Assessment of Polyp and Mass Histopathology by Intravenous Contrast-Enhanced CT Colonography

Ronald M. Summers, Adam Huang, Jianhua Yao, Shannon R. Campbell, Jennifer E. Dempsey, Andrew J. Dwyer, Marek Franaszek, Danny S. Brickman, Ingmar Bitter, Nicholas Petrick, Amy K. Hara

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Rationale and Objectives: We sought to demonstrate that intravenous contrast-enhanced CT colonography (CTC) can distinguish colonic adenomas from carcinomas. Methods: Supine intravenous contrast-enhanced CTC with colonoscopic and/or surgical correlation was performed on 25 patients with colonic adenomas or carcinomas. Standard deviation of mean polyp CT attenuation was computed and assessed using ANOVA and receiver-operating characteristic analyses. Results: Colonoscopy confirmed 32 polyps or masses 1 to 8 cm in size. The standard deviations of CT attenuation were carcinomas (n = 13; 36 ± 6 HU; range 28-48 HU) and adenomas (n = 19; 49 ± 14 HU; range 31-100 HU) (P = 0.005). At a standard deviation threshold of 42 HU, the sensitivity and specificity for classifying a polyp or mass as a carcinoma were 92% and 79%, respectively. The area under the receiver-operating characteristic curve was 0.89 ± 0.06 (95% confidence interval 0.73-0.96). Conclusions: Measurement of the standard deviation of CT attenuation on intravenous contrast-enhanced CTC permits histopathologic classification of polyps 1 cm or larger as carcinomas versus adenomas. The presence of ulceration or absence of muscular invasion in carcinomas creates overlap with adenomas, reducing the specificity of carcinoma classification.

Original languageEnglish (US)
Pages (from-to)1490-1495
Number of pages6
JournalAcademic radiology
Volume13
Issue number12
DOIs
StatePublished - Dec 1 2006

Keywords

  • CT, 3D reconstruction
  • CT, colon
  • colon cancer
  • image processing
  • intravenous contrast enhancement

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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    Summers, R. M., Huang, A., Yao, J., Campbell, S. R., Dempsey, J. E., Dwyer, A. J., Franaszek, M., Brickman, D. S., Bitter, I., Petrick, N., & Hara, A. K. (2006). Assessment of Polyp and Mass Histopathology by Intravenous Contrast-Enhanced CT Colonography. Academic radiology, 13(12), 1490-1495. https://doi.org/10.1016/j.acra.2006.09.051