| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH |
|
|
|
|||||||
|
|||||||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Gastrointestinal Imaging |
1 From the Departments of Radiology (S.H.P., H.K.H., M.J.K., K.W.K., A.Y.K., D.H.Y., M.G.L., P.N.K., Y.M.S.) and Internal Medicine (S.K.Y., S.J.M., Y.I.M.), University of Ulsan College of Medicine, Asan Medical Center, 388–1 Poongnap-Dong, Songpa-Gu, 138–040 Seoul, Korea. Received April 2, 2004; revision requested June 8; revision received June 26; accepted July 27. Address correspondence to H.K.H. (e-mail: hkha@amc.seoul.kr).
PURPOSE: To determine causes of false-negative results at multi–detector row computed tomographic (CT) colonography and determine presumptive causes with logistic regression analysis.
MATERIALS AND METHODS: Institutional review board approval and informed consent were obtained. The study included 394 colonic segments in 31 men and 25 women at high risk for colorectal cancer (mean age ± standard deviation, 60.2 years ± 9.3 for men and 56.8 years ± 13.3 for women). Multi–detector row CT colonography and colonoscopy (reference standard) were performed in a blinded manner, and the results were compared. CT colonographic findings were interpreted in consensus by two readers using a primary two-dimensional with three-dimensional problem-solving approach. Adequacy of colonic preparation and distention was recorded. Sensitivity and specificity were obtained with 95% confidence intervals (CIs). Lesions missed at CT colonography were retrospectively reassessed to identify why they were missed, and, if the causes were not apparent, logistic regression analysis was performed to determine the presumptive causes.
RESULTS: Colonic preparation and distention were optimal in 17 patients (30%) but suboptimal in 37 (66%) and poor enough to make the results nondiagnostic in two (4%). Twenty-nine of 63 lesions were missed at CT colonography. When all flat, sessile, and pedunculated lesions (n = 63) were included, sensitivities were 75% (nine of 12; 95% CI: 48%, 100%) for lesions 10 mm or larger and 79% (19 of 24; 95% CI: 65%, 93%) for those 6 mm or larger. When only sessile and pedunculated lesions (n = 60) were included, corresponding sensitivities were 100% (nine of nine; 73%, 100%) and 90% (19 of 21; 78%, 100%), respectively. All three missed lesions larger than 10 mm were flat, and all three flat lesions were missed. Two 3-mm high lesions, including one invasive adenocarcinoma, were misinterpreted as feces at blinded image review; one 1-mm high tubular adenoma with adenocarcinoma foci could not be visualized even in retrospect. Sessile or pedunculated polyps 5 mm or smaller were significantly more likely to be missed than those 6 mm or larger (adjusted odds ratio, 11.6; P = .027).
CONCLUSION: Aside from inadequate bowel preparation and/or distention, flat lesions and small polyps are the two main causes for missed lesions at multi–detector row CT colonography.
© RSNA, 2005
This article has been cited by other articles:
|
|
 |
|
  R. L. Van Uitert, R. M. Summers, J. M. White, K. K. Deshpande, J. R. Choi, and P. J. Pickhardt Temporal and Multiinstitutional Quality Assessment of CT Colonography Am. J. Roentgenol., November 1, 2008; 191(5): 1503 - 1508. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. H. Kim, J. M. Lee, C.-I. Shin, H. C. Kim, J.-G. Lee, J. H. Kim, J. Y. Choi, H. W. Eun, J. K. Han, J. Y. Lee, et al. Effects of Spatial Resolution and Tube Current on Computer-aided Detection of Polyps on CT Colonographic Images: Phantom Study Radiology, August 1, 2008; 248(2): 492 - 503. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. M. Soetikno, T. Kaltenbach, and R. V. Rouse Screening for Nonpolypoid Colorectal Neoplasms--Reply JAMA, June 18, 2008; 299(23): 2743 - 2744. [Full Text] [PDF]
|
|
|
|
|
|
K. K. Deshpande, R. M. Summers, R. L. Van Uitert, M. Franaszek, L. Brown, A. J. Dwyer, J. G. Fletcher, J. R. Choi, and P. J. Pickhardt Quality Assessment for CT Colonography: Validation of Automated Measurement of Colonic Distention and Residual Fluid Am. J. Roentgenol., December 1, 2007; 189(6): 1457 - 1463. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. H. Kim, J. M. Lee, H. W. Eun, M. W. Lee, J. K. Han, J. Y. Lee, and B. I. Choi Two- versus Three-dimensional Colon Evaluation with Recently Developed Virtual Dissection Software for CT Colonography Radiology, September 1, 2007; 244(3): 852 - 864. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. H. Kim, J. M. Lee, J.-G. Lee, J. H. Kim, P. A. Lefere, J. K. Han, and B. I. Choi Computer-Aided Detection of Colonic Polyps at CT Colonography Using a Hessian Matrix-Based Algorithm: Preliminary Study Am. J. Roentgenol., July 1, 2007; 189(1): 41 - 51. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. K. Choi, S. H. Park, D. Y. Kim, and H. K. Ha Malignant Rectal Polyp Overlooked on CT Colonography Because of Retention Balloon: Opposing Crescent Appearance as Sign of Compressed Polyp Am. J. Roentgenol., July 1, 2007; 189(1): W1 - W3. [Full Text] [PDF]
|
|
|
|
 |
|
 A. C. Silva, S. D. Beaty, A. K. Hara, J. G. Fletcher, J. L. Fidler, C. O. Menias, and C. D. Johnson Spectrum of Normal and Abnormal CT Appearances of the Ileocecal Valve and Cecum with Endoscopic and Surgical Correlation RadioGraphics, July 1, 2007; 27(4): 1039 - 1054. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. H. Park, S. S. Lee, E. K. Choi, S. Y. Kim, S.-K. Yang, J. H. Kim, and H. K. Ha Flat Colorectal Neoplasms: Definition, Importance, and Visualization on CT Colonography Am. J. Roentgenol., April 1, 2007; 188(4): 953 - 959. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Mang, A. Maier, C. Plank, C. Mueller-Mang, C. Herold, and W. Schima Pitfalls in Multi-Detector Row CT Colonography: A Systematic Approach RadioGraphics, March 1, 2007; 27(2): 431 - 454. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Halligan, S. H. Park, and H. K. Ha Causes of False-Negative Findings at CT Colonography Radiology, March 1, 2006; 238(3): 1075 - 1077. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH |
| RADIOLOGY | RADIOGRAPHICS | RSNA JOURNALS ONLINE |
