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Comparison of 64-Detector CT Colonography and Conventional Colonoscopy in the Detection of Colorectal Lesions.

Devir C, Kebapci M, Temel T, Ozakyol A - Iran J Radiol (2016)

Bottom Line: For polyps between 6mm and 9 mm, MDCT colonography displayed 75% sensitivity and 100% specificity, with a positive predictive value of 100% and a negative predictive value of 90%.For polyps ≤ 5 mm MDCT colonography displayed 88% sensitivity and 100% specificity with a positive predictive value of 100% and a negative predictive value of 95%.CT colonography is a safe and minimally invasive technique, a valuable diagnostic tool for examining the entire colon and a good alternative compared to other colorectal cancer screening tests because of its high sensitivity values in colorectal lesions over 1 cm.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Research and Training Hospital, Kutahya Dumlupinar University, Kutahya, Turkey.

ABSTRACT

Background: Colon cancer is a leading cause of morbidity and mortality in developed countries. The early detection of colorectal cancer using screening programs is important for managing early-stage colorectal cancers and polyps. Modalities that allow examination of the entire colon are conventional colonoscopy, double contrast barium enema examination and multi-detector computed tomography (MDCT) colonography.

Objectives: To compare CT colonography and conventional colonoscopy results and to evaluate the accuracy of CT colonography for detecting colorectal lesions.

Patients and methods: In a prospective study performed at Gastroenterology and Radiology Departments of Medical Faculty of Eskisehir Osmangazi University, CT colonography and colonoscopy results of 31 patients with family history of colorectal carcinoma, personal or family history of colorectal polyps, lower gastrointestinal tract bleeding, change in bowel habits, iron deficiency anemia and abdominal pain were compared. Regardless of the size, CT colonography and conventional colonoscopy findings for all the lesions were cross - tabulated and the sensitivity, specificity, and positive and negative predictive values were calculated. To assess the agreement between CT colonography and conventional colonoscopy examinations, the Kappa coefficient of agreementt was used. Statistical analysis was performed by SPSS ver 15.0.

Results: Regardless of the size, MDCT colonography showed 83% sensitivity and 95% specificity, with a positive predictive value of 95% and a negative predictive value of 83% for the detection of colorectal polyps and masses. MDCT colonography displayed 92% sensitivity and 95% specificity, with a positive predictive value of 92% and a negative predictive value of 95% for polyps ≥ 10 mm. For polyps between 6mm and 9 mm, MDCT colonography displayed 75% sensitivity and 100% specificity, with a positive predictive value of 100% and a negative predictive value of 90%. For polyps ≤ 5 mm MDCT colonography displayed 88% sensitivity and 100% specificity with a positive predictive value of 100% and a negative predictive value of 95%.

Conclusions: CT colonography is a safe and minimally invasive technique, a valuable diagnostic tool for examining the entire colon and a good alternative compared to other colorectal cancer screening tests because of its high sensitivity values in colorectal lesions over 1 cm.

No MeSH data available.


Related in: MedlinePlus

A 55-year-old man suffering from abdominal pain. A and B, Axial CT images: Tumor in the sigmoid colon and two adjacent polyps. C and D, Virtual colonoscopy appearance of tumors and polyps.
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fig22509: A 55-year-old man suffering from abdominal pain. A and B, Axial CT images: Tumor in the sigmoid colon and two adjacent polyps. C and D, Virtual colonoscopy appearance of tumors and polyps.

Mentions: Among 11 patients with pathological findings, three patients had tumors, one patient had two polyps, one patient had three polyps, one patient had four polyps and one patient had six polyps. In one patient with a tumor, two polyps were detected in the adjacent lesion. The samples from MDCT colonography findings in the patients are shown in Figures 1 and 2. Seven of the total 24 polyps were ≤ 5 mm, six polyps were between 6 mm and 9 mm, and 11 polyps were ≥ 10 mm. In a histopathological examination of 24 polyps detected using MDCT colonography, nine polyps were diagnosed as tubular adenoma, two polyps were diagnosed as tubulovillous adenoma, and 10 polyps were diagnosed as hyperplastic polyp. Histopathological diagnosis of all three tumors was adenocarcinoma (Table 3). In addition to the detection of polyps, CT colonography was effective in diagnosing colorectal cancer in three cases in our study.


