Journal
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
Volume 6, Issue 2, Pages 220-227Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.cgh.2007.11.007
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Funding
- NCRR NIH HHS [K12 RR023251, KL2 RR024983-01, K12 RR023251-03] Funding Source: Medline
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Background & Aims: clinical management of polyps discovered by computed tomographic (CT) colonography depends on polyp size. However, size measured by CT colonography is an estimate, and its agreement with other measures is not well characterized. We hypothesized that size measurement by CT colonography varies substantially compared with measurement by other methods. Methods: We performed a secondary data analysis of a multicenter study of CT colonography in comparison with colonoscopy. Polyp size was determined by CT colonography, at colonoscopy, and measurement prefixation with a ruler. Agreement was assessed using descriptive statistics and Bland-Altman methodology. Results: Six hundred trial participants completed both tests. Ninety-five percent limits of agreement indicated that estimates of size by CT colonography were between 52% lower to 64% higher than prefixation polyp size estimates. Ninety-five percent limits of agreement stratified by categories of clinical importance indicated that estimates of size by CT colonography were between 44% lower to 84% higher for polyps 0.6 cm or smaller, 44% lower to 44% higher for polyps 0.6 to 0.9 cm, and 48% lower to 22% higher for polyps smaller than 0.6 cm, 44% lower to 44% higher for polyps 0.6 cm to 0.9 cm, and 48% lower to 22% higher for polyps larger than 0.9 cm. compare with prefixation estimates. Analysis of participants with 1 identified polyp in the same colon segment showed that categorization based on CT colonography measurement (ie, < 0.6 cm, 0.6-0.9 cm, or > 0.9 cm) differed from prefixation measurement for 43% of participants. Conclusions: Polyp size estimation by CT colonography varies from prefixation and colonoscopic measures of size. Future studies should clarify whether size estimation by CT colonography is sufficiently reliable as a primary factor to guide clinical management.
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