Twodimensional Methods

Pineau et al. (2003) conducted a comparative study with optic colonoscopy assessing the diagnostic accuracy of virtual colonoscopy using oral contrast. The colonography examination was done with a primary 2D method with 3D problem solving. In a population of 205 patients the sensitivity for large (>10 mm) colorectal polyps was 78%. The reported specificity was higher (95%). This decreased for medium-sized (6-9 mm) polyps to 75 and 83% respectively.

Johnson et al. (2003b) conducted a multi-center accuracy study (18 radiologists) with a primary axial 2D method with MPR and 3D for problem solving. The average sensitivity for large polyps was 75% with a corresponding specificity of 73%, for polyps >6 mm these figures were 54 and 72% respectively. Experienced readers performed better.

Iannaccone et al. (2004b) used a primary axial 2D method for detection of colorectal polyps in a partly symptomatic population of 203 patients. Patients had not been cathartically prepared but oral contrast was added to a low fiber diet, two days prior to the colonography examination. The average sensitivity per polyp for three observers was 100% for large polyps and 86% for polyps >6 mm. Specificity per patient was 100% for large polyps and 94% for polyps >6 mm.

These studies show that in a high prevalence population, primary 2D studies report good results for large polyps.

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