Magnetic Resonance Colonography for the Detection of Colorectal Neoplasia in Asymptomatic Adults

Graser, Anno; Melzer, Anja; Lindner, Evelyn; Nagel, Dorothea; Herrmann, Karin; Stieber, P.; Schirra, Jörg; Mansmann, Ulrich; Reiser, Maximilian; Göke, Burkhard; Kolligs, Frank T.

doi:10.1053/j.gastro.2012.12.041

Cited by 45 publications

(27 citation statements)

References 40 publications

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“…Especially the comparison with colonoscopy screening, which is for example implemented in Austria, Greece and Poland, 43 is interesting because CTC and MRC have comparable test characteristics for large adenomas and CRC compared with colonoscopy screening [13][14][15][16][17][18][19][20][21] but are less invasive. Also, bowel preparation, which is an important barrier in colonoscopy screening, 7,44 is likely to be less burdensome for imaging techniques.…”

Section: Discussionmentioning

confidence: 99%

“…31 Table 1 provides an overview of the lesion-specific test characteristics for all evaluated screening tests. Test characteristics were based on meta-analyses on CTC, 16,17,33 screening trials and a meta-analysis on MRC [18][19][20][21] and a systematic review on colonoscopy. 34 Because the literature does not provide lesion-specific FIT sensitivities, these were estimated via calibration of the model-predicted FIT positivity and detection rates for advanced adenomas and CRC to figures reported for a Dutch FIT screening trial.…”

Section: Screening Strategiesmentioning

confidence: 99%

“…These studies showed that MRC has a lower sensitivity for small and large adenomas than colonoscopy but has a similar sensitivity for CRC. [18][19][20][21] The results on patient acceptance for MRC compared with colonoscopy are inconclusive. 22,23 The general idea is that higher patient acceptance may be achievable because MRC can be conducted after limited bowel preparation with faecal tagging.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The potential of imaging techniques as a screening tool for colorectal cancer: a cost-effectiveness analysis

Greuter¹,

Berkhof²,

Fijneman³

et al. 2016

BJR

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Objective: Imaging may be promising for colorectal cancer (CRC) screening, since it has test characteristics comparable with colonoscopy but is less invasive. We aimed to assess the potential of CT colonography (CTC) and MR colonography (MRC) in terms of (cost-effectiveness) using the Adenoma and Serrated pathway to Colorectal CAncer model. Methods: We compared several CTC and MRC strategies with 5-or 10-yearly screening intervals with no screening, 10-yearly colonoscopy screening and biennial faecal immunochemical test (FIT) screening. We assumed trial-based participation rates in the base-case analyses and varied the rates in sensitivity analyses. Incremental lifetime costs and health effects were estimated from a healthcare perspective. Results: The health gain of CTC and MRC was similar and ranged from 0.031 to 0.048 life-year gained compared with no screening, for 2-5 screening rounds. Lifetime costs per person for MRC strategies were €60-110 higher than those for CTC strategies with an equal number of screening rounds. All imaging-based strategies were cost-effective compared with no screening. FIT screening was the dominant screening strategy, leading to most LYG and highest cost-savings. Compared with three rounds of colonoscopy screening, CTC with five rounds was found to be cost-effective in an incremental analysis of imaging strategies. Assumptions on screening participation have a major influence on the ordering of strategies in terms of costs and effects. Conclusion: CTC and MRC have potential for CRC screening, compared with no screening and compared with three rounds of 10-yearly colonoscopy screening. When taking FIT screening as the reference, imaging is not costeffective. Participation is an important driver of effectiveness and cost estimates. Advances in knowledge: This is the first study to assess the cost-effectiveness of MRC screening for CRC.

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Section: Discussionmentioning

confidence: 99%

Section: Screening Strategiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The potential of imaging techniques as a screening tool for colorectal cancer: a cost-effectiveness analysis

Greuter¹,

Berkhof²,

Fijneman³

et al. 2016

BJR

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“…In a recent prospective study from Germany in 286 asymptomatic adults, sensitivities of 78.4 and 75% for adenomas >5 mm and advanced adenomas were reported with a specificity of 95.3% [35]. More data are needed before any recommendations concerning the use of MR-C for CRC screening can be made.…”

Section: Mr Colonographymentioning

confidence: 99%

Controversies in Colorectal Cancer Screening

Pox¹

2014

Digestion

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Background: Colorectal cancer (CRC) is one of the most common cancers worldwide and a good candidate for screening programmes. However, there is controversy concerning which of the available screening tests should be used. Summary: There is general agreement that screening for CRC in the asymptomatic population should begin at the age of 50. Several different screening methods are available which can be separated into those that mainly detect cancers: faecal occult blood tests [guaiac (FOBT) and immunochemical (FIT)], genetic stool tests, blood tests and the M2-pyruvate kinase (M2-PK) test. Methods that detect cancers and polyps are colonoscopy, sigmoidoscopy, CT-colonography (CT-C) and colon capsule endoscopy. The only tests for which a reduction in CRC mortality compared to no screening have been proven in randomized trials are FOBT and sigmoidoscopy. Several trials suggest that FIT are superior to FOBT in terms of detection rates of cancers and advanced adenomas and possibly compliance. There is indirect evidence suggesting efficacy of colonoscopy as a screening test. The role of CT-C is controversial. There is data suggesting a good sensitivity for neoplasia >9 mm with a lower sensitivity for smaller neoplasia. However, radiation exposure is considered a major limitation in some countries. Unresolved questions include the lesion cut-off for referral to colonoscopy and work-up of extracolonic findings. For other methods, like genetic stool testing using newer markers, blood tests, capsule endoscopy and M2-PK, there is currently insufficient data on screening of the asymptomatic population. Key Messages: Colorectal screening is recommended and should be performed in the form of an organized programme. If detection of early-stage cancers is the aim of a screening programme, FIT seem to be superior to FOBT. If detection and removal of adenomas is the aim of a screening programme, endoscopic methods seem to be good alternatives. Sigmoidoscopy is easier to perform but will likely only have an effect on distal cancers. Colonoscopy is more invasive but enables inspection of the whole colon. The role of CT-C, capsule endoscopy, genetic stool tests, blood tests and M2-PK is currently unknown.

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“…18,19 Although magnetic resonance colonography does not expose the individual to radiation and requires no sedation, use of intravenous contrast agent is required. 20 Capsule endoscopy is non-invasive and also requires no sedation but the bowel preparation is more complicated than that required for colonoscopy. 21 A recent report showed that faecal quantification of Fusobacterium nucleatum could be a useful supplement to faecal immunochemical test in the diagnosis of CRC and advanced adenoma.…”

mentioning

confidence: 99%

Challenges to the adoption of risk algorithms for colorectal cancer screening programmes: perspectives for future research

Huang¹,

Huang²

2017

Hong Kong Med J

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Magnetic Resonance Colonography for the Detection of Colorectal Neoplasia in Asymptomatic Adults

Cited by 45 publications

References 40 publications

The potential of imaging techniques as a screening tool for colorectal cancer: a cost-effectiveness analysis

The potential of imaging techniques as a screening tool for colorectal cancer: a cost-effectiveness analysis

Controversies in Colorectal Cancer Screening

Challenges to the adoption of risk algorithms for colorectal cancer screening programmes: perspectives for future research

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