Comparison of 64-Detector CT Colonography and Conventional Colonoscopy in the Detection of Colorectal Lesions.

Devir C, Kebapci M, Temel T, Ozakyol A - Iran J Radiol (2016)

A 55-year-old man suffering from abdominal pain. A and B, Axial CT images: Tumor in the sigmoid colon and two adjacent polyps. C and D, Virtual colonoscopy appearance of tumors and polyps.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4835868&req=5

fig22509: A 55-year-old man suffering from abdominal pain. A and B, Axial CT images: Tumor in the sigmoid colon and two adjacent polyps. C and D, Virtual colonoscopy appearance of tumors and polyps.
Mentions: Among 11 patients with pathological findings, three patients had tumors, one patient had two polyps, one patient had three polyps, one patient had four polyps and one patient had six polyps. In one patient with a tumor, two polyps were detected in the adjacent lesion. The samples from MDCT colonography findings in the patients are shown in Figures 1 and 2. Seven of the total 24 polyps were ≤ 5 mm, six polyps were between 6 mm and 9 mm, and 11 polyps were ≥ 10 mm. In a histopathological examination of 24 polyps detected using MDCT colonography, nine polyps were diagnosed as tubular adenoma, two polyps were diagnosed as tubulovillous adenoma, and 10 polyps were diagnosed as hyperplastic polyp. Histopathological diagnosis of all three tumors was adenocarcinoma (Table 3). In addition to the detection of polyps, CT colonography was effective in diagnosing colorectal cancer in three cases in our study.

Bottom Line: For polyps between 6mm and 9 mm, MDCT colonography displayed 75% sensitivity and 100% specificity, with a positive predictive value of 100% and a negative predictive value of 90%.For polyps ≤ 5 mm MDCT colonography displayed 88% sensitivity and 100% specificity with a positive predictive value of 100% and a negative predictive value of 95%.CT colonography is a safe and minimally invasive technique, a valuable diagnostic tool for examining the entire colon and a good alternative compared to other colorectal cancer screening tests because of its high sensitivity values in colorectal lesions over 1 cm.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Research and Training Hospital, Kutahya Dumlupinar University, Kutahya, Turkey.

ABSTRACT

Background: Colon cancer is a leading cause of morbidity and mortality in developed countries. The early detection of colorectal cancer using screening programs is important for managing early-stage colorectal cancers and polyps. Modalities that allow examination of the entire colon are conventional colonoscopy, double contrast barium enema examination and multi-detector computed tomography (MDCT) colonography.

Objectives: To compare CT colonography and conventional colonoscopy results and to evaluate the accuracy of CT colonography for detecting colorectal lesions.

Patients and methods: In a prospective study performed at Gastroenterology and Radiology Departments of Medical Faculty of Eskisehir Osmangazi University, CT colonography and colonoscopy results of 31 patients with family history of colorectal carcinoma, personal or family history of colorectal polyps, lower gastrointestinal tract bleeding, change in bowel habits, iron deficiency anemia and abdominal pain were compared. Regardless of the size, CT colonography and conventional colonoscopy findings for all the lesions were cross - tabulated and the sensitivity, specificity, and positive and negative predictive values were calculated. To assess the agreement between CT colonography and conventional colonoscopy examinations, the Kappa coefficient of agreementt was used. Statistical analysis was performed by SPSS ver 15.0.

Results: Regardless of the size, MDCT colonography showed 83% sensitivity and 95% specificity, with a positive predictive value of 95% and a negative predictive value of 83% for the detection of colorectal polyps and masses. MDCT colonography displayed 92% sensitivity and 95% specificity, with a positive predictive value of 92% and a negative predictive value of 95% for polyps ≥ 10 mm. For polyps between 6mm and 9 mm, MDCT colonography displayed 75% sensitivity and 100% specificity, with a positive predictive value of 100% and a negative predictive value of 90%. For polyps ≤ 5 mm MDCT colonography displayed 88% sensitivity and 100% specificity with a positive predictive value of 100% and a negative predictive value of 95%.

Conclusions: CT colonography is a safe and minimally invasive technique, a valuable diagnostic tool for examining the entire colon and a good alternative compared to other colorectal cancer screening tests because of its high sensitivity values in colorectal lesions over 1 cm.

No MeSH data available.


Related in: MedlinePlus