Routine Abdomen/Pelvis CT Scans for discovering colorectal cancer
In a recent study, the detection rate of colorectal cancer (CRC) using routine abdomen and pelvis CT scans was analysed. The research, which included 204 CT exams, aimed to report the performance of this diagnostic tool in a mixed dataset containing scans from both CRC patients and those without the disease [1].
The study found that the radiologists involved demonstrated a sensitivity of 64-77% and specificity of 83-86% for the detection of CRC. However, it was noted that the average maximum tumor diameter was significantly larger for detected cancers (4.8 ± 2.8 cm) compared to missed ones (2.8-2.9 cm) [2]. This suggests that while routine abdomen/pelvis CT scans can be effective for detecting larger colorectal tumors, they may fall short when it comes to identifying small CRCs.
The study also highlighted the importance of regional lymphadenopathy as a highly specific finding for CRC. The presence of lymph nodes with abnormal size or structure was a strong predictive feature for the disease [3].
In contrast, CT colonography (CTC), a specialized CT technique, has shown superior performance in detecting colorectal cancers, including small lesions. CTC is designed as a colorectal cancer screening tool and can visualize the colon lumen in detail, making it more sensitive for detecting small tumors compared to routine abdomen/pelvis CT scans [4].
The findings of this study underscore the importance of using appropriate diagnostic tools for colorectal cancer screening. While routine abdomen/pelvis CT scans are effective for detecting metastatic disease and larger colorectal tumors, they are less effective for detecting small colorectal cancers compared to dedicated screening tools like CT colonography or colonoscopy [5].
References: [1] Study on the detection rate of colorectal cancer in a mixed dataset containing CT exams from both patients with and without cancer. [2] Radiologist-reported diagnostic confidence was strongly associated with diagnostic accuracy. [3] Regional lymphadenopathy is a highly specific finding for colorectal cancer. [4] CT colonography (CTC) is a specialized CT technique designed as a colorectal cancer screening tool, demonstrating superior performance compared to stool-based tests. [5] CT colonography enhances detection sensitivity, including for smaller lesions, as it is specifically designed for colorectal screening with fine intraluminal imaging, while conventional abdomen/pelvis CT serves more for staging and metastasis detection rather than early tumor identification.
- To effectively detect small colorectal cancers, it's crucial to consider alternative health-and-wellness strategies beyond routine abdomen and pelvis CT scans, such as specialized therapies-and-treatments like CT colonography.
- In light of this study, medical-conditions like colorectal cancer could benefit from the use of appropriate health-and-wellness approaches that prioritize the identification of small lesions, like CT colonography, over routine abdomen and pelvis CT scans which are better suited for metastatic disease and larger tumors detection.
