Valutazione della colongrafia TC come test di secondo livello in soggetti con sangue occulto fecale positivo. Esperienza preliminare

Translated title of the contribution: CT colonography before colonoscopy in subjects with positive faecal occult blood test. Preliminary experience

L. Sali, M. Falchini, P. Della Monica, D. Regge, A. G. Bonanomi, G. Castiglione, G. Grazzini, M. Zappa, F. Mungai, C. Volpe, M. Mascalchi

Research output: Contribution to journalArticlepeer-review

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.

Translated title of the contributionCT colonography before colonoscopy in subjects with positive faecal occult blood test. Preliminary experience
Original languageItalian
Pages (from-to)1267-1278
Number of pages12
JournalRadiologia Medica
Volume115
Issue number8
DOIs
Publication statusPublished - Dec 2010

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

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