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CT-colonography after incomplete colonoscopy: what is the diagnostic yield?
Hendrikus J M Pullens1, Maarten S van Leeuwen, Robert J F Laheij
1Department of Gastroenterology and Hepatology, University Medical Center, Utrecht, The Netherlands. H.J.M.Pullens@umcutrecht.nl
Diseases of the Colon and Rectum
|April 12, 2013
Summary
Computed tomography-colonography (CTC) aids diagnosis after incomplete colonoscopy, revealing additional intra- and extracolonic findings. This imaging technique offers valuable insights for patient management when standard colonoscopy is unsuccessful.
Area of Science:
- Gastroenterology
- Radiology
- Medical Imaging
Background:
- Computed tomography-colonography (CTC) is a valuable tool when colonoscopy is incomplete.
- CTC offers the potential to identify extracolonic lesions in addition to colonic findings.
Purpose of the Study:
- To evaluate the diagnostic yield of CTC for intra- and extracolonic findings in patients with incomplete colonoscopies.
- To determine the clinical relevance and need for further workup of detected lesions.
Main Methods:
- Retrospective observational study of 136 CT-colonographies following incomplete colonoscopies.
- Data extracted from radiology, endoscopy reports, and electronic medical records.
- Analysis of all intra- and extracolonic findings for clinical relevance and indication for further management.
Main Results:
- Incomplete colonoscopies identified colorectal cancer in 8.8% and polyps in 19.9%.
- CTC additionally detected 11.0% more polyps and 2.9% more colorectal cancers.
- CTC revealed clinically significant extracolonic findings in 5.9% of patients, including diverticulitis and tumors.
Conclusions:
- CTC provides added value in cases of incomplete colonoscopy, identifying relevant additional lesions in 19.1% of patients.
- CTC findings can guide further diagnostic and therapeutic interventions.
- CTC can be utilized for staging colorectal cancer when detected after an incomplete colonoscopy.
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