Format

Send to

Choose Destination
Ann Intern Med. 2004 Sep 7;141(5):352-9.

Location of adenomas missed by optical colonoscopy.

Author information

1
Department of Radiology, University of Wisconsin Medical School, E3/311 Clinical Science Center, 600 Highland Avenue, Madison, WI 53792-3252, USA. ppickhardt@mail.radiology.wisc.edu

Abstract

BACKGROUND:

Previous estimates of the adenoma miss rate with optical colonoscopy (OC) are hindered by the use of OC as its own reference standard.

OBJECTIVE:

To evaluate the frequency and characteristics of colorectal neoplasms that are missed prospectively on OC by using virtual colonoscopy (VC) as a separate reference standard.

DESIGN:

Prospective, multicenter screening trial.

SETTING:

3 medical centers.

PARTICIPANTS:

1233 asymptomatic adults who underwent same-day VC and OC.

MEASUREMENTS:

Colorectal neoplasms (adenomatous polyps) missed at OC before VC results were unblinded.

RESULTS:

Fourteen (93.3%) of 15 nonrectal neoplasms were located on a fold; 10 (71.4%) of these were located on the backside of a fold. Five (83.3%) of 6 rectal lesions were located within 10 cm of the anal verge.

LIMITATIONS:

Estimation of the OC miss rate depended on polyp detection on both VC and second-look OC and therefore underestimates the true OC miss rate, particularly for smaller polyps.

CONCLUSIONS:

Most clinically significant adenomas missed prospectively on OC are located behind a fold or near the anal verge. The 12% OC miss rate for large adenomas (>or=10 mm) when state-of-the-art 3-dimensional VC is used as a separate reference standard is increased from the previous 0% to 6% estimates derived by using OC as its own reference standard.

PMID:
15353426
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center