Extracolonic findings of computed tomographic colonography in Koreans

Abstract

Aim: To determine the frequency and characteristics of extracolonic lesions detected using computed tomographic (CT) colonography.

Methods: The significance of extracolonic lesions was classified as high, intermediate, or low. Medical records were reviewed to establish whether further investigations were carried out pertaining to the extracolonic lesions that were detected by CT colonography.

Results: A total of 920 cases from 7 university hospitals were included, and 692 extracolonic findings were found in 532 (57.8%) patients. Of 692 extracolonic findings, 60 lesions (8.7%) were highly significant, 250 (36.1%) were of intermediate significance, and 382 (55.2%) were of low significance. CT colonography revealed fewer extracolonic findings in subjects who were without symptoms (P < 0.001), younger (P < 0.001), or who underwent CT colonography with no contrast enhancement (P = 0.005). CT colonography with contrast enhancement showed higher cost-effectiveness in detecting highly significant extracolonic lesions in older subjects and in subjects with symptoms.

Conclusion: Most of the extracolonic findings detected using CT colonography were of less significant lesions. The role of CT colonography would be optimized if this procedure was performed with contrast enhancement in symptomatic older subjects.

Figure 1

Cost of detecting highly significant extracolonic lesions. Cost-effectiveness was assessed using the following calculation for each group. Poor cost-effectiveness in the detection of highly significant lesions was observed for subjects aged below 60 year-old (US $ 3442), subjects without symptoms (US $ 3737), and CT colonography performed without contrast enhancement (US $ 4221).