Biomedical subjects

Amy K Hara

Publications and source records attributed to Amy K Hara.

3 recordsLinked to original sources

PubMed2003

Small bowel: preliminary comparison of capsule endoscopy with barium study and CT.

PURPOSE: To retrospectively compare capsule endoscopic (CE) findings with findings at barium studies or computed tomography (CT) in patients without evidence of small-bowel stricture at barium examination. MATERIALS AND METHODS: Fifty-two patients underwent CE, and the majority (43 of 52) did so for obscure gastrointestinal bleeding. Forty-two (81%) of 52 patients underwent 36 small-bowel follow-through examinations; four, enteroclysis; and 19, contrast material-enhanced CT of the abdomen and pelvis within 6 months of CE (either before or after CE). Imaging results were retrospectively reviewed and compared with CE, standard endoscopic, and surgical results. Findings of any examinations between CE and imaging that were discrepant were retrospectively reviewed by a radiologist not blinded to CE results. Proportion of positive findings at CE was compared with proportion of positive findings at barium studies and CT in the same patients. Statistical significance was calculated with McNemar chi2 statistic. RESULTS: Barium examination findings were positive in one (3%) of 40 patients; CE findings were positive in 22 (55%) (P <.001). CT demonstrated small-bowel findings in four (21%) of 19 patients, but CE demonstrated findings in 12 (63%) of 19 patients (P =.02). The most common CE finding, angioectasia (n = 11), was not detected at any imaging study. More ulcers (n = 8) were detected with CE than with barium study (one of eight) and CT (three of six). At CE, three of five surgically confirmed masses (carcinoid, intussusception, lymphangioma) were identified, but two jejunal tumors were not detected in a patient with poor bowel preparation. At barium study, no masses (zero of five) were detected; at CT, one of four masses was detected. CONCLUSION: In patients without a small-bowel stricture at barium study, more small-bowel disease was found at CE when findings were retrospectively compared with barium examination and CT findings.

Adult↗

PubMed2003

Computerized tomographic colonography: performance evaluation in a retrospective multicenter setting.

BACKGROUND & AIMS: No multicenter study has been reported evaluating the performance and interobserver variability of computerized tomographic colonography. The aim of this study was to assess the accuracy of computerized tomographic colonography for detecting clinically important colorectal neoplasia (polyps >or=10 mm in diameter) in a multi-institutional study. METHODS: A retrospective study was developed from 341 patients who had computerized tomographic colonography and colonoscopy among 8 medical centers. Colonoscopy and pathology reports provided the standard. A random sample of 117 patients, stratified by criterion standard, was requested. Ninety-three patients were included (47% with polyps >or=10 mm; mean age, 62 years; 56% men; 84% white; 40% reported colorectal symptoms; 74% at increased risk for colorectal cancer). Eighteen radiologists blinded to the criterion standard interpreted computerized tomography colonography examinations, each using 2 of 3 different software display platforms. RESULTS: The average area under the receiver operating characteristic curve for identifying patients with at least 1 lesion >or=10 mm was 0.80 (95% lower confidence bound, 0.74). The average sensitivity and specificity were 75% (95% lower confidence bound, 68%) and 73% (95% lower confidence bound, 66%), respectively. Per-polyp sensitivity was 75%. A trend was observed for better performance with more observer experience. There was no difference in performance across software display platforms. CONCLUSIONS: Computerized tomographic colonography performance compared favorably with reported performance of fecal occult blood testing, flexible sigmoidoscopy, and barium enema. A prospective study evaluating the performance of computerized tomography colonography in a screening population is indicated.

Colonic Neoplasms↗

PubMed2002

The future of colorectal imaging: computed tomographic colonography.

The development of colorectal cancer screening alternatives that are attractive to patients and effective for screening is critical for reducing this too-common and deadly disease. CTC is an exciting technique that is the only imaging alternative developed since the barium enema for colon screening. In the past few years, many obstacles to clinical implementation of CTC have been eliminated. For example, there is no longer any post-processing time, which was previously as long as 8 to 10 hours, and the interpretation time has been drastically reduced from 4 hours to 15 to 20 minutes. The majority of studies have demonstrated excellent results for detection of lesions > or = 1 cm, with few false positives. This examination will continue to improve with the development of automated (computer) detection programs and automated 3D rendering algorithms. In addition, cathartic bowel preparation, one of the biggest obstacles to patient compliance with colorectal cancer screening, may be eliminated if successful fecal tagging can be developed. The most important issue that remains is its performance in a screening population, and studies are currently underway to answer that important question.

Clinical Trials as Topic↗