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 journalArticle

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 languageItalian
Pages (from-to)1267-1278
Number of pages12
JournalRadiologia Medica
Volume115
Issue number8
DOIs
Publication statusPublished - Dec 2010

Fingerprint

Computed Tomographic Colonography
Occult Blood
Hematologic Tests
Colonoscopy
Adenoma
Tomography
Colorectal Neoplasms
Optical Tomography
Neoplasms
Costs and Cost Analysis
Sensitivity and Specificity
Population

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 journalArticle

Sali, L, Falchini, M, Della Monica, P, Regge, D, Bonanomi, AG, Castiglione, G, Grazzini, G, Zappa, M, Mungai, F, Volpe, C & Mascalchi, M 2010, 'Valutazione della colongrafia TC come test di secondo livello in soggetti con sangue occulto fecale positivo. Esperienza preliminare', Radiologia Medica, vol. 115, no. 8, pp. 1267-1278. https://doi.org/10.1007/s11547-010-0569-1
Sali, L. ; Falchini, M. ; Della Monica, P. ; Regge, D. ; Bonanomi, A. G. ; Castiglione, G. ; Grazzini, G. ; Zappa, M. ; Mungai, F. ; Volpe, C. ; Mascalchi, M. / Valutazione della colongrafia TC come test di secondo livello in soggetti con sangue occulto fecale positivo. Esperienza preliminare. In: Radiologia Medica. 2010 ; Vol. 115, No. 8. pp. 1267-1278.
@article{674cb87d9869446487e9058749c12b69,
title = "Valutazione della colongrafia TC come test di secondo livello in soggetti con sangue occulto fecale positivo. Esperienza preliminare",
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.",
keywords = "Colorectal cancer screening, Computed tomography colonography, Faecal occult blood test",
author = "L. Sali and M. Falchini and {Della Monica}, P. and D. Regge and Bonanomi, {A. G.} and G. Castiglione and G. Grazzini and M. Zappa and F. Mungai and C. Volpe and M. Mascalchi",
year = "2010",
month = "12",
doi = "10.1007/s11547-010-0569-1",
language = "Italian",
volume = "115",
pages = "1267--1278",
journal = "Radiologia Medica",
issn = "0033-8362",
publisher = "Springer-Verlag Italia s.r.l.",
number = "8",

}

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 -