Computerized tomographic colonography

Performance evaluation in a retrospective multicenter setting

C. Daniel Johnson, Alicia Y. Toledano, Benjamin A. Herman, Abraham H. Dachman, Elizabeth G. McFarland, Matthew A. Barish, James A. Brink, Randy D. Ernst, Joel G. Fletcher, Robert A. Halvorsen, Amy K. Hara, Kenneth D. Hopper, Robert E. Koehler, David S.K. Lu, Michael Macari, Robert L. MacCarty, Frank H. Miller, Martina Morrin, Erik K. Paulson, Judy Yee & 1 others Michael Zalis

Research output: Contribution to journalArticle

90 Citations (Scopus)

Abstract

Background & Aims: No multicenter study has been reported evaluating the performance and interobserver variability of computerized tomographic colonography. The aim of this study was to assess the accuracy of computerized tomographic colonography for detecting clinically important colorectal neoplasia (polyps ≥10 mm in diameter) in a multi-institutional study. Methods: A retrospective study was developed from 341 patients who had computerized tomographic colonography and colonoscopy among 8 medical centers. Colonoscopy and pathology reports provided the standard. A random sample of 117 patients, stratified by criterion standard, was requested. Ninety-three patients were included (47% with polyps ≥10 mm; mean age, 62 years; 56% men; 84% white; 40% reported colorectal symptoms; 74% at increased risk for colorectal cancer). Eighteen radiologists blinded to the criterion standard interpreted computerized tomography colonography examinations, each using 2 of 3 different software display platforms. Results: The average area under the receiver operating characteristic curve for identifying patients with at least 1 lesion ≥10 mm was 0.80 (95% lower confidence bound, 0.74). The average sensitivity and specificity were 75% (95% lower confidence bound, 68%) and 73% (95% lower confidence bound, 66%), respectively. Per-polyp sensitivity was 75%. A trend was observed for better performance with more observer experience. There was no difference in performance across software display platforms. Conclusions: 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.

Original languageEnglish (US)
Pages (from-to)688-695
Number of pages8
JournalGastroenterology
Volume125
Issue number3
DOIs
StatePublished - Sep 1 2003
Externally publishedYes

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Polyps
Colonoscopy
Software
Tomography
Sigmoidoscopy
Occult Blood
Observer Variation
ROC Curve
Multicenter Studies
Colorectal Neoplasms
Retrospective Studies
Prospective Studies
Pathology
Sensitivity and Specificity
Population
Neoplasms

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Johnson, C. D., Toledano, A. Y., Herman, B. A., Dachman, A. H., McFarland, E. G., Barish, M. A., ... Zalis, M. (2003). Computerized tomographic colonography: Performance evaluation in a retrospective multicenter setting. Gastroenterology, 125(3), 688-695. https://doi.org/10.1016/S0016-5085(03)01058-8

Computerized tomographic colonography : Performance evaluation in a retrospective multicenter setting. / Johnson, C. Daniel; Toledano, Alicia Y.; Herman, Benjamin A.; Dachman, Abraham H.; McFarland, Elizabeth G.; Barish, Matthew A.; Brink, James A.; Ernst, Randy D.; Fletcher, Joel G.; Halvorsen, Robert A.; Hara, Amy K.; Hopper, Kenneth D.; Koehler, Robert E.; Lu, David S.K.; Macari, Michael; MacCarty, Robert L.; Miller, Frank H.; Morrin, Martina; Paulson, Erik K.; Yee, Judy; Zalis, Michael.

In: Gastroenterology, Vol. 125, No. 3, 01.09.2003, p. 688-695.

Research output: Contribution to journalArticle

Johnson, CD, Toledano, AY, Herman, BA, Dachman, AH, McFarland, EG, Barish, MA, Brink, JA, Ernst, RD, Fletcher, JG, Halvorsen, RA, Hara, AK, Hopper, KD, Koehler, RE, Lu, DSK, Macari, M, MacCarty, RL, Miller, FH, Morrin, M, Paulson, EK, Yee, J & Zalis, M 2003, 'Computerized tomographic colonography: Performance evaluation in a retrospective multicenter setting', Gastroenterology, vol. 125, no. 3, pp. 688-695. https://doi.org/10.1016/S0016-5085(03)01058-8
Johnson CD, Toledano AY, Herman BA, Dachman AH, McFarland EG, Barish MA et al. Computerized tomographic colonography: Performance evaluation in a retrospective multicenter setting. Gastroenterology. 2003 Sep 1;125(3):688-695. https://doi.org/10.1016/S0016-5085(03)01058-8
Johnson, C. Daniel ; Toledano, Alicia Y. ; Herman, Benjamin A. ; Dachman, Abraham H. ; McFarland, Elizabeth G. ; Barish, Matthew A. ; Brink, James A. ; Ernst, Randy D. ; Fletcher, Joel G. ; Halvorsen, Robert A. ; Hara, Amy K. ; Hopper, Kenneth D. ; Koehler, Robert E. ; Lu, David S.K. ; Macari, Michael ; MacCarty, Robert L. ; Miller, Frank H. ; Morrin, Martina ; Paulson, Erik K. ; Yee, Judy ; Zalis, Michael. / Computerized tomographic colonography : Performance evaluation in a retrospective multicenter setting. In: Gastroenterology. 2003 ; Vol. 125, No. 3. pp. 688-695.
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AU - Dachman, Abraham H.

AU - McFarland, Elizabeth G.

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AU - Brink, James A.

AU - Ernst, Randy D.

AU - Fletcher, Joel G.

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AU - Hopper, Kenneth D.

AU - Koehler, Robert E.

AU - Lu, David S.K.

AU - Macari, Michael

AU - MacCarty, Robert L.

AU - Miller, Frank H.

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