Prospective, blinded comparison of helical CT and CT arterial portography in the assessment of hepatic metastasis from colorectal carcinoma Journal Article

Authors: Schwartz, L.; Brody, L.; Brown, K.; Covey, A.; Tuorto, S.; Mazumdar, M.; Riedel, E.; Jarnagin, W.; Getrajdman, G.; Fong, Y.
Article Title: Prospective, blinded comparison of helical CT and CT arterial portography in the assessment of hepatic metastasis from colorectal carcinoma
Abstract: Objective: This prospective blinded comparison of helical CT and helical CT arterial portography aimed to detect liver metastasis from colorectal carcinoma. Methods and Materials: 50 patients with colorectal carcinoma were evaluated comparing helical CT with helical CT arterial portography. Each imaging study was evaluated on a 5-point ROC scale by radiologists blinded to the other imaging findings, and the results were compared, with the surgical and pathologic findings as the gold standard. Results: Of the 127 lesions found at pathology identified as metastatic colorectal cancer, helical CT correctly identified 85 (69%) and CT portography 96 (76%). When subgroups with lesions <3 cm (48 patients) and patients with maximum tumor size <3 cm (18 patients) were considered, CT portography was always better than helical CT in terms of sensitivity, specificity, positive predictive value, and negative predictive value. ROC analysis adjusting for multiple lesions per patient revealed significantly greater area under the curve (AUC) for the subgroup of lesions <3 cm (CT-AUC of 77% and CT portography AUC of 81%; P = 0.002). Conclusions: For identification of large metastases, helical CT and CT portography have similar yield. However, for detection of small liver metastases, CT portography remains superior for lesion detectability. © 2006 Société Internationale de Chirurgie.
Keywords: adult; controlled study; middle aged; cancer surgery; major clinical study; area under the curve; liver neoplasms; follow-up studies; cancer diagnosis; neoplasm staging; sensitivity and specificity; prospective studies; reproducibility of results; computer assisted tomography; diagnosis, differential; tumor volume; diagnostic imaging; colorectal carcinoma; colorectal neoplasms; tomography, spiral computed; liver metastasis; statistical significance; diagnostic value; predictive validity; hepatectomy; roc curve; spiral computer assisted tomography; portal phlebography; portography
Journal Title: World Journal of Surgery
Volume: 30
Issue: 10
ISSN: 0364-2313
Publisher: Springer  
Date Published: 2006-10-01
Start Page: 1892
End Page: 1899
Language: English
DOI: 10.1007/s00268-005-0483-1
PUBMED: 16855806
PROVIDER: scopus
PMCID: PMC1578594
Notes: --- - "Export Date: 4 June 2012" - "CODEN: WJSUD" - "Source: Scopus"
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MSK Authors
  1. Madhu Mazumdar
    123 Mazumdar
  2. Lawrence H Schwartz
    281 Schwartz
  3. Anne Covey
    119 Covey
  4. William R Jarnagin
    590 Jarnagin
  5. Yuman Fong
    745 Fong
  6. Lynn Brody
    93 Brody
  7. Karen T Brown
    163 Brown
  8. Scott J Tuorto
    23 Tuorto