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MR colonography for the detection of cclorectal neoplasia in asymptomatic adults

This month's issue of Gastroenterology investigates magnetic resonance colonography for the detection of colorectal neoplasia in asymptomatic adults.

News image

Colonoscopy is the preferred screening test for colorectal neoplasia.

The fecal occult blood test detects neoplasias with low levels of sensitivity.

Computed tomographic colonography detects neoplasias with high levels of sensitivity but involves exposure to radiation.

Dr Anno Graser from Germany reported that they investigated whether magnetic resonance colonography can be used to screen for colorectal adenomas and cancers.

The team analyzed data from 286 asymptomatic adults who underwent 3 Tesla magnetic resonance colonography and colonoscopic examinations on the same day.

The research team reported that the fecal occult blood test was performed before bowel preparation.

Colonoscopists were initially blinded to the findings on magnetic resonance colonography and unblinded after withdrawal from the respective segments.

The team of doctors calculated sensitivities for adenoma and per-patient sensitivities, and specificities based on the unblinded results of colonoscopy.

Sensitivities of MR colonography, and colonoscopy for adenomas 6 mm were 78%
Gastroenterology

The researchers detected 133 adenomas and 2 cancers in 86 patients.

The team found that 37 adenomas were 6 mm, and 20 adenomas were advanced.

The researchers reported that sensitivities of magnetic resonance colonography, and colonoscopy for adenomas 6 mm were 78% and 97%.

For advanced adenomas these values were 75% and 100%, respectively.

Magnetic resonance colonography identified 87%, colonoscopy identified 97%, and fecal occult blood test 10% of individuals with adenomas 6 mm and 84%, 100%, and 18% of individuals with advanced neoplasia.

The doctors found that specificities of magnetic resonance colonography , colonoscopy, and fecal occult blood test for individuals with adenomas 6 mm were 95%, 97% , and 92%, respectively.

Dr Graser's team commented, "3 Tesla magnetic resonance colonography detects colorectal adenomas 6 mm, and advanced neoplasia with high levels of sensitivity and specificity."

"Although magnetic resonance colonography  detects colorectal neoplasia with lower levels of sensitivity than colonoscopy, it strongly outperforms one-time fecal occult blood test."

Gastroenterol 2013: 144(4): 743-750
01 April 2013

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