Document Detail


Critical analysis of the performance of double-contrast barium enema for detecting colorectal polyps > or = 6 mm in the era of CT colonography.
MedLine Citation:
PMID:  18212223     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The purpose of our study was to perform a meta-analysis comparing the performance of double-contrast barium enema (DCBE) with CT colonography (CTC) for the detection of colorectal polyps > or = 6 mm using endoscopy as the gold standard. MATERIALS AND METHODS: Prospective DCBE and CTC studies were identified. Percentages of polyps and of patients with polyps > or = 10 mm and 6-9 mm were abstracted. The performance of DCBE versus CTC was determined by separately evaluating each technique's performance versus that of endoscopy, and contrasting the techniques. The I-squared statistic and Fisher's exact test were used for heterogeneity, the Cochran-Mantel-Haenszel and the Kruskal-Wallis tests for correlation, and the A(z) test for comparing pooled weighted estimates of performance. RESULTS: Eleven studies of DCBE (5,995 patients, 1,548 polyps) and 30 studies of CTC (6,573 patients, 2,348 polyps) fulfilled inclusion criteria. For polyps > or = 10 mm, a 0.121-per-patient sensitivity difference favored CTC (p < 0.0001; DCBE, 0.702 [95% CI, 0.687-0.715]; CTC, 0.823 [0.809-0.836]). For polyps > or = 10 mm, a 0.031-per-polyp sensitivity difference favored CTC (p < 0.0001; DCBE, 0.715 [0.703-0.726]; CTC, 0.746 [0.735-0.757]). For polyps > or = 10 mm, a specificity difference of 0.104 favored CTC (p = 0.001; DCBE, 0.850 [0.847-0.855]; CTC, 0.954 [0.952-0.955]). DCBE was also significantly less sensitive for 6- to 9-mm polyps (p < 0.001). CONCLUSION: DCBE has statistically lower sensitivity and specificity than CTC for detecting colorectal polyps > or = 6 mm.
Authors:
Jacob Sosna; Tamar Sella; Oumar Sy; Philip T Lavin; Ruth Eliahou; Shifra Fraifeld; Eugene Libson
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Publication Detail:
Type:  Comparative Study; Journal Article; Meta-Analysis; Review    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  190     ISSN:  1546-3141     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-01-23     Completed Date:  2008-02-11     Revised Date:  2008-02-15    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  374-85     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, Hadassah Hebrew University Medical Center, POB 12000, Jerusalem, Israel. jacobs@hadassah.org.il
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MeSH Terms
Descriptor/Qualifier:
Barium Sulfate / administration & dosage*,  diagnostic use*
Colonic Polyps / epidemiology*,  radiography*
Colonography, Computed Tomographic / statistics & numerical data*
Enema
Female
Humans
Intestinal Polyps / epidemiology,  radiography
Male
Prevalence
Reproducibility of Results
Sensitivity and Specificity
Chemical
Reg. No./Substance:
7727-43-7/Barium Sulfate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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