• Charlotte J Tutein Nolthenius, Thierry N Boellaard, Margriet C de Haan, C Yung Nio, Maarten G J Thomeer, Shandra Bipat, Montauban van SwijndregtAlexander DADDepartment of Radiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands., Marc J van de Vijver, Katharina Biermann, Ernst J Kuipers, Evelien Dekker, and Jaap Stoker.
• Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
• Am. J. Gastroenterol. 2015 Dec 1; 110 (12): 1682-90.

ObjectivesVolumetric growth assessment has been proposed for predicting advanced histology at surveillance computed tomography (CT) colonography (CTC). We examined whether is it possible to predict which small (6-9 mm) polyps are likely to become advanced adenomas at surveillance by assessing volumetric growth.MethodsIn an invitational population-based CTC screening trial, 93 participants were diagnosed with one or two 6-9 mm polyps as the largest lesion(s). They were offered a 3-year surveillance CTC. Participants in whom surveillance CTC showed lesion(s) of ≥6 mm were offered colonoscopy. Volumetric measurements were performed on index and surveillance CTC, and polyps were classified into growth categories according to ±30% volumetric change (>30% growth as progression, 30% growth to 30% decrease as stable, and >30% decrease as regression). Polyp growth was related to histopathology.ResultsBetween July 2012 and May 2014, 70 patients underwent surveillance CTC after a mean surveillance interval of 3.3 years (s.d. 0.3; range 3.0-4.6 years). In all, 33 (35%) of 95 polyps progressed, 36 (38%) remained stable, and 26 (27%) regressed, including an apparent resolution in 13 (14%) polyps. In 68 (83%) of the 82 polyps at surveillance, histopathology was obtained; 15 (47%) of 32 progressing polyps were advanced adenomas, 6 (21%) of 28 stable polyps, and none of the regressing polyps.ConclusionsThe majority of 6-9 mm polyps will not progress to advanced neoplasia within 3 years. Those that do progress to advanced status can in particular be found among the lesions that increased in size on surveillance CTC.

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