CT colonography before colonoscopy in subjects with positive faecal occult blood test. Preliminary experience.
Radiol Med
; 115(8): 1267-78, 2010 Dec.
Article
em En, It
| MEDLINE
| ID: mdl-20680499
ABSTRACT
PURPOSE:
We report a preliminary evaluation of the performance of computed tomography colonography (CTC) systematically obtained before optical colonoscopy (OC) in subjects with positive faecal occult blood test (FOBT) within a population-based screening programme for colorectal cancer (CRC). MATERIALS ANDMETHODS:
Seventy-nine subjects with positive FOBT from a regional screening programme were invited to perform same day CTC and OC. CTC was performed with standard bowel preparation. OC with segmental unblinding was the reference standard. A per-patient per-adenoma analysis was performed.RESULTS:
Forty-nine of 79 subjects (62%) with positive FOBT adhered to the study and completed both examinations. Twenty-two (44.9%) of the 49 had a cancer or an adenoma ≥6 mm. Per-patient sensitivity, specificity, negative predictive value and positive predictive value for cancer or adenoma ≥6 mm were 95.5% (95%CI77.2%-99.9%), 51.9% (95%CI32.0%-71.3%), 93.3% (95%CI68.1%-99.8%) and 61.8% (95%CI43.6%-77.8%).CONCLUSIONS:
In the setting of a FOBT-based screening programme for CRC, CTC showed a high sensitivity, but relatively low specificity and positive predictive value, for cancer and adenoma ≥6 mm. Probably performing CTC without faecal tagging as second line test after a positive FOBT is not a cost-effective strategy.
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
/
Tipos_de_cancer
/
Colon_e_reto
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Colorretais
/
Programas de Rastreamento
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Colonografia Tomográfica Computadorizada
Tipo de estudo:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
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Screening_studies
Limite:
Aged
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Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
/
It
Revista:
Radiol Med
Ano de publicação:
2010
Tipo de documento:
Article
País de afiliação:
Itália