title: Teleradiology based CT colonography to screen a population group of a remote island; at average risk for colorectal cancer.
abstract: OBJECTIVE
  To prospectively assess the performance of teleradiology-based CT colonography to screen a population group of an island, at average risk for colorectal cancer.
  
  
  METHODS
  A cohort of 514 patients living in Madeira, Portugal, was enrolled in the study. Institutional review board approval was obtained and all patients signed an informed consent. All patients underwent both CT colonography and optical colonoscopy. CT colonography was interpreted by an experienced radiologist at a remote centre using tele-radiology. Per-patient sensitivity, specificity, positive (PPV) and negative (NPV) predictive values with 95% confidence intervals (95%CI) were calculated for colorectal adenomas and advanced neoplasia ≥6 mm.
  
  
  RESULTS
  510 patients were included in the study. CT colonography obtained a per-patient sensitivity, specificity, PPV and, NPV for adenomas ≥6 mm of 98.11% (88.6-99.9% 95% CI), 90.97% (87.8-93.4% 95% CI), 56.52% (45.8-66.7% 95% CI), 99.75% (98.4-99.9% 95% CI). For advanced neoplasia ≥6 mm per-patient sensitivity, specificity, PPV and, NPV were 100% (86.7-100% 95% CI), 87.07% (83.6-89.9% 95% CI), 34.78% (25.3-45.5% 95% CI) and 100% (98.8-100% 95% CI), respectively.
  
  
  CONCLUSIONS
  In this prospective trial, teleradiology-based CT colonography was accurate to screen a patient cohort of a remote island, at average risk for colorectal cancer.
authors.affiliation: VCTC, Virtual Colonoscopy Teaching Centre, Akkerstraat 32c, B-8830 Hooglede, Belgium. radiologie@skynet.be
authors.forename: Philippe
authors.initials: P
authors.lastname: Lefere
authors.forename: Celso
authors.initials: C
authors.lastname: Silva
authors.forename: Stefaan
authors.initials: S
authors.lastname: Gryspeerdt
authors.forename: António
authors.initials: A
authors.lastname: Rodrigues
authors.forename: Rita
authors.initials: R
authors.lastname: Vasconcelos
authors.forename: Ricardo
authors.initials: R
authors.lastname: Teixeira
authors.forename: Francisco Henriques
authors.initials: FH
authors.lastname: de Gouveia
mesh_terms: D000368:Aged; D023881:Colonography, Computed Tomographic / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011174:Portugal / Q000453:epidemiology; D015995:Prevalence; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D019112:Teleradiology / Q000706:statistics & numerical data*