Document Detail


Prospective, blinded comparison of helical CT and CT arterial portography in the assessment of hepatic metastasis from colorectal carcinoma.
MedLine Citation:
PMID:  16855806     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: This prospective blinded comparison of helical CT and helical CT arterial portography aimed to detect liver metastasis from colorectal carcinoma. METHODS AND MATERIALS: 50 patients with colorectal carcinoma were evaluated comparing helical CT with helical CT arterial portography. Each imaging study was evaluated on a 5-point ROC scale by radiologists blinded to the other imaging findings, and the results were compared, with the surgical and pathologic findings as the gold standard. RESULTS: Of the 127 lesions found at pathology identified as metastatic colorectal cancer, helical CT correctly identified 85 (69%) and CT portography 96 (76%). When subgroups with lesions <3 cm (48 patients) and patients with maximum tumor size <3 cm (18 patients) were considered, CT portography was always better than helical CT in terms of sensitivity, specificity, positive predictive value, and negative predictive value. ROC analysis adjusting for multiple lesions per patient revealed significantly greater area under the curve (AUC) for the subgroup of lesions <3 cm (CT-AUC of 77% and CT portography AUC of 81%; P = 0.002). CONCLUSIONS: For identification of large metastases, helical CT and CT portography have similar yield. However, for detection of small liver metastases, CT portography remains superior for lesion detectability.
Authors:
L Schwartz; L Brody; K Brown; A Covey; S Tuorto; M Mazumdar; E Riedel; W Jarnagin; G Getrajdman; Y Fong
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  World journal of surgery     Volume:  30     ISSN:  0364-2313     ISO Abbreviation:  World J Surg     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-09-26     Completed Date:  2006-12-21     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1892-9; discussion 1900-1     Citation Subset:  IM    
Affiliation:
Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, New York 10021, USA.
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MeSH Terms
Descriptor/Qualifier:
Colorectal Neoplasms / pathology*,  radiography*
Diagnosis, Differential
Female
Follow-Up Studies
Hepatectomy
Humans
Liver Neoplasms / radiography*,  secondary*,  surgery
Male
Middle Aged
Neoplasm Staging / methods
Portography / methods*
Prospective Studies
Reproducibility of Results
Sensitivity and Specificity
Tomography, Spiral Computed*
Grant Support
ID/Acronym/Agency:
R01 CA061524-06/CA/NCI NIH HHS; R01 CA072632-03/CA/NCI NIH HHS; R01 CA075416-03/CA/NCI NIH HHS; R01CA61524/CA/NCI NIH HHS; R01CA72632/CA/NCI NIH HHS; R01CA75416/CA/NCI NIH HHS
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