CT colonography for combined colonic and extracolonic surveillance after curative resection of colorectal cancer

Hye Jin Kim, Seong Ho Park, Perry J. Pickhardt, Sang Nam Yoon, Seung Soo Lee, Judy Yee, David H. Kim, Ah Young Kim, Jin Cheon Kim, Chang Sik Yu, Hyun Kwon Ha

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Purpose: To determine the accuracy of contrast material-enhanced computed tomographic (CT) colonography for postoperative surveillance in colorectal cancer patients without clinical or laboratory evidence of disease recurrence. Materials and Methods: The Institutional Review Board approved this HIPAA-compliant study and waived informed consent. Between January 2006 and December 2007, 742 consecutive patients without clinical or laboratory evidence of recurrence following curative-intent colorectal cancer surgery underwent contrastenhanced CT colonography. Of these, 548 patients who had subsequent colonoscopy and pathologic confirmation of colonic lesions (reference standard) were included in the colonic analysis. All 742 patients were included in the extracolonic analysis. Sensitivity and specificity of CT colonography for nonanastomotic colonic lesions at least 6 mm in size and anastomotic lesions of any size, including performance according to lesion histologic type, were determined. Diagnostic yields of contrast-enhanced CT colonography for colonic cancers and for extracolonic recurrences were obtained. Results: CT colonography depicted all six metachronous cancers and one anastomotic recurrence within the colon in six patients (0.8%; 95% confidence interval [CI]: 0.3%, 1.8%]), for per-patient and per-lesion sensitivities of 100% (95% CIs: 64.3%, 100% and 67.8%, 100%, respectively). All cancer lesions within the colon were amenable to additional curative treatment. CT colonography per-patient and perlesion sensitivity was 81.8% (95% CI: 60.9%, 93.3%) and 80.8% (95% CI: 64.3%, 97.2%), respectively, for advanced neoplasia and 80.0% (95% CI: 68.6%, 88.1%) and 78.5% (95% CI: 68.3%, 88.7%), respectively, for all adenomatous lesions. Negative predictive values for adenocarcinoma, advanced neoplasia, and all adenomatous lesions were 100%, 99.1%, and 97.0%, respectively. CT colonography specificity was 93.1% (95% CI: 90.4%, 95.2%). Contrast-enhanced CT colonography enabled detection of extracolonic recurrences in an additional 11 patients (1.5%; 95% CI: 0.8%, 2.7%). Conclusion: Contrast-enhanced CT colonography is an accurate and practical surveillance tool following colorectal cancer surgery in patients without clinical or laboratory evidence of recurrence, allowing for simultaneous less-invasive evaluation of both colon and extracolonic organs.

Original languageEnglish (US)
Pages (from-to)697-704
Number of pages8
JournalRadiology
Volume257
Issue number3
DOIs
StatePublished - Dec 1 2010
Externally publishedYes

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Computed Tomographic Colonography
Colorectal Neoplasms
Confidence Intervals
Recurrence
Colorectal Surgery
Colon
Neoplasms
Health Insurance Portability and Accountability Act
Research Ethics Committees
Colonoscopy
Informed Consent
Colonic Neoplasms
Contrast Media
Adenocarcinoma
Sensitivity and Specificity

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

CT colonography for combined colonic and extracolonic surveillance after curative resection of colorectal cancer. / Kim, Hye Jin; Park, Seong Ho; Pickhardt, Perry J.; Yoon, Sang Nam; Lee, Seung Soo; Yee, Judy; Kim, David H.; Kim, Ah Young; Kim, Jin Cheon; Yu, Chang Sik; Ha, Hyun Kwon.

In: Radiology, Vol. 257, No. 3, 01.12.2010, p. 697-704.

Research output: Contribution to journalArticle

Kim, HJ, Park, SH, Pickhardt, PJ, Yoon, SN, Lee, SS, Yee, J, Kim, DH, Kim, AY, Kim, JC, Yu, CS & Ha, HK 2010, 'CT colonography for combined colonic and extracolonic surveillance after curative resection of colorectal cancer', Radiology, vol. 257, no. 3, pp. 697-704. https://doi.org/10.1148/radiol.10100385
Kim, Hye Jin ; Park, Seong Ho ; Pickhardt, Perry J. ; Yoon, Sang Nam ; Lee, Seung Soo ; Yee, Judy ; Kim, David H. ; Kim, Ah Young ; Kim, Jin Cheon ; Yu, Chang Sik ; Ha, Hyun Kwon. / CT colonography for combined colonic and extracolonic surveillance after curative resection of colorectal cancer. In: Radiology. 2010 ; Vol. 257, No. 3. pp. 697-704.
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T1 - CT colonography for combined colonic and extracolonic surveillance after curative resection of colorectal cancer

AU - Kim, Hye Jin

AU - Park, Seong Ho

AU - Pickhardt, Perry J.

