Diagnosis and Staging of Colonic Tumors by Conventional Abdominal Sonography as Compared with Hydrocolonic Sonography

Limberg, Bernd

doi:10.1056/nejm199207093270201

Cited by 87 publications

(55 citation statements)

References 23 publications

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“…It also permits the visualization of the five layers of the colon wall showing the complete characteristics of the tumor (38). The sensitivity in the detection of CRC in the different studies oscillates between 83 and 97% and the specificity is in and around 98% (38)(39)(40)(41)(42)(43). Additionally, the precision in the T staging oscillates between 70 and 98% (40,43).…”

Section: Discussionmentioning

confidence: 99%

The value of abdominal ultrasound in the diagnosis of colon cancer

Martı́nez-Ares

Barrenechea

Souto-Ruzo

et al. 2005

Rev. esp. enferm. dig.

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Introduction: colon cancer is one of the main causes of cancer death. Diagnosis requires the examination of the entire large bowel by means of radiological or endoscopic techniques. Many patients suspect of colon cancer are referred for colonoscopy but nevertheless this suspicion is not confirmed after endoscopic examination. The objective of this study is the evaluation of the reliability of abdominal ultrasound in the diagnosis of these tumors.Material and method: we selected patients suspect of colon cancer referred to the endoscopy unit for a colonoscopy. An abdominal ultrasound was carried out on all patients prior to the endoscopy. Considering the endoscopic examination as a gold standard, the sensibility, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the ultrasonography were evaluated. Likewise, a series of analytical and clinical parameters were evaluated, in an attempt to establish associated factors of a colon cancer. The statistical analysis was carried out by means of the statistical package SPSS 12.0 for Windows.Results: 145 patients were included in the study (56.6% males) with an average 66.72 years of age (22-89). A cancer was diagnosed in 42 cases (28.9%). In the diagnosis of colon cancer, abdominal ultrasound presents a sensitivity of 79.06%, a specificity of 92.15%, a PPV and a NPV of 80.9% and of 91.2%, respectively. Excluding from the analysis lesions of the rectal ampulla, which cannot be adequately evaluated by means of ultrasound, the figures for sensitivity, specificity, PPV and NPV increase to 91.8, 92.1, 80.9 and 96.9% respectively. The univariate analysis showed that an age over 65 years and the presence of microcytosis are associated to a greater risk of colon cancer while after multivariate analysis only the presence of microcytosis resulted to be an independent predictive factor of cancer.Conclusions: abdominal ultrasound presents high sensitivity, specificity, PPV and NPV in the diagnosis of colon cancer. The combination of an ultrasonography and a rectoscopy permits us to rule out the presence of a colorectal carcinoma. In patients with microcytosis of 65 years and over, if there is strong clinical suspicion, a negative ultrasound may not be sufficient to rule out a colorectal neoplasia.

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Section: Discussionmentioning

confidence: 99%

The value of abdominal ultrasound in the diagnosis of colon cancer

Martı́nez-Ares

Barrenechea

Souto-Ruzo

et al. 2005

Rev. esp. enferm. dig.

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“…For example, in a thin patient with a fluid-filled stomach, a layered structure can be imaged in the healthy stomach and in patients with peptic ulcer disease [4]. Water can even be introduced in to the colon by enema to facilitate transabdominal US delineation of pathological thickening as seen in ulcerative colitis or colorectal cancer [5][6][7]. A layered structure can also be visualized and is helpful in the diagnosis of acute appendicitis [8,9].…”

Section: Ultrasound Imaging Of the Gi Wallmentioning

confidence: 99%

High-frequency ultrasonographic imaging of the gastrointestinal wall

Ødegaard

Nesje

Lærum

et al. 2012

Expert Review of Medical Devices

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“…Tanto la sensibilidad como la especificidad alcanzadas, en ambos casos, son similares a las publicadas en la literatura, si bien es cierto que, especialmente en el caso del cáncer gástrico, el número de pacientes con este diagnóstico es muy reducido. En lo que al diagnóstico del cáncer de colon se refiere, nuestras cifras (sensibilidad del 100%, una especificidad del 94,5%) están bastante por encima de las obtenidas por otros autores que también han usado la ecografía convencional (14)(15)(16)(17)(18)(19)(20) y están muy próximas a las obtenidas mediante ecografía hidrocolónica (21)(22)(23)(24)(25)(26). Ya en un estudio previo publicado recientemente por nuestro grupo (aunque en este caso se incluían pacientes en los que se sospechaba específicamente un cáncer de colon e incluíamos a 42 pacientes con cáncer de colon) se obtenían unas cifras de precisión diagnóstica similares (27).…”

Section: Discussionunclassified

Utilidad de la ecografía en el diagnóstico de los pacientes con sospecha de neoplasias del tubo digestivo

Ares

Aguirre

Barrenechea

et al. 2008

Rev. esp. enferm. dig.

