Detection of colorectal polyps with CT colography: initial assessment of sensitivity and specificity.

PURPOSE To estimate the sensitivity and specificity of computed tomographic (CT) colography in detection of colorectal polyps and to compare these findings with those at axial CT. MATERIALS AND METHODS In 70 consecutive patients, CT colography and colonoscopy were performed. Helical axial CT images and CT colographic images (multiplanar two- and three-dimensional endoluminal images) were evaluated separately by two radiologists blinded to results from colonoscopy and other imaging studies. Findings were compared with those at colonoscopy, which was the standard. RESULTS The sensitivity and specificity for the two observers with CT colography averaged 75% and 90% in patients with adenomas 10 mm in diameter or larger, 66% and 63% in patients with adenomas 5 mm in diameter or greater, and 45% and 80% for patients with adenomas less than 5 mm in diameter, respectively. Sensitivity and specificity with axial CT were lower than those with CT colography (58% and 74%, respectively) in patients with adenomas 10 mm in diameter or larger. CONCLUSION Compared with axial CT, CT colography appears to have superior sensitivity and specificity in detection of clinically important colorectal adenomas. Early performance of CT colography seems promising for detection of colorectal polyps 5 mm and larger.