Suspected extracolonic neoplasms detected on CT colonography: literature review and possible outcomes.
Suspected extracolonic neoplasms detected on CT colonography: literature review and possible outcomes.
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DOI：
10.1016/j.acra.2013.01.017
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发表时间：
2013-06
影响因子：
4.8
通讯作者：
Zafar HM
中科院分区：
文献类型：
--
作者：
Wernli KJ;Rutter CM;Dachman AH;Zafar HM
This study summarizes the literature on the detection of cancer among indeterminate extracolonic findings on CT colonography in five targeted organs. We searched PubMed for English-language literature published between January 1, 1994 and December 31, 2010. We describe extracolonic findings in the kidney, lung, liver, pancreas, and ovary suspect for malignancy as they are associated with high mortality. For each organ, we calculated the median prevalence, positive predictive value (PPV), and false positive rate of malignancy, and a pooled false-positive rate across studies. Of 91 publications initially identified, 24 were eligible for review. Indeterminate renal masses on CT colonography had 20.5% median PPV and low pooled false positive rate of 1.3% (95% CI 0.6–2.0). In contrast, indeterminate masses of the lung, liver, pancreas, and ovary had low PPV (medians ranged from 0–3.8%). Indeterminate masses of the ovary resulted in the highest pooled false-positive rate of 2.2%. Results were similar in studies of both screening and non-screening populations. We estimated the probability of false positive results through the detection of significant extracolonic findings as 46 per 1,000 for men and 68 per 1,000 for women. Indeterminate renal masses newly detected on CT colonography have an estimated one in five chance of malignancy and therefore warrant further follow-up to provide a definitive diagnosis. Conversely, indeterminate masses of the lung, liver, pancreas, and ovary are associated with high false positive rates and merit more conservative clinical follow-up.
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