AJR 2009; 193:70-78
Seong Ho Park, So Yeon Kim,Seung Soo Lee, Luca Bogoni, Ah Young Kim, Suk-Kyun Yang,Seung-Jae Myung, Jeong-Sik Byeon,Byong Duk Ye, Hyun Kwon Ha
OBJECTIVE. The purpose of our study was to determine the sensitivity of CT colonog¬raphy (CTC) interpreted by human readers and with computer-aided detection (CAD) for genuinely nonpolypoid colorectal lesions, defined as 2 mm or less in lesion height at colonos¬copy.
MATERIALS AND METHODS. A computerized database search for a 33-month pe¬riod found 21 patients who had undergone both colonoscopy and CTC and who had a total of 23 genuinely nonpolypoid colorectal lesions: eight adenomas (9-30 mm in width), 10 stage Tis or Tl adenocarcinomas (10-25 mm), and five nonadenomatous lesions (8-20 mm). CTC was performed using a cathartic preparation and fecal tagging and was interpreted by experi¬enced readers in a blinded manner using a primary 3D method and with CAD.
RESULTS. The sensitivities of human readers for nonpolypoid adenomatous lesions (i.e., both adenomas and adenocarcinomas), adenocarcinomas, and nonadenomatous lesions were 66.7% (12/18), 90% (9/10), and 0% (0/5), respectively. Sensitivities were 55.6% (10/18), 90% (9/10), and 0% (0/5) for CAD. A 10-mm stage Tl adenocarcinoma was missed by a human read¬er on blinded review but was detected with CAD. Both human readers and CAD yielded signifi¬cantly higher sensitivity for adenomatous lesions than for nonadenomatous lesions (p - 0.014 and 0.046, respectively) and for adenocarcinomas than for noncancerous lesions (p = 0.003 and 0.0001, respectively).
CONCLUSION. CTC showed a high sensitivity for nonpolypoid stage Tis and Tl adeno¬carcinomas 10 mm or greater in width despite the limited overall sensitivity for nonpolypoid adenomatous lesions, when performed using cathartic preparation and fecal tagging.
