Comparison of extracolonic findings and clinical outcomes in a screening and diagnostic CT colonography population

Michio Taya, Cody McHargue, Zina J. Ricci, Milana Flusberg, Stefanie Weinstein, Judy Yee

Research output: Contribution to journalArticle

Abstract

Purpose: To compare the distribution of extracolonic findings and clinical outcomes between screening and diagnostic CT colonography (CTC) populations. Methods: 388 consecutive patients (369 men, 19 women; mean ± SD age 67.8 ± 10 years) who underwent first-time CTC (4/2011–4/2017) at a Veteran’s Affairs Medical Center were divided into screening (asymptomatic) or diagnostic (symptomatic) cohorts based on CTC indication. CTC reporting and data system E-scores for extracolonic findings were retrospectively assigned based on prospective CTC radiologic reports. Multinomial logistic regression was used to examine the association between E-scores and CTC indication. Electronic medical records of all patients with E3 or E4 scores were reviewed (median follow-up 2.8 years) to determine clinical outcomes. Results: 68% (262/388) underwent screening and 32% (126/388) diagnostic CTC. 7.2% (28/388) had extracolonic findings considered potentially significant (E4), 4.4% (17/388) had indeterminate but likely unimportant findings (E3), and 88.4% (347/388) had normal or unimportant findings (E1 or E2). E-scores were not significantly different between screening and diagnostic CTC when adjusted for age, gender, and prior imaging (p = 0.44). 4.6% (12/262) of patients with E3/E4 findings in the screening cohort demonstrated clinically significant outcomes, compared with 4.0% (5/126) in the diagnostic cohort, including a total of three extracolonic malignancies (0.8%) and three abdominal aortic aneurysms (0.8%). 4.6% (18/388) underwent follow-up imaging studies to confirm a benign outcome after detection of a category E3/E4 finding. Conclusions: The distribution of extracolonic findings and clinical outcomes were not statistically significantly different between screening and diagnostic CTC populations.

Original languageEnglish (US)
JournalAbdominal Radiology
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Computed Tomographic Colonography
Population
Electronic Health Records
Abdominal Aortic Aneurysm
Veterans
Information Systems
Logistic Models

Keywords

  • C-RADS
  • CT colonography
  • Extracolonic findings
  • Screening

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology

Cite this

Comparison of extracolonic findings and clinical outcomes in a screening and diagnostic CT colonography population. / Taya, Michio; McHargue, Cody; Ricci, Zina J.; Flusberg, Milana; Weinstein, Stefanie; Yee, Judy.

In: Abdominal Radiology, 01.01.2018.

Research output: Contribution to journalArticle

Taya, Michio ; McHargue, Cody ; Ricci, Zina J. ; Flusberg, Milana ; Weinstein, Stefanie ; Yee, Judy. / Comparison of extracolonic findings and clinical outcomes in a screening and diagnostic CT colonography population. In: Abdominal Radiology. 2018.
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abstract = "Purpose: To compare the distribution of extracolonic findings and clinical outcomes between screening and diagnostic CT colonography (CTC) populations. Methods: 388 consecutive patients (369 men, 19 women; mean ± SD age 67.8 ± 10 years) who underwent first-time CTC (4/2011–4/2017) at a Veteran’s Affairs Medical Center were divided into screening (asymptomatic) or diagnostic (symptomatic) cohorts based on CTC indication. CTC reporting and data system E-scores for extracolonic findings were retrospectively assigned based on prospective CTC radiologic reports. Multinomial logistic regression was used to examine the association between E-scores and CTC indication. Electronic medical records of all patients with E3 or E4 scores were reviewed (median follow-up 2.8 years) to determine clinical outcomes. Results: 68{\%} (262/388) underwent screening and 32{\%} (126/388) diagnostic CTC. 7.2{\%} (28/388) had extracolonic findings considered potentially significant (E4), 4.4{\%} (17/388) had indeterminate but likely unimportant findings (E3), and 88.4{\%} (347/388) had normal or unimportant findings (E1 or E2). E-scores were not significantly different between screening and diagnostic CTC when adjusted for age, gender, and prior imaging (p = 0.44). 4.6{\%} (12/262) of patients with E3/E4 findings in the screening cohort demonstrated clinically significant outcomes, compared with 4.0{\%} (5/126) in the diagnostic cohort, including a total of three extracolonic malignancies (0.8{\%}) and three abdominal aortic aneurysms (0.8{\%}). 4.6{\%} (18/388) underwent follow-up imaging studies to confirm a benign outcome after detection of a category E3/E4 finding. Conclusions: The distribution of extracolonic findings and clinical outcomes were not statistically significantly different between screening and diagnostic CTC populations.",
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AU - Taya, Michio

AU - McHargue, Cody

AU - Ricci, Zina J.

