Comparative Evaluation of Optical Colonoscopy and Multidetector Computerized Tomographic Colonoscopy for Detection of Colonic Polyps in Acromegaly: A Preliminary Study

Patients with acromegaly are at increased risk of development of colonic polyps and these are considered as precursors of colonic carcinoma. Multidetector computed tomographic colonoscopy (MDCTC) is a newer modality for detecting colonic neoplasms. There is no data on the utility of this method in patients with acromegaly. A total of 24 patients (15 men) with active acromegaly (mean + SD; age, 35.4 + 13.13 years) without any symptoms of colonic disease underwent optical colonoscopy (OC) and MDCTC preferably on the same day or within I week of each other and the findings of these 2 investigations were compared. MDCTC localized colonic polyps in 8 patients and in the remaining no abnormality was detected. OC detected colonic polyps in only 4 patients in whom MDCTC was also abnormal. MDCTC and OC were concordant in 20 (83.4%) patients and discordant in 4 (16.6%). MDCTC was false positive in 4 patients and false negative in none. Based on these findings, the sensitivity and specificity of MDCTC were 100% and 80%, respectively, whereas the accuracy, positive and negative predictive values were 83%, 50%, and 100%, respectively. All polyps were subcentimetric in size and hyperplastic on biopsy. MDCTC is a sensitive modality for detection of colonic polyps in acromegalics. Its use for the initial screening in acromegaly has promise. A larger study should be done to confirm this finding.