Literature DB >> 15067626

Comparison of the relative sensitivity of CT colonography and double-contrast barium enema for screen detection of colorectal polyps.

C Daniel Johnson1, Robert L MacCarty, Timothy J Welch, Lynn A Wilson, William S Harmsen, Duane M Ilstrup, David A Ahlquist.   

Abstract

BACKGROUND & AIMS: In a population reflective of a screening setting, our aim was to compare the relative sensitivity and specificity of computed tomography (CT) colonography with double-contrast barium enema (DCBE) for detection of colorectal polyps and to assess the added value of double reading at CT colonography, using endoscopy as the arbiter.
METHODS: This prospective, blinded study comprised 837 asymptomatic persons at higher than average risk for colorectal cancer who underwent CT colonography followed by same-day DCBE. Examinations with polyps > or =5 mm in diameter were referred to colonoscopy.
RESULTS: CT colonography readers detected 56%-79% of polyps > or =10 mm in diameter. In comparison, the sensitivity at DCBE varied between 39% and 56% for the 31 polyps > or =1 cm. All of the readers detected more polyps at CT colonography than DCBE, but the difference was statistically significant for only a single reader (P = 0.02). Relative specificity for polyps > or =10 mm on a per-patient basis ranged from 96% to 99% at CT colonography, and 99%-100% at DCBE. Doubly read CT colonography detected significantly more polyps than DCBE (81% vs. 45% for polyps > or =1 cm [P = <0.01], and 72% vs. 44% for polyps 5-9 mm [P < or = 0.01]).
CONCLUSIONS: Double-read CT colonography is significantly more sensitive in detecting polyps than single-read double contrast barium enema. DCBE was significantly more specific than CT colonography.

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Year:  2004        PMID: 15067626     DOI: 10.1016/s1542-3565(04)00061-8

Source DB:  PubMed          Journal:  Clin Gastroenterol Hepatol        ISSN: 1542-3565            Impact factor:   11.382


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