OBJECTIVES: To investigate the ability of staging computed tomography (CT) without bowel preparation to accurately localize colonic tumors compared to optical colonoscopy. METHODS: The local institutional review board approved this retrospective and HIPAA-compliant study. Forty-six patients with colonic adenocarcinoma, preoperative colonoscopy, and staging CT within 60 days of resection were included. Patients underwent contrast enhanced CT imaging without bowel preparation or oral contrast. The colon was divided into four segments with the operative reports used as the standard. Rectal and cecal cancers were excluded. CT scans were reviewed by 5 readers in a segmental binary fashion using a 5-point confidence scale in two sessions blinded and unblinded to the colonoscopy report. RESULTS: At surgery 49 tumors were found in 46 patients. Readers detected 86.1%, 74.3%, and 66.9% of lesions with 92.0%, 94.1%, and 95.4% accuracy for confidence scores of ≥ 3, ≥ 4, and 5. CT interobserver agreement was good (κ=0.82) for the unblinded and moderate (κ=0.60) for the blinded read. Colonoscopic localization was only 78.7% accurate with 2 tumors undiscovered. Colonoscopic accuracy was low in the descending colon (57.1%) and the transverse colon (55.6%). CONCLUSIONS: Preoperative staging CT is more accurate than colonoscopy in the localization of colonic tumors.
OBJECTIVES: To investigate the ability of staging computed tomography (CT) without bowel preparation to accurately localize colonic tumors compared to optical colonoscopy. METHODS: The local institutional review board approved this retrospective and HIPAA-compliant study. Forty-six patients with colonic adenocarcinoma, preoperative colonoscopy, and staging CT within 60 days of resection were included. Patients underwent contrast enhanced CT imaging without bowel preparation or oral contrast. The colon was divided into four segments with the operative reports used as the standard. Rectal and cecal cancers were excluded. CT scans were reviewed by 5 readers in a segmental binary fashion using a 5-point confidence scale in two sessions blinded and unblinded to the colonoscopy report. RESULTS: At surgery 49 tumors were found in 46 patients. Readers detected 86.1%, 74.3%, and 66.9% of lesions with 92.0%, 94.1%, and 95.4% accuracy for confidence scores of ≥ 3, ≥ 4, and 5. CT interobserver agreement was good (κ=0.82) for the unblinded and moderate (κ=0.60) for the blinded read. Colonoscopic localization was only 78.7% accurate with 2 tumors undiscovered. Colonoscopic accuracy was low in the descending colon (57.1%) and the transverse colon (55.6%). CONCLUSIONS: Preoperative staging CT is more accurate than colonoscopy in the localization of colonic tumors.
Authors: Michele Manigrasso; Marco Milone; Mario Musella; Pietro Venetucci; Francesco Maione; Ugo Elmore; Gaetano Gallo; Roberto Perinotti; Giovanni Domenico De Palma Journal: Updates Surg Date: 2021-10-05
Authors: Susan J Moug; Spyridon Fountas; Mark S Johnstone; Adam S Bryce; Andrew Renwick; Lindsey J Chisholm; Kathryn McCarthy; Amy Hung; Robert H Diament; John R McGregor; Myo Khine; James D Saldanha; Khurram Khan; Graham Mackay; E Fiona Leitch; Ruth F McKee; John H Anderson; Ben Griffiths; Alan Horgan; Sonia Lockwood; Carly Bisset; Richard Molloy; Mark Vella Journal: Surg Endosc Date: 2016-11-08 Impact factor: 4.584