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
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.
Is Part Of
VCU Radiology Publications
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.