AB147. SOH26AB_0048. Diagnostic accuracy of computed tomography (CT) in detecting primary colonic tumour and nodal presence with correlation to final histopathology
Colorectal Session II

AB147. SOH26AB_0048. Diagnostic accuracy of computed tomography (CT) in detecting primary colonic tumour and nodal presence with correlation to final histopathology

Anwaar Albahri1, Ahmed Kazi2, Emmeline Nugent2

1School of Medicine, University of Galway, Galway, Ireland; 2Department of Surgery, University Hospital Galway, Galway, Ireland

Background: Colorectal cancer is associated with significant morbidity and mortality. Accurate preoperative staging is essential for guiding multidisciplinary management. This study aims to evaluate the accuracy of computed tomography (CT) in detecting primary colon cancer, lymph node metastases, and estimating tumour size compared with final histopathology.

Methods: A retrospective analysis was conducted on 563 patients at University Hospital Galway in Galway, Ireland, between January 2021 and July 2025. Diagnostic accuracy metrics and odds ratios were calculated, and agreement in tumour size was assessed using a scatter plot and Bland-Altman analysis.

Results: Of 563 patients, 502 (89.2%) had histologically confirmed colon cancer, while 61 (10.8%) had benign lesions. CT showed sensitivity, specificity, and an overall accuracy of 82.7% [95% confidence interval (CI): 81.2–84.0%], 65.6% (95% CI: 53.3–76.3%), and 80.8%, respectively, for primary tumour detection. For nodal involvement, the corresponding values were 66.5%, 66.4%, and 66.4%. CT-reported lymphadenopathy correlated with histopathological nodal metastasis [diagnostic odds ratio (DOR) =3.92, P<0.001]. CT overestimated tumour size with a mean difference of 7.47 mm, and demonstrated greater sensitivity for advanced compared to early tumours (P=1.9×10−9; χ2=36.0). CT also incorrectly identified the tumour location in 7.2% of patients, with the sigmoid colon being the most incorrectly identified site (n=18).

Conclusions: This study demonstrates that CT has high accuracy for the preoperative diagnosis and staging of colonic lesions, however with certain limitations. Similarly, CT showed moderate performance with a significant correlation to histopathological nodal metastases. Accurate staging, correlation with endoscopy, histopathology, and discussion at a multidisciplinary meeting are key to ensuring excellent patient outcomes.

Keywords: Colon cancer; computed tomography (CT); diagnostic accuracy; histopathology; lymph nodes

Acknowledgments

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Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-26-ab147
Cite this abstract as: Albahri A, Kazi A, Nugent E. AB147. SOH26AB_0048. Diagnostic accuracy of computed tomography (CT) in detecting primary colonic tumour and nodal presence with correlation to final histopathology. Mesentery Peritoneum 2026;10:AB147.

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