CT Colonography (CTC) Update: September, 2008

Mission

ICER's mission is to lead innovation in comparative effectiveness research through methods that integrate considerations of clinical benefit and economic value. Through a unique collaboration with patients, clinicians, manufacturers, insurers and other healthcare stakeholders, ICER develops tools to support patient decisions and medical policy that share the goal of achieving maximum value for every healthcare dollar.

Staff Only

Original Review Release Date: January 31, 2008

In order to aid decision-makers in applying the results of its reviews, ICER provides updates on new evidence during the first year after the release of a final appraisal document. An ICER update seeks to give perspective on new evidence in light of the original conclusions of the appraisal.

New Evidence

Results from the National CT Colonography Trial, conducted by the American College of Radiology Imaging Network (ACRIN), were published in the September 18, 2008 issue of the New England Journal of Medicine.1 In the ACRIN study, the largest multicenter study of CTC published to date, over 2,500 asymptomatic patients were scheduled for optical colonoscopy at 15 clinical sites across the U.S. Patients first received CTC, followed by same-day colonoscopy in most cases. CTC sensitivity and specificity for detecting polyps ≥10 mm in size were 90% and 86%. As expected, sensitivity and specificity for polyps ≥6 mm were somewhat lower (78%, 88%). The range of sensitivity across individual radiologist interpreters was 67%-100%. Extracolonic findings were reported in 66% of the participants; 16% were deemed to require either additional evaluation or urgent care. No data on the subsequent outcomes or costs due to incidental findings were reported.