Area Editoriale
Objective The primary aim of thisstudy was to use meta-regression techniques to compare the diagnostic accuracyof computed tomography colonography (CTC) and magnetic resonance colonography(MRC), compared with conventional colonoscopy for patients presenting withcolorectal cancer (CRC). Method Quantitative meta-analysis was performed usingprospective studies reporting comparative data between CTC and MRC individuallyto conventional colonoscopy. Study quality was assessed and sensitivities,specificities, diagnostic odds ratios (DOR) were calculated. Summary receiveroperating characteristic (SROC) curves and sensitivity analysis were utilized.Meta-regression was used to indirectly compare the two modalities followingadjustment for patient and study characteristics. Results Overall sensitivityand specificity for CTC (0.96, 95% CI 0.92-0.99; 1.00, 95% CI 0.99-1.00respectively) and MRC (0.91, 95% CI 0.79-0.97; 0.98, 95% CI 0.96-0.99respectively) for the detection of CRC was similar. Meta-regression analysisshowed no significant difference in the diagnostic accuracy of both modalities(beta = -0.64, P = 0.37 and 95% CI of 0.12-2.39). Both tests showed high areaunder the SROC curve (CTC = 0.99; MRC =0.98), with high DORs (CTC = 1461.90,95% CI 544.89-3922.30; MRC = 576.41, 95% CI 135.00-2448.56). Factors thatenhanced the overall accuracy of MRC were the use intravenous contrast, faecaltagging and exclusion of low-quality studies. No factors improved diagnosticaccuracy from CTC except studies with more than 100 patients (AUC = 1.00, DOR =2938.35, 95%CI 701.84-12 302.91). Conclusion This meta-analysis suggested thatCTC and MRC have similar diagnostic accuracy for detecting CRC. Study quality,size and intravenous/intra-luminal contrast agents affect diagnostic accuracies.For an exact comparison to be made, studies evaluating CTC, MRC and colonoscopyin the same patient cohort would be necessary.Leggil'articolo