Prospective Study Comparing Multislice CT Colonography With Colonoscopy in the Detection of Colorectal Cancer and Polyps

Munikrishnan, Venkatesh; Gillams, Alice; Lees, W. R.; Vaizey, C. J.; Boulos, P B

doi:10.1007/s10350-004-6755-2

Cited by 43 publications

(18 citation statements)

References 23 publications

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“…[13][14][15][16][17] In addition, colonoscopies performed for a positive FOBT result had a higher detection rate for small adenomas 6 to 9 mm in size, which confirms the data previously reported by Morikawa et al 18 Although previous studies showed that certain signs and symptoms are associated with an increased risk of finding CRC but not adenomas, 19 the detection rates of diminutive and small adenomas for indications of symptoms (OR 0.73 for small adenomas) and GI bleed (OR 0.67 for small adenomas) were lower than for screening; these colonoscopies are performed to identify a cause of the symptoms. Accounting for individual colonoscopists is a strength of this study because previous studies have noted interprovider variation in preparation ratings 7 and ADRs 20-23 as well as correlation between detection rates and preparation ratings.…”

Section: Discussionmentioning

confidence: 99%

The effect of colonoscopy preparation quality on adenoma detection rates

Sherer

Imler

Imperiale

2012

Gastrointestinal Endoscopy

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Section: Discussionmentioning

confidence: 99%

The effect of colonoscopy preparation quality on adenoma detection rates

Sherer

Imler

Imperiale

2012

Gastrointestinal Endoscopy

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“…We included 47 prospective studies involving 10,546 patients that compared CTC to the reference standard of CC or surgery [17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63]. Table 2 shows detailed information from individual studies.…”

Section: Resultsmentioning

confidence: 99%

Accuracy of Computed Tomographic Colonography for the Detection of Polyps and Colorectal Tumors: A Systematic Review and Meta-Analysis

et al. 2009

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Background: The real accuracy of computed tomographic colonography (CTC) is still unknown. Objective: To perform a meta-analysis of the diagnostic accuracy of CTC for the detection of polyps and colorectal tumors. Methods: Selection of studies:Studiesassessing the accuracy of CTC for the detection of colorectal polyps and tumors were selected. Data synthesis:Meta-analyses combining sensitivities, specificities and likelihood ratios (LRs) for the diagnosis of polyps and colorectal tumors were carried out. Results: Forty-seven studies, providing data of 10,546 patients, were included. Overall per-polyp sensitivity of CTC was 66% (64–68%), for polyps 6–9 mm in size it was 59% (56–61%), and 76% (73–79%) for polyps larger than 9 mm. Overall per-patient sensitivity was 69% (66–72%), for polyps 6–9 mm 60% (56–65%), and 83% (70–85%) for lesions larger than 9 mm. Overall CTC specificity was 83% (81–84%). Positive and negative LRs were 2.9 (1.8–4) and 0.38 (0.27–0.53), respectively; for polyps 6–9 mm in size, they were 3.8 (2.5–5.7) and 0.4 (0.27–0.59), and 12.3 (7.7–19.4) and 0.19 (0.12–0.3) for polyps larger than 9 mm. Conclusion: CTC is highly specific for the detection of colorectal polyps and tumors. Some studies reported high sensitivities, but the results of the studies were highly heterogeneous, while the studied variables explained only part of this discrepancy.

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“…Conclusion: CAD can detect symptomatic colorectal cancer but must be applied to both prone and supine acquisitions for best performance. CT colonography (CTC) is increasingly used as a relatively non-invasive method of colonic investigation both for colorectal cancer screening [1,2] and in patients with symptoms suggestive of colorectal cancer [3][4][5][6]. Despite the advent of modern visualisation workstations, accurate interpretation of CTC is known to be difficult and requires substantial observer training [7][8][9][10].…”

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confidence: 99%

CT colonography: computer-assisted detection of colorectal cancer

Robinson

Halligan²,

Iinuma³

et al. 2011

BJR

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Objectives: Computer-aided detection (CAD) for CT colonography (CTC) has been developed to detect benign polyps in asymptomatic patients. We aimed to determine whether such a CAD system can also detect cancer in symptomatic patients. Methods: CTC data from 137 symptomatic patients subsequently proven to have colorectal cancer were analysed by a CAD system at 4 different sphericity settings: 0, 50, 75 and 100. CAD prompts were classified by an observer as either true-positive if overlapping a cancer or false-positive if elsewhere. Colonoscopic data were used to aid matching. Results: Of 137 cancers, CAD identified 124 (90.5%), 122 (89.1%), 119 (86.9%) and 102 (74.5%) at a sphericity of 0, 50, 75 and 100, respectively. A substantial proportion of cancers were detected on either the prone or supine acquisition alone. Of 125 patients with prone and supine acquisitions, 39.3%, 38.3%, 43.2% and 50.5% of cancers were detected on a single acquisition at a sphericity of 0, 50, 75 and 100, respectively. CAD detected three cancers missed by radiologists at the original clinical interpretation. Falsepositive prompts decreased with increasing sphericity value (median 65, 57, 45, 24 per patient at values of 0, 50, 75, 100, respectively) but many patients were poorly prepared. Conclusion: CAD can detect symptomatic colorectal cancer but must be applied to both prone and supine acquisitions for best performance. CT colonography (CTC) is increasingly used as a relatively non-invasive method of colonic investigation both for colorectal cancer screening [1,2] and in patients with symptoms suggestive of colorectal cancer [3][4][5][6]. Despite the advent of modern visualisation workstations, accurate interpretation of CTC is known to be difficult and requires substantial observer training [7][8][9][10]. It has been suggested that computer-aided detection (CAD) may enhance reader performance and perhaps also diminish the learning curve for CTC [11,12]. Recent studies confirm that reader sensitivity is increased when interpretation is supplemented by CAD [13][14][15][16].Most claims for the potential benefits of CAD have been made in the context of colorectal cancer screening [12,17], which targets both early cancer and its precursor, the adenomatous polyp. In asymptomatic individuals, the prevalence of adenomas vastly exceeds that of early cancer and so CAD systems have naturally been optimised for polyp detection. However, CTC is also advocated for symptomatic patients, in whom the prevalence of established carcinoma is much higher [18]. Even then, symptoms suggesting cancer are both nonspecific and common in the general population, with the result that most patients investigated do not actually have cancer [18], and CAD to assist diagnosis of colorectal cancer is therefore an attractive concept. Cancers, like polyps, are usually characterised by softtissue protrusion into the bowel lumen. It is therefore possible that CAD systems may serendipitously identify cancers. We aimed to determine whether a CAD system developed to detect co...

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Prospective Study Comparing Multislice CT Colonography With Colonoscopy in the Detection of Colorectal Cancer and Polyps

Cited by 43 publications

References 23 publications

The effect of colonoscopy preparation quality on adenoma detection rates

The effect of colonoscopy preparation quality on adenoma detection rates

Accuracy of Computed Tomographic Colonography for the Detection of Polyps and Colorectal Tumors: A Systematic Review and Meta-Analysis

CT colonography: computer-assisted detection of colorectal cancer

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