Diagnostic value of CT-colonography as compared to colonoscopy in an asymptomatic screening population: a meta-analysisReport as inadecuate




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European Radiology

, Volume 21, Issue 8, pp 1747–1763

First Online: 01 April 2011Received: 14 November 2010Revised: 01 February 2011Accepted: 03 February 2011

Abstract

ObjectivesPrevious meta-analyses on CT-colonography included both average and high risk individuals, which may overestimate the diagnostic value in screening. A meta-analysis was performed to obtain the value of CT-colonography for screening.

MethodsA search was performed using PubMed, Embase and Cochrane. Article selection and critical appraisal was done by two reviewers. Inclusion criteria: prospective, randomized trials or cohort studies comparing CT-colonography with colonoscopy ≥50 participants, ≥95% average risk participants ≥50 years. Study characteristics and 2 × 2 contingency Tables were recorded. Sensitivity and specificity estimates were calculated per patient and per polyp ≥6 mm, ≥10 mm, using univariate and bivariate analyses.

ResultsFive of 1,021 studies identified were included, including 4,086 participants <1% high risk. I-values showed substantial heterogeneity, especially for 6–9 mm polyps and adenomas: 68.1% vs. 78.6% sensitivity per patient. Estimated sensitivities for patients with polyps or adenomas ≥ 6 mm were 75.9% and 82.9%, corresponding specificities 94.6% and 91.4%. Estimated sensitivities for patients with polyps or adenomas ≥ 10 mm were 83.3% and 87.9%, corresponding specificities 98.7% and 97.6%. Estimated sensitivities per polyp for advanced adenomas ≥ 6 mm and ≥ 10 mm were 83.9% and 83.8%.

ConclusionCompared to colonoscopy, CT-colonography has a high sensitivity for adenomas ≥ 10 mm. For advanced adenomas ≥ 6 mm sensitivity is somewhat lower.

KeywordsColorectal cancer Screening CT-Colonography Colonoscopy Sensitivity and specificity  Download fulltext PDF



Author: Margriet C. de Haan - Rogier E. van Gelder - Anno Graser - Shandra Bipat - Jaap Stoker

Source: https://link.springer.com/







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