Abstract Purpose. We report a preliminary evaluation of the performance of computed tomography colonography (CTC) systematically obtained before optical colonoscopy (OC) in subjects with positive faecal occult blood test (FOBT) within a population-based screening programme for colorectal cancer (CRC). Materials and methods. Seventy-nine subjects with positive FOBT from a regional screening programme were invited to perform same day CTC and OC. CTC was performed with standard bowel preparation. OC with segmental unblinding was the reference standard. A perpatient per-adenoma analysis was performed. Results. Forty-nine of 79 subjects (62%) with positive FOBT adhered to the study and completed both examinations. Twenty-two (44.9%) of the 49 had a cancer or an adenoma ≥6 mm. Per-patient sensitivity, specificity, negative predictive value and positive predictive value for cancer or adenoma ≥6 mm were 95.5% (95%CI:77.2%–99.9%), 51.9% (95%CI:32.0%–71.3%), 93.3% (95%CI:68.1%–99.8%) and 61.8% (95%CI:43.6%–77.8%). Conclusions. In the setting of a FOBT-based screening programme for CRC, CTC showed a high sensitivity, but relatively low specificity and positive predictive value, for cancer and adenoma ≥6 mm. Probably performing CTC without faecal tagging as second line test after a positive FOBT is not a cost-effective strategy.
CT colonography before colonoscopy in subjects with positive faecal occult blood test. Preliminary experience / Sali L; Falchini M; Della Monica P; Regge D; Bonanomi AG; Castiglione G; Grazzini G; Zappa M; Mungai F; Volpe C; Mascalchi M.. - In: LA RADIOLOGIA MEDICA. - ISSN 0033-8362. - STAMPA. - 115:(2010), pp. 1267-1278.
CT colonography before colonoscopy in subjects with positive faecal occult blood test. Preliminary experience.
SALI, LAPO;FALCHINI, MASSIMO;MASCALCHI, MARIO
2010
Abstract
Abstract Purpose. We report a preliminary evaluation of the performance of computed tomography colonography (CTC) systematically obtained before optical colonoscopy (OC) in subjects with positive faecal occult blood test (FOBT) within a population-based screening programme for colorectal cancer (CRC). Materials and methods. Seventy-nine subjects with positive FOBT from a regional screening programme were invited to perform same day CTC and OC. CTC was performed with standard bowel preparation. OC with segmental unblinding was the reference standard. A perpatient per-adenoma analysis was performed. Results. Forty-nine of 79 subjects (62%) with positive FOBT adhered to the study and completed both examinations. Twenty-two (44.9%) of the 49 had a cancer or an adenoma ≥6 mm. Per-patient sensitivity, specificity, negative predictive value and positive predictive value for cancer or adenoma ≥6 mm were 95.5% (95%CI:77.2%–99.9%), 51.9% (95%CI:32.0%–71.3%), 93.3% (95%CI:68.1%–99.8%) and 61.8% (95%CI:43.6%–77.8%). Conclusions. In the setting of a FOBT-based screening programme for CRC, CTC showed a high sensitivity, but relatively low specificity and positive predictive value, for cancer and adenoma ≥6 mm. Probably performing CTC without faecal tagging as second line test after a positive FOBT is not a cost-effective strategy.File | Dimensione | Formato | |
---|---|---|---|
sali10.pdf
Accesso chiuso
Tipologia:
Versione finale referata (Postprint, Accepted manuscript)
Licenza:
Tutti i diritti riservati
Dimensione
259.23 kB
Formato
Adobe PDF
|
259.23 kB | Adobe PDF | Richiedi una copia |
I documenti in FLORE sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.