Diagnostic value of magnetic resonance and computed tomography colonography for the diagnosis of colorectal cancer: A systematic review and meta-analysis.

ABSTRACT

BACKGROUND: Surgical resection is the recommended procedure for colorectal cancer (CRC), but majority of the patients were diagnosed with advanced or metastatic CRC. Currently, there were inconsistent results about the diagnostic value of magnetic resonance colonography (MRC) and computed tomography colonography (CTC) in early CRC diagnosis. Our study conducted this meta-analysis to investigate the diagnostic value of MRC and CTC for CRC surveillance. METHODS: A comprehensive literature search was conducted in PubMed, Embase, and the Cochrane library to select relevant studies. The summary sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and the area under the receiver operating characteristic curves (AUC) were calculated to evaluate the diagnostic value of MRC and CTC, respectively. RESULT: Twenty-five studies including 2985 individuals were selected in the final analysis. Eight studies evaluated the diagnostic value of MRC, and 17 studies assessed CTC. The summary sensitivity, specificity, PLR, NLR, DOR, and AUC in MRC for early detection of CRC were 0.98 (95% confidence interval, CI 0.80-1.00), 0.94 (95% CI 0.85-0.97), 15.48 (95% CI 6.30-38.04), 0.02 (95% CI 0.00-0.25), 115.09 (95% CI 15.37-862.01), and 0.98 (95% CI 0.97-0.99), respectively. In addition, the sensitivity, specificity, PLR, NLR, DOR, and AUC of CTC for diagnosing CRC were 0.97 (95% CI 0.88-0.99), 0.99 (95% CI 0.99-1.00), 154.11 (95% CI 67.81-350.22), 0.03 (95% CI 0.01-0.13), 642.51 (95% CI 145.05-2846.02), and 1.00 (95% CI 0.99-1.00). No significant differences were found between MRC and CTC for DOR in all the subsets. CONCLUSION: The findings of meta-analysis indicated that MRC and CTC have higher diagnostic values for early CRC diagnosis. However, the DOR for diagnosing CRC between MRC and CTC showed no significance.