Diagnostic accuracy of computed tomography colonography in patients at high risk for colorectal cancer: a meta-analysis.

AIM: To explore the diagnostic value of computed tomography colonography (CTC) compared with conventional colonoscopy in individuals at high risk for colorectal cancer (CRC). METHOD: PubMed, EMBASE, the Cochrane Library and the Web of Science were searched by two independent reviewers for potentially eligible studies published up until 31 October 2018 that were based on a per-patient analysis. STATA, Meta-DiSc, and Revman were used to perform this meta-analysis. A random effect model was used, and a subgroup analysis was conducted to explore the sources of heterogeneity. RESULTS: A total of 14 full-text articles, containing 3578 patients, were included in this meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR) and the area under the summary receiver operating characteristic (SROC) curve (AUC) of CTC for detecting polyps >/=6mm were 0.87 (95% CI, 0.83-0.90), 0.90 (95% CI, 0.86-0.93), 9.08 (95% CI, 6.28-13.13), 0.14 (95% CI, 0.11-0.18) and 0.94 (95% CI, 0.92-0.96), respectively. For polyps >/=10mm, the pooled sensitivity, specificity, PLR and NLR of CTC were 0.91 (95% CI, 0.86-0.94), 0.98 (95% CI, 0.95-0.99), 40.36 (95% CI, 19.16-85.03), 0.90(95% CI, 0.06-0.14) and 0.98 (95% CI, 0.96-0.99), respectively. CONCLUSION: In this meta-analysis, CTC had high diagnostic accuracy for detecting polyps >/=6mm and >/=10mm in patients at high risk of developing CRC and it had a higher sensitivity and specificity for detecting polyps >/=10mm than polyps >/=6mm. However, the results should be used cautiously due to the significant heterogeneity.