AU - Flusberg, Milana

AU - Weinstein, Stefanie

AU - Yee, Judy

PY - 2018/1/1

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N2 - Purpose: To compare the distribution of extracolonic findings and clinical outcomes between screening and diagnostic CT colonography (CTC) populations. Methods: 388 consecutive patients (369 men, 19 women; mean ± SD age 67.8 ± 10 years) who underwent first-time CTC (4/2011–4/2017) at a Veteran’s Affairs Medical Center were divided into screening (asymptomatic) or diagnostic (symptomatic) cohorts based on CTC indication. CTC reporting and data system E-scores for extracolonic findings were retrospectively assigned based on prospective CTC radiologic reports. Multinomial logistic regression was used to examine the association between E-scores and CTC indication. Electronic medical records of all patients with E3 or E4 scores were reviewed (median follow-up 2.8 years) to determine clinical outcomes. Results: 68% (262/388) underwent screening and 32% (126/388) diagnostic CTC. 7.2% (28/388) had extracolonic findings considered potentially significant (E4), 4.4% (17/388) had indeterminate but likely unimportant findings (E3), and 88.4% (347/388) had normal or unimportant findings (E1 or E2). E-scores were not significantly different between screening and diagnostic CTC when adjusted for age, gender, and prior imaging (p = 0.44). 4.6% (12/262) of patients with E3/E4 findings in the screening cohort demonstrated clinically significant outcomes, compared with 4.0% (5/126) in the diagnostic cohort, including a total of three extracolonic malignancies (0.8%) and three abdominal aortic aneurysms (0.8%). 4.6% (18/388) underwent follow-up imaging studies to confirm a benign outcome after detection of a category E3/E4 finding. Conclusions: The distribution of extracolonic findings and clinical outcomes were not statistically significantly different between screening and diagnostic CTC populations.

AB - Purpose: To compare the distribution of extracolonic findings and clinical outcomes between screening and diagnostic CT colonography (CTC) populations. Methods: 388 consecutive patients (369 men, 19 women; mean ± SD age 67.8 ± 10 years) who underwent first-time CTC (4/2011–4/2017) at a Veteran’s Affairs Medical Center were divided into screening (asymptomatic) or diagnostic (symptomatic) cohorts based on CTC indication. CTC reporting and data system E-scores for extracolonic findings were retrospectively assigned based on prospective CTC radiologic reports. Multinomial logistic regression was used to examine the association between E-scores and CTC indication. Electronic medical records of all patients with E3 or E4 scores were reviewed (median follow-up 2.8 years) to determine clinical outcomes. Results: 68% (262/388) underwent screening and 32% (126/388) diagnostic CTC. 7.2% (28/388) had extracolonic findings considered potentially significant (E4), 4.4% (17/388) had indeterminate but likely unimportant findings (E3), and 88.4% (347/388) had normal or unimportant findings (E1 or E2). E-scores were not significantly different between screening and diagnostic CTC when adjusted for age, gender, and prior imaging (p = 0.44). 4.6% (12/262) of patients with E3/E4 findings in the screening cohort demonstrated clinically significant outcomes, compared with 4.0% (5/126) in the diagnostic cohort, including a total of three extracolonic malignancies (0.8%) and three abdominal aortic aneurysms (0.8%). 4.6% (18/388) underwent follow-up imaging studies to confirm a benign outcome after detection of a category E3/E4 finding. Conclusions: The distribution of extracolonic findings and clinical outcomes were not statistically significantly different between screening and diagnostic CTC populations.

KW - C-RADS

KW - CT colonography

KW - Extracolonic findings

KW - Screening

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