• Michio Taya, Cody McHargue, Zina J Ricci, Milana Flusberg, Stefanie Weinstein, and Judy Yee.
• Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA. michio.taya@virginiamason.org.
• Abdom Radiol (NY). 2019 Feb 1; 44 (2): 429-437.

PurposeTo compare the distribution of extracolonic findings and clinical outcomes between screening and diagnostic CT colonography (CTC) populations.Methods388 consecutive patients (369 men, 19 women; mean ± SD age 67.8 ± 10 years) who underwent first-time CTC (4/2011-4/2017) at a Veteran's Affairs Medical Center were divided into screening (asymptomatic) or diagnostic (symptomatic) cohorts based on CTC indication. CTC reporting and data system E-scores for extracolonic findings were retrospectively assigned based on prospective CTC radiologic reports. Multinomial logistic regression was used to examine the association between E-scores and CTC indication. Electronic medical records of all patients with E3 or E4 scores were reviewed (median follow-up 2.8 years) to determine clinical outcomes.Results68% (262/388) underwent screening and 32% (126/388) diagnostic CTC. 7.2% (28/388) had extracolonic findings considered potentially significant (E4), 4.4% (17/388) had indeterminate but likely unimportant findings (E3), and 88.4% (347/388) had normal or unimportant findings (E1 or E2). E-scores were not significantly different between screening and diagnostic CTC when adjusted for age, gender, and prior imaging (p = 0.44). 4.6% (12/262) of patients with E3/E4 findings in the screening cohort demonstrated clinically significant outcomes, compared with 4.0% (5/126) in the diagnostic cohort, including a total of three extracolonic malignancies (0.8%) and three abdominal aortic aneurysms (0.8%). 4.6% (18/388) underwent follow-up imaging studies to confirm a benign outcome after detection of a category E3/E4 finding.ConclusionsThe distribution of extracolonic findings and clinical outcomes were not statistically significantly different between screening and diagnostic CTC populations.

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