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

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.

Can Computed Tomography Colonography Replace Optical Colonoscopy in Detecting Colorectal Lesions?: State of the Art

“…22 Ginnerup et al 23 reported that CTC and OC have similar overall detection rates for colorectal lesions >6 mm. Devir et al 24 and Gluecker et al 25 showed that CTC has good sensitivity and specificity for the detection of colorectal lesions > 10 mm, although its accuracy in detecting polyps decreased as the size of the lesions decreased. These results are similar to those reported by Pineau et al, 22 Laghi et al, 15 and Hoppe et al 26 Additionally, Chaparro Sánchez et al 27 found that the sensitivity of CTC for the detection of colorectal lesions was highly variable and dependent on the lesion size: sensitivity was greater for larger lesions and considerably lower for lesions < 5 mm.…”

“…Ginnerup et al [ 23 ] reported that CTC and OC have similar overall detection rates for colorectal lesions >6 mm. Devir et al [ 24 ] and Gluecker et al [ 25 ] showed that CTC has good sensitivity and specificity for the detection of colorectal lesions >10 mm, although its accuracy in detecting polyps decreased as the size of the lesions decreased. These results are similar to those reported by Pineau et al [ 22 ], Laghi et al [ 15 ], and Hoppe et al [ 26 ].…”

Appendiceal mucinous cystadenoma presenting as abdominal internal hernia: a case report

“…And usually the benign and malignant could be told with the typical features of CT which is the enhancing nodular lesion in the wall ( 25 , 31 , 32 ). Regarding to the diagnosis of appendiceal mucinous cystadenoma, ultrasound shows the location of mucocele which usually situated at the proximal appendiceal orifice causing distal lumen obstruction ( 30 ) and CT scan, the most helpful imaging examination ( 5 , 33 ), shows the density of contents, complications like inflammation and compression, relationship between peri appendiceal tissue and pseudomyxoma ( 34 ). And appendiceal mucinous cystadenoma should be differentially diagnosed from ovary cyst, lymphocele, abscess, enteric duplication cyst, hematoma and hydrosalpinx ( 25 , 35 ).…”

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“…CTC allows the accurate assessment of both colonic and extracolonic pathologies as a useful diagnostic tool in patients for whom complete OC is not achievable [19]. CTC is a valuable diagnostic tool for examining the entire colon and a good alternative compared to other CRC screening tests because of its high sensitivity values [20,21], especially in colorectal lesions over 1 cm. [20,22] CTC combined with OC provides a more accurate preoperative determination of CRC localization and invasion depth than OC alone [23].…”