Prospective Comparing the Efficacy of CT Colonography and Colonoscopy for Detecting Colorectal Adenomatous Polyp in Asymptomatic Adults

Korean J Gastrointest Endosc > Volume 31(4); 2005 > Article

Korean Journal of Gastrointestinal Endoscopy 2005;31(4): 229-236.

무증상 성인의 대장 선종 발견에 있어서 CT 대장조영술과 대장내시경검사의 유용성에 대한 전향적 비교

김영선·김나영*·김세형^‡·박민정·임선희·임정윤·조경란·김선신·은효원·조경수·최병인^‡·정현채^†·송인성^†·신찬수·조상헌·오병희

서울대학교병원 헬스케어시스템 강남센터, 헬스케어연구소, *분당서울대학교병원 내과, ^†서울대학교 의과대학 내과학교실, ^‡방사선과학교실

Prospective Comparing the Efficacy of CT Colonography and Colonoscopy for Detecting Colorectal Adenomatous Polyp in Asymptomatic Adults

Young Sun Kim, M.D., Nayoung Kim, M.D.*, Sae Hyoung Kim, M.D.^‡, Min Jung Park, M.D., Seon Hee Lim, M.D., Jeong Yoon Yim, M.D., Kyung Ran Cho, M.D., Sun Sin Kim, M.D., Hyo Won Eun, M.D., Kyoung Soo Cho, M.D., Byung Inhn Choi, M.D.^‡, H

Seoul National University Hospital, Healthcare System Gangnam Center, Healthcare Research Institute, Seoul, *Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Departments of ^‡Internal Medicine and ^†Radiology, Seoul National University College of Medicine, Seoul, Korea

Abstract

Background/Aims:
The purpose of this study is to evaluate the efficacy of CT colonography (CTC) in comparison with colonoscopy for the detection of colorectal adenomatous polyp in asymptomatic adults.
Methods:
A total 208 asymptomatic adults underwent successive CTC and colonoscopy, on the same day.
Results:
On the analysis of adenomatous polyps per subject, the sensitivity of CTC was 90% (9/10) in case of polyps ≥10 mm in size, and 67.7% (21/31) in case of polyps ≥6 mm in size. Those values of colonoscopy were 100% and 93.5%, respectively. The per-patient specificity of CTC was 98.0% (194/198) in case of polyps ≥10 mm in size and 88.1% (156/177) in case of polyps ≥6 mm in size. CTC missed 4 (3 flat adenomas and, 1 sessile adenoma) out of 17 adenomatous polyps ≥10 mm in size in 2 subjects.
Conclusions:
In asymptomatic adults, the sensitivity of CTC for detecting adenomatous polyps was lower than that of colonoscopy, particularly for the small lesions below 10 mm in size, and also for the flat adenomas ≥ 10 mm in size. However, CTC showed a high sensitivity and specificity for detecting the subjects with clinically important colorectal adenomatous polyps ≥ 10 mm in size. These results suggest that CTC has potential as a screening method for colorectal neoplasm. (Korean J Gastrointest Endosc 2005;31:229⁣236)

Key Words: CT colonography, Colonoscopy, Asymptomatic, Adenomatous polyp

주요어: CT 대장조영술, 대장내시경검사, 무증상, 선종