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CT colonography for surveillance of patients with colorectal cancer: Systematic review and meta-analysis of diagnostic efficacy.

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Title: CT colonography for surveillance of patients with colorectal cancer: Systematic review and meta-analysis of diagnostic efficacy.
Authors: Porté, François1, Uppara, Mallikarjuna2, Malietzis, George2, Faiz, Omar2, Halligan, Steve3, Athanasiou, Thanos4, Burling, David1 dburling@nhs.net, Porté, François5 (AUTHOR)
Source: European Radiology. Jan2017, Vol. 27 Issue 1, p51-60. 10p. 3 Diagrams, 3 Charts, 1 Graph.
Subjects: Colon cancer patients, Computed tomography, Colon cancer diagnosis, Colonoscopy, Serous fluids
Abstract: Purpose: To review primary research evidence investigating performance of CT colonography for colorectal cancer surveillance. The financial impact of using CT colonography for surveillance was also estimated.Methods: We identified primary studies of CT colonography for surveillance of colorectal cancer patients. A summary ROC curve was constructed. Inter-study heterogeneity was explored using the I2 value. Financial impact was estimated for a theoretical cohort of patients, based on Cancer Research UK statistics.Results: Seven studies provided data on 880 patients. Five of seven studies (765 patients) were included for qualitative analysis. Sensitivity of CT colonography for detection of anastomotic recurrence was 95 % (95 % CI 62 - 100), specificity 100 % (95 % CI 75 - 100) and sensitivity for metachronous cancers was 100 %. No statistical heterogeneity was detected (I2 = 0 %). We estimated that CT colonography as a 'single test' alternative to colonoscopy and standard CT for surveillance would potentially save €20,785,232 (£14,803,404) for an annual cohort of UK patients.Conclusion: CT colonography compares favourably to colonoscopy for detection of anastomotic recurrence and metachronous colorectal cancer, and appears financially beneficial. These findings should be considered alongside limitations of small patient numbers and high clinical heterogeneity between studies.Key Points: • CT colonography compares favourably to colonoscopy/standard CT for colorectal cancer surveillance. • CT colonography offers single-test luminal, serosal and extra-colonic assessment. • CT colonography is a potentially cost-saving alternative to standard surveillance protocols. [ABSTRACT FROM AUTHOR]
Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: CT colonography for surveillance of patients with colorectal cancer: Systematic review and meta-analysis of diagnostic efficacy.
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  Data: <searchLink fieldCode="AR" term="%22Porté%2C+François%22">Porté, François</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Uppara%2C+Mallikarjuna%22">Uppara, Mallikarjuna</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Malietzis%2C+George%22">Malietzis, George</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Faiz%2C+Omar%22">Faiz, Omar</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Halligan%2C+Steve%22">Halligan, Steve</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Athanasiou%2C+Thanos%22">Athanasiou, Thanos</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22Burling%2C+David%22">Burling, David</searchLink><relatesTo>1</relatesTo><i> dburling@nhs.net</i><br /><searchLink fieldCode="AR" term="%22Porté%2C+François%22">Porté, François</searchLink><relatesTo>5</relatesTo> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22European+Radiology%22">European Radiology</searchLink>. Jan2017, Vol. 27 Issue 1, p51-60. 10p. 3 Diagrams, 3 Charts, 1 Graph.
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  Data: <searchLink fieldCode="DE" term="%22Colon+cancer+patients%22">Colon cancer patients</searchLink><br /><searchLink fieldCode="DE" term="%22Computed+tomography%22">Computed tomography</searchLink><br /><searchLink fieldCode="DE" term="%22Colon+cancer+diagnosis%22">Colon cancer diagnosis</searchLink><br /><searchLink fieldCode="DE" term="%22Colonoscopy%22">Colonoscopy</searchLink><br /><searchLink fieldCode="DE" term="%22Serous+fluids%22">Serous fluids</searchLink>
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  Data: <bold>Purpose: </bold>To review primary research evidence investigating performance of CT colonography for colorectal cancer surveillance. The financial impact of using CT colonography for surveillance was also estimated.<bold>Methods: </bold>We identified primary studies of CT colonography for surveillance of colorectal cancer patients. A summary ROC curve was constructed. Inter-study heterogeneity was explored using the I2 value. Financial impact was estimated for a theoretical cohort of patients, based on Cancer Research UK statistics.<bold>Results: </bold>Seven studies provided data on 880 patients. Five of seven studies (765 patients) were included for qualitative analysis. Sensitivity of CT colonography for detection of anastomotic recurrence was 95 % (95 % CI 62 - 100), specificity 100 % (95 % CI 75 - 100) and sensitivity for metachronous cancers was 100 %. No statistical heterogeneity was detected (I2 = 0 %). We estimated that CT colonography as a 'single test' alternative to colonoscopy and standard CT for surveillance would potentially save €20,785,232 (£14,803,404) for an annual cohort of UK patients.<bold>Conclusion: </bold>CT colonography compares favourably to colonoscopy for detection of anastomotic recurrence and metachronous colorectal cancer, and appears financially beneficial. These findings should be considered alongside limitations of small patient numbers and high clinical heterogeneity between studies.<bold>Key Points: </bold>• CT colonography compares favourably to colonoscopy/standard CT for colorectal cancer surveillance. • CT colonography offers single-test luminal, serosal and extra-colonic assessment. • CT colonography is a potentially cost-saving alternative to standard surveillance protocols. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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