AI Article Synopsis
- The study assessed the effectiveness of computed tomographic (CT) virtual colonoscopy in detecting colorectal neoplasia among 1,233 asymptomatic adults, with findings compared against standard optical colonoscopy.
- Results showed that virtual colonoscopy had high sensitivity rates for detecting adenomatous polyps, reaching up to 93.9% for larger polyps (at least 8 mm), while optical colonoscopy had slightly lower sensitivity at 91.5% for the same size.
- Overall, CT virtual colonoscopy is a reliable screening tool for colorectal issues in average-risk adults and performs comparably to optical colonoscopy in identifying important lesions.
Article Abstract
Background: We evaluated the performance characteristics of computed tomographic (CT) virtual colonoscopy for the detection of colorectal neoplasia in an average-risk screening population.
Methods: A total of 1233 asymptomatic adults (mean age, 57.8 years) underwent same-day virtual and optical colonoscopy. Radiologists used the three-dimensional endoluminal display for the initial detection of polyps on CT virtual colonoscopy. For the initial examination of each colonic segment, the colonoscopists were unaware of the findings on virtual colonoscopy, which were revealed to them before any subsequent reexamination. The sensitivity and specificity of virtual colonoscopy and the sensitivity of optical colonoscopy were calculated with the use of the findings of the final, unblinded optical colonoscopy as the reference standard.
Results: The sensitivity of virtual colonoscopy for adenomatous polyps was 93.8 percent for polyps at least 10 mm in diameter, 93.9 percent for polyps at least 8 mm in diameter, and 88.7 percent for polyps at least 6 mm in diameter. The sensitivity of optical colonoscopy for adenomatous polyps was 87.5 percent, 91.5 percent, and 92.3 percent for the three sizes of polyps, respectively. The specificity of virtual colonoscopy for adenomatous polyps was 96.0 percent for polyps at least 10 mm in diameter, 92.2 percent for polyps at least 8 mm in diameter, and 79.6 percent for polyps at least 6 mm in diameter. Two polyps were malignant; both were detected on virtual colonoscopy, and one of them was missed on optical colonoscopy before the results on virtual colonoscopy were revealed.
Conclusions: CT virtual colonoscopy with the use of a three-dimensional approach is an accurate screening method for the detection of colorectal neoplasia in asymptomatic average-risk adults and compares favorably with optical colonoscopy in terms of the detection of clinically relevant lesions.
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| http://dx.doi.org/10.1056/NEJMoa031618 | DOI Listing |
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