Multidetector-row CT duodenography in familial adenomatous polyposis: a pilot study

AIM: To investigate the feasibility of using multidetector-row computed tomography (CT) duodenography to stage duodenal polyposis in patients with familial adenomatous polyposis. MATERIALS AND METHODS: Six patients underwent multidetector-row CT duodenography before upper gastrointestinal endoscopy....

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Bibliographic Details
Published in:Clinical radiology 2004-10, Vol.59 (10), p.939-945
Main Authors: Taylor, S.A., Halligan, S., Moore, L., Saunders, B.P., Gallagher, M., Phillips, R.K.S., Bartram, C.I.
Format: Article
Language:English
Subjects:
Adenomatous polyposis coli
Adenomatous Polyposis Coli - diagnostic imaging
Adult
Biological and medical sciences
Cohort Studies
Computed tomography (CT)
Duodenal Neoplasms - diagnostic imaging
Duodenum - diagnostic imaging
Duodenum, neoplasms
Endoscopy, Gastrointestinal
Feasibility Studies
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Medical sciences
Middle Aged
Neoplasm Staging - methods
Pilot Projects
Retrospective Studies
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Tomography, X-Ray Computed - instrumentation
Tomography, X-Ray Computed - methods
Tumors
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Summary:AIM: To investigate the feasibility of using multidetector-row computed tomography (CT) duodenography to stage duodenal polyposis in patients with familial adenomatous polyposis. MATERIALS AND METHODS: Six patients underwent multidetector-row CT duodenography before upper gastrointestinal endoscopy. A single-blinded radiologist used a surface shaded three-dimensional endoluminal fly though and two-dimensional axial and multiplanar reformats to assign a score for maximum polyp size and number based on the Spigelman classification. Comparison was made with the corresponding Spigelman scores obtained from subsequent endoscopy. RESULTS: CT duodenography was technically successful in five of six patients. The CT derived Spigelman score based on maximum polyp size was accurate in all five patients. The CT derived Spigelman score based on polyp number was accurate in only two cases: Polyp number was overestimated in one patient and underestimated in a further two. In retrospect, fine carpeting of tiny duodenal polyps was poorly visualized with CT. CONCLUSIONS: CT duodenography is technically feasible and accurately predicts maximum polyp size but CT estimates of polyp number are relatively inaccurate. CT duodenography potentially has a useful role for duodenal surveillance in those patients intolerant of conventional endoscopy.
ISSN:0009-9260
1365-229X
DOI:10.1016/j.crad.2004.05.011