Extracolonic findings in an asymptomatic screening population undergoing intravenous contrast-enhanced computed tomography colonography.
OBJECTIVE
The purpose of this study was to evaluate extracolonic findings that could be encountered with computed tomography colonography (CTC) using intravenous (IV) contrast material in an asymptomatic screening population.


METHODS
Intravenous contrast medium-enhanced CTC was performed in 2230 asymptomatic adults (mean age, 57.5 years). Axial images were prospectively examined for extracolonic lesions. These findings were classified into three categories: potentially important findings, likely unimportant findings, and clinically unimportant findings. Potentially important extracolonic findings were defined as those which required immediate further diagnostic studies and treatment. Clinical and radiologic follow up, missed lesions and clinical outcomes were assessed using medical records (mean duration of follow up, 1.6 years).


RESULTS
A total of 115 new potentially important findings in 5.2% of subjects (115/2230) were found. Subsequent medical or surgical intervention was performed in 2.0% (45/2230). New extracolonic cancer was detected in 0.5% (12/2230), and the majority of them (83.3%) were not metastasized. Computed tomography colonography missed eight potentially important extracolonic findings in eight subjects (0.4%, 8/2230): 0.8-cm early-stage prostatic cancer, six adrenal mass and one intraductal papillary mucinous tumor. There were no severe life-threatening complications related to contrast medium.


CONCLUSIONS
Intravenous contrast-enhanced CTC could safely detect asymptomatic early-stage extracolonic malignant diseases without an unreasonable number of additional work-ups, thus reducing their morbidity or mortality.
Kim
Young Sun
YS
Seoul National University Hospital, Healthcare System Gangnam Center, Healthcare Research Institute Seoul, Korea.
Kim
Nayoung
N
Kim
Soo Young
SY
Cho
Kyoung Soo
KS
Park
Min Jung
MJ
Choi
Seung Ho
SH
Lim
Seon Hee
SH
Yim
Jeong Yoon
JY
Cho
Kyung Ran
KR
Kim
Chung Hyeon
CH
Kim
Dong Hee
DH
Kim
Sun Sin
SS
Kim
Jeong Hoon
JH
Choi
Byung Inhn
BI
Jung
Hyun Chae
HC
Song
In Sung
IS
Shin
Chan Soo
CS
Cho
Sang-Heon
SH
Oh
Byung-Hee
BH
D000311:Adrenal Glands / Q000000981:diagnostic imaging; D000368:Aged; D000369:Aged, 80 and over; D001659:Biliary Tract / Q000000981:diagnostic imaging; D001808:Blood Vessels / Q000473:pathology; D003106:Colon / Q000000981:diagnostic imaging*; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging*; D003287:Contrast Media / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D003362:Cost-Benefit Analysis; D042241:Early Diagnosis; D004947:Esophagus / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007668:Kidney / Q000000981:diagnostic imaging; D008099:Liver / Q000000981:diagnostic imaging; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000379:methods*; D008499:Medical Records; D008875:Middle Aged; D009369:Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D010179:Pancreas / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013270:Stomach / Q000000981:diagnostic imaging; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000191:economics; D014566:Urogenital System / Q000473:pathology
D003287:Contrast Media