostic_test business.industry General Medicine Middle Aged medicine.disease Endoscopy medicine.anatomical_structure Female Radiology medicine.symptom business Colorectal Neoplasms Colonography Computed Tomographic |
| Zdroj: | AJR. American journal of roentgenology. 183(5) |
| ISSN: | 0361-803X |
| Popis: | The clinical significance of flat lesions in colorectal cancer screening remains uncertain. The purpose of this study was to investigate the frequency, histology, and virtual colonoscopy detection of flat lesions in an asymptomatic screening population.The morphology of all detected polyps was prospectively recorded as flat or polypoid (sessile or pedunculated) in 1,233 consecutive asymptomatic adults who underwent same-day virtual colonoscopy and optical colonoscopy. A flat morphology was defined as a shallow plaquelike broad-based lesion with a height of less than one half of its width.Of 344 polyps of 6 mm or greater confirmed at optical colonoscopy, 17 (4.9%) were labeled as flat at both virtual colonoscopy and optical colonoscopy; 17 (4.9%), at optical colonoscopy only; and 25 (7.3%), at virtual colonoscopy only, yielding 59 total lesions in 52 (4.2%) of 1,233 patients. Twenty-nine (49.2%) of 59 flat lesions were adenomatous, of which four measured 10 mm or greater and one 6- to 9-mm lesion was histologically advanced. None of the 148 diminutive flat lesions (or = 5 mm) detected at optical colonoscopy was histologically advanced. Virtual colonoscopy prospectively detected 24 (82.8%) of 29 flat adenomas and 47 (80.0%) of all 59 flat lesions 6 mm or greater. In comparison, the sensitivity of virtual colonoscopy for the detection of polypoid adenomas and all polypoid lesions of 6 mm or greater was 86.2% (156/181, p = 0.58) and 81.0% (231/285, p = 0.86), respectively.Flat adenomas measuring 6 mm or greater are uncommon in a typical Western screening population, and advanced flat neoplasms are rare. The sensitivity of virtual colonoscopy for detecting flat lesions was similar to that of polypoid lesions. These results indicate that flat lesions are not a significant drawback for virtual colonoscopy screening. |
| Databáze: | OpenAIRE |
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