Document Type

Article

Original Publication Date

2008

Journal/Book/Conference Title

The New England Journal of Medicine

Volume

359

Issue

12

DOI of Original Publication

10.1056/NEJMoa0800996

Comments

Originally Published at http://dx.doi.org/10.1056/NEJMoa0800996

The article was updated on December 25, 2008 at NEJM.org. The correction was published as follows:

Accuracy of CT Colonography for Detection of Large Adenomas and Cancers (Original Article, N Engl J Med 2008:359;1207 1217) . In Table 4 (page 1215), row 2, the table entry should read, “No. of lesions.” We regret the error. The table has been corrected on the Journal's Web site at www.nejm.org.

Date of Submission

January 2015

Abstract

Background

Computed tomographic (CT) colonography is a noninvasive option in screening for colorectal cancer. However, its accuracy as a screening tool in asymptomatic adults has not been well defined.

Methods

We recruited 2600 asymptomatic study participants, 50 years of age or older, at 15 study centers. CT colonographic images were acquired with the use of standard bowel preparation, stool and fluid tagging, mechanical insufflation, and multidetector-row CT scanners (with 16 or more rows). Radiologists trained in CT colonography reported all lesions measuring 5 mm or more in diameter. Optical colonoscopy and histologic review were performed according to established clinical protocols at each center and served as the reference standard. The primary end point was detection by CT colonography of histologically confirmed large adenomas and adenocarcinomas (10 mm in diameter or larger) that had been detected by colonoscopy; detection of smaller colorectal lesions (6 to 9 mm in diameter) was also evaluated.

Results

Complete data were available for 2531 participants (97%). For large adenomas and cancers, the mean (±SE) per-patient estimates of the sensitivity, specificity, positive and negative predictive values, and area under the receiver-operating-characteristic curve for CT colonography were 0.90±0.03, 0.86±0.02, 0.23±0.02, 0.99±

Conclusions

In this study of asymptomatic adults, CT colonographic screening identified 90% of subjects with adenomas or cancers measuring 10 mm or more in diameter. These findings augment published data on the role of CT colonography in screening patients with an average risk of colorectal cancer. (ClinicalTrials.gov number, NCT00084929; American College of Radiology Imaging Network [ACRIN] number, 6664.)

Rights

From the New England Journal of Medicine, Johnson, C. D., Chen, M. H., Toledano, A.Y. et al., Accuracy of CT Colonography for Detection of Large Adenomas and Cancers, Vol. 359, Page 1207, Copyright © 2008 Massachusetts Medical Society. Reprinted with permission.

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