title: Diagnostic value of CT-colonography as compared to colonoscopy in an asymptomatic screening population: a meta-analysis.
abstract: OBJECTIVE
  Previous meta-analyses on CT-colonography included both average and high risk individuals, which may overestimate the diagnostic value in screening. A meta-analysis was performed to obtain the value of CT-colonography for screening.
  
  
  METHODS
  A search was performed using PubMed, Embase and Cochrane. Article selection and critical appraisal was done by two reviewers.
  
  
  METHODS
  prospective, randomized trials or cohort studies comparing CT-colonography with colonoscopy (≥50 participants), ≥95% average risk participants ≥50 years. Study characteristics and 2 × 2 contingency Tables were recorded. Sensitivity and specificity estimates were calculated per patient and per polyp (≥6 mm, ≥10 mm), using univariate and bivariate analyses.
  
  
  RESULTS
  Five of 1,021 studies identified were included, including 4,086 participants (<1% high risk). I(2)-values showed substantial heterogeneity, especially for 6-9 mm polyps and adenomas: 68.1% vs. 78.6% (sensitivity per patient). Estimated sensitivities for patients with polyps or adenomas ≥ 6 mm were 75.9% and 82.9%, corresponding specificities 94.6% and 91.4%. Estimated sensitivities for patients with polyps or adenomas ≥ 10 mm were 83.3% and 87.9%, corresponding specificities 98.7% and 97.6%. Estimated sensitivities per polyp for advanced adenomas ≥ 6 mm and ≥ 10 mm were 83.9% and 83.8%.
  
  
  CONCLUSIONS
  Compared to colonoscopy, CT-colonography has a high sensitivity for adenomas ≥ 10 mm. For (advanced) adenomas ≥ 6 mm sensitivity is somewhat lower.
authors: Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. m.c.dehaan@amc.uva.nl
authors: Margriet C
authors: MC
authors: de Haan
authors: Rogier E
authors: RE
authors: van Gelder
authors: Anno
authors: A
authors: Graser
authors: Shandra
authors: S
authors: Bipat
authors: Jaap
authors: J
authors: Stoker
mesh_terms: D000368:Aged; D023881:Colonography, Computed Tomographic; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D012680:Sensitivity and Specificity