Diagnostic accuracy and tolerability of contrast enhanced CT colonoscopy in symptomatic patients with increased risk for colorectal cancer.
OBJECTIVE
We compared the accuracy and tolerability of intravenous contrast enhanced spiral computed tomography colonography (CTC) and optical colonoscopy (OC) for the detection of colorectal neoplasia in symptomatic patients for colorectal neoplasia.


METHODS
A prospective study was performed in 48 patients with symptomatic patients with increased risk for colorectal cancer. Spiral CTC was performed in supine and prone positions after colonic cleansing. The axial, 2D MPR and virtual endoluminal views were analyzed. Results of spiral CTC were compared with OC which was done within 15 days. The psychometric tolerance test was asked to be performed for both CTC and colonoscopy after the procedure.


RESULTS
Ten lesions in 9 of 48 patients were found in CTC and confirmed with OC. Two masses and eight polyps, consisted of 1 tubulovillous, 1 tubular, 2 villous adenoma, 4 adenomatous polyp, 4 adenocarcinoma, were identified. Lesion prevalence was 21%. Sensitivity, specificity, accuracy, positive and negative predictive values were found 100%, 87%, 89%, 67% and 100%, respectively. Psychometric tolerance test showed that CTC significantly more comfortable comparing with OC (p=0.00). CTC was the preferred method in 37% while OC was preferred in 6% of patients. In both techniques, the most unpleasant part was bowel cleansing.


CONCLUSIONS
Contrast enhanced CTC is a highly accurate method in detecting colorectal lesions. Since the technique was found to be more comfortable and less time consuming compare to OE, it may be preferable in management of symptomatic patients with increased risk for colorectal cancer.
Ozsunar
Yelda
Y
Department of Radiology, School of Medicine, Adnan Menderes University, Aydin, Turkey. yozsunar@adu.edu.tr
Coskun
Gülten
G
Delibaş
Naciye
N
Uz
Burcin
B
Yükselen
Vahit
V
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D023881:Colonography, Computed Tomographic / Q000379:methods* / Q000523:psychology*; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging* / Q000523:psychology*; D003287:Contrast Media; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D003287:Contrast Media