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The Effect of Diagnostic Confidence on the Probability of Optical Colonoscopic Confirmation of Potential Polyps Detected on CT Colonography: Prospective Assessment in 1,339 Asymptomatic Adults

Perry J. Pickhardt1,2,3, J. Richard Choi3,4, Pamela A. Nugent2 and William R. Schindler5

1 Department of Radiology, University of Wisconsin Medical School, E3/311 Clinical Science Center, 600 Highland Ave., Madison, WI 53792-3252.
2 Department of Radiology, National Naval Medical Center, Bethesda, MD 20889.
3 Department of Radiology and Nuclear Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814.
4 Department of Radiology, Walter Reed Army Medical Center, Washington, DC 20307-5001.
5 Department of Gastroenterology, Naval Medical Center-San Diego, San Diego, CA 92134-5000.



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  		Fig. 1. —Line graph shows relationship between diagnostic confidence level for lesions detected on CT colonography and likelihood that matching polyps will be found on optical colonoscopy. For each category of polyp size, likelihood of match increases as diagnostic confidence increases. In addition, relative spread between match rates generally increases at larger polyp sizes. {diamondsuit} = level-1 confidence, {blacksquare} = level-2 confidence, {blacktriangleup} = level-3 confidence.

 


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  		Fig. 2. —Line graph shows relationship between diagnostic confidence level for lesions detected on CT colonography and likelihood that adenomatous (neoplastic) polyps will be found on optical colonoscopy. For each category of polyp size, likelihood of adenoma match increases as diagnostic confidence increases. Note that, as in Figure 1, relative spread between match rates generally increases at larger polyp sizes. {diamondsuit} = level-1 confidence, {blacksquare} = level-2 confidence, {blacktriangleup} = level-3 confidence.

 

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