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Related Experiment Videos

Colonoscopy and multidetector-array computed-tomographic colonography: detection rates and feasibility.

B Ginnerup Pedersen1, T E M Christiansen, N C Bjerregaard

  • 1Department of Radiology, Aarhus Amtssygehus, Aarhus University Hospital, Tage Hansensgade 2, 8000 Aarhus C, Denmark. ginnerup-kelsen@dadlnet.dk

Endoscopy
|August 21, 2003
PubMed
Summary
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Multidetector-array CT colonography (MDCTC) and colonoscopy have similar sensitivity for detecting large colorectal polyps. However, MDCTC is less likely to provide a technically adequate examination compared to colonoscopy.

Area of Science:

  • Gastroenterology
  • Radiology
  • Medical Imaging

Background:

  • Computed-tomographic (CT) colonography is a minimally invasive method for detecting colorectal neoplasms.
  • Multidetector-array CT colonography (MDCTC) offers a potential alternative to conventional colonoscopy.

Purpose of the Study:

  • To compare the performance characteristics of MDCTC and conventional colonoscopy.
  • To evaluate detection rates and adequacy of examination in a prospective, blinded study.

Main Methods:

  • A prospective, blinded study involving 150 patients (66 symptomatic, 75 surveillance, 7 preoperative).
  • Patients underwent both MDCTC and conventional colonoscopy.
  • Colonoscopy served as the gold standard, with a second-pass colonoscopy used if MDCTC was positive and initial colonoscopy was negative.

Related Experiment Videos

Main Results:

  • Both MDCTC and colonoscopy detected all 11 carcinomas.
  • Overall detection rates for polypoid lesions ≥6 mm were 81% for MDCTC and 87% for colonoscopy (P=0.52).
  • Colonoscopy showed a significantly higher detection rate for polyps 6-9 mm in size (P=0.008).
  • Technically satisfying MDCTC was obtained in 76% of patients, compared to 91% for colonoscopy (P<0.01).
  • MDCTC demonstrated a specificity of 97% for lesions ≥6 mm.

Conclusions:

  • MDCTC and colonoscopy exhibit comparable overall sensitivity for detecting polypoid lesions ≥6 mm.
  • Colonoscopy is more likely to provide an adequately examined patient.
  • MDCTC may be limited by issues such as insufficient air distension in the sigmoid colon.