Literature DB >> 14657315

Detection of colorectal lesions: lower-dose multi-detector row helical CT colonography compared with conventional colonoscopy.

Riccardo Iannaccone1, Andrea Laghi, Carlo Catalano, James A Brink, Filippo Mangiapane, Simona Trenna, Francesca Piacentini, Roberto Passariello.   

Abstract

PURPOSE: To compare the performance of lower-dose multi-detector row helical computed tomographic (CT) colonography with that of conventional colonoscopy in the detection of colorectal lesions.
MATERIALS AND METHODS: One hundred fifty-eight patients underwent multi-detector row helical CT colonography (beam collimation, 4 x 2.5 mm; table feed, 17.5 mm/sec; voltage, 140 kV; and effective dose, 10 mAs) followed by conventional colonoscopy. Conventional colonoscopy served as the reference standard. Two radiologists interpreted CT colonographic images to assess the presence of polyps or carcinomas. Sensitivity was calculated on both a per-polyp and a per-patient basis. In the latter, specificity and positive and negative predictive values were also calculated. Weighted CT dose index was calculated on the basis of measurements obtained in a standard body phantom. Effective dose was estimated by using commercially available software.
RESULTS: CT colonography correctly depicted all 22 carcinomas (sensitivity, 100%) and 52 of 74 polyps (sensitivity, 70.3%). Sensitivity for detection was 100% in all 13 polyps 10 mm or larger in diameter, 83.3% in 20 of 24 polyps 6-9 mm, and 51.3% in 19 of 37 lesions 5 mm or smaller. With regard to the per-patient analysis, CT colonography had a sensitivity of 96.0%, a specificity of 96.6%, a positive predictive value of 94.1%, and a negative predictive value of 97.7%. The total weighted CT dose index for combined prone and supine acquisitions was 2.74 mGy. The simulated effective doses for complete CT colonography were 1.8 mSv in men and 2.4 mSv in women.
CONCLUSION: Lower-dose multi-detector row helical CT colonography ensures substantial dose reduction while maintaining excellent sensitivity for detection of colorectal carcinomas and polyps larger than 6 mm in diameter.

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Year:  2003        PMID: 14657315     DOI: 10.1148/radiol.2293021399

Source DB:  PubMed          Journal:  Radiology        ISSN: 0033-8419            Impact factor:   11.105


  30 in total

Review 1.  CT colonography: perforation rates and potential radiation risks.

Authors:  A Berrington de Gonzalez; Kwang Pyo Kim; Judy Yee
Journal:  Gastrointest Endosc Clin N Am       Date:  2010-04

2.  Computed tomography colonography: colon examination or Pandora's box.

Authors:  R Iannaccone; A Laghi; C Catalano; F Mangiapane; D Marin; R Passariello
Journal:  Gut       Date:  2004-06       Impact factor: 23.059

3.  Screening for colon cancer.

Authors:  J P Heiken
Journal:  Cancer Imaging       Date:  2006-10-31       Impact factor: 3.909

4.  Diagnostic radiation exposure and cancer risk.

Authors:  M B Frenz; A S Mee
Journal:  Gut       Date:  2005-06       Impact factor: 23.059

Review 5.  Colonoscopy vs CT colonography to screen for colorectal neoplasia in average-risk patients.

Authors:  J M Hardacre; J L Ponsky; M E Baker
Journal:  Surg Endosc       Date:  2005-03       Impact factor: 4.584

6.  Effective radiation doses in CT colonography: results of an inventory among research institutions.

Authors:  Sebastiaan Jensch; Rogier E van Gelder; Henk W Venema; Johannes B Reitsma; Patrick M M Bossuyt; Johan S Laméris; Jaap Stoker
Journal:  Eur Radiol       Date:  2006-01-18       Impact factor: 5.315

7.  Reader error during CT colonography: causes and implications for training.

Authors:  Andrew Slater; Stuart A Taylor; Emily Tam; Louise Gartner; Julia Scarth; Chand Peiris; Arun Gupta; Michele Marshall; David Burling; Steve Halligan
Journal:  Eur Radiol       Date:  2006-05-16       Impact factor: 5.315

8.  [CT colonography: patient preparation and examination technique].

Authors:  P Lefere; S Gryspeerdt; T Mang
Journal:  Radiologe       Date:  2008-02       Impact factor: 0.635

9.  Diagnostic performance of CT colonography for the detection of colorectal polyps.

Authors:  Ji-young Yun; Hee Jeong Ro; Jong Beom Park; Jung-Bin Choi; Ji Eun Chung; Yong Jin Kim; Won Hyuck Suh; Jong Kyun Lee
Journal:  Korean J Radiol       Date:  2007 Nov-Dec       Impact factor: 3.500

10.  Computed tomography colonography (virtual colonoscopy): climax of a new era of validation and transition into community practice.

Authors:  Jacob Thomas; Jeffrey Carenza; Elizabeth McFarland
Journal:  Clin Colon Rectal Surg       Date:  2008-08
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