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European Radiology
Published in: European Radiology 7/2010

01-07-2010 | Gastrointestinal

Positive predictive value for polyps detected at screening CT colonography

Authors: Perry J. Pickhardt, Steven M. Wise, David H. Kim

Published in: European Radiology | Issue 7/2010

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Abstract

Purpose

To determine the positive predictive value (PPV) for polyps detected at CT colonography (CTC).

Methods

Assessment of 739 colorectal lesions ≥6 mm detected prospectively at CTC screening in 479 patients was performed. By-polyp PPV was analyzed according to small (6–9 mm) versus large (≥10 mm) size; morphology (sessile/pedunculated/flat); diagnostic confidence level (3 = most confident, 1 = least confident); and histology. By-patient PPV was analyzed at various polyp size thresholds.

Results

By-polyp PPV for CTC-detected lesions ≥6 mm, 6–9 mm, and ≥10 mm was 91.6% (677/739), 90.1% (410/451), and 92.7% (267/288), respectively (p = 0.4). By-polyp PPV according to sessile, pedunculated, flat, and mass-like morphology was 92.5% (441/477), 96.5% (139/144), 77.7% (73/94), and 97.6% (40/41), respectively (p < 0.0001 for flat versus polypoid morphology). By-polyp PPV according to diagnostic confidence level was 94.7% (554/585) for highest (= level 3), 83.5% (106/127) for intermediate (= level 2), and 63.0% (17/27) for lowest (= level 1) confidence (p < 0.0001 for levels-2/3 versus level-1). By-patient PPV at 6-mm, 8-mm, 10-mm, and 30-mm polyp size thresholds was 92.3% (442/479), 93.0% (306/329), 93.1% (228/245), and 97.4% (38/39), respectively.

Conclusion

The overall per-polyp and per-patient PPV for lesions ≥6 mm was 92% for CTC screening. Increased diagnostic confidence and polypoid (non-flat) morphology correlated with a higher PPV, whereas small versus large polyp size had very little effect.
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Metadata
Title
Positive predictive value for polyps detected at screening CT colonography
Authors
Perry J. Pickhardt
Steven M. Wise
David H. Kim
Publication date
01-07-2010
Publisher
Springer-Verlag
Published in
European Radiology / Issue 7/2010
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-009-1704-z

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