CT Colonography versus Colonoscopy for the Detection of Advanced Neoplasia

Kim, David H.; Pickhardt, Perry J.; Taylor, Andrew; Leung, Winifred K.; Winter, Thomas C.; Hinshaw, J. Louis; Gopal, Deepak V.; Reichelderfer, Mark; Hsu, Richard; Pfau, Patrick R.

doi:10.1056/nejmoa070543

Cited by 635 publications

(402 citation statements)

References 31 publications

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“…Key categories of colorectal polyp findings at repeat CT colonography screening (eg, C-RADS categories C2-C4, advanced neoplasia, invasive cancer, lesion morphology, lesion location, etc) were compared against summary statistics from earlier programmatic results for initial CT colonography screening as reported in previous publications (5,(20)(21)(22). Fisher exact test and Pearson x 2 test were used, where applicable, to test for differences in categorical variables.…”

Section: Discussionmentioning

confidence: 99%

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Colorectal Findings at Repeat CT Colonography Screening after Initial CT Colonography Screening Negative for Polyps Larger than 5 mm

Pickhardt¹,

Pooler²,

Mbah³

et al. 2017

Radiology

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Purpose:To determine the rate and types of polyps detected at repeat computed tomographic (CT) colonography screening after initial negative findings at CT colonography screening. Materials and Methods:Among 5640 negative CT colonography screenings (no polyps  6 mm) performed before 2010 at one medical center, 1429 (25.3%; mean age, 61.4 years; 736 women, 693 men) patients have returned for repeat CT colonography screening (mean interval, 5.7 years 6 0.9; range, 4.5-10.7 years). Positive rates and histologic findings of initial and repeat screening were compared in this HIPAAcompliant, institutional review board-approved study. For all patients with positive findings at repeat CT colonography, the findings were directly compared against the initial CT colonography findings. Fisher exact, Pearson x 2 , and Student t tests were applied as indicated. Results:Repeat CT colonography screening was positive for lesions 6 mm or larger in 173 (12.1%) adults (compared with 14.3% at initial CT colonography screening, P = .29).In the 173 patients, 29.5% (61 of 207) of nondiminutive polyps could be identified as diminutive at the initial CT colonography and 12.6% (26 of 207) were missed. Large polyps, advanced neoplasia (advanced adenomas and cancer), and invasive cancer were seen in 3.8% (55 of 1429), 2.8% (40 of 1429), and 0.14% (two of 1429), respectively, at follow-up, compared with 5.2% (P = .02), 3.2% (P = .52), and 0.45% (P = .17), respectively, at initial screening. Of 42 advanced lesions in 40 follow-up screenings, 33 (78.6%) were right sided and 22 (52.4%) were flat, compared with 45.4% (P , .001) and 11.3% (P , .001), respectively, at initial screening. Large right-sided serrated lesions were confirmed in 20 individuals (1.4%), compared with 0.5% (P , .001) confirmed at initial screening. Conclusion:Positive rates for large polyps at repeat CT colonography screening (3.7%) were lower compared with those at initial screening (5.2%). However, more advanced rightsided lesions were detected at follow-up CT colonography, many of which were flat, serrated lesions. The cumulative findings support both the nonreporting of diminutive lesions and a 5-10-year screening interval.q RSNA, 2016

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Section: Discussionmentioning

confidence: 99%

“…The CT colonography technique used at our institution has been described in detail elsewhere (5,12). In summary, patients underwent a low-volume bowel preparation on the day prior to CT colonography by using a cathartic cleansing agent.…”

Section: Ct Colonography Technique and Interpretationmentioning

confidence: 99%

Colorectal Findings at Repeat CT Colonography Screening after Initial CT Colonography Screening Negative for Polyps Larger than 5 mm

Pickhardt¹,

Pooler²,

Mbah³

et al. 2017

Radiology

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“…Considerable progress has already been made towards 'virtual CT colonoscopy'. 2,[110][111][112][113] There is less experience with virtual MR colonoscopy, but this approach also appears promising, especially because it avoids exposure to radiation. 2,114 Imaging techniques (MRI, CT) are likely to play an increasingly important role in the diagnosis of cardiovascular defects and perhaps also in screening for risk factors for cardiovascular conditions.…”

Section: Structural Imagingmentioning

confidence: 99%

Rapid aneuploidy detection or karyotyping? Ethical reflection

et al. 2011

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“…Les résultats des différentes études évaluant l'efficacité de cette méthode sont discordants [13,14]. La sensibilité rapportée de cette technique pour les lésions de plus de 9 mm est comprise entre 85 % et 94 % et la spécificité entre 96 % et 97 % [13][14][15]. Dans la méta-analyse de Mulhall et al [14] (33 études correspondant à 6 393 patients), le taux de sensibilité de la coloscopie virtuelle était de 70 % pour les polypes de 6-9 mm et les taux de spécificité correspondants étaient de 93 %.…”

Section: Colosopie Virtuelleunclassified

Dépistage organisé du cancer colorectal en France : Rôle de l’Institut National du Cancer

Viguier¹,

Nathan

2009

Med Sci (Paris)

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CT Colonography versus Colonoscopy for the Detection of Advanced Neoplasia

Abstract: Primary CTC and OC screening strategies resulted in similar detection rates for advanced neoplasia, although the numbers of polypectomies and complications were considerably smaller in the CTC group. These findings support the use of CTC as a primary screening test before therapeutic OC.

Cited by 635 publications

References 31 publications

Colorectal Findings at Repeat CT Colonography Screening after Initial CT Colonography Screening Negative for Polyps Larger than 5 mm

Colorectal Findings at Repeat CT Colonography Screening after Initial CT Colonography Screening Negative for Polyps Larger than 5 mm

Rapid aneuploidy detection or karyotyping? Ethical reflection

Dépistage organisé du cancer colorectal en France : Rôle de l’Institut National du Cancer

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