Colon polyps and carcinomas: prospective comparison of the single- and double-contrast examination in the same patients.

Roos, Albert de; Hermans, J.; Shaw, P C; Kroon, Herman M.

doi:10.1148/radiology.154.1.3964926

Cited by 42 publications

(5 citation statements)

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“…Others have found that these areas are where diagnostic difficulties most commonly arise [16][17][18]. Although 14 (54%) of the missed lesions were in the sigmoid colon, diverticula were present in only four cases, and contributed to the perceptive error in only two of these.…”

Section: Discussionmentioning

confidence: 96%

“…And the ability to angle the tube is likely to be especially useful in detecting strictures, so many of which were missed in our series. In addition, perhaps in selected cases (patients with anemia or rectal bleeding) the biphasic barium enema technique of de Roos et al [17,18], using the advantages of single-contrast and double-contrast techniques, should be used to increase the detection/perception of strictures. Although all retrospectively visible carcinomas could be seen on standard views (posteroanterior, anteroposterior, angled sigmoid, decubitus, and prone rectum) as Eisenberg et al [21] found for diagnosed carcinomas, we are reluctant to dismiss as superfluous the prone left posterior oblique and supine right anterior oblique views as these two views best show the ascending colon and hepatic flexure where over one quarter of the missed carcinomas were found.…”

Section: Discussionmentioning

confidence: 99%

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Colonoscopically detected colorectal cancer missed on barium enema

Anderson

Cook

Coates

1991

Gastrointest Radiol

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The radiographs and clinical records of 26 patients with colorectal cancer missed on barium enema, and subsequently detected at colonoscopy, were reviewed to determine the cause of radiological error. Twenty (77%) of the patients were female. In 24 of 26 patients, anemia and/or rectal bleeding was a presenting feature. Fourteen of the 26 (54%) missed cancers were in the sigmoid colon, 10 (38%) in the ascending colon or hepatic flexure, and two (8%) in the rectum. Tumor size ranged from 20-100 mm. Fifteen were polyps, and 11 annular cancers. Fourteen (54%) were Dukes C or D tumors. Twenty-eight barium enemas in 23 patients were available for review: 86% were double-contrast studies. In 18 (76%), the cancer could be seen in retrospect and, in over half, the tumor was obvious. The dominant perceptive error was due to missing the lesion in the barium pool. Other major errors were missing the lesion en face or in overlapping loops. As most cancers were missed because of observer perceptive error, by both experienced and inexperienced radiologists, the authors recommend double reporting of all barium enemas.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Colonoscopically detected colorectal cancer missed on barium enema

Anderson

Cook

Coates

1991

Gastrointest Radiol

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“…The early detection and accurate diagnosis of colorectal tumors will, therefore, depend on techniques that permit visualization of the entire colon. For this purpose, either colonoscopy or barium enema examination are suitable as the initial diagnostic method as well as for periodic screening of the high-risk group of patients [18,[24][25][26][27][28]. They include individuals with chronic ulcerative colitis, familial polyposis and Gardner syndrome, previous colorectal polyp or carcinoma, and those with family history of large bowel cancer [15,19,26].…”

Section: Discussionmentioning

confidence: 99%

Colorectal carcinomas: Diagnostic implications of their changing frequency and anatomic distribution

Ghahremani

Dowlatshahi

1989

World j. surg.

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This retrospective review included 1,694 consecutive cases of colorectal carcinoma diagnosed at the University of Chicago Medical Center during a 25-year period (1960 through 1984). The number and percentage of tumors occurring within 7 anatomic segments of the large bowel were determined. The statistical data for a recent 5-year interval were then compared with those of the 2 preceding decades. There was a 10.2% increase in the frequency of cancers originating in the cecum or ascending colon, while rectal and rectosigmoid carcinomas declined by 15.8% during the same study period. These data provide further evidence for a progressive left-to-right shift in cancer distribution within the colon during the past quarter century. Currently, the most proximal and distal 20-25 cm segments of the large bowel (cecum or ascending colon versus rectum and rectosigmoid) each harbor approximately 25% of the tumors. Therefore, the classic medical teaching that over 50% of colorectal cancers would be detectable by digital examination and/or proctosigmoidoscopy is no longer accurate. This documented increase in proximal colon cancers and redistribution of lesions within various large bowel segments indicate the growing importance of barium enema and colonoscopy as the optimal techniques for detection of colorectal neoplasms.

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“…Single-contrast barium enema has been shown to have about 75% sensitivity and specificity for detection of polypoid lesions [309,310]; double-contrast (air-contrast) barium enema improves on this [311,312]. Even so, most studies have found that double-contrast barium enemas miss a proportion of polypoid lesions subsequently detected at colonoscopy [311,313,314].…”

Section: Barium Enema Radiographymentioning

confidence: 99%

Neoplastic and Nonneoplastic Polyps of the Colon and Rectum

Macrae

Young

2008

Textbook of Gastroenterology

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Epidemiology PrevalenceInformation on the prevalence of polyps comes from autopsy studies and from colonoscopic surveys, which are of a much smaller scale. Autopsy studies generally show a higher prevalence of polyps and adenomas than endoscopic studies. Prevalence rates vary considerably between gender (males more common), ethnic groups, and countries, and reflect the rates of colorectal cancer in those population groups (see Chapter 63). In the United States, autopsy studies suggest an overall polyp prevalence of up to 50% [6,7], but colonoscopic surveys suggest no more than 40% [8][9][10][11][12][13][14][15]. In autopsy studies, fixation of the colon and careful use of a magnifying glass allow detection of small polyps that are more readily missed during colonoscopy [16][17][18][19][20].More than 90% of polyps detected at colonoscopy are epithelial in origin, that is, adenomas or hyperplastic polyps, and 75% of these are adenomas [8][9][10][11][12][13]. In the case of diminutive epithelial polyps (less than 5 mm), about half are hyperplastic [14,15].Age is the major determinant of adenoma prevalence [6,7]. Size at detection also increases with age [20]. Colorectal adenomas are uncommon in patients younger than 30 years of age. Anatomical distributionStudies show that colorectal adenomas are more common in the distal colon and rectum, similar to the distribution of colorectal cancer (see Chapter 63). Distribution, however, relates to size. Small adenomas are more uniformly distributed throughout the entire colon, whereas large adenomas (greater than 1 cm) show a distal predominance [7,8,21,22].

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Colon polyps and carcinomas: prospective comparison of the single- and double-contrast examination in the same patients.

Cited by 42 publications

References 0 publications

Colonoscopically detected colorectal cancer missed on barium enema

Colonoscopically detected colorectal cancer missed on barium enema

Colorectal carcinomas: Diagnostic implications of their changing frequency and anatomic distribution

Neoplastic and Nonneoplastic Polyps of the Colon and Rectum

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