Desempenho da colonografia tomográfica computadorizada com marcação fecal para o rastreamento de pólipo colorretal : revisão sistemática e metanálise

Abstract

Imaging screening in asymptomatic patients to look for polyps is the main form of prevention against CRC. Computed tomography colonography (CTC) has emerged as an alternative to the traditional gold standard, optical colonoscopy. However, the cathartic preparations also used in this method have an impact on patient tolerance and test acceptance. Therefore, new schemes that include fecal marking, with reduction or elimination of catharsis have been published in the last two decades. Therefore, the aim of the present study was to compare the diagnostic performance of CTC with fecal tagging and optical colonoscopy for the detection of clinically significant polyps. Materials and methods: Systematic review and meta-analysis. MEDLINE (via PUBMED), EMBASE, LILACS, Scopus and Web of Science databases were searched from January 2001 (first article with CT colonography without cathartic preparation) to January 2022. Data collection and extraction were performed by two independent researchers. The quality of the studies was analyzed according to the QUADAS-2 tool. The diagnostic performance test was performed using the Meta-Disc software version 1.4. Results: 266 studies were identified, and 11 were eligible for meta-analysis, comprising 3,941 subjects (mean age 59.1 ± 6.0 years). The pooled sensitivity and specificity were 0.88 (95% CI 0.82 – 0.92) and 0.97 (95% CI 0.95 – 0.98), respectively, with an accuracy of 0.94. Moderate heterogeneity was found for sensitivity (67.4%) and specificity (61.1%). Conclusions: the present meta-analysis showed good diagnostic performance of CT colonography with fecal labeling to detect clinically significant polyps.