CT colonography for surveillance of patients with colorectal cancer: Systematic review and meta-analysis of diagnostic efficacy

Abstract

• CT colonography compares favourably to colonoscopy/standard CT for colorectal cancer surveillance. • CT colonography offers single-test luminal, serosal and extra-colonic assessment. • CT colonography is a potentially cost-saving alternative to standard surveillance protocols.

Prospective Trial Evaluating the Surgical Anastomosis at One-Year Colorectal Cancer Surveillance: CT Colonography Versus Optical Colonoscopy and Implications for Patient Care

“…14 A recent meta-analysis looking at additional CTC studies showed excellent pooled sensitivity for detecting both local cancer recurrence (95%) and metachronous cancers (100%). 13 Specificity for anastomotic cancer in this meta-analysis was reported to be 100%. However, specificity for anastomotic cancer recurrence may not reflect the actual OC referral rate from CTC related to abnormal focal findings at the anastomosis.…”

“…Since standard CT is common to both arms, either approach can likely detect extraluminal peri-anastomotic recurrence, although the CT-CTC combination may have some advantages in this regard. Although prior retrospective studies have shown that CTC is highly sensitive for detecting anastomotic and peri-anastomotic cancer recurrence, 13 the rate of potential CTC false-positives leading to unnecessary OC referral (with associated increased costs) is less certain. 4 This is perhaps of greatest relevance in relatively low-risk post-surgical cohorts without clinical evidence of recurrent disease.…”

“…6 Rather, local recurrence tends to be extramural and peri-anastomotic, 7 leading some investigators to consider using CT colonography (CTC) technique at the time of diagnostic CT to simultaneously evaluate for both intra- and extra-luminal pathology, potentially sparing the patient of short-term OC if the colon can be cleared of relevant lesions. 8–14 Cumulative results from mainly single-center, retrospective studies have been very promising, 13 but likely require validation from a prospective multi-center trial setting. In particular, evaluation of the surgical anastomosis can be challenging at OC, with many potential false-positive results related to non-neoplastic findings, as well as potential false-negatives related to the lack of a detectable intraluminal component to most anastomotic and peri-anastomotic recurrences.…”

“…In particular, evaluation of the surgical anastomosis can be challenging at OC, with many potential false-positive results related to non-neoplastic findings, as well as potential false-negatives related to the lack of a detectable intraluminal component to most anastomotic and peri-anastomotic recurrences. 4,7,10,13 …”

Utilidad de la Colonografía-TC o Colonoscopia virtual en la patología colorrectal

“…El diagnóstico de las neoplasias sincrónicas de nuestra muestra, fueron todos ellos confirmados tras la intervención quirúrgica con un 100% de sensibilidad para su detección, como los hallazgos publicados por Park et al 140 en el 2012 y reforzados por los hallazgos de Porté et al 141 en el 2017, donde afirma así como otros autores que la CV es actualmente la única prueba diagnóstica alternativa a la colonoscopia óptica incompleta, por este motivo.…”