CT colonography versus optical colonoscopy and double contrast barium enema in the detection of colorectal neoplasia: a comparative analysis

Capel, Robert (2009) CT colonography versus optical colonoscopy and double contrast barium enema in the detection of colorectal neoplasia: a comparative analysis. BSc dissertation, University of Portsmouth.

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    Abstract

    Aim: To discuss whether or not Computed Tomographic colonoscopy is more suited as a second line imaging modality in the detection of colorectal neoplasia in contrast to other possible modalities. Methods: A search strategy was formulated to allow for the gathering of reliable and valid literature that addressed the subject of comparing CT colonography (CTC) to double contrast barium enema (DCBE) and optical colonoscopy (OC). Both quantitative and qualitative comparisons were conisdered. In total 14 papers were found to satisfy the inclusion criteria of the study, and taken forward for critical analysis. The papers comprised of nine comparative cohort studies, two meta-analyses, and one qualitative cohort study. Results: Sensitivity and specificity results have been obtained from the studies, along with the key comparisons between the three modalities. This has allowed for the areas where possible performance affecting variables are located to be discussed and a direct comparison of CTC to both OC and DCBE to be made. The advantages and limitations of CTC as a modality have also been highlighted. Conclusions and Recommendations: Based on the findings of this literature review, CTC has been shown to exceed, or at least equal, the performance of DCBE. Once other factors are also taken into consideration, CTC may be considered to be the more appropriate modality, although at the time of writing, CTC is still inferior to OC in the detection of colorectal neoplasia. OC remains the "gold standard" modality. Key recommendations were that there needs to be a strict standardisation of bowel preparation technique, scan parameters, and the training and experience required by persons to report on CTC examinations. Further research into the cost-effectiveness of CTC, its current areas of development, and the performance effect of radiation dose reduction is required.

    Item Type: Dissertation
    Departments/Research Groups: Faculty of Science > School of Health Sciences and Social Work
    Depositing User: Jane Polwin
    Date Deposited: 20 Jan 2011 12:48
    Last Modified: 28 Jan 2015 11:14
    URI: http://eprints.port.ac.uk/id/eprint/648

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