Role of CT colonography in differentiating sigmoid cancer from chronic diverticular disease.

Purpose: To evaluate the accuracy of computed tomography colonography (CTC) in differentiating chronic diverticular disease from colorectal cancer (CRC), using morphological and textural parameters. Materials and methods: We included 95 consecutive patients with histologically proven chronic diverticular disease (n = 53) or CRC (n = 42) who underwent CTC. One radiologist, unaware of histological findings, evaluated CTC studies for the presence of potential discriminators including: maximum thickness, involved segment length, shouldering phenomenon, growth pattern, diverticula, fascia thickening, fat tissue edema, loco-regional lymph nodes, mucosal pattern. Another radiologist performed volumetric texture analysis on the involved segment. Results: Several qualitative imaging parameters resulted to significantly correlated with colorectal cancer, including absence of diverticula in the affected segment, straightened growth pattern and shouldering phenomenon. A maximum wall thickness/involved segment length ratio < 0.1 had 98% specificity and 47% sensitivity in identifying diverticular disease. Regarding first-order texture analysis parameters, kurtosis resulted to be significantly different between the two groups. Conclusions: Absence of diverticula, straightened growth pattern and shouldering phenomenon are significantly associated with CRC (71–91% sensitivity; 82–91%). [ABSTRACT FROM AUTHOR]