Can the localization of primary colonic tumors be improved by staging CT without specific bowel preparation compared to optical colonoscopy?

Journal Article

OBJECTIVES: To investigate the ability of staging computed tomography (CT) without bowel preparation to accurately localize colonic tumors compared to optical colonoscopy. METHODS: The local institutional review board approved this retrospective and HIPAA-compliant study. Forty-six patients with colonic adenocarcinoma, preoperative colonoscopy, and staging CT within 60 days of resection were included. Patients underwent contrast enhanced CT imaging without bowel preparation or oral contrast. The colon was divided into four segments with the operative reports used as the standard. Rectal and cecal cancers were excluded. CT scans were reviewed by 5 readers in a segmental binary fashion using a 5-point confidence scale in two sessions blinded and unblinded to the colonoscopy report. RESULTS: At surgery 49 tumors were found in 46 patients. Readers detected 86.1%, 74.3%, and 66.9% of lesions with 92.0%, 94.1%, and 95.4% accuracy for confidence scores of ≥ 3, ≥ 4, and 5. CT interobserver agreement was good (κ=0.82) for the unblinded and moderate (κ=0.60) for the blinded read. Colonoscopic localization was only 78.7% accurate with 2 tumors undiscovered. Colonoscopic accuracy was low in the descending colon (57.1%) and the transverse colon (55.6%). CONCLUSIONS: Preoperative staging CT is more accurate than colonoscopy in the localization of colonic tumors.

Full Text

Duke Authors

Cited Authors

  • Feuerlein, S; Grimm, LJ; Davenport, MS; Haystead, CM; Miller, CM; Neville, AM; Jaffe, TA

Published Date

  • October 2012

Published In

Volume / Issue

  • 81 / 10

Start / End Page

  • 2538 - 2542

PubMed ID

  • 22209431

Electronic International Standard Serial Number (EISSN)

  • 1872-7727

International Standard Serial Number (ISSN)

  • 0720-048X

Digital Object Identifier (DOI)

  • 10.1016/j.ejrad.2011.12.004

Language

  • eng