There have been no multicenter studies which evaluate the performance and inter-observer variability of computerized tomographic colonography.
In this study, a team of physicians from the United States assessed computerized tomographic colonography for detecting colorectal neoplasia (polyps ≥ 10 mm in diameter).
The team performed a retrospective study which included 341 patients who had computerized tomographic colonography and colonoscopy at 8 centers.
|Per-polyp sensitivity was 75%.|
Colonoscopy and pathology reports provided the standard.
The team selected a random sample of 117 patients; these were stratified by criterion standard. Overall, the team evaluated 93 patients.
There were 18 radiologists who were blinded to the criterion standard. They interpreted computerized tomography colonography examinations using 2 of 3 different software display platforms.
The team found that the average area under the receiver operating characteristic curve for identifying patients with at least 1 lesion ≥ 10 mm was 0.80.
In addition, they determined that the average sensitivity and specificity were 75% and 73%, respectively. Furthermore, per-polyp sensitivity was 75%.
The physicians found that there was a trend towards better performance with more observer experience. There was no difference in performance across software display platforms.
Dr Daniel Johnson's team concluded, "Computerized tomographic colonography performance compared favorably with reported performance of fecal occult blood testing, flexible sigmoidoscopy, and barium enema".
"A prospective study evaluating the performance of computerized tomography colonography in a screening population is indicated".