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Related Experiment Videos

Occult colorectal polyps on CT colonography: implications for surveillance.

Robert L MacCarty1, C Daniel Johnson, Joel G Fletcher

  • 1Mayo Clinic, Mayo Medical School, Mary Clinic E-2, 200 First St. SW, Rochester, MN 55905, USA.

AJR. American Journal of Roentgenology
|April 25, 2006
PubMed
Summary

Colonographically occult polyps are common in patients previously screened for colorectal neoplasms. These invisible polyps, often flat, contribute significantly to detection failures in CT colonography (CTC).

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Area of Science:

  • Gastroenterology
  • Radiology
  • Medical Imaging

Background:

  • Colorectal cancer screening aims to detect and remove neoplasms.
  • CT colonography (CTC) is a less invasive screening tool for colorectal polyps.
  • Variability in CTC sensitivity for polyp detection necessitates understanding missed lesions.

Purpose of the Study:

  • To determine the prevalence of polyps invisible on CT colonography (CTC).
  • To analyze the characteristics and reasons for missed polyps in a previously screened population.
  • To investigate factors contributing to discordant reported sensitivities for CTC polyp detection.

Main Methods:

  • Seventy-five patients with prior polyp screening underwent same-day colonoscopy and CTC.
  • CTC scans were prospectively interpreted by a radiologist.

Related Experiment Videos

  • Missed polyps were retrospectively analyzed and categorized as occult, perception, or technical errors.

    • Main Results:

    • Thirty polyps (≥5 mm) were detected by colonoscopy; 18 were missed prospectively on CTC.
    • Twelve of the 18 missed polyps were occult (invisible on CTC even in retrospect).
    • Ten occult polyps had a flat morphology; perception and technical errors accounted for fewer missed polyps.

    Conclusions:

    • Colonographically occult polyps are prevalent and a major cause of CTC detection failures.
    • The high prevalence of occult polyps may result from prior screening removing easier-to-detect lesions.
    • Understanding occult polyps is crucial for improving CTC accuracy in surveillance populations.