Kolon Hastalıklarında Sanal Kolonoskopinin Tanısal Değeri

Year 2025, Volume: 16 Issue: 1, 27 - 33, 25.03.2025

İhsaniye Süer Doğan , Esin Çakmakçı Midia , Yıldıran Songür , Baki Hekimoğlu

https://doi.org/10.18663/tjcl.1603140

Abstract

Amaç: Çok kesitli bilgisayarlı tomografi (BT) kolonografinin kolorektal lezyonların görülmesindeki ve ek bulguların araştırılmasındaki etkinliğini değerlendirmektir.
Gereç ve Yöntemler: Kolorektal patolojisi olan veya klinik olarak şüphelenilen 22 hastaya aynı gün BT kolonografi sonra konvansiyonel kolonoskopi incelemesi yapıldı. Çok kesitli BT kolonografi, konvansiyonel kolonoskopi sonuçları karşılaştırıldı.
Bulgular: BT kolonografi de 22 hastanın 10 tanesi (%45) normal olarak değerlendirildi. Dört hastada (%18) barsak duvarında kalınlaşma, 8 hastada (%36) polipoid lezyon saptandı. Konvansiyonel kolonoskopi de saptanan 9 polipoid lezyonun 8 tanesi BT kolonografi de saptandı. Boyut farkı gözetmeksizin tüm polipoid lezyonlarda BT kolonografinin duyarlılığı %89, 1 cm’den küçük polipoid lezyonlarda %50, 1 cm’den büyük polipoid lezyonlarda %100 bulundu.
Sonuç: BT kolonografisinin kolorektal polipoid lezyonları tespit etme duyarlılığı %89 olarak bulundu. Bu sonuçlar BT kolonografisinin kolonun kapsamlı değerlendirilmesi için değerli bir tanı yöntemi olduğunu göstermektedir. BT kolonografisi, kolorektal lezyonları tespit etmedeki yüksek duyarlılığı ve nispeten güvenli ve minimal invaziv yapısı nedeniyle geleneksel kolorektal kanser tarama yöntemlerine uygulanabilir bir alternatif sunmaktadır.

Keywords

Bilgisayarlı Tomografi Kolonografi, Kolonoskopi, Kolon Polip, Kolorektal Neoplazmalar

Ethical Statement

This thesis study was conducted with the permission of the Radiology Department of Social Security Institution Dışkapı Ankara Training Hospital (ethical approval date: 18.07.2022 no: 08)

The Diagnostic Value of Virtual Colonoscopy in Colonic Diseases

Abstract

Aim: This study aims to assess the diagnostic accuracy of multi-slice computed tomography (CT) colonography in
detecting colorectal lesions.
Material and Methods: 22 patients with confirmed or clinically suspected colorectal pathology underwent multi-slice CT colonography followed by conventional colonoscopy on the same day. The diagnostic findings of multi-slice CT colonography were compared with those obtained from conventional colonoscopy.
Results: Of 22 patients who underwent CT colonography, 10 (45%) were evaluated as normal. Bowel wall thickening was observed in 4 patients (18%), while polypoid lesions were detected in 8 (36%). Among the 9 polypoid lesions identified through conventional colonoscopy, 8 were also detected by CT colonography. The overall sensitivity of CT colonography for polypoid lesions, regardless of size, was 89%. Sensitivity was 50% for lesions smaller than 1 cm and 100% for lesions larger than 1 cm. When polypoid lesions were evaluated according to their histology, the sensitivity of CT Colonography was found to be 50% in tubular adenoma, 100% in tubulovillous adenoma, and 100% in adenocarcinoma.
Conclusion: The sensitivity of CT colonography for detecting colorectal polypoid lesions was found to be 89%. These results indicate that CT colonography is a valuable diagnostic modality for comprehensive evaluation of the colon. CT colonography represents a viable alternative to traditional colorectal cancer screening methods due to its high sensitivity for detecting colorectal lesions, coupled with its relatively safe and minimally invasive nature.

