Tags

Type your tag names separated by a space and hit enter

Differentiation between diverticulitis and colorectal cancer: quantitative CT perfusion measurements versus morphologic criteria--initial experience.
Radiology. 2007 Feb; 242(2):456-62.R

Abstract

PURPOSE

To determine whether computed tomographic (CT) perfusion measurements in prospectively recruited patients can be used to differentiate between diverticulitis and colorectal cancer and to compare this discrimination with that of standard morphologic criteria.

MATERIALS AND METHODS

After institutional review board approval and written informed consent were obtained, 60 patients (24 men, 36 women; mean age, 69 years; range, 33.5-90.4 years; 20 patients with cancer, 20 with diverticulitis, and 20 with inactive diverticular disease) underwent CT perfusion imaging at the level of the colonic abnormality, and perfusion parameters were calculated. Analysis of variance was used to investigate any differences in perfusion between the patient groups. Two independent observers also analyzed an abdominopelvic CT study obtained immediately after the CT perfusion study and noted standard morphologic criteria for differential diagnosis. The sensitivity and specificity of CT perfusion measurements for determining the diagnostic category were compared with morphologic criteria by means of multivariate analysis to identify the most discriminatory criteria.

RESULTS

Mean blood volume, blood flow, transit time, and permeability were significantly different between patients with cancer and those with diverticulitis (P < .0001); patients with cancer had the highest blood volume, blood flow, and permeability and the shortest transit time. The most discriminatory criteria for determining diagnostic category were blood volume, transit time, permeability, and presence of pericolonic nodes (P = .05, .02, .04, and .02, respectively). Blood volume and blood flow each had a sensitivity of 80% and had specificity of 70% and 75%, respectively, for cancer in comparison with standard morphologic criteria: less than 5 cm of bowel involvement (45% sensitivity, 95% specificity), presence of a mass (85% sensitivity, 90% specificity), pericolonic inflammation (75% sensitivity, 5% specificity), and pericolonic nodes (90% sensitivity, 45% specificity).

CONCLUSION

CT perfusion measurements enable differentiation and better discrimination, in comparison with morphologic criteria, between cancer and diverticulitis.

Authors+Show Affiliations

Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood, England.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

17255417

Citation

Goh, Vicky, et al. "Differentiation Between Diverticulitis and Colorectal Cancer: Quantitative CT Perfusion Measurements Versus Morphologic Criteria--initial Experience." Radiology, vol. 242, no. 2, 2007, pp. 456-62.
Goh V, Halligan S, Taylor SA, et al. Differentiation between diverticulitis and colorectal cancer: quantitative CT perfusion measurements versus morphologic criteria--initial experience. Radiology. 2007;242(2):456-62.
Goh, V., Halligan, S., Taylor, S. A., Burling, D., Bassett, P., & Bartram, C. I. (2007). Differentiation between diverticulitis and colorectal cancer: quantitative CT perfusion measurements versus morphologic criteria--initial experience. Radiology, 242(2), 456-62.
Goh V, et al. Differentiation Between Diverticulitis and Colorectal Cancer: Quantitative CT Perfusion Measurements Versus Morphologic Criteria--initial Experience. Radiology. 2007;242(2):456-62. PubMed PMID: 17255417.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Differentiation between diverticulitis and colorectal cancer: quantitative CT perfusion measurements versus morphologic criteria--initial experience. AU - Goh,Vicky, AU - Halligan,Steve, AU - Taylor,Stuart A, AU - Burling,David, AU - Bassett,Paul, AU - Bartram,Clive I, PY - 2007/1/27/pubmed PY - 2007/2/24/medline PY - 2007/1/27/entrez SP - 456 EP - 62 JF - Radiology JO - Radiology VL - 242 IS - 2 N2 - PURPOSE: To determine whether computed tomographic (CT) perfusion measurements in prospectively recruited patients can be used to differentiate between diverticulitis and colorectal cancer and to compare this discrimination with that of standard morphologic criteria. MATERIALS AND METHODS: After institutional review board approval and written informed consent were obtained, 60 patients (24 men, 36 women; mean age, 69 years; range, 33.5-90.4 years; 20 patients with cancer, 20 with diverticulitis, and 20 with inactive diverticular disease) underwent CT perfusion imaging at the level of the colonic abnormality, and perfusion parameters were calculated. Analysis of variance was used to investigate any differences in perfusion between the patient groups. Two independent observers also analyzed an abdominopelvic CT study obtained immediately after the CT perfusion study and noted standard morphologic criteria for differential diagnosis. The sensitivity and specificity of CT perfusion measurements for determining the diagnostic category were compared with morphologic criteria by means of multivariate analysis to identify the most discriminatory criteria. RESULTS: Mean blood volume, blood flow, transit time, and permeability were significantly different between patients with cancer and those with diverticulitis (P < .0001); patients with cancer had the highest blood volume, blood flow, and permeability and the shortest transit time. The most discriminatory criteria for determining diagnostic category were blood volume, transit time, permeability, and presence of pericolonic nodes (P = .05, .02, .04, and .02, respectively). Blood volume and blood flow each had a sensitivity of 80% and had specificity of 70% and 75%, respectively, for cancer in comparison with standard morphologic criteria: less than 5 cm of bowel involvement (45% sensitivity, 95% specificity), presence of a mass (85% sensitivity, 90% specificity), pericolonic inflammation (75% sensitivity, 5% specificity), and pericolonic nodes (90% sensitivity, 45% specificity). CONCLUSION: CT perfusion measurements enable differentiation and better discrimination, in comparison with morphologic criteria, between cancer and diverticulitis. SN - 0033-8419 UR - https://www.unboundmedicine.com/medline/citation/17255417/Differentiation_between_diverticulitis_and_colorectal_cancer:_quantitative_CT_perfusion_measurements_versus_morphologic_criteria__initial_experience_ L2 - https://pubs.rsna.org/doi/10.1148/radiol.2422051670?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -