Abstract
Purpose: To compare the distribution of extracolonic findings and clinical outcomes between screening and diagnostic CT colonography (CTC) populations. Methods: 388 consecutive patients (369 men, 19 women; mean ± SD age 67.8 ± 10 years) who underwent first-time CTC (4/2011–4/2017) at a Veteran’s Affairs Medical Center were divided into screening (asymptomatic) or diagnostic (symptomatic) cohorts based on CTC indication. CTC reporting and data system E-scores for extracolonic findings were retrospectively assigned based on prospective CTC radiologic reports. Multinomial logistic regression was used to examine the association between E-scores and CTC indication. Electronic medical records of all patients with E3 or E4 scores were reviewed (median follow-up 2.8 years) to determine clinical outcomes. Results: 68% (262/388) underwent screening and 32% (126/388) diagnostic CTC. 7.2% (28/388) had extracolonic findings considered potentially significant (E4), 4.4% (17/388) had indeterminate but likely unimportant findings (E3), and 88.4% (347/388) had normal or unimportant findings (E1 or E2). E-scores were not significantly different between screening and diagnostic CTC when adjusted for age, gender, and prior imaging (p = 0.44). 4.6% (12/262) of patients with E3/E4 findings in the screening cohort demonstrated clinically significant outcomes, compared with 4.0% (5/126) in the diagnostic cohort, including a total of three extracolonic malignancies (0.8%) and three abdominal aortic aneurysms (0.8%). 4.6% (18/388) underwent follow-up imaging studies to confirm a benign outcome after detection of a category E3/E4 finding. Conclusions: The distribution of extracolonic findings and clinical outcomes were not statistically significantly different between screening and diagnostic CTC populations.
Original language | English (US) |
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Pages (from-to) | 429-437 |
Number of pages | 9 |
Journal | Abdominal Radiology |
Volume | 44 |
Issue number | 2 |
DOIs | |
State | Published - Feb 15 2019 |
Keywords
- C-RADS
- CT colonography
- Extracolonic findings
- Screening
ASJC Scopus subject areas
- Radiological and Ultrasound Technology
- Radiology Nuclear Medicine and imaging
- Gastroenterology
- Urology