title: Diagnostic Accuracy of CT for Local Staging of Colon Cancer: A Systematic Review and Meta-Analysis.
abstract: OBJECTIVE
  The purpose of this article is to determine the accuracy of CT in the detection of tumor invasion beyond the bowel wall and nodal involvement of colon carcinomas. A literature search was performed to identify studies describing the accuracy of CT in the staging of colon carcinomas. Studies including rectal carcinomas that were inseparable from colon carcinomas were excluded. Publication bias was explored by using a Deeks funnel plot asymmetry test. A hierarchic summary ROC model was used to construct a summary ROC curve and to calculate summary estimates of sensitivity, specificity, and diagnostic odds ratios (ORs).
  
  
  CONCLUSIONS
  On the basis of a total of 13 studies, pooled sensitivity, specificity, and diagnostic ORs for detection of tumor invasion beyond the bowel wall (T3-T4) were 90% (95% CI, 83-95%), 69% (95% CI, 62-75%), and 20.6 (95% CI, 10.2-41.5), respectively. For detection of tumor invasion depth of 5 mm or greater (T3cd-T4), estimates from four studies were 77% (95% CI, 66-85%), 70% (95% CI, 53-83%), and 7.8 (95% CI, 4.2-14.2), respectively. For nodal involvement (N+), 16 studies were included with values of 71% (95% CI, 59-81%), 67% (95% CI, 46-83%), and 4.8 (95% CI, 2.5-9.4), respectively. Two studies using CT colonography were included with sensitivity and specificity of 97% (95% CI, 90-99%) and 81% (95% CI, 65-91%), respectively, for detecting T3-T4 tumors. CT has good sensitivity for the detection of T3-T4 tumors, and evidence suggests that CT colonography increases its accuracy. Discriminating between T1-T3ab and T3cd-T4 cancer is challenging, but data were limited. CT has a low accuracy in detecting nodal involvement.
authors.affiliation: 1 Department of Radiology, Catharina Hospital Eindhoven, PO Box 1350, 5602 ZA, Eindhoven, The Netherlands.|2 GROW School of Oncology and Developmental Biology, University of Maastricht, Maastricht, The Netherlands.
authors.forename: Elias
authors.initials: E
authors.lastname: Nerad
authors.affiliation: 3 Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: Max J
authors.initials: MJ
authors.lastname: Lahaye
authors.affiliation: 3 Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: Monique
authors.initials: M
authors.lastname: Maas
authors.affiliation: 4 Department of Epidemiology, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Patty
authors.initials: P
authors.lastname: Nelemans
authors.affiliation: 5 Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Frans C H
authors.initials: FC
authors.lastname: Bakers
authors.affiliation: 2 GROW School of Oncology and Developmental Biology, University of Maastricht, Maastricht, The Netherlands.|6 Department of Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: Geerard L
authors.initials: GL
authors.lastname: Beets
authors.affiliation: 2 GROW School of Oncology and Developmental Biology, University of Maastricht, Maastricht, The Netherlands.|3 Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: Regina G H
authors.initials: RG
authors.lastname: Beets-Tan
mesh_terms: D003110:Colonic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D008207:Lymphatic Metastasis; D009361:Neoplasm Invasiveness / Q000000981:diagnostic imaging* / Q000473:pathology*; D009367:Neoplasm Staging; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
keywords: CT; colonic neoplasms; meta-analysis; neoplasm staging; x-ray