Accuracy of CT Colonography for Detection of Large Adenomas and Cancers
By C. Johnson, Mei‐Hsiu Chen, Alicia Y. Toledano, Jay P. Heiken, A. Dachman, Mark D. Kuo, C. Menias, B. Siewert, J. Cheema, Richard G. Obregon and 12 more. New England Journal of Medicine, 2008
1,154 citations recorded by the source corpus.
Background CT Colonography (CTC) is a non-invasive option for colorectal cancer (CRC) screening. The accuracy of CTC as a screening tool among asymptomatic adults has not been well defined. Methods The National CT Colonography Trial recruited 2600 asymptomatic participants, age ≥ 50 years, at 15 study centers. CTC images were acquired using standard bowel preparation, stool/fluid tagging, mechanical insufflation, ≥16 row CT scanners. Trained CTC radiologists reported all lesions ≥ 5 mm in diameter. Colonoscopy was performed according to established clinical protocols at each center and served as the reference standard. Detection by CTC of patients with large (≥10 mm), histologically-confirmed adenomas and adenocarcinomas which were detected by colonoscopy was the primary endpoint; detection of smaller (6–9 mm) colorectal lesions was also evaluated. Results Complete data were available for 2531 (97%) participants. For large adenomas and cancers the per patient estimates for sensitivity, specificity, positive and negative predictive values and area under the receiver operating characteristic curve were 0.90 ±0.03, 0.86 ± 0.02, 0.23 ± 0.02, 0.99 ±<0.01 and 0.89 ± 0.02, respectively. The sensitivity of 90% indicates that CTC failed to detect a lesion ≥10mm in 10% of patients. Per-polyp sensitivity for large adenomas or cancers was 0.84 ± 0.04. Per-patient sensitivity estimates in detecting patients with adenomas ≥ 6 mm, was 0.78. Conclusions In this study of asymptomatic adults, CTC screening identified 90% of patients with adenomas and cancers ≥ 10 mm in diameter. These findings augment published data regarding the role of CTC in average-risk CRC screening.
Subfields: Epidemiology, Oncology
View Paper: https://www.semanticscholar.org/paper/fea00b8739782b9f49dc70929ae738968624194e
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Citations in the corpus
- Colorectal cancer screening for average‐risk adults: 2018 guideline update from the American Cancer Society (2018, positive): “In the 2 largest and highest quality studies of CTC, CRC detection rates with CTC were essentially identical to those achieved with optical colonoscopy.(136,137) A systematic review and meta-analysis of 49 studies using colonoscopy as the reference standard estimated that the sensitivity of CTC for ”
- Improving Computer-aided Detection using Convolutional Neural Networks and Random View Aggregation (2015, methodology): “In CT colonography (CTC), patients are typically scanned in the prone and supine positions [56], so we obtain two CT volumes per patient study.”
- Comparative Validation of Polyp Detection Methods in Video Colonoscopy: Results From the MICCAI 2015 Endoscopic Vision Challenge (2017, neutral): “For instance, CT colonography has a low small lesions (5 mm or less) detection rate due to resolution constraints [7] and it implies using ionising radiation.”