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RESUMENIntroducción: el valor predictivo positivo de síntomas y signos en el diagnóstico del cáncer de colon y gástrico es bajo. Además, muchos pacientes son remitidos para descartar una neoplasia digestiva, sin síntomas que sugieran su localización, siendo el VPP de la clínica aún menor. En este trabajo evaluamos la utilidad de la ecografía como primera aproximación diagnóstica.Material y método: se han reclutado 79 pacientes (48 varones, edad media 69,3 años). En todos ellos se realiza una ecografía antes de la endoscopia. Se evalúa la precisión en el diagnóstico del cáncer de colon y gástrico, los diagnósticos ecográficos y el número de endoscopias que se evitarían. También se buscan factores predictivos de la localización de la neoplasia.Resultados: se han diagnosticado 5 neoplasias gástricas (6,3%) y 12 de colon (19%), 3 cáncer de páncreas (3,8%), 2 neoplasias uterinas (2,5%) y 2 hipernefromas (2,5%). Las cifras de sensibilidad, especificidad, VPP, VPN y precisión de la ecografía fueron 80%, 98,6%; 80%; 98,6%; y 97,4% respectivamente en el diagnóstico del cáncer gástrico, y del 100%, 94,5%; 80%; 100% y 95,5% respectivamente en el diagnóstico del cáncer de colon. La ecografía permitió evitar el 10% de las endoscopias. El único dato que orienta la localización de la neoplasia es la presencia de anemia, que se asocia con mayor frecuencia al diagnóstico de cáncer de colon: 30,4 versus 4,3% (p = 0,033).Conclusiones: en los pacientes remitidos para descartar una neoplasia digestiva, con síntomas inespecíficos, se diagnostica con frecuencia de patología neoplásica ajena al tubo digestivo. Si consideramos, además, la elevada precisión diagnóstica de la ecografía, esta podría ser una muy buena primera aproximación diagnóstica.Palabras clave: Cáncer de colon. Cáncer gástrico. Ecografía. Diagnóstico. Precisión. Utilidad. ABSTRACTBackground: the Positive Predictive Value (PPV) of signs and symptoms for the diagnosis of colon and gastric cancer is low. Furthermore, many patients are referred to us to discard a digestive tract neoplasm with no symptoms suggestive of its whereabouts, in whom clinical PPV is even lower. This study evaluates the usefulness of ultrasonography as a first approach to diagnosis.Material and methods: seventy-nine patients were recruited into the study (48 males with an average age of 69.3 years). Ultrasonography was performed on all patients prior to endoscopy. Parameters studied included diagnostic accuracy for colon and gastric cancer, ultrasonographic diagnoses, and number of endoscopies that can be avoided. Predictive factors for neoplasm location were also studied.Results: five gastric cancers (6.3%), 12 colon cancers (15,1%), 3 pancreatic cancers (3.8%), 2 uterine neoplasms (2.5%), and 2 hypernephromas (2.5%) were diagnosed. The figures for sensitivity, specificity, PPV, Negative Predictive Value (NPV) and global accuracy of ultrasonography were 80%, 98.6%, 80%, 98.6%, and 97.4%, respectively, for gastric cancer, while these figures were 100%, 94.5%, 80%, 100%, and 95.5%, respectively, for...

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Diagnosis and Staging of Colonic Tumors by Conventional Abdominal Sonography as Compared with Hydrocolonic Sonography

Abstract: Hydrocolonic sonography, a new diagnostic procedure, can facilitate the diagnosis and staging of colonic tumors.

Cited by 87 publications

References 23 publications

The value of abdominal ultrasound in the diagnosis of colon cancer

The value of abdominal ultrasound in the diagnosis of colon cancer

High-frequency ultrasonographic imaging of the gastrointestinal wall

Utilidad de la ecografía en el diagnóstico de los pacientes con sospecha de neoplasias del tubo digestivo

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