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An initial experience with screening for colon polyps using spiral CT with and without CT colography (virtual colonoscopy)
Gastrointest Endosc. 1999 Sep; 50(3):309-13.GE

Abstract

BACKGROUND

Computed tomographic (CT) colography (virtual colonoscopy) is a new imaging method for detection of colon polyps and cancer.

OBJECTIVE

To evaluate the sensitivity of CT colography for polyp detection in a population without symptoms that included persons without colon neoplasia and with radiologists blinded to colonoscopic findings.

METHODS

Forty-six persons without symptoms underwent spiral CT followed by same-day colonoscopy with subsequent inspection of two-dimensional axial CT images, interactive multiplanar images, and surfaced and volume-rendered images of the colon (three-dimensional CT colography).

RESULTS

Three-dimensional CT colography was superior to two-dimensional axial imaging for detection of colon polyps. Three-dimensional CT colography depicted 1 of 4 (25%) adenomas 2 cm in diameter or larger, 6 of 10 (60%) adenomas 1 to 1.9 cm, 6 of 14 (43%) 6 to 9 mm, and 7 of 65 (11%) 5 mm in diameter or smaller. Three-dimensional CT colography showed a polyp that might have led to colonoscopy in 3 of 4 (75%) patients whose largest adenoma was 2 cm or larger, 5 of 6 (83%) patients with largest adenoma 1 to 1.9 cm, 3 of 7 (43%) patients with largest adenoma 6 to 9 mm, and 4 of 16 patients (25%) with largest adenoma 5 mm or smaller. Large, flat adenomas of the right colon were difficult to identify with three-dimensional CT colography. The specificity of three-dimensional CT colography for patients with adenomas 1 cm in diameter or larger was 89%. Examination of patients with missed adenomas after unblinding indicated that meticulous bowel preparation and adequate distention are critical to accurate interpretation. Perceptual errors were common.

CONCLUSIONS

CT colography as performed in this study is not adequate as a colorectal cancer screening test. Several technical factors that appear critical to accurate performance of CT colography are defined.

Authors+Show Affiliations

Department of Medicine, Indiana University School of Medicine, Indianapolis, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10462648

Citation

Rex, D K., et al. "An Initial Experience With Screening for Colon Polyps Using Spiral CT With and Without CT Colography (virtual Colonoscopy)." Gastrointestinal Endoscopy, vol. 50, no. 3, 1999, pp. 309-13.
Rex DK, Vining D, Kopecky KK. An initial experience with screening for colon polyps using spiral CT with and without CT colography (virtual colonoscopy). Gastrointest Endosc. 1999;50(3):309-13.
Rex, D. K., Vining, D., & Kopecky, K. K. (1999). An initial experience with screening for colon polyps using spiral CT with and without CT colography (virtual colonoscopy). Gastrointestinal Endoscopy, 50(3), 309-13.
Rex DK, Vining D, Kopecky KK. An Initial Experience With Screening for Colon Polyps Using Spiral CT With and Without CT Colography (virtual Colonoscopy). Gastrointest Endosc. 1999;50(3):309-13. PubMed PMID: 10462648.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - An initial experience with screening for colon polyps using spiral CT with and without CT colography (virtual colonoscopy) AU - Rex,D K, AU - Vining,D, AU - Kopecky,K K, PY - 1999/8/27/pubmed PY - 1999/8/27/medline PY - 1999/8/27/entrez SP - 309 EP - 13 JF - Gastrointestinal endoscopy JO - Gastrointest. Endosc. VL - 50 IS - 3 N2 - BACKGROUND: Computed tomographic (CT) colography (virtual colonoscopy) is a new imaging method for detection of colon polyps and cancer. OBJECTIVE: To evaluate the sensitivity of CT colography for polyp detection in a population without symptoms that included persons without colon neoplasia and with radiologists blinded to colonoscopic findings. METHODS: Forty-six persons without symptoms underwent spiral CT followed by same-day colonoscopy with subsequent inspection of two-dimensional axial CT images, interactive multiplanar images, and surfaced and volume-rendered images of the colon (three-dimensional CT colography). RESULTS: Three-dimensional CT colography was superior to two-dimensional axial imaging for detection of colon polyps. Three-dimensional CT colography depicted 1 of 4 (25%) adenomas 2 cm in diameter or larger, 6 of 10 (60%) adenomas 1 to 1.9 cm, 6 of 14 (43%) 6 to 9 mm, and 7 of 65 (11%) 5 mm in diameter or smaller. Three-dimensional CT colography showed a polyp that might have led to colonoscopy in 3 of 4 (75%) patients whose largest adenoma was 2 cm or larger, 5 of 6 (83%) patients with largest adenoma 1 to 1.9 cm, 3 of 7 (43%) patients with largest adenoma 6 to 9 mm, and 4 of 16 patients (25%) with largest adenoma 5 mm or smaller. Large, flat adenomas of the right colon were difficult to identify with three-dimensional CT colography. The specificity of three-dimensional CT colography for patients with adenomas 1 cm in diameter or larger was 89%. Examination of patients with missed adenomas after unblinding indicated that meticulous bowel preparation and adequate distention are critical to accurate interpretation. Perceptual errors were common. CONCLUSIONS: CT colography as performed in this study is not adequate as a colorectal cancer screening test. Several technical factors that appear critical to accurate performance of CT colography are defined. SN - 0016-5107 UR - https://www.unboundmedicine.com/medline/citation/10462648/An_initial_experience_with_screening_for_colon_polyps_using_spiral_CT_with_and_without_CT_colography__virtual_colonoscopy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5107(99)00429-0 DB - PRIME DP - Unbound Medicine ER -