Keywords

Computed Tomography Colonography, Colonoscopy, Colonic Polyp, Colorectal Neoplasms

Ethical Statement

This thesis study was conducted with the permission of the Radiology Department of Social Security Institution Dışkapı Ankara Training Hospital (ethical approval date: 18.07.2022 no: 08)

References

• Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209–49.
• Duan B, Zhao Y, Bai J, Wang J, Duan X, Luo X, et al. Colorectal Cancer: An Overview. In: Morgado-Diaz JA, editor. Gastrointestinal Cancers [Internet]. Brisbane (AU): Exon Publications; 2022 Sep 30. Chapter 1.
• Chung DJ, Huh KC, Choi WJ, Kim JK. CT colonography using 16-MDCT in the evaluation of colorectal cancer. AJR Am J Roentgenol. 2005;184(1):98–103.
• Sha J, Chen J, Lv X, Liu S, Chen R, Zhang Z. Computed tomography colonography versus colonoscopy for detection of colorectal cancer: a diagnostic performance study. BMC Med Imaging. 2020;20(1):51.
• Zygulska AL, Pierzchalski P. Novel Diagnostic Biomarkers in Colorectal Cancer. Int J Mol Sci. 2022;23(2):852.
• Gupta S. Screening for Colorectal Cancer. Hematol Oncol Clin North Am. 2022;36(3):393-414.
• Spada C, Hassan C, Bellini D, Burling D, Cappello G, Carretero C,et al. Imaging alternatives to colonoscopy: CT colonography and colon capsule. European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) Guideline - Update 2020. Eur Radiol. 2021;31(5):2967-2982.
• Kadari M, Subhan M, Saji Parel N, Krishna PV, Gupta A, Uthayaseelan K, et al. CT Colonography and Colorectal Carcinoma: Current Trends and Emerging Developments. Cureus. 2022;14(5): e24916.
• Hara AK, Johnson CD, Reed JE, Ahlquist DA Nelson H, Ehman RL, et al. Detection of colorectal polyps by computed tomographic colography: feasibility of a novel technique. Gastroenterology. 1996;110(1):284-90.
• Hara AK, Johnson CD, Reed JE, Ahlquist DA Nelson H, MacCarty RL, Harmsen WS, Ilstrup DM. Detection of colorectal polyps with CT colography: initial assessment of sensitivity and specificity. Radiology. 1997;205(1):59-65.
• Fletcher JG, Johnson CD, Welch TJ, MacCarty RL, Ahlquist DA, Reed JE, et al. Optimization of CT colonography technique: prospective trial in 180 patients. Radiology. 2000;216(3):704-11.
• Hara AK, Johnson CD, MacCarty RL, Welch TJ, McCollough CH, Harmsen WS. CT colonography: single- versus multi-detector row imaging. Radiology. 2001;219(2):461-5.
• Yee J, Akerkar GA, Hung RK, Steinauer-Gebauer AM, Wall SD, McQuaid KR. Colorectal neoplasia: performance characteristics of CT colonography for detection in 300 patients. Radiology. 2001;219(3):685-92.
• Mulhall BP, Veerappan GR, Jackson JL. Meta-analysis: computed tomographic colonography. Ann Intern Med. 2005 Apr 19;142(8):635-50.
• Sato K, Tanaka T, Sato J, Shibata E, Nagai Y, Murono K, et al. Usefulness of preoperative CT colonography for colon cancer. Asian J Surg. 2017;40(6):438-43.
• Weinberg DS, Pickhardt PJ, Bruining DH, Edwards K, Fletcher JG, Gollub MJ, et al. Computed Tomography Colonography vs Colonoscopy for Colorectal Cancer Surveillance After Surgery. Gastroenterology. 2018;154(4):927-934.e4.
• Royster AP, Fenlon HM, Clarke PD, Nunes DP, Ferrucci JT. CT colonoscopy of colorectal neoplasms: two-dimensional and three-dimensional virtual-reality techniques with colonoscopic correlation. AJR Am J Roentgenol. 1997;169(5):1237-42.
• Ryu HS, Kim HJ, Ji WB, Kim BC, Kim JH, Moon SK, et al. Colon cancer: the 2023 Korean clinical practice guidelines for diagnosis and treatment. Ann Coloproctol. 2024;40(2):89-113.
• Fenlon HM, McAneny DB, Nunes DP, Clarke PD, Ferrucci JT. Occlusive colon carcinoma: virtual colonoscopy in the preoperative evaluation of the proximal colon. Radiology. 1999;210(2):423-8.
• Arora G, Mannalithara A, Singh G, Gerson LB, Triadafilopoulos G. Risk of perforation from a colonoscopy in adults: a large population-based study. Gastrointest Endosc. 2009; 69:654–64.
• Warren JL, Klabunde CN, Mariotto AB, Meekins A, Topor M, Brown ML, et al. Adverse events after outpatient colonoscopy in the Medicare population. Ann Intern Med. 2009; 150:849–57.