title: Computerized tomographic colonography: performance evaluation in a retrospective multicenter setting.
abstract: OBJECTIVE
  No multicenter study has been reported evaluating the performance and interobserver variability of computerized tomographic colonography. The aim of this study was to assess the accuracy of computerized tomographic colonography for detecting clinically important colorectal neoplasia (polyps >or=10 mm in diameter) in a multi-institutional study.
  
  
  METHODS
  A retrospective study was developed from 341 patients who had computerized tomographic colonography and colonoscopy among 8 medical centers. Colonoscopy and pathology reports provided the standard. A random sample of 117 patients, stratified by criterion standard, was requested. Ninety-three patients were included (47% with polyps >or=10 mm; mean age, 62 years; 56% men; 84% white; 40% reported colorectal symptoms; 74% at increased risk for colorectal cancer). Eighteen radiologists blinded to the criterion standard interpreted computerized tomography colonography examinations, each using 2 of 3 different software display platforms.
  
  
  RESULTS
  The average area under the receiver operating characteristic curve for identifying patients with at least 1 lesion >or=10 mm was 0.80 (95% lower confidence bound, 0.74). The average sensitivity and specificity were 75% (95% lower confidence bound, 68%) and 73% (95% lower confidence bound, 66%), respectively. Per-polyp sensitivity was 75%. A trend was observed for better performance with more observer experience. There was no difference in performance across software display platforms.
  
  
  CONCLUSIONS
  Computerized tomographic colonography performance compared favorably with reported performance of fecal occult blood testing, flexible sigmoidoscopy, and barium enema. A prospective study evaluating the performance of computerized tomography colonography in a screening population is indicated.
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: C Daniel
authors.initials: CD
authors.lastname: Johnson
authors.forename: Alicia Y
authors.initials: AY
authors.lastname: Toledano
authors.forename: Benjamin A
authors.initials: BA
authors.lastname: Herman
authors.forename: Abraham H
authors.initials: AH
authors.lastname: Dachman
authors.forename: Elizabeth G
authors.initials: EG
authors.lastname: McFarland
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Barish
authors.forename: James A
authors.initials: JA
authors.lastname: Brink
authors.forename: Randy D
authors.initials: RD
authors.lastname: Ernst
authors.forename: Joel G
authors.initials: JG
authors.lastname: Fletcher
authors.forename: Robert A
authors.initials: RA
authors.lastname: Halvorsen
authors.forename: Amy K
authors.initials: AK
authors.lastname: Hara
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Hopper
authors.forename: Robert E
authors.initials: RE
authors.lastname: Koehler
authors.forename: David S k
authors.initials: DS
authors.lastname: Lu
authors.forename: Michael
authors.initials: M
authors.lastname: Macari
authors.forename: Robert L
authors.initials: RL
authors.lastname: Maccarty
authors.forename: Frank H
authors.initials: FH
authors.lastname: Miller
authors.forename: Martina
authors.initials: M
authors.lastname: Morrin
authors.forename: Erik K
authors.initials: EK
authors.lastname: Paulson
authors.forename: Judy
authors.initials: J
authors.lastname: Yee
authors.forename: Michael
authors.initials: M
authors.lastname: Zalis
mesh_terms: D003110:Colonic Neoplasms / Q000175:diagnosis; D003111:Colonic Polyps / Q000175:diagnosis; D023881:Colonography, Computed Tomographic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity