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Radiologic Imaging Modalities for Colorectal Cancer. Dig Dis Sci 2022; 67:2792-2804. [PMID: 34328590 DOI: 10.1007/s10620-021-07166-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 07/07/2021] [Indexed: 12/09/2022]
Abstract
BACKGROUND Studies reported various diagnostic value of radiologic imaging modalities for diagnosis and management of colorectal cancer (CRC). AIMS To summary the diagnosis and management of CRC using computed tomography colonography (CTC), magnetic resonance colonography (MRC), and positron emission tomography (PET)/computed tomography (CT). METHODS Comprehensive literature searches were conducted in PubMed, EmBase, and the Cochrane library for studies published before April 2021. The diagnostic performance of CTC, MRC, and PET/CT for CRC was summarized. RESULTS A total of 54 studies (17 studies for CTC, 8 studies for MRC, and 29 studies for PET/CT) were selected for final analysis. The sensitivity and specificity for CTC ranged from 27 to 100%, 88 to 100%, respectively, and the pooled sensitivity and specificity for CTC were 0.97 (95% CI 0.88-0.99) and 0.99 (95% CI 0.99-1.00). The sensitivity and specificity for MRC ranged from 48 to 100%, 60 to 100%, respectively, and the pooled sensitivity and specificity for MRC were 0.98 (95% C: 0.77-1.00) and 0.94 (95% CI 0.84-0.98). The sensitivity and specificity for PET/CT ranged from 84 to 100%, 33 to 100%, respectively, and the pooled sensitivity and specificity for PET/CT were 0.94 (95% CI 0.92-0.96) and 0.94 (95% CI 0.90-0.97). The area under the receiver operating characteristic curve for CTC, MRC, and PET/CT was 1.00 (95% CI 0.99-1.00), 0.99 (95% CI 0.98-1.00), and 0.97 (0.95% CI 0.95-0.98), respectively. CONCLUSIONS This study suggested both CTC and MRC with relative higher diagnostic value for diagnosing CRC, while PET/CT with higher diagnostic value in detecting local recurrence for patients with CRC.
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Gao Y, Wang J, Lv H, Xue Y, Jia R, Liu G, Bai W, Wu Y, Zhang L, Yang J. Diagnostic value of magnetic resonance and computed tomography colonography for the diagnosis of colorectal cancer: A systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e17187. [PMID: 31574825 PMCID: PMC6775409 DOI: 10.1097/md.0000000000017187] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Surgical resection is the recommended procedure for colorectal cancer (CRC), but majority of the patients were diagnosed with advanced or metastatic CRC. Currently, there were inconsistent results about the diagnostic value of magnetic resonance colonography (MRC) and computed tomography colonography (CTC) in early CRC diagnosis. Our study conducted this meta-analysis to investigate the diagnostic value of MRC and CTC for CRC surveillance. METHODS A comprehensive literature search was conducted in PubMed, Embase, and the Cochrane library to select relevant studies. The summary sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and the area under the receiver operating characteristic curves (AUC) were calculated to evaluate the diagnostic value of MRC and CTC, respectively. RESULT Twenty-five studies including 2985 individuals were selected in the final analysis. Eight studies evaluated the diagnostic value of MRC, and 17 studies assessed CTC. The summary sensitivity, specificity, PLR, NLR, DOR, and AUC in MRC for early detection of CRC were 0.98 (95% confidence interval, CI: 0.80-1.00), 0.94 (95% CI: 0.85-0.97), 15.48 (95% CI: 6.30-38.04), 0.02 (95% CI: 0.00-0.25), 115.09 (95% CI: 15.37-862.01), and 0.98 (95% CI: 0.97-0.99), respectively. In addition, the sensitivity, specificity, PLR, NLR, DOR, and AUC of CTC for diagnosing CRC were 0.97 (95% CI: 0.88-0.99), 0.99 (95% CI: 0.99-1.00), 154.11 (95% CI: 67.81-350.22), 0.03 (95% CI: 0.01-0.13), 642.51 (95% CI: 145.05-2846.02), and 1.00 (95% CI: 0.99-1.00). No significant differences were found between MRC and CTC for DOR in all the subsets. CONCLUSION The findings of meta-analysis indicated that MRC and CTC have higher diagnostic values for early CRC diagnosis. However, the DOR for diagnosing CRC between MRC and CTC showed no significance.
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Affiliation(s)
- Yanjun Gao
- Department of Medical Imaging, Xi’an No. 3 Hospital
| | - Jing Wang
- Department of Medical Imaging, Xi’an Hospital of TCM
| | - Hairong Lv
- Department of Medical Imaging, Xi’an No. 3 Hospital
| | - Yongjie Xue
- Department of Medical Imaging, Xi’an No. 3 Hospital
| | - Rongrong Jia
- Department of Medical Imaging, Xi’an No. 3 Hospital
| | - Ge Liu
- Department of Medical Imaging, Xi’an No. 3 Hospital
| | - Weixian Bai
- Department of Medical Imaging, Xi’an No. 3 Hospital
| | - Yi Wu
- Department of Medical Imaging, Xi’an No. 3 Hospital
| | - Lang Zhang
- Department of Medical Imaging, Xi’an No. 3 Hospital
| | - Junle Yang
- Department of Medical Imaging, Xi’an Central Hospital, Xi’an, China
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Ulus S, Suleyman E, Ozcan UA, Karaarslan E. Whole-Body MRI Screening in Asymptomatic Subjects; Preliminary Experience and Long-Term Follow-Up Findings. Pol J Radiol 2016; 81:407-14. [PMID: 27635171 PMCID: PMC5008738 DOI: 10.12659/pjr.897570] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 01/25/2016] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The aim of this study is to describe the technique and to evaluate the results of whole-body magnetic resonance imaging in an asymptomatic population. MATERIAL/METHODS Between March 2009 and December 2011, 118 consecutive subjects undergoing thorough medical check-up were prospectively included in the study. MRI was performed with a 205-cm moving table, parallel imaging and automatic image composing software. RESULTS In 83 subjects (70%), 103 benign lesions were detected. Two malignant (adrenal and renal carcinoma) lesions and one precancerous (pancreatic mucinous carcinoma) lesion were detected. The most common lesions were renal cysts, liver hemangiomas, liver cysts, thyroid nodules, and uterine leiomyomas. CONCLUSIONS WB-MRI is able to cover area from head to toes in one diagnostic work-up, and besides the anatomic regions evaluated by conventional radiological modalities, i.e. brain parenchyma, bones and extremities, can be evaluated in one examination.
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Affiliation(s)
- Sila Ulus
- Department of Radiology, Acıbadem University, School of Medicine, Istanbul, Turkey
| | - Erdogan Suleyman
- Department of Radiology, Acıbadem Maslak Hospital, Istanbul, Turkey
| | - Umit Aksoy Ozcan
- Department of Radiology, Acıbadem University, School of Medicine, Istanbul, Turkey
| | - Ercan Karaarslan
- Department of Radiology, Acıbadem University, School of Medicine, Istanbul, Turkey
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Abstract
Colonoscopy can be associated with many problems, such as mechanical trauma due to the distal tip contacting the colon wall or health issues due to the extended use of anesthesia. In order to eliminate these complications, an automatic adjustable colonoscope was designed. This device uses sensors, actuators, and a control system to automatically position the distal tip in the center of the colon lumen. The sensors were tested to determine their ability to accurately sense the distance from the tip to the surface. The actuators were tested to determine the correlation between motor rotation and displacement of the distal tip. The control system was tested to assess the ability of the device to position the tip in the center of the test tube and the ability to navigate through a flat test course. It was determined that the sensors could accurately determine distances from 0 to 15 mm from the test surface in all test conditions. The motors for up-down movement and left-right movement of the colonoscope had response times of 0.57 s and 0.69 s, respectively, when the motors were rotated from 0 deg to 90 deg. The control system was able to safely move the colonoscope tip away from all walls of the test apparatus. It was also able to navigate through the flat test course without coming in contact with the walls. The automatic adjustable colonoscope has demonstrated that it can safely and effectively position the distal tip to avoid contact with the walls of the test surface.
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Affiliation(s)
- Jonathan D. Litten
- Department of Mechanical Engineering, Ohio University, 259 Stocker Center, Athens, OH 45701
| | - JungHun Choi
- Department of Mechanical Engineering and Biomedical Engineering Program, Ohio University, 254 Stocker Center, Athens, OH 45701
| | - David Drozek
- College of Osteopathic Medicine, Department of Specialty Medicine, Ohio University, 106 Parks Hall, Athens, OH 45701
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Litten JD, Choi J, Drozek D. Development of a colonoscopy add-on device for improvement of the intubation process. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2011; 4:197-208. [PMID: 22915947 PMCID: PMC3417891 DOI: 10.2147/mder.s27728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
A colonoscopy add-on device has been developed to reduce intubation time without modification of the current colonoscope and peripheral devices. One of the main purposes of the system is to minimize trauma caused by the distal tip of the colonoscope. The detachable sensory fixture at the end of the distal tip measures the distance between the distal tip and the colon wall in three directions, and the actuation system attached at the base of the colonoscope controls the distal tip by rotating two dial knobs. The device controls the distal tip to minimize contact between the distal tip and the colon wall, and the distal tip ideally points out the next possible lumen. A compatibility test of the infrared sensory system was carried out, and the design of the actuation system was accomplished. The system is integrated and controlled by a microprocessor. The device was tested in a silicon colon and porcine intestine. The results showed that a colonoscopist successfully reached the cecum with the aid of the colonoscopy add-on device without significant contact between the colon wall and the distal tip. The colonoscopy aid device was very helpful for the novice colonoscopist.
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Affiliation(s)
- Jonathan D Litten
- Department of Mechanical Engineering, Ohio University, Athens, OH, USA
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Zijta F, Florie J, Jensch S, Bipat S, Nievelstein R, Poulus M, Thomassen-de Graaf M, Montauban van Swijndregt A, Stoker J. Diagnostic performance of radiographers as compared to radiologists in magnetic resonance colonography. Eur J Radiol 2010; 75:e12-7. [DOI: 10.1016/j.ejrad.2009.10.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Accepted: 10/14/2009] [Indexed: 11/26/2022]
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Magnetic resonance colonography for colorectal cancer screening in patients with Lynch syndrome gene mutation. Fam Cancer 2010; 9:555-61. [DOI: 10.1007/s10689-010-9350-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Liang Z, Richards R. Virtual colonoscopy vs optical colonoscopy. EXPERT OPINION ON MEDICAL DIAGNOSTICS 2010; 4:159-169. [PMID: 20473367 PMCID: PMC2869208 DOI: 10.1517/17530051003658736] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
IMPORTANCE OF THE FIELD: The high prevalence of colon carcinoma combined with the low compliance of currently recommended screening guidelines explains the continued high mortality rate of colon cancer. Utilizing a strategy of virtual colonoscopy (VC) in asymptomatic patients over 50, with optical colonoscopy (OC) follow-up for removal of detected adenomatous polyps may result in lowering the colon cancer death rate. However, the screening potential of VC has not yet been widely recognized. Debates and doubts of its potential benefits have been frequently seen in the literature since VC was first reported in 1994. AREAS COVERED IN THIS REVIEW: This article reviews the currently available screening options and discuss their advantages and drawbacks. TAKE HOME MESSAGE: VC has many advantages over the existing screening options and its several drawbacks can be mitigated so that it would become a valuable screening modality. A strategy that utilizes VC for population-based screening over the age of 50 and OC for screening high-risk individuals and those with positive VC findings would result in a significantly reduced rate of colon cancer deaths.
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Affiliation(s)
- Zhengrong Liang
- IEEE Fellow, Professor of Radiology, Computer Science and Biomedical Engineering, School of Medicine, L4-120, Health Sciences Center, Stony Brook University, Stony Brook, NY 11794-8460, USA, (Tel): +1 631-444-7837, (Fax): +1 631-444-6450
| | - Robert Richards
- Associate Professor, Program Director - GI Fellowship, Department of Medicine/Gastroenterology, Health Science Center, Level 17, Room 060, Stony Brook University, Stony Brook, NY 11794-8173, USA, (Tel): +1 631-444-7623
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Morin S, Cobbold J, Lim A, Eliahoo J, Thomas E, Mehta S, Durighel G, Fitzpatrick J, Bell J, Taylor-Robinson S. Incidental findings in healthy control research subjects using whole-body MRI. Eur J Radiol 2009; 72:529-33. [DOI: 10.1016/j.ejrad.2008.08.006] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2008] [Revised: 07/14/2008] [Accepted: 08/12/2008] [Indexed: 12/21/2022]
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Zijta FM, Bipat S, Stoker J. Magnetic resonance (MR) colonography in the detection of colorectal lesions: a systematic review of prospective studies. Eur Radiol 2009; 20:1031-46. [PMID: 19936754 PMCID: PMC2850516 DOI: 10.1007/s00330-009-1663-4] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2009] [Revised: 08/26/2009] [Accepted: 09/17/2009] [Indexed: 12/16/2022]
Abstract
Objective To determine the diagnostic accuracy of MR-colonography for the detection of colorectal lesions. Methods A comprehensive literature search was performed for comparative MR-colonography studies, published between May 1997 and February 2009, using the MEDLINE, EMBASE and Cochrane databases. We included studies if MR-colonography findings were prospectively compared with conventional colonoscopy in (a)symptomatic patients. Two reviewers independently extracted study design characteristics and data for summarising sensitivity and specificity. Heterogeneity in findings between studies was tested using I2 test statistics. Sensitivity and specificity estimates with 95% confidence intervals (CI) were calculated on per patient basis and summary sensitivity on per polyp basis, using bivariate and univariate statistical models. Results Thirty-seven studies were found to be potentially relevant and 13 fulfilled the inclusion criteria. The study population comprised 1,285 patients with a mean disease prevalence of 44% (range 22–63%). Sensitivity for the detection of CRC was 100%. Significant heterogeneity was found for overall per patient sensitivity and specificity. For polyps with a size of 10 mm or larger, per patient sensitivity and specificity estimates were 88% (95% CI 63–97%; I2 = 37%) and 99% (95% CI 95–100%; I2 = 60%). On a per polyp basis, polyps of 10 mm or larger were detected with a sensitivity of 84% (95% CI 66–94%; I2 = 51%). The data were too heterogeneous for polyps smaller than 6 mm and 6–9 mm. Conclusion MR-colonography can accurately detect colorectal polyps more than 10 mm in size
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Affiliation(s)
- Frank M Zijta
- Department of Radiology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
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Elliott A. Issues in medical exposures. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2009; 29:A107-A121. [PMID: 19454810 DOI: 10.1088/0952-4746/29/2a/s07] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Medical exposures account, on average, for some 14% of the background ionising radiation exposure in the UK and form the great majority of the non-natural component. In the United States of America, medical exposures comprised over 50% of the total in 2006. This is due primarily to an increase in x-ray computed tomography (CT) and positron emission tomography (PET) procedures. This paper highlights the potential problems in the use of CT scanning to investigate the asymptomatic individual, where the traditional risk/benefit considerations are less clear-cut than in conventional clinical situations. It draws on a recent COMARE report which examined the use of CT for whole body, heart, lung and colon studies. The number of PET facilities is increasing rapidly in the UK and, in addition to considerations of radiation dose to subjects, careful planning is necessary to limit doses to staff. In non-ionising radiation, a topic of keen interest at present is the use of increasingly powerful sunbeds, particularly by those aged under 18. Legislation and regulation vary widely across Europe and the Scottish Parliament has recently introduced the first UK regulation. It is suggested that further research is required into the effects of current UV systems and the reasons why tanning is thought so desirable by Caucasians. Lastly, a number of issues requiring radiobiological and epidemiological input are considered and actions to satisfy these identified.
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Affiliation(s)
- Alex Elliott
- Department of Clinical Physics, University of Glasgow, Glasgow G12 8QQ, UK
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12
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Bachmann LM, ter Riet G, Weber WE, Kessels AG. Multivariable adjustments counteract spectrum and test review bias in accuracy studies. J Clin Epidemiol 2009; 62:357-361.e2. [DOI: 10.1016/j.jclinepi.2008.02.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2007] [Revised: 01/29/2008] [Accepted: 02/12/2008] [Indexed: 01/11/2023]
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Alonso-Coello P, Marzo-Castillejo M, Mascort JJ, Hervás AJ, Viña LM, Ferrús JA, Ferrándiz J, López-Rivas L, Rigau D, Solà I, Bonfill X, Piqué JM. [Clinical practice guideline on the management of rectal bleeding (update 2007)]. GASTROENTEROLOGIA Y HEPATOLOGIA 2009; 31:652-67. [PMID: 19174083 DOI: 10.1016/s0210-5705(08)75814-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Pablo Alonso-Coello
- Centro Cochrane Iberoamericano, Servicio de Epidemiología Clínica y Salud Pública (Universidad Autónoma de Barcelona), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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Sun L, Wu H, Guan YS. Colonography by CT, MRI and PET/CT combined with conventional colonoscopy in colorectal cancer screening and staging. World J Gastroenterol 2008; 14:853-63. [PMID: 18240342 PMCID: PMC2687052 DOI: 10.3748/wjg.14.853] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Colorectal cancer (CRC) remains a leading cancer killer worldwide. But the disease is both curable and preventable at an early stage. Regular CRC cancer screening has been shown to reduce the risk of dying from CRC. However, the importance of large-scale screening is only now starting to be appreciated. This article reviews a variety of imaging procedures available for detecting ulcerative colitis (UC) and Crohn’s disease (CD), polyps and CRC in their early stage and also presents details on various screening options. Detecting, staging and re-staging of patients with CRC also require multimodality, multistep imaging approaches. Staging and re-staging with conventional colonoscopy (CC), computer tomography colonography (CTC), magnetic resonance colonography (MRC) and positron emission tomography/computer tomography colonography (PET/CTC) are of paramount importance in determining the most appropriate therapeutic method and in predicting the risk of tumor recurrence and overall prognosis. The advantages and limitations of these modalities are also discussed.
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Pinkernelle J, Bruhn H. Colorectal Cancer. Cancer Imaging 2008. [DOI: 10.1016/b978-012374212-4.50106-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Abstract
With improvements in therapy for colorectal cancer, accurate imaging has taken on an increased significance. Preoperative diagnosis of metastatic disease helps identify patients who could undergo combined resection or might benefit from systemic therapy before surgery. Accurate imaging of rectal cancer is critical in evaluating locally advanced disease treatable by combined modality therapy, including chemoradiation and surgery. Postoperative imaging enhances identification of recurrent disease that might be amenable to salvage surgery.
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Affiliation(s)
- Carl R Schmidt
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA
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Halligan S, Altman DG. Evidence-based Practice in Radiology: Steps 3 and 4—Appraise and Apply Systematic Reviews and Meta-Analyses. Radiology 2007; 243:13-27. [PMID: 17392245 DOI: 10.1148/radiol.2431051823] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A systematic review is performed in attempt to answer a specific research question by means of objective, unbiased evaluation of all pertinent available evidence. Component primary studies are selected on the basis of quality, and, if possible, their results are combined mathematically by using a process known as meta-analysis. While systematic review and meta-analysis are well-established methods to assess trials of therapeutic effects, they are increasingly more common in studies of diagnostic tests. In this article, the authors describe the benefits of a systematic approach over the traditional narrative review, illustrate the process, and examine some problems that are specific to systematic review and meta-analysis of diagnostic tests. They also explain how systematic review can help guide methodologic development for future research.
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Affiliation(s)
- Steve Halligan
- Department of Specialist Radiology, University College Hospital, Podium Level 2, 235 Euston Rd, London NW1 2BU, England.
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Florie J, van Gelder RE, Haberkorn B, Birnie E, Lavini C, Reitsma JB, Stoker J. Magnetic resonance colonography with limited bowel preparation: A comparison of three strategies. J Magn Reson Imaging 2007; 25:766-74. [PMID: 17340636 DOI: 10.1002/jmri.20880] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To prospectively compare three strategies of magnetic resonance colonography (MRC) with fecal tagging. MATERIALS AND METHODS Three strategies were compared: (S1) gadolinium as oral tagging agent and a gadolinium-water mixture for rectal filling (bright lumen), (S2) oral barium and water rectally, and (S3) oral barium and air rectally. In S2 and S3 (both dark lumen) gadolinium was injected intravenously. Three-dimensional (3D) T1-weighted and two-dimensional (2D) T2-weighted sequences were used. Two observers scored diagnostic confidence and image quality (contrast, homogeneity, artifacts), analyzed by chi-squared and Fisher's exact test. Patient experience and preference were determined by questionnaire (Mann-Whitney test). RESULTS A total of 45 patients were included, 15 were randomly assigned per strategy. Diagnostic confidence of S1 and S3 is significantly better than for S2. S1 has the additional advantage of showing significantly better contrast between bowel wall and lumen, and showing significantly better homogeneity on both T1- and T2-weighted sequences, but with significantly more artifacts on the T1-weighted sequences. S3 showed significantly better contrast and homogeneity than S2 on the T2-weighted sequences. Bowel preparation of S1 was rated significantly better. Patient preference was comparable. CONCLUSION Image quality was best using the bright lumen strategy or the dark lumen strategy using air for rectal filling. Although bowel preparation was rated best using the bright lumen strategy, patient preference was comparable.
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Affiliation(s)
- Jasper Florie
- Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
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SLATER A. Alteration in bowel habit. IMAGING 2006. [DOI: 10.1259/imaging/15701929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Abstract
Screening of asymptomatic average-risk patients for presence of colon cancer and early detection in precursor stages is of great interest to general population. Comprehensive evaluation of symptomatic or high-risk patients represents another important clinical focus. Available techniques for total colon imaging, rectal cancer staging and the role of positron emission tomography are discussed.
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Affiliation(s)
- Christoph Wald
- Department of Diagnostic Radiology, Lahey Clinic Medical Center, 41 Mall Road, Burlington, MA 01805, USA.
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Halligan S. Systematic reviews and meta-analysis of diagnostic tests. Clin Radiol 2005; 60:977-9. [PMID: 16124979 DOI: 10.1016/j.crad.2005.04.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2005] [Accepted: 04/26/2005] [Indexed: 01/18/2023]
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