Assessment of water enema computed tomography: an effective imaging technique for the diagnosis of colon cancer: Colon cancer: computed tomography using a water enema.
OBJECTIVE
The aim of this study was to assess the accuracy of water enema computed tomography (WECT) for the diagnosis of colon cancer.


METHODS
A total of 191 patients referred for clinically suspected colon cancer were prospectively evaluated by WECT in a multicenter trial. Examination was contrast enhanced helical CT after colon filling through a rectal tube. For all the cases, final diagnosis was obtained by colonoscopy and/or surgery. CT data were interpreted both locally and at a centralized site by a specialized and general radiologist.


RESULTS
Seventy-one patients were diagnosed with colon cancer. Overall, WECT sensitivity and specificity were 98.6 and 95.0%, respectively. Positive and negative predictive values were 92.1 and 99.1%, respectively. In a subgroup of 33 patients with unclean bowel, the sensitivity and specificity of WECT were 95.0 and 92.3%, respectively. The correlation between local radiologists and the specialized radiologist was excellent (Kappa = 0.87) as was the correlation between the general radiologist and the specialist (Kappa = 0.92).


CONCLUSIONS
This prospective analysis demonstrates that WECT is an effective, safe, and simple imaging technique for the diagnosis of colon cancer and can be proposed when a strong clinical suspicion of colon cancer is present, especially in frail patients.
Ridereau-Zins
Catherine
C
Departement de Radiologie, CHU Angers, 4, rue Larrey, Angers Cedex 09, 49933, France.
Aubé
Christophe
C
Luet
Dominique
D
Vielle
Bruno
B
Pilleul
Franck
F
Dumortier
Jérôme
J
Gandon
Yves
Y
Heresbach
Denis
D
Beziat
Christophe
C
Bailly
François
F
Debilly
Marjolaine
M
Carbonnel
Franck
F
Pierredon-Foulongne
Marie Ange
MA
Bismuth
Mickaël
M
Chretien
Jean-Marie
JM
Lebigot
Jérôme
J
Pessaux
Patrick
P
Valette
Pierre-Jean
PJ
D000368:Aged; D003106:Colon / Q000000981:diagnostic imaging; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging*; D003113:Colonoscopy; D003287:Contrast Media; D004733:Enema; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008297:Male; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014867:Water / Q000008:administration & dosage*
D003287:Contrast Media; D014867:Water