Diffusion-weighted MRI for the detection of colorectal polyps: feasibility study |
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Authors: | Anke M Leufkens Thomas C Kwee Maurice AAJ van den Bosch Willem PThM Mali Taro Takahara Peter D Siersema |
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Institution: | 1. Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands;2. Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands |
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Abstract: | The purpose of this study was to determine the feasibility of diffusion-weighted magnetic resonance imaging (DWI) for detecting colorectal polyps. DWI (high b-value of 1000 s/mm2) was prospectively performed in 26 symptomatic patients who were scheduled to undergo colonoscopy. DWI and colonoscopic findings were interpreted in a blinded manner. The sensitivity and positive predictive value (PPV) of DWI for the detection of clinically relevant polyps (≥ 6 mm) and colorectal cancer (CRC) were calculated on a per-lesion basis, using colonoscopy results as the standard of reference. Sensitivity, specificity, PPV and negative predictive value (NPV) on a per-patient basis were also calculated. Sensitivity and PPV on a per-lesion basis were 80.0% 95% confidence interval (CI): 49.0%–94.3%] and 72.7% (95% CI: 43.4%–90.3%) for polyps ≥ 6 mm and CRC. Sensitivity, specificity, PPV and NPV on a per-patient basis were 85.7% (95% CI: 48.7%–97.4%), 84.2% (95% CI: 62.4%–94.5%), 66.7% (95% CI: 35.4%–87.9%) and 94.1% (95% CI: 73.0%–99.0%) for polyps ≥ 6mm and CRC. In conclusion, DWI cannot yet be recommended in a clinical setting in which DWI is performed first and subsequent colonoscopy is only performed in patients with positive findings at DWI. Further (technical) developments are required to increase its diagnostic yield. |
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Keywords: | Colorectal Polyps Carcinoma Magnetic resonance imaging MRI Diffusion-weighted |
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