Related Experiment Videos
Incidental extracolonic findings at CT colonography
A K Hara1, C D Johnson, R L MacCarty
1Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. haraa2@yahoo.com
Radiology
|May 5, 2000
Summary
Computed tomographic (CT) colonography frequently identifies extracolonic findings, with highly important ones often leading to further patient examinations and interventions. This approach can detect serious disease cost-effectively, despite some limitations.
Area of Science:
- Radiology
- Gastroenterology
- Oncology
Background:
- Computed tomographic (CT) colonography is a widely used screening tool for colorectal cancer.
- Extracolonic findings are common during CT colonography but their clinical significance and impact on patient management are variable.
Purpose of the Study:
- To determine the frequency of extracolonic findings during CT colonography.
- To assess the impact of these findings on patient treatment and healthcare costs.
Main Methods:
- Two radiologists independently reviewed CT colonographic scans of 264 patients.
- Extracolonic findings were categorized by clinical importance (high, moderate, low).
- Patient charts were reviewed to assess treatment changes and costs were calculated using Medicare reimbursements.
Main Results:
- 11% of patients had highly important extracolonic findings, leading to further investigations in 7%.
- Six patients underwent surgery for incidentally discovered findings.
- Three extracolonic malignancies were missed during CT colonography.
- Additional work-up cost an average of $28 per patient.
Conclusions:
- Work-up for extracolonic findings is infrequent but valuable for highly important lesions.
- CT colonography has limitations in evaluating solid organs but can detect serious disease.
- Extracolonic findings at CT colonography can be clinically significant without substantially increasing costs.