Intestinal Imaging Centre, St Mark's Hospital, Harrow, UK.
Intestinal Imaging Centre, St Mark's Hospital, Harrow, UK.
Clin Radiol. 2021 Sep;76(9):665-673. doi: 10.1016/j.crad.2021.05.007. Epub 2021 Jun 18.
To audit the performance of computed tomography colonography (CTC) at St Mark's Hospital against the joint British Society of Gastrointestinal and Abdominal Radiology (BSGAR) and Royal College of Radiologists (RCR) standards.
A retrospective audit of all CTC studies between January 2012 to December 2017 was performed against the BSGAR/RCR standards along with additional data outwith the guidelines. Evidence was obtained from a central database, radiology information systems (RISs), picture archiving and communication systems (PACSs), and electronic patient records (EPRs).
Over the 6 years, 13,143 CTCs were performed and 12,996 (99%) were adequate or better. Of the cases 1,867 had a >6 mm polyp or cancer reported (polyp identification rate [PIR] 14%) and the positive predictive value (PPV) was 93% (1,148/1,240). Median radiation dose was 458 mGy·cm, mean additional acquisition rate was 19% (2,505/13,143), subsequent endoscopy rate was 9% (1,222/13,143) and mean interpretation time for a negative study was 34.6 minutes. Nine perforations occurred (perforation rate of 0.068%) and one was symptomatic (symptomatic perforation rate of 0.008%). For suspected cancers, the same-day endoscopy rate was 27% (96/360) and same-day staging rate was 76% (272/360). Post-imaging colorectal cancer rates (PICRC) was 3.06 per 100 cancers detected and 0.23 per 1,000 CTCs. The service was always rated "good" or higher by patients.
This audit shows the CTC service at St Mark's Hospital to be safe and of sufficiently high quality to meet the BSGAR/RCR standards with most outcomes equal to or above the aspirational target. Areas for service and individual reader improvement were also identified.
根据英国胃肠和腹部放射学会（BSGAR）和皇家放射学院（RCR）标准，对圣马克医院的计算机断层结肠成像（CTC）的性能进行审核。
对 2012 年 1 月至 2017 年 12 月期间所有的 CTC 研究进行回顾性审核，以 BSGAR/RCR 标准为基础，同时还纳入了指南以外的其他数据。证据来自中央数据库、放射信息系统（RIS）、图像存档和通信系统（PACS）和电子病历（EPR）。
在 6 年期间，共进行了 13143 例 CTC，其中 12996 例（99%）为足够或更好。在这些病例中，有 1867 例报告有>6mm 的息肉或癌症（息肉检出率[PIR]为 14%），阳性预测值（PPV）为 93%（1148/1240）。中位辐射剂量为 458mGy·cm，平均额外采集率为 19%（2505/13143），随后的内镜检查率为 9%（1222/13143），阴性研究的平均解释时间为 34.6 分钟。发生 9 例穿孔（穿孔率为 0.068%），1 例为症状性（症状性穿孔率为 0.008%）。对于疑似癌症，当天的内镜检查率为 27%（96/360），当天的分期率为 76%（272/360）。经影像学检查后发现的结直肠癌率（PICRC）为每 100 例检出癌症 3.06 例，每 1000 例 CTC 为 0.23 例。该服务始终被患者评为“良好”或更高。
本审核显示，圣马克医院的 CTC 服务安全且质量足够高，符合 BSGAR/RCR 标准，大多数结果与预期目标相等或更高。还确定了服务和个别读者改进的领域。
