Perry J Pickhardt1, Steven M Wise, David H Kim. 1. Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792-3252, USA. ppickhardt2@uwhealth.org
Abstract
PURPOSE: To determine the positive predictive value (PPV) for polyps detected at CT colonography (CTC). METHODS: Assessment of 739 colorectal lesions >or=6 mm detected prospectively at CTC screening in 479 patients was performed. By-polyp PPV was analyzed according to small (6-9 mm) versus large (>or=10 mm) size; morphology (sessile/pedunculated/flat); diagnostic confidence level (3 = most confident, 1 = least confident); and histology. By-patient PPV was analyzed at various polyp size thresholds. RESULTS: By-polyp PPV for CTC-detected lesions >or=6 mm, 6-9 mm, and >or=10 mm was 91.6% (677/739), 90.1% (410/451), and 92.7% (267/288), respectively (p = 0.4). By-polyp PPV according to sessile, pedunculated, flat, and mass-like morphology was 92.5% (441/477), 96.5% (139/144), 77.7% (73/94), and 97.6% (40/41), respectively (p < 0.0001 for flat versus polypoid morphology). By-polyp PPV according to diagnostic confidence level was 94.7% (554/585) for highest (= level 3), 83.5% (106/127) for intermediate (= level 2), and 63.0% (17/27) for lowest (= level 1) confidence (p < 0.0001 for levels-2/3 versus level-1). By-patient PPV at 6-mm, 8-mm, 10-mm, and 30-mm polyp size thresholds was 92.3% (442/479), 93.0% (306/329), 93.1% (228/245), and 97.4% (38/39), respectively. CONCLUSION: The overall per-polyp and per-patient PPV for lesions >or=6 mm was 92% for CTC screening. Increased diagnostic confidence and polypoid (non-flat) morphology correlated with a higher PPV, whereas small versus large polyp size had very little effect.
PURPOSE: To determine the positive predictive value (PPV) for polyps detected at CT colonography (CTC). METHODS: Assessment of 739 colorectal lesions >or=6 mm detected prospectively at CTC screening in 479 patients was performed. By-polyp PPV was analyzed according to small (6-9 mm) versus large (>or=10 mm) size; morphology (sessile/pedunculated/flat); diagnostic confidence level (3 = most confident, 1 = least confident); and histology. By-patient PPV was analyzed at various polyp size thresholds. RESULTS: By-polyp PPV for CTC-detected lesions >or=6 mm, 6-9 mm, and >or=10 mm was 91.6% (677/739), 90.1% (410/451), and 92.7% (267/288), respectively (p = 0.4). By-polyp PPV according to sessile, pedunculated, flat, and mass-like morphology was 92.5% (441/477), 96.5% (139/144), 77.7% (73/94), and 97.6% (40/41), respectively (p < 0.0001 for flat versus polypoid morphology). By-polyp PPV according to diagnostic confidence level was 94.7% (554/585) for highest (= level 3), 83.5% (106/127) for intermediate (= level 2), and 63.0% (17/27) for lowest (= level 1) confidence (p < 0.0001 for levels-2/3 versus level-1). By-patient PPV at 6-mm, 8-mm, 10-mm, and 30-mm polyp size thresholds was 92.3% (442/479), 93.0% (306/329), 93.1% (228/245), and 97.4% (38/39), respectively. CONCLUSION: The overall per-polyp and per-patient PPV for lesions >or=6 mm was 92% for CTC screening. Increased diagnostic confidence and polypoid (non-flat) morphology correlated with a higher PPV, whereas small versus large polyp size had very little effect.
Authors: Perry J Pickhardt; J Richard Choi; Inku Hwang; James A Butler; Michael L Puckett; Hans A Hildebrandt; Roy K Wong; Pamela A Nugent; Pauline A Mysliwiec; William R Schindler Journal: N Engl J Med Date: 2003-12-01 Impact factor: 91.245
Authors: Michael E Zalis; Matthew A Barish; J Richard Choi; Abraham H Dachman; Helen M Fenlon; Joseph T Ferrucci; Seth N Glick; Andrea Laghi; Michael Macari; Elizabeth G McFarland; Martina M Morrin; Perry J Pickhardt; Jorge Soto; Judy Yee Journal: Radiology Date: 2005-07 Impact factor: 11.105
Authors: Daniel Cornett; Courtney Barancin; Brent Roeder; Mark Reichelderfer; Terrance Frick; Deepak Gopal; David Kim; Perry J Pickhardt; Andrew Taylor; Patrick Pfau Journal: Am J Gastroenterol Date: 2008-06-28 Impact factor: 10.864
Authors: Daniele Regge; Cristiana Laudi; Giovanni Galatola; Patrizia Della Monica; Luigina Bonelli; Giuseppe Angelelli; Roberto Asnaghi; Brunella Barbaro; Carlo Bartolozzi; Didier Bielen; Luca Boni; Claudia Borghi; Paolo Bruzzi; Maria Carla Cassinis; Massimo Galia; Teresa Maria Gallo; Andrea Grasso; Cesare Hassan; Andrea Laghi; Maria Cristina Martina; Emanuele Neri; Carlo Senore; Giovanni Simonetti; Silvia Venturini; Giovanni Gandini Journal: JAMA Date: 2009-06-17 Impact factor: 56.272
Authors: C Daniel Johnson; Mei-Hsiu Chen; Alicia Y Toledano; Jay P Heiken; Abraham Dachman; Mark D Kuo; Christine O Menias; Betina Siewert; Jugesh I Cheema; Richard G Obregon; Jeff L Fidler; Peter Zimmerman; Karen M Horton; Kevin Coakley; Revathy B Iyer; Amy K Hara; Robert A Halvorsen; Giovanna Casola; Judy Yee; Benjamin A Herman; Lawrence J Burgart; Paul J Limburg Journal: N Engl J Med Date: 2008-09-18 Impact factor: 91.245
Authors: Cesare Hassan; Perry J Pickhardt; Perry Pickhardt; Andrea Laghi; Daniel H Kim; Daniel Kim; Angelo Zullo; Franco Iafrate; Lorenzo Di Giulio; Sergio Morini Journal: Arch Intern Med Date: 2008-04-14
Authors: Shelby J Fishback; Perry J Pickhardt; Sanjeev Bhalla; Christine O Menias; Robert G Congdon; Michael Macari Journal: Emerg Radiol Date: 2011-09-02
Authors: B Dustin Pooler; David H Kim; Vu P Lam; Elizabeth S Burnside; Perry J Pickhardt Journal: AJR Am J Roentgenol Date: 2014-06 Impact factor: 3.959
Authors: B Dustin Pooler; David H Kim; Jennifer M Weiss; Kristina A Matkowskyj; Perry J Pickhardt Journal: Radiology Date: 2015-08-14 Impact factor: 11.105