Computed Tomography colonography in suspected colorectal lesions and its correlation with Optical Colonoscopy.
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 1
Abstract
Introduction: Colorectal cancers is a common malignancy and early detection and treatment of polyps before they become malignant, as well as early detection of malignant tumors has significantly made the prognosis better. Optical Colonoscopy has been the standard test for evaluation of the colon, but the information is restricted to the lumen only. However Computed Tomography Colonography with Virtual colonoscopy acts as a single investigation combining the advantages of endoscopy with cross sectional imaging, thus allowing intraluminal, transmural and also extra colonic abdominal and pelvic organs. We prospectively compared Computed Tomography Colonography with Optical Colonoscopy for the detection of colorectal lesions Aim and Objectives: To determine the sensitivity of Computed Tomography Colonography with that of Optical Colonoscopy in the detection of Colorectal lesions (polyps and cancers). 2. To compare and correlate the imaging findings of Computed Tomography Colonography with that of Optical Colonoscopy in detection of colorectal malignant mass lesion taking histopathological report as the gold standard. Materials and methods: This study is a Cross sectional study conducted after obtaining approval from the ethics board committee of the institute and informed written consent from the patients. 58 adult Patients with suspected colorectal lesion underwent CT colonography and Optical colonoscopy during a period of 2 years. CT colonography, Optical colonoscopy and HPE findings were interpreted keeping each investigator blinded from each other of their findings. Data analysis was done with SPSS version 21. Results The sensitivity and specificity to detect polyp by CT Colongraphy are 96% and 87.9%. and by Optical Colonoscopy are of 100% (for all completed examination). Correlation for polyp detection by CT Colonography and Optical Colonoscopy was found to be significant at p<0.5. The sensitivity and specificity for detection of colorectal adenocarcinoma by CT Colonography are 100% and 97.6% and by Optical colonoscopy were of 93.8% and 97.6%. Extracolonic findings were seen in 22 patients (37.9%). Optical Colonoscopic examination was incomplete in 4 patients and CT Colonography had all complete examination in all the patients. Conclusion CT Colonography is a promising imaging modality in the detection of colorectal lesions with high sensitivity and specificity for polyps and cancer detection along with the added advantage of complete colonic examination and ability to see extraluminal or extracolonic findings compared to the Optical colonoscopy. Sensitivity and specificity for lesion detection can be further increased if CT Colonography is combined with Optical Colonoscopy and will be helpful in better, early and accurate detection of lesion and also better management by reducing false positive and false negative cases .
Authors and Affiliations
Dr. Nongthombam Thomson Luwang, Dr. Yumnam Priyabarta Singh, Dr. Angela B Marak, Dr. Meenakumari Ayekpam
Keywords
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- EP ID EP452692
- DOI 10.9790/0853-1801193548.
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