Colonoscopy detects significantly more flat adenomas than 3-tesla magnetic resonance colonography: a pilot trial
Background and study aims: Colorectal cancer (CRC) is one of the most common cancers worldwide, and several efforts have been made to reduce its occurrence or severity. Although colonoscopy is considered the gold standard in CRC prevention, it has its disadvantages: missed lesions, bleeding, and per...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Georg Thieme Verlag KG
2016-01-01
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| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-111501 |
| _version_ | 1811292962273886208 |
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| author | Robert Hüneburg Guido Kukuk Jacob Nattermann Christoph Endler Arndt-Hendrik Penner Karsten Wolter Hans Schild Christian Strassburg Tilman Sauerbruch Volker Schmitz Winfried Willinek |
| author_facet | Robert Hüneburg Guido Kukuk Jacob Nattermann Christoph Endler Arndt-Hendrik Penner Karsten Wolter Hans Schild Christian Strassburg Tilman Sauerbruch Volker Schmitz Winfried Willinek |
| author_sort | Robert Hüneburg |
| collection | DOAJ |
| description | Background and study aims: Colorectal cancer (CRC) is one of the most common cancers worldwide, and several efforts have been made to reduce its occurrence or severity. Although colonoscopy is considered the gold standard in CRC prevention, it has its disadvantages: missed lesions, bleeding, and perforation. Furthermore, a high number of patients undergo this procedure even though no polyps are detected. Therefore, an initial screening examination may be warranted. Our aim was to compare the adenoma detection rate of magnetic resonance colonography (MRC) with that of optical colonoscopy.
Patients and methods: A total of 25 patients with an intermediate risk for CRC (17 men, 8 women; mean age 57.6, standard deviation 11) underwent MRC with a 3.0-tesla magnet, followed by colonoscopy. The endoscopist was initially blinded to the results of MRC and unblinded immediately after examining the distal rectum. Following endoscopic excision, the size, anatomical localization, and appearance of all polyps were described according to the Paris classification.
Results: A total of 93 lesions were detected during colonoscopy. These included a malignant infiltration of the transverse colon due to gastric cancer in 1 patient, 28 adenomas in 10 patients, 19 hyperplastic polyps in 9 patients, and 45 non-neoplastic lesions. In 5 patients, no lesion was detected. MRC detected significantly fewer lesions: 1 adenoma (P = 0.001) and 1 hyperplastic polyp (P = 0.004). The malignant infiltration was seen with both modalities. Of the 28 adenomas, 23 (82 %) were 5 mm or smaller; only 4 adenomas 10 mm or larger (14 %) were detected.
Conclusion: MRC does not detect adenomas sufficiently independently of the location of the lesion. Even advanced lesions were missed. Therefore, colonoscopy should still be considered the current gold standard, even for diagnostic purposes. |
| first_indexed | 2024-04-13T04:54:11Z |
| format | Article |
| id | doaj.art-4365da0ed5194e7db94142425e4e1297 |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-04-13T04:54:11Z |
| publishDate | 2016-01-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-4365da0ed5194e7db94142425e4e12972022-12-22T03:01:33ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362016-01-010402E164E16910.1055/s-0041-111501Colonoscopy detects significantly more flat adenomas than 3-tesla magnetic resonance colonography: a pilot trialRobert Hüneburg0Guido Kukuk1Jacob Nattermann2Christoph Endler3Arndt-Hendrik Penner4Karsten Wolter5Hans Schild6Christian Strassburg7Tilman Sauerbruch8Volker Schmitz9Winfried Willinek10Department of Internal Medicine I, University Hospital of Bonn, Bonn, GermanyDepartment of Radiology, University Hospital of Bonn, Bonn, GermanyDepartment of Internal Medicine I, University Hospital of Bonn, Bonn, GermanyDepartment of Internal Medicine I, University Hospital of Bonn, Bonn, GermanyDepartment of Radiology, University Hospital of Bonn, Bonn, GermanyDepartment of Radiology, University Hospital of Bonn, Bonn, GermanyDepartment of Radiology, University Hospital of Bonn, Bonn, GermanyDepartment of Internal Medicine I, University Hospital of Bonn, Bonn, GermanyDepartment of Internal Medicine I, University Hospital of Bonn, Bonn, GermanyDepartment of Internal Medicine I, University Hospital of Bonn, Bonn, GermanyDepartment of Radiology, University Hospital of Bonn, Bonn, GermanyBackground and study aims: Colorectal cancer (CRC) is one of the most common cancers worldwide, and several efforts have been made to reduce its occurrence or severity. Although colonoscopy is considered the gold standard in CRC prevention, it has its disadvantages: missed lesions, bleeding, and perforation. Furthermore, a high number of patients undergo this procedure even though no polyps are detected. Therefore, an initial screening examination may be warranted. Our aim was to compare the adenoma detection rate of magnetic resonance colonography (MRC) with that of optical colonoscopy. Patients and methods: A total of 25 patients with an intermediate risk for CRC (17 men, 8 women; mean age 57.6, standard deviation 11) underwent MRC with a 3.0-tesla magnet, followed by colonoscopy. The endoscopist was initially blinded to the results of MRC and unblinded immediately after examining the distal rectum. Following endoscopic excision, the size, anatomical localization, and appearance of all polyps were described according to the Paris classification. Results: A total of 93 lesions were detected during colonoscopy. These included a malignant infiltration of the transverse colon due to gastric cancer in 1 patient, 28 adenomas in 10 patients, 19 hyperplastic polyps in 9 patients, and 45 non-neoplastic lesions. In 5 patients, no lesion was detected. MRC detected significantly fewer lesions: 1 adenoma (P = 0.001) and 1 hyperplastic polyp (P = 0.004). The malignant infiltration was seen with both modalities. Of the 28 adenomas, 23 (82 %) were 5 mm or smaller; only 4 adenomas 10 mm or larger (14 %) were detected. Conclusion: MRC does not detect adenomas sufficiently independently of the location of the lesion. Even advanced lesions were missed. Therefore, colonoscopy should still be considered the current gold standard, even for diagnostic purposes.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-111501 |
| spellingShingle | Robert Hüneburg Guido Kukuk Jacob Nattermann Christoph Endler Arndt-Hendrik Penner Karsten Wolter Hans Schild Christian Strassburg Tilman Sauerbruch Volker Schmitz Winfried Willinek Colonoscopy detects significantly more flat adenomas than 3-tesla magnetic resonance colonography: a pilot trial Endoscopy International Open |
| title | Colonoscopy detects significantly more flat adenomas than 3-tesla magnetic resonance colonography: a pilot trial |
| title_full | Colonoscopy detects significantly more flat adenomas than 3-tesla magnetic resonance colonography: a pilot trial |
| title_fullStr | Colonoscopy detects significantly more flat adenomas than 3-tesla magnetic resonance colonography: a pilot trial |
| title_full_unstemmed | Colonoscopy detects significantly more flat adenomas than 3-tesla magnetic resonance colonography: a pilot trial |
| title_short | Colonoscopy detects significantly more flat adenomas than 3-tesla magnetic resonance colonography: a pilot trial |
| title_sort | colonoscopy detects significantly more flat adenomas than 3 tesla magnetic resonance colonography a pilot trial |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-111501 |
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