CT colonography

Multiobserver diagnostic performance

Elizabeth G. McFarland, Thomas K. Pilgram, James A. Brink, Ronan A. McDermott, Cynthia V. Santillan, Patrick W. Brady, Jay Heiken, Dennis M. Balfe, Leonard B. Weinstock, Erik P. Thyssen, Benjamin Littenberg

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

PURPOSE: To prospectively evaluate multiobserver diagnostic performance and reader agreement for colorectal polyp detection in a well-characterized cohort of patients with increased number of polyps, compared with an average-risk patient, with colonoscopy as the reference standard. MATERIALS AND METHODS: A cohort of 70 patients suspected of having polyps was examined with spiral computed tomographic (CT) colonography, with colonoscopy performed the same day. After air insufflation per rectum, supine and prone images were obtained with single-detector row CT (5-mm collimation, 8-mm table increment, 2-mm reconstruction interval). Images were analyzed independently by four experienced abdominal radiologists using two-dimensional multiplanar reformation followed by selective use of three-dimensional endoscopic volume-rendered images. Data were analyzed both per polyp and per patient. RESULTS: Analysis per polyp demonstrated a pooled sensitivity of 0.68 for lesions 10 mm or larger (n = 40), with 75% agreement among the four readers. Analysis per patient demonstrated improved detection and agreement, with a pooled sensitivity of 0.88 for patients with polyps or cancers 10 mm or larger (n = 28), with 94% agreement. When sensitivity and receiver operating characteristic analyses were analyzed per polyp size threshold, results among readers converged and peaked at polyp diameters of approximately 10 mm. CONCLUSION: In this patient cohort, diagnostic performance and interobserver agreement with single-detector row CT colonography was sufficient for detection of patients with lesions 10 mm or larger, with more variable results for smaller polyps.

Original languageEnglish (US)
Pages (from-to)380-390
Number of pages11
JournalRadiology
Volume225
Issue number2
DOIs
StatePublished - Nov 1 2002
Externally publishedYes

Fingerprint

Computed Tomographic Colonography
Polyps
Colonoscopy
Insufflation
Rectum
ROC Curve
Air

Keywords

  • Colon neoplasms
  • Colon, CT
  • Computed tomography (CT), image processing
  • Diagnostic radiology, observer performance
  • Images, analysis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

McFarland, E. G., Pilgram, T. K., Brink, J. A., McDermott, R. A., Santillan, C. V., Brady, P. W., ... Littenberg, B. (2002). CT colonography: Multiobserver diagnostic performance. Radiology, 225(2), 380-390. https://doi.org/10.1148/radiol.2252011625

CT colonography : Multiobserver diagnostic performance. / McFarland, Elizabeth G.; Pilgram, Thomas K.; Brink, James A.; McDermott, Ronan A.; Santillan, Cynthia V.; Brady, Patrick W.; Heiken, Jay; Balfe, Dennis M.; Weinstock, Leonard B.; Thyssen, Erik P.; Littenberg, Benjamin.

In: Radiology, Vol. 225, No. 2, 01.11.2002, p. 380-390.

Research output: Contribution to journalArticle

McFarland, EG, Pilgram, TK, Brink, JA, McDermott, RA, Santillan, CV, Brady, PW, Heiken, J, Balfe, DM, Weinstock, LB, Thyssen, EP & Littenberg, B 2002, 'CT colonography: Multiobserver diagnostic performance', Radiology, vol. 225, no. 2, pp. 380-390. https://doi.org/10.1148/radiol.2252011625
McFarland EG, Pilgram TK, Brink JA, McDermott RA, Santillan CV, Brady PW et al. CT colonography: Multiobserver diagnostic performance. Radiology. 2002 Nov 1;225(2):380-390. https://doi.org/10.1148/radiol.2252011625
McFarland, Elizabeth G. ; Pilgram, Thomas K. ; Brink, James A. ; McDermott, Ronan A. ; Santillan, Cynthia V. ; Brady, Patrick W. ; Heiken, Jay ; Balfe, Dennis M. ; Weinstock, Leonard B. ; Thyssen, Erik P. ; Littenberg, Benjamin. / CT colonography : Multiobserver diagnostic performance. In: Radiology. 2002 ; Vol. 225, No. 2. pp. 380-390.
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abstract = "PURPOSE: To prospectively evaluate multiobserver diagnostic performance and reader agreement for colorectal polyp detection in a well-characterized cohort of patients with increased number of polyps, compared with an average-risk patient, with colonoscopy as the reference standard. MATERIALS AND METHODS: A cohort of 70 patients suspected of having polyps was examined with spiral computed tomographic (CT) colonography, with colonoscopy performed the same day. After air insufflation per rectum, supine and prone images were obtained with single-detector row CT (5-mm collimation, 8-mm table increment, 2-mm reconstruction interval). Images were analyzed independently by four experienced abdominal radiologists using two-dimensional multiplanar reformation followed by selective use of three-dimensional endoscopic volume-rendered images. Data were analyzed both per polyp and per patient. RESULTS: Analysis per polyp demonstrated a pooled sensitivity of 0.68 for lesions 10 mm or larger (n = 40), with 75{\%} agreement among the four readers. Analysis per patient demonstrated improved detection and agreement, with a pooled sensitivity of 0.88 for patients with polyps or cancers 10 mm or larger (n = 28), with 94{\%} agreement. When sensitivity and receiver operating characteristic analyses were analyzed per polyp size threshold, results among readers converged and peaked at polyp diameters of approximately 10 mm. CONCLUSION: In this patient cohort, diagnostic performance and interobserver agreement with single-detector row CT colonography was sufficient for detection of patients with lesions 10 mm or larger, with more variable results for smaller polyps.",
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AU - McFarland, Elizabeth G.

