Diagnostic value of CT-colonography as compared to colonoscopy in an asymptomatic screening population: a meta-analysis
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Margriet C. de Haan & Rogier E. van Gelder & Anno Graser & Shandra Bipat & Jaap Stoker
- چاپ و سال / کشور: 2011
Description
Objectives Previous meta-analyses on CT-colonography included both average and high risk individuals, which may overestimate the diagnostic value in screening. A meta-analysis was performed to obtain the value of CTcolonography for screening. Methods A search was performed using PubMed, Embase and Cochrane. Article selection and critical appraisal was done by two reviewers. Inclusion criteria: prospective, randomized trials or cohort studies comparing CTcolonography with colonoscopy (.50 participants), .95% average risk participants .50 years. Study characteristics and 2پ~2 contingency Tables were recorded. Sensitivity and specificity estimates were calculated per patient and per polyp (.6 mm, .10 mm), using univariate and bivariate analyses. Results Five of 1,021 studies identified were included, including 4,086 participants (<1% high risk). I2-values showed substantial heterogeneity, especially for 6.9 mm polyps and adenomas: 68.1% vs. 78.6% (sensitivity per patient). Estimated sensitivities for patients with polyps or adenomas .6 mm were 75.9% and 82.9%, corresponding specificities 94.6% and 91.4%. Estimated sensitivities for patients with polyps or adenomas .10 mm were 83.3% and 87.9%, corresponding specificities 98.7% and 97.6%. Estimated sensitivities per polyp for advanced adenomas .6 mm and .10 mm were 83.9% and 83.8%. Conclusion Compared to colonoscopy, CT-colonography has a high sensitivity for adenomas .10 mm. For (advanced) adenomas .6 mm sensitivity is somewhat lower.
Eur Radiol (2011) 21:1747–1763 DOI 10.1007/s00330-011-2104-8 Received: 14 November 2010 / Revised: 1 February 2011 / Accepted: 3 February 2011 / Published online: 1 April 2011