AU - Yoon, Sang Nam

AU - Lee, Seung Soo

AU - Yee, Judy

AU - Kim, David H.

AU - Kim, Ah Young

AU - Kim, Jin Cheon

AU - Yu, Chang Sik

AU - Ha, Hyun Kwon

PY - 2010/12/1

Y1 - 2010/12/1

N2 - Purpose: To determine the accuracy of contrast material-enhanced computed tomographic (CT) colonography for postoperative surveillance in colorectal cancer patients without clinical or laboratory evidence of disease recurrence. Materials and Methods: The Institutional Review Board approved this HIPAA-compliant study and waived informed consent. Between January 2006 and December 2007, 742 consecutive patients without clinical or laboratory evidence of recurrence following curative-intent colorectal cancer surgery underwent contrastenhanced CT colonography. Of these, 548 patients who had subsequent colonoscopy and pathologic confirmation of colonic lesions (reference standard) were included in the colonic analysis. All 742 patients were included in the extracolonic analysis. Sensitivity and specificity of CT colonography for nonanastomotic colonic lesions at least 6 mm in size and anastomotic lesions of any size, including performance according to lesion histologic type, were determined. Diagnostic yields of contrast-enhanced CT colonography for colonic cancers and for extracolonic recurrences were obtained. Results: CT colonography depicted all six metachronous cancers and one anastomotic recurrence within the colon in six patients (0.8%; 95% confidence interval [CI]: 0.3%, 1.8%]), for per-patient and per-lesion sensitivities of 100% (95% CIs: 64.3%, 100% and 67.8%, 100%, respectively). All cancer lesions within the colon were amenable to additional curative treatment. CT colonography per-patient and perlesion sensitivity was 81.8% (95% CI: 60.9%, 93.3%) and 80.8% (95% CI: 64.3%, 97.2%), respectively, for advanced neoplasia and 80.0% (95% CI: 68.6%, 88.1%) and 78.5% (95% CI: 68.3%, 88.7%), respectively, for all adenomatous lesions. Negative predictive values for adenocarcinoma, advanced neoplasia, and all adenomatous lesions were 100%, 99.1%, and 97.0%, respectively. CT colonography specificity was 93.1% (95% CI: 90.4%, 95.2%). Contrast-enhanced CT colonography enabled detection of extracolonic recurrences in an additional 11 patients (1.5%; 95% CI: 0.8%, 2.7%). Conclusion: Contrast-enhanced CT colonography is an accurate and practical surveillance tool following colorectal cancer surgery in patients without clinical or laboratory evidence of recurrence, allowing for simultaneous less-invasive evaluation of both colon and extracolonic organs.

AB - Purpose: To determine the accuracy of contrast material-enhanced computed tomographic (CT) colonography for postoperative surveillance in colorectal cancer patients without clinical or laboratory evidence of disease recurrence. Materials and Methods: The Institutional Review Board approved this HIPAA-compliant study and waived informed consent. Between January 2006 and December 2007, 742 consecutive patients without clinical or laboratory evidence of recurrence following curative-intent colorectal cancer surgery underwent contrastenhanced CT colonography. Of these, 548 patients who had subsequent colonoscopy and pathologic confirmation of colonic lesions (reference standard) were included in the colonic analysis. All 742 patients were included in the extracolonic analysis. Sensitivity and specificity of CT colonography for nonanastomotic colonic lesions at least 6 mm in size and anastomotic lesions of any size, including performance according to lesion histologic type, were determined. Diagnostic yields of contrast-enhanced CT colonography for colonic cancers and for extracolonic recurrences were obtained. Results: CT colonography depicted all six metachronous cancers and one anastomotic recurrence within the colon in six patients (0.8%; 95% confidence interval [CI]: 0.3%, 1.8%]), for per-patient and per-lesion sensitivities of 100% (95% CIs: 64.3%, 100% and 67.8%, 100%, respectively). All cancer lesions within the colon were amenable to additional curative treatment. CT colonography per-patient and perlesion sensitivity was 81.8% (95% CI: 60.9%, 93.3%) and 80.8% (95% CI: 64.3%, 97.2%), respectively, for advanced neoplasia and 80.0% (95% CI: 68.6%, 88.1%) and 78.5% (95% CI: 68.3%, 88.7%), respectively, for all adenomatous lesions. Negative predictive values for adenocarcinoma, advanced neoplasia, and all adenomatous lesions were 100%, 99.1%, and 97.0%, respectively. CT colonography specificity was 93.1% (95% CI: 90.4%, 95.2%). Contrast-enhanced CT colonography enabled detection of extracolonic recurrences in an additional 11 patients (1.5%; 95% CI: 0.8%, 2.7%). Conclusion: Contrast-enhanced CT colonography is an accurate and practical surveillance tool following colorectal cancer surgery in patients without clinical or laboratory evidence of recurrence, allowing for simultaneous less-invasive evaluation of both colon and extracolonic organs.

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