AU - Pilgram, Thomas K.

AU - Brink, James A.

AU - McDermott, Ronan A.

AU - Santillan, Cynthia V.

AU - Brady, Patrick W.

AU - Heiken, Jay

AU - Balfe, Dennis M.

AU - Weinstock, Leonard B.

AU - Thyssen, Erik P.

AU - Littenberg, Benjamin

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N2 - PURPOSE: To prospectively evaluate multiobserver diagnostic performance and reader agreement for colorectal polyp detection in a well-characterized cohort of patients with increased number of polyps, compared with an average-risk patient, with colonoscopy as the reference standard. MATERIALS AND METHODS: A cohort of 70 patients suspected of having polyps was examined with spiral computed tomographic (CT) colonography, with colonoscopy performed the same day. After air insufflation per rectum, supine and prone images were obtained with single-detector row CT (5-mm collimation, 8-mm table increment, 2-mm reconstruction interval). Images were analyzed independently by four experienced abdominal radiologists using two-dimensional multiplanar reformation followed by selective use of three-dimensional endoscopic volume-rendered images. Data were analyzed both per polyp and per patient. RESULTS: Analysis per polyp demonstrated a pooled sensitivity of 0.68 for lesions 10 mm or larger (n = 40), with 75% agreement among the four readers. Analysis per patient demonstrated improved detection and agreement, with a pooled sensitivity of 0.88 for patients with polyps or cancers 10 mm or larger (n = 28), with 94% agreement. When sensitivity and receiver operating characteristic analyses were analyzed per polyp size threshold, results among readers converged and peaked at polyp diameters of approximately 10 mm. CONCLUSION: In this patient cohort, diagnostic performance and interobserver agreement with single-detector row CT colonography was sufficient for detection of patients with lesions 10 mm or larger, with more variable results for smaller polyps.

AB - PURPOSE: To prospectively evaluate multiobserver diagnostic performance and reader agreement for colorectal polyp detection in a well-characterized cohort of patients with increased number of polyps, compared with an average-risk patient, with colonoscopy as the reference standard. MATERIALS AND METHODS: A cohort of 70 patients suspected of having polyps was examined with spiral computed tomographic (CT) colonography, with colonoscopy performed the same day. After air insufflation per rectum, supine and prone images were obtained with single-detector row CT (5-mm collimation, 8-mm table increment, 2-mm reconstruction interval). Images were analyzed independently by four experienced abdominal radiologists using two-dimensional multiplanar reformation followed by selective use of three-dimensional endoscopic volume-rendered images. Data were analyzed both per polyp and per patient. RESULTS: Analysis per polyp demonstrated a pooled sensitivity of 0.68 for lesions 10 mm or larger (n = 40), with 75% agreement among the four readers. Analysis per patient demonstrated improved detection and agreement, with a pooled sensitivity of 0.88 for patients with polyps or cancers 10 mm or larger (n = 28), with 94% agreement. When sensitivity and receiver operating characteristic analyses were analyzed per polyp size threshold, results among readers converged and peaked at polyp diameters of approximately 10 mm. CONCLUSION: In this patient cohort, diagnostic performance and interobserver agreement with single-detector row CT colonography was sufficient for detection of patients with lesions 10 mm or larger, with more variable results for smaller polyps.

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KW - Computed tomography (CT), image processing

KW - Diagnostic radiology, observer performance

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