title: CT-colonography in the follow-up of acute diverticulitis: patient acceptance and diagnostic accuracy.
abstract: OBJECTIVE
  The aim of this study was to assess CT-colonography (CTC) in the follow-up of diverticulitis regarding patient acceptance and diagnostic accuracy for diverticular disease, adenomas and cancer, with colonoscopy as a reference standard.
  
  
  METHODS
  A prospective comparative study where half of the patients underwent colonoscopy first, followed immediately by CTC. The other half had the examinations in the reverse order. Patient experiences and findings were registered after every examination, blinded to the examiner.
  
  
  RESULTS
  Of a total of 110 consecutive patients, 108 were included in the study, with a median age of 56 years (range 27-84). The success rate was 91% for colonoscopy and 86% for CTC. Examination time was 25 min for both methods. The mean time for CTC evaluation was 20 min. Eighty-three per cent of the patients received sedation during colonoscopy. Despite this, patients experienced colonoscopy as more painful (p < 0.001) and uncomfortable (p < 0.001). Diverticulosis and polyps were detected in 94% and 20% with colonoscopy and in 94% and 29% with CTC, respectively. Sensitivity and specificity for CTC in the detection of diverticulosis was 99% and 67%, with a good agreement (κ = 0.71). Regarding detection of polyps, the sensitivity and specificity were 47% and 75%, with a poor agreement (κ = 0.17). No cancer was found.
  
  
  CONCLUSIONS
  CTC was less painful and unpleasant and can be used for colonic investigation in the follow-up of diverticulitis. CTC detected diverticulosis with good accuracy while the detection accuracy of small polyps was poor. CTC is a viable alternative, especially in case of incomplete colonoscopy or in a situation with limited colonoscopy resources.
authors.affiliation: Colorectal Unit, Department of Surgery and Centre for Clinical Research, Uppsala University, Västmanlands Hospital, Västerås, Sweden. abbas.chabok@ltv.se
authors.forename: Abbas
authors.initials: A
authors.lastname: Chabok
authors.forename: Kenneth
authors.initials: K
authors.lastname: Smedh
authors.forename: Sven
authors.initials: S
authors.lastname: Nilsson
authors.forename: Marianne
authors.initials: M
authors.lastname: Stenson
authors.forename: Lars
authors.initials: L
authors.lastname: Påhlman
mesh_terms: D000208:Acute Disease; D000236:Adenoma / Q000175:diagnosis / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging*; D023881:Colonography, Computed Tomographic; D003113:Colonoscopy; D003937:Diagnosis, Differential; D004239:Diverticulitis, Colonic / Q000175:diagnosis / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D016037:Single-Blind Method