title: Assessment of water enema computed tomography: an effective imaging technique for the diagnosis of colon cancer: Colon cancer: computed tomography using a water enema.
abstract: 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.
authors.affiliation: Departement de Radiologie, CHU Angers, 4, rue Larrey, Angers Cedex 09, 49933, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Ridereau-Zins
authors.forename: Christophe
authors.initials: C
authors.lastname: Aubé
authors.forename: Dominique
authors.initials: D
authors.lastname: Luet
authors.forename: Bruno
authors.initials: B
authors.lastname: Vielle
authors.forename: Franck
authors.initials: F
authors.lastname: Pilleul
authors.forename: Jérôme
authors.initials: J
authors.lastname: Dumortier
authors.forename: Yves
authors.initials: Y
authors.lastname: Gandon
authors.forename: Denis
authors.initials: D
authors.lastname: Heresbach
authors.forename: Christophe
authors.initials: C
authors.lastname: Beziat
authors.forename: François
authors.initials: F
authors.lastname: Bailly
authors.forename: Marjolaine
authors.initials: M
authors.lastname: Debilly
authors.forename: Franck
authors.initials: F
authors.lastname: Carbonnel
authors.forename: Marie Ange
authors.initials: MA
authors.lastname: Pierredon-Foulongne
authors.forename: Mickaël
authors.initials: M
authors.lastname: Bismuth
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Chretien
authors.forename: Jérôme
authors.initials: J
authors.lastname: Lebigot
authors.forename: Patrick
authors.initials: P
authors.lastname: Pessaux
authors.forename: Pierre-Jean
authors.initials: PJ
authors.lastname: Valette
mesh_terms: 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*
chemical_list: D003287:Contrast Media; D014867:Water