Colorectal neoplasms: prospective comparison of thin-section low-dose multi-detector row CT colonography and conventional colonoscopy for detection.
OBJECTIVE
To prospectively compare thin-section low-dose multi-detector row computed tomographic (CT) colonography with conventional colonoscopy for the detection of colorectal neoplasms.


METHODS
One hundred five patients underwent CT colonography immediately before colonoscopy. Supine and prone CT colonographic acquisitions to image the region during a 30-second breath hold were performed. CT colonographic images were prospectively interpreted for the presence, location, size, and morphologic features of polyps. The time of image interpretation was noted. Sensitivity, specificity, and positive and negative predictive values of CT colonography were calculated, with 95% CIs, by using colonoscopic findings as the reference standard. The weighted CT dose index was calculated on the basis of measurements in a standard body phantom. Effective dose was calculated by using commercially available software.


RESULTS
Median CT data interpretation time was 12 minutes. One hundred thirty-two polyps in 59 patients were identified at colonoscopy; no polyps were detected in 46 patients. Sensitivities for detection of polyps smaller than 5 mm, 6-9 mm, and larger than 10 mm in diameter were 12% (11 of 91 polyps), 70% (19 of 27 polyps), and 93% (13 of 14 polyps), respectively. Estimated overall specificity was 97.7% (515 of 527 imaging results). The total weighted CT dose index for combined supine and prone CT colonography was 11.4 mGy. The effective doses for combined CT colonography were 5.0 mSv and 7.8 mSv for men and women, respectively.


CONCLUSIONS
Low-dose multi-detector row CT colonography has excellent sensitivity and specificity for detection of colorectal neoplasms 10 mm and larger.
Macari
Michael
M
Department of Radiology, New York University Medical Center, Tisch Hospital, 560 First Ave, Suite HW 207, New York, NY 10016, USA. michael.macari@med.nyu.edu
Bini
Edmund J
EJ
Xue
Xiaonan
X
Milano
Andrew
A
Katz
Seth S
SS
Resnick
Daniel
D
Chandarana
Hersh
H
Krinsky
Glen
G
Klingenbeck
Klaus
K
Marshall
Christopher H
CH
Megibow
Alec J
AJ
D000368:Aged; D003106:Colon / Q000000981:diagnostic imaging; D003111:Colonic Polyps / Q000175:diagnosis / Q000000981:diagnostic imaging; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods