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Analysis of air contrast barium enema, computed tomographic colonography, and colonoscopy: prospective comparison.

Publication ,  Journal Article
Rockey, DC; Paulson, E; Niedzwiecki, D; Davis, W; Bosworth, HB; Sanders, L; Yee, J; Henderson, J; Hatten, P; Burdick, S; Sanyal, A; Rubin, DT ...
Published in: Lancet
January 22, 2005

BACKGROUND: The usefulness of currently available colon imaging tests, including air contrast barium enema (ACBE), computed tomographic colonography (CTC), and colonoscopy, to detect colon polyps and cancers is uncertain. We aimed to assess the sensitivity of these three imaging tests. METHODS: Patients with faecal occult blood, haematochezia, iron-deficiency anaemia, or a family history of colon cancer underwent three separate colon-imaging studies--ACBE, followed 7-14 days later by CTC and colonoscopy on the same day. The primary outcome was detection of colonic polyps and cancers. Outcomes were assessed by building an aggregate view of the colon, taking into account results of all three tests. FINDINGS: 614 patients completed all three imaging tests. When analysed on a per-patient basis, for lesions 10 mm or larger in size (n=63), the sensitivity of ACBE was 48% (95% CI 35-61), CTC 59% (46-71, p=0.1083 for CTC vs ACBE), and colonoscopy 98% (91-100, p<0.0001 for colonoscopy vs CTC). For lesions 6-9 mm in size (n=116), sensitivity was 35% for ACBE (27-45), 51% for CTC (41-60, p=0.0080 for CTC vs ACBE), and 99% for colonoscopy (95-100, p<0.0001 for colonoscopy vs CTC). For lesions of 10 mm or larger in size, the specificity was greater for colonoscopy (0.996) than for either ACBE (0.90) or CTC (0.96) and declined for ACBE and CTC when smaller lesions were considered. INTERPRETATION: Colonoscopy was more sensitive than other tests, as currently undertaken, for detection of colonic polyps and cancers. These data have important implications for diagnostic use of colon imaging tests.

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Published In

Lancet

DOI

EISSN

1474-547X

Publication Date

January 22, 2005

Volume

365

Issue

9456

Start / End Page

305 / 311

Location

England

Related Subject Headings

  • Sensitivity and Specificity
  • Pneumoradiography
  • Middle Aged
  • Male
  • Humans
  • General & Internal Medicine
  • Female
  • Enema
  • Colonoscopy
  • Colonography, Computed Tomographic
 

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Rockey, D. C., Paulson, E., Niedzwiecki, D., Davis, W., Bosworth, H. B., Sanders, L., … Halvorsen, R. (2005). Analysis of air contrast barium enema, computed tomographic colonography, and colonoscopy: prospective comparison. Lancet, 365(9456), 305–311. https://doi.org/10.1016/S0140-6736(05)17784-8
Rockey, D. C., E. Paulson, D. Niedzwiecki, W. Davis, H. B. Bosworth, L. Sanders, J. Yee, et al. “Analysis of air contrast barium enema, computed tomographic colonography, and colonoscopy: prospective comparison.Lancet 365, no. 9456 (January 22, 2005): 305–11. https://doi.org/10.1016/S0140-6736(05)17784-8.
Rockey DC, Paulson E, Niedzwiecki D, Davis W, Bosworth HB, Sanders L, et al. Analysis of air contrast barium enema, computed tomographic colonography, and colonoscopy: prospective comparison. Lancet. 2005 Jan 22;365(9456):305–11.
Rockey, D. C., et al. “Analysis of air contrast barium enema, computed tomographic colonography, and colonoscopy: prospective comparison.Lancet, vol. 365, no. 9456, Jan. 2005, pp. 305–11. Pubmed, doi:10.1016/S0140-6736(05)17784-8.
Rockey DC, Paulson E, Niedzwiecki D, Davis W, Bosworth HB, Sanders L, Yee J, Henderson J, Hatten P, Burdick S, Sanyal A, Rubin DT, Sterling M, Akerkar G, Bhutani MS, Binmoeller K, Garvie J, Bini EJ, McQuaid K, Foster WL, Thompson WM, Dachman A, Halvorsen R. Analysis of air contrast barium enema, computed tomographic colonography, and colonoscopy: prospective comparison. Lancet. 2005 Jan 22;365(9456):305–311.
Journal cover image

Published In

Lancet

DOI

EISSN

1474-547X

Publication Date

January 22, 2005

Volume

365

Issue

9456

Start / End Page

305 / 311

Location

England

Related Subject Headings

  • Sensitivity and Specificity
  • Pneumoradiography
  • Middle Aged
  • Male
  • Humans
  • General & Internal Medicine
  • Female
  • Enema
  • Colonoscopy
  • Colonography, Computed Tomographic