Role of CT Colonography in Colonic Lesions and Its Correlation with Conventional Colonoscopic Findings
Background: Preoperative evaluation in patients with colorectal carcinoma is essential for a correct therapeutic plan. Conventional colonoscopy has certain limitations including its inability to detect synchronous lesions in case of distal obstructive mass and inaccurate tumour localization. CT...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2015-04-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/5853/12686_CE[Ra_Ash]_F(P)_PF1(PAK)_PFA(AK)_PF2(PAG).pdf |
| Summary: | Background: Preoperative evaluation in patients with colorectal
carcinoma is essential for a correct therapeutic plan. Conventional
colonoscopy has certain limitations including its inability to
detect synchronous lesions in case of distal obstructive mass
and inaccurate tumour localization. CT colonography combines
cross sectional imaging with virtual colonoscopic images and
offers a comprehensive preoperative evaluation in patients
with colorectal carcinoma including detection of synchronous
lesions with accurate segmental localization and loco regional
staging.
Aim: The objective was to determine the role of CT colonography
in various colonic lesions and to correlate the findings with
conventional colonoscopy and histopathological findings.
Settings and Design: This prospective study included
50 patients with clinical symptoms suspicious of colonic
pathology.
Materials and Methods: All the patients underwent both CT
colonography and conventional colonoscopy on the same day.
CT colonography was performed in supine and prone position.
Considering histopathological and/or surgical findings as gold
standard, sensitivity and specificity of both the modalities were
calculated.
Results: Conventional colonoscopy missed two synchronous
lesions proximal to occlusive mass and one lesion proximal to
the anastomotic site; all were detected with CT colonography.
One carpet lesion in rectum and one case of mild ulcerative
colitis were missed by CT colonography. Sensitivity and
specificity for detection of colorectal cancer were 97.56% and
100%, resp. with PPV and NPV of 100% and 93.75%, for CT
colonography and 92.68% and 100%, respectively with PPV
and NPV of 100% and 83.3% for conventional colonoscopy.
Sensitivity for correct detection of acute and chronic ulcerative
colitis of CT colonography was 66.6 % and 100 %, resp.
Conclusion: CT colonography has higher sensitivity than conventional colonoscopy for detection of colorectal carcinoma,
including its ability to detect abnormalities proximal to obstructing lesion, accurate segmental localization of lesions and staging. However, some limitations of CT colonography were difficulty in detection of flat lesions and lack of information about
hyperemia and superficial mucosal erosion, where conventional
colonoscopy scored over CT colonography. |
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| ISSN: | 2249-782X 0973-709X |