NDLI: Magnetic resonance colonography for colorectal cancer screening in patients with Lynch syndrome gene mutation

Content Provider	Springer Nature Link
Author	Lim, Eu Jin Leung, Christopher Pitman, Alex Stella, Damien L. Brown, Gregor Slattery, Masha Marion, Kaye Macrae, Finlay
Copyright Year	2010
Abstract	Lynch syndrome gene carriers have a 50–80% risk of colorectal cancer (CRC). Current guidelines recommend yearly colonoscopy, with associated procedure-related risks. Magnetic resonance colonography (MRC) was evaluated as a non-invasive alternative for CRC screening in this high-risk population. Adult Lynch syndrome gene carriers underwent both screening procedures on the same day. MRI radiologists read the scans and rated image quality. Endoscopists performed colonoscopy unaware of MRC findings until after procedure completion. If lesions were detected, their number, size and location were noted. Post-procedure, patients compared discomfort and inconvenience of MRC and colonoscopy on a visual analogue scale. Thirty patients were recruited. 83% of the MRC scans were of adequate to good quality. MRC detected three lesions in three patients (70, 36, 17 mm). All 3 were independently detected on colonoscopy, excised and found to be CRC. MRC failed to detect a 3 mm CRC found on colonoscopy. CRC prevalence was 13%. Colonoscopy detected a further 30 polyps, all <10 mm. Of these, 17 were hyperplastic polyps and 10 normal mucosa. Colonoscopy had a false positive rate of 32% as defined by histology. MRC failed to detect any polyp <10 mm. Mean patient discomfort scores were 20% for MRC and 68% for colonoscopy, P = 0.003. Mean patient inconvenience scores were 54% for MRC and 52% for colonoscopy, P = 0.931. MRC was reliable in detecting large polyps, potentially CRC. However MRC currently has poor sensitivity in detecting small polyps, limiting its utility in adenoma screening at this time. MRC was associated with less discomfort than CC.
Starting Page	555
Ending Page	561
Page Count	7
File Format	PDF
ISSN	13899600
Journal	Familial Cancer
Volume Number	9
Issue Number	4
e-ISSN	15737292
Language	English
Publisher	Springer Netherlands
Publisher Date	2010-05-22
Publisher Place	Dordrecht
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Lynch syndrome Magnetic resonance colonography Colonoscopy Colorectal cancer screening Biomedicine general Epidemiology Human Genetics Cancer Research
Content Type	Text
Resource Type	Article
Subject	Genetics Cancer Research Genetics (clinical) Oncology

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