Computed tomographic colonography: Difference between revisions
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In [[medicine]], '''computed tomographic colonography''', also called '''CT colonography''' and '''virtual colonoscopy''', is a "non-invasive [[diagnostic imaging|imaging]] method that uses [[computed tomography | computed tomographic]] data combined with specialized imaging software to examine the [[colon]]."<ref>{{MeSH}}</ref> | In [[medicine]], '''computed tomographic colonography''', also called '''CT colonography''' and '''virtual colonoscopy''', is a "non-invasive [[diagnostic imaging|imaging]] method that uses [[computed tomography | computed tomographic]] data combined with specialized imaging software to examine the [[colon]]."<ref>{{MeSH}}</ref> | ||
==Accuracy== | |||
According to the [[US Preventive Services Task Force|US Preventive Services Task Force]] (USPSTF), the accuracy of CT colonography is: | |||
For adenomas at least 10 mm in size | For adenomas at least 10 mm in size | ||
* [[Sensitivity and specificity| sensitivity]] = 92% | * [[Sensitivity and specificity| sensitivity]] = 92% | ||
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* [[Sensitivity and specificity| specificity]] is uncertain and ranges from 80 to 88% | * [[Sensitivity and specificity| specificity]] is uncertain and ranges from 80 to 88% | ||
The [[positive predictive value]] of seeing a colonic polyp greater than 10 mm in size with CT colonoscopy and actually having such a polyp by [[colonoscopy]] is about 25%.<ref name="pmid18799557">{{cite journal |author=Johnson CD, Chen MH, Toledano AY, ''et al'' |title=Accuracy of CT colonography for detection of large adenomas and cancers |journal=The New England journal of medicine |volume=359 |issue=12 |pages=1207–17 |year=2008 |month=September |pmid=18799557 |doi=10.1056/NEJMoa0800996 |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=18799557&promo=ONFLNS19 |issn=}}</ref> | |||
==Role in colorectal cancer prevention== | |||
A [[clinical practice guideline]] by the [[US Preventive Services Task Force]] (USPSTF) gave a [http://www.ahrq.gov/clinic/3rduspstf/ratings.htm grade I recommendation] for CT colongraphy in [[mass screening|screening]] for [[colorectal cancer]] stating "the evidence is insufficient to assess the benefits and harms of computed tomographic colonography."<ref name="pmid18838716">{{cite journal |author=U.S. Preventive Services Task Force |title=Screening for Colorectal Cancer: U.S. Preventive Services Task Force Recommendation Statement |journal=Annals of internal medicine |volume= |issue= |pages= |year=2008 |month=October |pmid=18838716 |doi= |url= |issn=}}</ref><ref name="pmid18838718">{{cite journal |author=Whitlock EP, Lin JS, Liles E, Beil TL, Fu R |title=Screening for Colorectal Cancer: A Targeted, Updated Systematic Review for the U.S. Preventive Services Task Force |journal=Annals of internal medicine |volume= |issue= |pages= |year=2008 |month=October |pmid=18838718 |doi= |url= |issn=}}</ref> The most recent study used by the [[systematic review]] for this [[clinical practice guideline]] was in 2008.<ref name="pmid18799557">{{cite journal |author=Johnson CD, Chen MH, Toledano AY, ''et al'' |title=Accuracy of CT colonography for detection of large adenomas and cancers |journal=The New England journal of medicine |volume=359 |issue=12 |pages=1207–17 |year=2008 |month=September |pmid=18799557 |doi=10.1056/NEJMoa0800996 |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=18799557&promo=ONFLNS19 |issn=}}</ref> | |||
A joint [[clinical practice guideline]] by the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology states that CT colonography is an acceptable option for [[colorectal cancer]] [[mass screening|screening]].<ref name="pmid18384785">{{cite journal |author=Levin B, Lieberman DA, McFarland B, ''et al'' |title=Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology |journal=Gastroenterology |volume=134 |issue=5 |pages=1570–95 |year=2008 |month=May |pmid=18384785 |doi=10.1053/j.gastro.2008.02.002 |url=http://linkinghub.elsevier.com/retrieve/pii/S0016-5085(08)00232-1 |issn=}}</ref> | |||
==References== | ==References== | ||
<references/> | <references/> | ||
Revision as of 22:10, 23 October 2008
In medicine, computed tomographic colonography, also called CT colonography and virtual colonoscopy, is a "non-invasive imaging method that uses computed tomographic data combined with specialized imaging software to examine the colon."[1]
Accuracy
According to the US Preventive Services Task Force (USPSTF), the accuracy of CT colonography is: For adenomas at least 10 mm in size
- sensitivity = 92%
- specificity is uncertain and ranges from 88 to 96%
For adenomas at smaller than 10 mm in size
- sensitivity is uncertain and ranges from 65[2] to 89%
- specificity is uncertain and ranges from 80 to 88%
The positive predictive value of seeing a colonic polyp greater than 10 mm in size with CT colonoscopy and actually having such a polyp by colonoscopy is about 25%.[2]
Role in colorectal cancer prevention
A clinical practice guideline by the US Preventive Services Task Force (USPSTF) gave a grade I recommendation for CT colongraphy in screening for colorectal cancer stating "the evidence is insufficient to assess the benefits and harms of computed tomographic colonography."[3][4] The most recent study used by the systematic review for this clinical practice guideline was in 2008.[2]
A joint clinical practice guideline by the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology states that CT colonography is an acceptable option for colorectal cancer screening.[5]
References
- ↑ Anonymous (2024), Computed tomographic colonography (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ 2.0 2.1 2.2 Johnson CD, Chen MH, Toledano AY, et al (September 2008). "Accuracy of CT colonography for detection of large adenomas and cancers". The New England journal of medicine 359 (12): 1207–17. DOI:10.1056/NEJMoa0800996. PMID 18799557. Research Blogging.
- ↑ U.S. Preventive Services Task Force (October 2008). "Screening for Colorectal Cancer: U.S. Preventive Services Task Force Recommendation Statement". Annals of internal medicine. PMID 18838716. [e]
- ↑ Whitlock EP, Lin JS, Liles E, Beil TL, Fu R (October 2008). "Screening for Colorectal Cancer: A Targeted, Updated Systematic Review for the U.S. Preventive Services Task Force". Annals of internal medicine. PMID 18838718. [e]
- ↑ Levin B, Lieberman DA, McFarland B, et al (May 2008). "Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology". Gastroenterology 134 (5): 1570–95. DOI:10.1053/j.gastro.2008.02.002. PMID 18384785. Research Blogging.