Cover Image

Comparison of high-frequency transabdominal ultrasonography and spiral computed tomography with colonoscopy in diagnosis of colon cancer

Wangju Sumnyan, Ojing Komut, Leena Ligu

Abstract


Objective: To compare high-frequency transabdominal ultrasonography (USG) and spiral computed tomography (CT) with colonoscopy in diagnosis of colon cancer. Design: A prospective comparative study of accuracy of USG and CT scan with colonoscopy. Subjects: Sixty patients with a clinical suspicion of colon cancer after a detailed clinical history and a thorough clinical examination were included. Patients with a known diagnosis of colon cancer or in whom histopathological diagnosis could not be established were excluded. Methods: All 60 patients who met the inclusion and exclusion criteria underwent transabdominal USG, CT scan-abdomen & pelvis, followed by colonoscopy. The CT and USG scans were reported by different radiologists without previous knowledge of any findingsof the other test or of the subsequent colonoscopy. The colonoscopy was performed by different clinicians, none of whom was aware of the USG or CT diagnosis. Result: Colonoscopy diagnosed 29 patients with colon cancer out of 60 enrolled patients.  USG detected colon cancer in all the 29 patients with a sensitivity of 100% and a specificity of 87.1%. CT scan diagnosed colon cancer in all the 29 patients with a sensitivity of 100% and a specificity of 74.2%. Conclusions: Colonoscopy is still necessary when a suspicious lesion is identified. However, CT and USG can screen out suspected patients who can be subsequently referred for colonoscopy. This would reduce the need for colonoscopy in a large proportion of clinically suspected patients andalso avoidan invasive procedure like colonoscopy as first line investigation in elderly patients suspected of having colonic cancer.

Full Text:

PDF HTML

References


Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M et al. Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int. J. Cancer.2015 Mar;136(5): E359-86.doi: 10.1002/ijc.29210.

Arnold M, Sierra MS, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global patterns and trends in colorectal cancer incidence and mortality. Gut.2017;66 (4): 683-91. doi: 10.1136/gutjnl-2015-310912

Martın-Lopez JE, Beltran-Calvo C, Rodrıguez-Lopez R, Molina-Lopezl T. Comparison of the accuracy of CT colonography and colonoscopy in the diagnosis of colorectal cancer. Colorectal Disease. 2014 Mar; 16(3): O82–9.doi: 10.1111/codi.12506.

Day JJ, Freeman AH, Coni NK, Dixon AK. Barium enema or computed tomography for the frail elderly patient? Clin Radiol .1993 Jul; 48: 48-51.doi: https:// doi.org/10.1016/S0009-9260(05)80108-4

Bor R,Fabian A,Szepes Z. Role of ultrasound in colorectal diseases.World J Gastroenterol. 2016 Nov; 22 (43): 9477–87.doi: 10.3748/wjg. v22.i43.9477.

Shirahama M, Koga T, Ishibashi H, Uchida S, Ohta Y. Sonographic features of colon carcinoma seen with high-frequency transabdominal ultrasound. J Clin Ultrasound.1994 Jul-Aug; 22(6):359-65.https://doi.org/ 10.1002/jcu.1870220602.

Balthazar E J, Megibow A J, Hulnick D, Naidich DP. Carcinoma of the colon: Detection and preoperative staging by CT. AJR. 1988 Feb ; 150(2):301-6.DOI: 10. 2214/ajr.150.2.301

Owens AP, Banerjee B, Morewood DJW: Sonography as an aid to diagnosis of caecal carcinoma in the elderly. Clin Radiol. 1983 Nov; 34:669-72.

Sianesi M, Rossi A, Miselli A, Farinon AM. Ultrasonic detection of colonic carcinoma in emergency. Dis Colon Rectum.1984 Mar; 27(3)168-71.

Khoo HT. The ultrasonic demonstration of colonic carcinoma. Aust Rdiol .1981 Mar; 25(1):23-30.

Price J, Metreweli C. Ultrasonographic diagnosis of clinically non-palpable primary colonic neoplasms. BJR. 1988;61(723):190-5.DOI: 10.1259/0007-1285-61-723-190.

Hirooka N, Ohno T, Misonoo M, Kobayashi C, MushaH,. Mori H, et al. Sono-enterocolonography by oral water administration. J Clin Ultrasound.1989 Oct; 17 (8): 585-9.

LimbergB.Diagnosis of large bowel tumors by colonic sonography. Lancet.1990 Jan; 335(8682):144-6.

Limberg B. Diagnosis and staging of colonic tumors by conventional abdominal sonography as compared with hydrocolonic sonography. N Engl J Med. 1992; 327:65-9.

Chui DW, Gooding GA, McQuaid KR,Griswold V,Grendell JH. Hydrocolonic ultrasonography in the detection of colonic polyps and tumors. N Engl J Med.1994 Dec; 331 (25):1685-8.DOI: 10.1056/NEJM 199412223312504

W K Loftus, C Metreweli, Sung JJ, Yang WT, Leung VK, Set PA.Ultrasound, CT and colonoscopy of colonic cancer. Br JRadiol.1999 Feb;72(854):144-8.doi: 10.1259/bjr.72.854.10365063.

Fink, M., Freeman AH, Dixon AK,Coni NK. Computed tomography of the colon in elderly people. Br Med J. 1994; 308(6935):1018.

Loftus WK, Metreweli C, Sung JJ, Yang WT, Leung VK, Set PA. Ultrasound, CT and colonoscopy of colonic cancer. Bri J Radiol. 1999 Feb; 72(854):144-8.

Okizuka H, Sugimura K, Shinozaki N, Watanabe K. Colorectal carcinoma: evaluation with ultrafast CT. Clin Imaging.1995 Oct-Dec; 19(4):247–51.

Amin Z, Boulos PB, Lees WR. Technical report: spiral CT pneumocolon for suspected colonic neoplasms. Clin Radiol. 1996 Jan; 51(1):56–61.

Hara AK, Johnson CD, Reed JE, Ahlquist DA, Nelson H, Ehman RL, McCollough CH, Ilstrup DM. Detection of colorectal polyps by computed tomographic colography: feasibility of a novel technique. Gastroenterology.1996 Jan; 110 (1):284-90.

Macari M, Berman P, Dicker M, Milano M, Megibow AJ. Usefulness of CT colonography in patients with incomplete colonoscopy. AJR Am J Roentgenol.1999 Sep; 173(3):561-4. DOI: 10.2214/ ajr. 173.3.10470879.

Morrin MM, Kruskal JB, Farrell RJ, Goldberg SN, McGee JB, Raptopoulus V. Endoluminal CT colono-graphy after incomplete endoscopic colonoscopy. AJR Am J Roentgenol .1999 Apr; 172:913-8.doi: 10.2214/ ajr. 172.4.10587120

Fenlon HM, McAneny DB, Nunes DP, Clarke PD, Ferrucci JT. Occlusive colon carcinoma: virtual colonoscopy in the preoperative evaluation of the proximal colon. Radiology. 1999 Feb; 210(2):423-8. DOI: 10.1148/radiology.210.2. r99fe21423.

Rex DK, Cutler CS, Lemmel GT, Rahamani EY, Clark DW, Helper DJ, et al.Colonoscopic miss rates of adenomas determined by back-to-back colonoscopies. Gastroenterology.1997 Jan; 112(1):24-8.


Refbacks

  • There are currently no refbacks.