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首页> 外文期刊>Academic radiology >CT colonography versus optical colonoscopy for screening asymptomatic patients for colorectal cancer a patient, intervention, comparison, outcome (PICO) analysis.
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CT colonography versus optical colonoscopy for screening asymptomatic patients for colorectal cancer a patient, intervention, comparison, outcome (PICO) analysis.

机译：CT结肠造影与光学结肠镜检查对无症状患者进行大肠癌筛查的患者，干预，比较，结局（PICO）分析。

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RATIONALE AND OBJECTIVES: The American College of Radiology has recently endorsed the use of computed tomographic colonography (CTC) for colon cancer screening. With advances in technology and postprocessing software, the quality of computed tomographic colonographic studies has improved, and new techniques are being developed to reduce radiation exposure and increase patient acceptance of the procedure. The aim of colorectal cancer screening is to reduce the incidence of malignancy by identifying and removing presymptomatic lesions. The aim of this study was to answer the clinical question: In an asymptomatic patient at average risk for colon cancer, is CTC equivalent to optical colonoscopy (OC) for detecting clinically significant polyps? MATERIALS AND METHODS: A systematic literature review was conducted to evaluate CTC compared to OC, using the patient, intervention, comparison intervention, outcome (PICO) search strategy. The PubMed search used Medical Subject Headings, including the terms "computed tomography colonography," "colonoscopy," "screening," and "polyp." Each of the retrieved articles was assigned a level of evidence using the Centre for Evidence-Based Medicine's hierarchy of validity for diagnostic studies. RESULTS: PICO search criteria and review of abstracts identified 16 relevant studies. Using the Centre for Evidence-Based Medicine's hierarchy of validity, there were three level 1c studies, two level 2a studies, three level 2b studies, four level 3b studies, two level 4 studies, and two level 5 studies. All relevant studies demonstrated that CTC had high or moderately high per patient and per polyp sensitivity and specificity compared to OC for clinically relevant polyps (>5 mm). CONCLUSIONS: The majority of evidence suggests that CTC is an acceptable alternative to OC, particularly in the group of patients who are either unwilling or unable to undergo OC. The results of the large, multicenter American College of Radiology Imaging Network study are pending. This trial presented preliminary results in 2007 suggesting that the sensitivity and specificity of CTC are high and comparable to those of OC.
机译：理由和目标：美国放射学院最近批准了计算机断层摄影结肠成像（CTC）用于结肠癌筛查。随着技术和后处理软件的进步，计算机断层摄影结肠成像研究的质量得到了改善，并且正在开发新技术以减少辐射暴露并提高患者对该程序的接受度。结肠直肠癌筛查的目的是通过识别和消除症状前病变来减少恶性肿瘤的发生。这项研究的目的是回答临床问题：在无症状的平均结肠癌风险患者中，CTC是否等同于光学结肠镜检查（OC）以检测具有临床意义的息肉？材料与方法：使用患者，干预，比较干预，结果（PICO）搜索策略，进行了系统的文献综述，以评估CTC与OC的比较。 PubMed搜索使用了医学主题词，包括术语“计算机断层扫描结肠造影”，“结肠镜检查”，“筛查”和“息肉”。使用基于证据的医学中心对诊断研究的有效性等级，为每篇检索的文章分配了一定程度的证据。结果：PICO检索标准和摘要审查确定了16项相关研究。使用循证医学中心的有效性等级，有3个1c级研究，2个2a级研究，3个2b级研究，4个3b级研究，两个4级研究和两个5级研究。所有相关研究表明，与OC有关的临床相关息肉（> 5 mm）相比，CTC对每个患者和每个息肉的敏感性和特异性均较高或中等。结论：大多数证据表明CTC是OC的可接受替代方案，特别是在不愿或无法接受OC的患者群体中。大型，多中心的美国放射学院影像网络研究的结果正在等待中。该试验在2007年提供了初步结果，表明CTC的敏感性和特异性很高，与OC相当。

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