Concordance between Contrast Enhanced CT, Colonoscopy, and IntraOperative Localization of Colon Tumors

The aim of the study is to evaluate the extent of agreement between CT, colonoscopy, and intraoperative findings in the anatomical localization of colonic tumors. In this retrospective analysis of consecutive patients (n = 193) with biopsy-proven colonic adenocarcinoma between December 2020 and December 2023, colonoscopic and CT localization were compared against surgical localization, which served as the reference standard. All statistical analyses were performed using IBM SPSS Analytics 22.0 software. Kappa statistics were used to establish agreement between the diagnostic methods. We observed a substantial (0.73) agreement between CT and surgical localization, while moderate (0.57) agreement was noted between colonoscopy and surgical localization as well as between CT and colonoscopy (0.58). CT showed a sensitivity of 82.6%, specificity of 95.1%, positive predictive value of 73.5%, negative predictive value of 97.1%, and an overall accuracy of 93.3%, while colonoscopy showed a sensitivity of 60.8%, specificity of 94.7%, positive predictive value of 66%, negative predictive value of 93.5% and an overall accuracy of 89.8% in localization of colonic tumors with respect to intraoperative localization. We demonstrate only moderate to substantial concordance rates between CT, colonoscopy, and surgery for the localization of the colon cancer. In the current rapidly evolving landscape of colon cancer management, standardizing the anatomical location of tumor is critical to optimally compare treatment outcomes between colonic tumors at different sites.