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Previous Volume 349:2191-2200 December 4, 2003 Number 23 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Supplementary Material Editorial by Morrin, M. M. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

ABSTRACT

Background We evaluated the performance characteristics of computed tomographic (CT) virtual colonoscopy for the detection of colorectal neoplasia in an average-risk screening population.

Methods A total of 1233 asymptomatic adults (mean age, 57.8 years) underwent same-day virtual and optical colonoscopy. Radiologists used the three-dimensional endoluminal display for the initial detection of polyps on CT virtual colonoscopy. For the initial examination of each colonic segment, the colonoscopists were unaware of the findings on virtual colonoscopy, which were revealed to them before any subsequent reexamination. The sensitivity and specificity of virtual colonoscopy and the sensitivity of optical colonoscopy were calculated with the use of the findings of the final, unblinded optical colonoscopy as the reference standard.

Results The sensitivity of virtual colonoscopy for adenomatous polyps was 93.8 percent for polyps at least 10 mm in diameter, 93.9 percent for polyps at least 8 mm in diameter, and 88.7 percent for polyps at least 6 mm in diameter. The sensitivity of optical colonoscopy for adenomatous polyps was 87.5 percent, 91.5 percent, and 92.3 percent for the three sizes of polyps, respectively. The specificity of virtual colonoscopy for adenomatous polyps was 96.0 percent for polyps at least 10 mm in diameter, 92.2 percent for polyps at least 8 mm in diameter, and 79.6 percent for polyps at least 6 mm in diameter. Two polyps were malignant; both were detected on virtual colonoscopy, and one of them was missed on optical colonoscopy before the results on virtual colonoscopy were revealed.

Conclusions CT virtual colonoscopy with the use of a three-dimensional approach is an accurate screening method for the detection of colorectal neoplasia in asymptomatic average-risk adults and compares favorably with optical colonoscopy in terms of the detection of clinically relevant lesions.

Source Information

From the Departments of Radiology (P.J.P., P.A.N.) and Gastroenterology (J.A.B., P.A.M.), National Naval Medical Center; the Department of Radiology, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences (P.J.P., M.L.P.); and the National Cancer Institute, Division of Cancer Prevention (P.A.M.) — all in Bethesda, Md.; the Departments of Radiology (J.R.C.) and Gastroenterology (I.H., R.K.W.), Walter Reed Army Medical Center, Washington, D.C.; and the Departments of Radiology (M.L.P., H.A.H.) and Gastroenterology (W.R.S.), Naval Medical Center San Diego, San Diego, Calif.

Address reprint requests to Dr. Pickhardt at the University of Wisconsin Medical School, Department of Radiology, E3/311 Clinical Science Center, 600 Highland Ave., Madison, WI 53792-3252, or at ppickhardt{at}mail.radiology.wisc.edu.

Full Text of this Article

Related Letters:

Virtual Colonoscopy to Screen for Colorectal Cancer
Rockey D. C., Zarchy T. M., Pais S., Uribe J. R., Bongiorno C., Katz P. O., Thomas G. S., Pickhardt P. J.
Extract | Full Text | PDF  
N Engl J Med 2004; 350:1148-1150, Mar 11, 2004. Correspondence

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• Kim, D. H., Pickhardt, P. J., Taylor, A. J., Leung, W. K., Winter, T. C., Hinshaw, J. L., Gopal, D. V., Reichelderfer, M., Hsu, R. H., Pfau, P. R. (2007). CT Colonography versus Colonoscopy for the Detection of Advanced Neoplasia. NEJM 357: 1403-1412 [Abstract] [Full Text]  
• Hanson, M. E., Pickhardt, P. J., Kim, D. H., Pfau, P. R. (2007). Anatomic Factors Predictive of Incomplete Colonoscopy Based on Findings at CT Colonography. Am. J. Roentgenol. 189: 774-779 [Abstract] [Full Text]  
• Baker, M. E., Bogoni, L., Obuchowski, N. A., Dass, C., Kendzierski, R. M., Remer, E. M., Einstein, D. M., Cathier, P., Jerebko, A., Lakare, S., Blum, A., Caroline, D. F., Macari, M. (2007). Computer-aided Detection of Colorectal Polyps: Can It Improve Sensitivity of Less-Experienced Readers? Preliminary Findings. Radiology 245: 140-149 [Abstract] [Full Text]  
• Florie, J., Birnie, E., van Gelder, R. E., Jensch, S., Haberkorn, B., Bartelsman, J. F., van der Sluys Veer, A., Snel, P., van der Hulst, V. P. M., Bonsel, G. J., Bossuyt, P. M. M., Stoker, J. (2007). MR Colonography with Limited Bowel Preparation: Patient Acceptance Compared with That of Full-Preparation Colonoscopy. Radiology 245: 150-159 [Abstract] [Full Text]  
• Johnson, C. D., Fletcher, J. G., MacCarty, R. L., Mandrekar, J. N., Harmsen, W. S., Limburg, P. J., Wilson, L. A. (2007). Effect of Slice Thickness and Primary 2D Versus 3D Virtual Dissection on Colorectal Lesion Detection at CT Colonography in 452 Asymptomatic Adults. Am. J. Roentgenol. 189: 672-680 [Abstract] [Full Text]  
• Glick, S. (2007). Will 3D Virtual Dissection Display Prove to Be the Display Format for Reviewing CT Colonography Examinations?. Radiology 244: 629-630 [Full Text]  
• Kim, S. H., Lee, J. M., Eun, H. W., Lee, M. W., Han, J. K., Lee, J. Y., Choi, B. I. (2007). Two- versus Three-dimensional Colon Evaluation with Recently Developed Virtual Dissection Software for CT Colonography. Radiology 244: 852-864 [Abstract] [Full Text]  
• Fletcher, J. G., Booya, F., Summers, R. M., Roy, D., Guendel, L., Schmidt, B., McCollough, C. H., Fidler, J. L. (2007). Comparative Performance of Two Polyp Detection Systems on CT Colonography. Am. J. Roentgenol. 189: 277-282 [Abstract] [Full Text]  
• Pickhardt, P. J. (2007). Screening CT Colonography: How I Do It. Am. J. Roentgenol. 189: 290-298 [Abstract] [Full Text]