Bibliographic Details
| Title: |
Appearances of screen-detected versus symptomatic colorectal cancers at CT colonography. |
| Authors: |
Plumb, Andrew1, Pathiraja, Fiona1, Taylor, Stuart1, Halligan, Steve1, Nickerson, Claire2, Wooldrage, Katherine3, Atkin, Wendy3, Burling, David4, Plumb, Andrew A5 (AUTHOR), Taylor, Stuart A5 (AUTHOR), Atkin, Wendy S6 (AUTHOR) |
| Source: |
European Radiology. Dec2016, Vol. 26 Issue 12, p4313-4322. 10p. 1 Color Photograph, 1 Black and White Photograph, 3 Charts, 1 Graph. |
| Subjects: |
Hereditary nonpolyposis colorectal cancer, Computed tomography, Colon cancer diagnosis, Virtual colonoscopy, Patients, Clinical trials, Colon tumors, Comparative studies, Fecal occult blood tests, Longitudinal method, Research methodology, Medical cooperation, Medical screening, Rectum tumors, Research, Tumor classification, Evaluation research, Research bias, Retrospective studies, Early detection of cancer |
| Abstract: |
Objectives: The aim of this study was to compare the morphology, radiological stage, conspicuity, and computer-assisted detection (CAD) characteristics of colorectal cancers (CRC) detected by computed tomographic colonography (CTC) in screening and symptomatic populations.Methods: Two radiologists independently analyzed CTC images from 133 patients diagnosed with CRC in (a) two randomized trials of symptomatic patients (35 patients with 36 tumours) and (b) a screening program using fecal occult blood testing (FOBt; 98 patients with 100 tumours), measuring tumour length, volume, morphology, radiological stage, and subjective conspicuity. A commercial CAD package was applied to both datasets. We compared CTC characteristics between screening and symptomatic populations with multivariable regression.Results: Screen-detected CRC were significantly smaller (mean 3.0 vs 4.3 cm, p < 0.001), of lower volume (median 9.1 vs 23.2 cm3, p < 0.001) and more frequently polypoid (34/100, 34 % vs. 5/36, 13.9 %, p = 0.02) than symptomatic CRC. They were of earlier stage than symptomatic tumours (OR = 0.17, 95 %CI 0.07-0.41, p < 0.001), and were judged as significantly less conspicuous (mean conspicuity 54.1/100 vs. 72.8/100, p < 0.001). CAD detection was significantly lower for screen-detected (77.4 %; 95 %CI 67.9-84.7 %) than symptomatic CRC (96.9 %; 95 %CI 83.8-99.4 %, p = 0.02).Conclusions: Screen-detected CRC are significantly smaller, more frequently polypoid, subjectively less conspicuous, and less likely to be identified by CAD than those in symptomatic patients.Key Points: • Screen-detected colorectal cancers (CRC) are significantly smaller than symptomatic CRC. • Screening cases are significantly less conspicuous to radiologists than symptomatic tumours. • Screen-detected CRC have different morphology compared to symptomatic tumours (more polypoid, fewer annular). • A commercial computer-aided detection (CAD) system was significantly less likely to note screen-detected CRC. [ABSTRACT FROM AUTHOR] |
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| Database: |
Engineering Source |
