Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Eur Radiol. 2011 Aug;21(8):1747-63. doi: 10.1007/s00330-011-2104-8. Epub 2011 Apr 1.
Previous meta-analyses on CT-colonography included both average and high risk individuals, which may overestimate the diagnostic value in screening. A meta-analysis was performed to obtain the value of CT-colonography for screening.
A search was performed using PubMed, Embase and Cochrane. Article selection and critical appraisal was done by two reviewers.
prospective, randomized trials or cohort studies comparing CT-colonography with colonoscopy (≥50 participants), ≥95% average risk participants ≥50 years. Study characteristics and 2 × 2 contingency Tables were recorded. Sensitivity and specificity estimates were calculated per patient and per polyp (≥6 mm, ≥10 mm), using univariate and bivariate analyses.
Five of 1,021 studies identified were included, including 4,086 participants (<1% high risk). I(2)-values showed substantial heterogeneity, especially for 6-9 mm polyps and adenomas: 68.1% vs. 78.6% (sensitivity per patient). Estimated sensitivities for patients with polyps or adenomas ≥ 6 mm were 75.9% and 82.9%, corresponding specificities 94.6% and 91.4%. Estimated sensitivities for patients with polyps or adenomas ≥ 10 mm were 83.3% and 87.9%, corresponding specificities 98.7% and 97.6%. Estimated sensitivities per polyp for advanced adenomas ≥ 6 mm and ≥ 10 mm were 83.9% and 83.8%.
Compared to colonoscopy, CT-colonography has a high sensitivity for adenomas ≥ 10 mm. For (advanced) adenomas ≥ 6 mm sensitivity is somewhat lower.
之前的 CT 结肠成像荟萃分析包括平均风险和高风险个体，这可能高估了筛查的诊断价值。进行了一项荟萃分析以获取 CT 结肠成像在筛查中的价值。
使用 PubMed、Embase 和 Cochrane 进行搜索。由两名评审员进行文章选择和批判性评估。
前瞻性、随机试验或队列研究，比较 CT 结肠成像与结肠镜检查（≥50 名参与者），≥95%的平均风险参与者≥50 岁。记录研究特征和 2×2 列联表。使用单变量和双变量分析计算每位患者和每个息肉（≥6mm、≥10mm）的敏感性和特异性估计值。
从 1021 项研究中确定了 5 项研究，共包括 4086 名参与者（<1%高风险）。I(2)值显示出明显的异质性，特别是对于 6-9mm 的息肉和腺瘤：68.1%比 78.6%（每位患者的敏感性）。≥6mm 息肉或腺瘤患者的估计敏感性分别为 75.9%和 82.9%，相应的特异性分别为 94.6%和 91.4%。≥10mm 息肉或腺瘤患者的估计敏感性分别为 83.3%和 87.9%，相应的特异性分别为 98.7%和 97.6%。≥6mm 和≥10mm 的高级腺瘤每个息肉的估计敏感性分别为 83.9%和 83.8%。
与结肠镜检查相比，CT 结肠成像对≥10mm 的腺瘤具有较高的敏感性。对于≥6mm 的（高级）腺瘤，敏感性略低。
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