Computed Tomography Colonography as a Sensible Option for Colorectal Cancer Screening: Evidence Based on Metanalysis

Abstract

Objective This metanalysis aimed to evaluate the sensitivity and specificity of computed tomography colonography in colorectal polyp detection.

Methods A literature search was performed in the PubMed and Web of Science databases.

Results A total of 1,872 patients (males 57.2%, females 42.8%) aged 49 to 82 years old (mean age 59.7 ± 5.3 years) were included in this metanalysis. The estimated sensitivity of computed tomography colonography was 88.4% (46.3–95.7%, coefficient of variation [CV] = 28.5%) and the estimated specificity was 73.6% (47.4–100.0%, CV = 37.5%). For lesions up to 9 mm, the sensitivity was 82.5% (62.0–99.9%, CV = 25.1%) and the specificity was 79.2% (32.0–98.0%, CV = 22.9%). For lesions > 9 mm, the sensitivity was 90.2% (64.0–100.0%, CV = 7.4%) and the specificity was 94.7% (80.0–100.0%, CV = 6.2%). No statistically significant differences in sensitivity according to the size of the lesion were found (p = 0.0958); however, the specificity was higher for lesions > 9 mm (p < 0.0001).

Conclusions Most of the studies analyzed in the present work were conducted before 2010, which is about a decade after computed tomography colonography started being indicated as a screening method by European and American guidelines. Therefore, more studies aimed at analyzing the technique after further technological advancements are necessary, which could lead to the development of more modern devices.

Resumo

Objetivo Esta meta-análise teve como objetivo avaliar a sensibilidade e especificidade da colonografia por tomografia computadorizada na detecção de pólipos colorretais.

Métodos Foi realizada uma pesquisa bibliográfica nas bases de dados da PubMed e da Web of Science.

Resultados Um total de 1.872 pacientes, 57,2% homens e 42,8% mulheres, com idades entre 49 a 82 anos de idade (média de 59,7 ± 5,3 anos) foram incluídos nesta meta análise. A sensibilidade da colonografia por tomografia computadorizada foi estimada em 88,4% (46,3–95,7%; coeficiente de variância [CV] = 28,5%) e a especificidade em 73,6% (47,4%–100,0%; CV = 37,5%). Para lesões de até 9 mm, a sensibilidade foi de 82,5% (62,0–99,9%; CV = 25,1%) e a especificidade de 79,2% (32,0–98,0%; CV = 22,9%). Para lesões maiores que 9 mm, a sensibilidade foi de 90,2% (64,0–100,0%; CV = 7,4%) e a especificidade de 94,7% (80,0–100,0%; CV = 6,2%). Não houve diferença estatisticamente significante entre as sensibilidades por tamanho da lesão (p = 0,0958), porém a especificidade foi maior em lesões acima de 9 mm (p < 0,0001).

Conclusão A maioria dos estudos analisados no presente trabalho foi realizada antes de 2010, cerca de uma década depois que a colonografia por tomografia computadorizada passou a ser indicada como método de triagem pelas diretrizes europeias e americanas. Portanto, são necessários mais estudos com o objetivo de analisar a técnica após maiores avanços tecnológicos, o que poderia levar ao desenvolvimento de dispositivos mais modernos.

Keywords

virtual colonoscopy - CT colonography - optic colonoscopy - colon cancer - diagnosis

Palavras-chave

colonoscopia virtual - colonografia por tomografia computadorizada - colonoscopia ótica - câncer colorretal - diagnóstico

Publikationsverlauf

Eingereicht: 03. Juni 2020

Angenommen: 08. August 2020

Artikel online veröffentlicht:
19. März 2021

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