BACKGROUND: We investigated whether flat lesions of the colon could be detected on computed tomographic colonography (CTC). METHODS: CTC and conventional colonoscopy were performed on 547 consecutive patients. A subset of 22 polyps was described as flat on colonoscopy (n = 16) or CTC (n = 6) and are the basis of this report. CTC was performed with a standard technique (5-mm collimation, 3-mm reconstruction intervals). Patients were scanned in supine and prone positions. Examinations were randomly assigned and reviewed in a blinded fashion by two of three radiologists. Prospective interpretations were recorded. All patients had conventional colonoscopy, which served as the gold standard. RESULTS: Twenty-two flat lesions ranging from 0.4 to 3.5 cm were histologically classified as adenomatous (n = 8) or hyperplastic (n = 14). The sensitivities for detecting all flat lesions and flat adenomas by each reviewer were 43% and 100%, 65% and 100%, and 15% and 13%, respectively. "Double reading" resulted in detection of 68% of all lesions and 100% of adenomas. Of the seven hyperplastic polyps missed by both reviewers, four were identified retrospectively. CONCLUSION: Flat lesions of the colon represent an important source of false negative CTC examinations. Awareness of their morphology can assist radiologists in finding most of these challenging lesions.
BACKGROUND: We investigated whether flat lesions of the colon could be detected on computed tomographic colonography (CTC). METHODS: CTC and conventional colonoscopy were performed on 547 consecutive patients. A subset of 22 polyps was described as flat on colonoscopy (n = 16) or CTC (n = 6) and are the basis of this report. CTC was performed with a standard technique (5-mm collimation, 3-mm reconstruction intervals). Patients were scanned in supine and prone positions. Examinations were randomly assigned and reviewed in a blinded fashion by two of three radiologists. Prospective interpretations were recorded. All patients had conventional colonoscopy, which served as the gold standard. RESULTS: Twenty-two flat lesions ranging from 0.4 to 3.5 cm were histologically classified as adenomatous (n = 8) or hyperplastic (n = 14). The sensitivities for detecting all flat lesions and flat adenomas by each reviewer were 43% and 100%, 65% and 100%, and 15% and 13%, respectively. "Double reading" resulted in detection of 68% of all lesions and 100% of adenomas. Of the seven hyperplastic polyps missed by both reviewers, four were identified retrospectively. CONCLUSION: Flat lesions of the colon represent an important source of false negative CTC examinations. Awareness of their morphology can assist radiologists in finding most of these challenging lesions.
Authors: Stuart A Taylor; Steve Halligan; David Burling; Simon Morley; Paul Bassett; Wendy Atkin; Clive I Bartram Journal: Eur Radiol Date: 2004-02-10 Impact factor: 5.315
Authors: Rogier E van Gelder; Jasper Florie; C Yung Nio; Sebastiaan Jensch; Steven W de Jager; Frans M Vos; Henk W Venema; Joep F Bartelsman; Johannes B Reitsma; Patrick M M Bossuyt; Johan S Laméris; Jaap Stoker Journal: Eur Radiol Date: 2006-11-22 Impact factor: 5.315
Authors: Ronald M Summers; Jiamin Liu; Jianhua Yao; Linda Brown; J Richard Choi; Perry J Pickhardt Journal: AJR Am J Roentgenol Date: 2009-11 Impact factor: 3.959
Authors: V Panebianco; M Osimani; D Lisi; E Santucci; M Ciccariello; S Iori; C Catalano; R Passariello Journal: Radiol Med Date: 2008-12-11 Impact factor: 3.469