Double-contrast barium enema study with computed radiography: assessment in detection of colorectal polyps

Feasibility and diagnostic performance of digital radiography in gastrointestinal imaging have not been fully investigated. We performed double-contrast barium enema study with computed radiography (CR-DCBE) on a routine basis, and the efficacy of this system for detection of colorectal polyps was investigated. The files of 76 patients, who had undergone both CR-DCBE and colonoscopy, were reviewed by two observers who were blinded to the colonoscopic findings. The radiation dose of CR-DCBE was reduced to 50% of conventional film-screen system. By using colonoscopic findings as a reference, the sensitivity and positive predictive value for colorectal polyps were 66% to 71% and 32% to 41%, respectively. There was no significant interobserver difference. The use of postprocessing with gray-scale reversal and edge enhancement did not significantly improve the results. The sensitivity for polyps smaller than 1 cm was comparable with published data of conventional film-screen systems. Our preliminary results show that CR-DCBE has an acceptable sensitivity for detection of colorectal polyps. It is suggested that the use of CR is a promising approach to digital gastrointestinal radiography.