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.
| Original language | Italian |
|---|---|
| Pages (from-to) | 1267-1278 |
| Number of pages | 12 |
| Journal | Radiologia Medica |
| Volume | 115 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - Dec 2010 |
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ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Medicine(all)
Cite this
Valutazione della colongrafia TC come test di secondo livello in soggetti con sangue occulto fecale positivo. Esperienza preliminare. / Sali, L.; Falchini, M.; Della Monica, P.; Regge, D.; Bonanomi, A. G.; Castiglione, G.; Grazzini, G.; Zappa, M.; Mungai, F.; Volpe, C.; Mascalchi, M.
In: Radiologia Medica, Vol. 115, No. 8, 12.2010, p. 1267-1278.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Valutazione della colongrafia TC come test di secondo livello in soggetti con sangue occulto fecale positivo. Esperienza preliminare
AU - Sali, L.
AU - Falchini, M.
AU - Della Monica, P.
AU - Regge, D.
AU - Bonanomi, A. G.
AU - Castiglione, G.
AU - Grazzini, G.
AU - Zappa, M.
AU - Mungai, F.
AU - Volpe, C.
AU - Mascalchi, M.
PY - 2010/12
Y1 - 2010/12
N2 - 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.
AB - 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.
KW - Colorectal cancer screening
KW - Computed tomography colonography
KW - Faecal occult blood test
UR - http://www.scopus.com/inward/record.url?scp=78751649166&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=78751649166&partnerID=8YFLogxK
U2 - 10.1007/s11547-010-0569-1
DO - 10.1007/s11547-010-0569-1
M3 - Articolo
C2 - 20680499
AN - SCOPUS:78751649166
VL - 115
SP - 1267
EP - 1278
JO - Radiologia Medica
JF - Radiologia Medica
SN - 0033-8362
IS - 8
ER -