Evidence map›Paper›PMID 40767870›Full record

SynthesisEuropean radiology2026

CT diagnostic performance for preoperative staging of colon cancer: a systematic review and meta-analysis.

Joao Miranda, Giovanni B Torri, Meiri Andreia Maria da Silva, Gustavo Monjardim, Miriana Mariussi, Luiza G Schmitt, Camila Piovesan Wiethan, Tiago Leal Ghezzi, Caroline Lorenzoni Almeida Ghezzi, Stephan Altmayer and 2 more

Registry-linked trialAbstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in European radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07255729 (Machine Learning-Based Exosomal microRNA Signature for Preoperative Staging and Chemotherapy Eligibility in Colon Cancer), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07255729 recruitingnot on this map

Machine Learning-Based Exosomal microRNA Signature for Preoperative Staging and Chemotherapy Eligibility in Colon Cancer

TypeobservationalSponsorCity of Hope Medical CenterRan2025 to 2028Enrolled400ConditionsColon CancerArmsDiagnostic Test: EXPOSE assay（Small RNA-seq of exosomal miRNAs）, Diagnostic Test: EXPOSE RT-qPCR panel
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Joao Miranda *Department of Radiology, Mayo Clinic, Rochester, MN, USA. joaomirandamd@gmail.com.ORCID http://orcid.org/0000-0003-1273-3108
Giovanni B Torri *Department of Radiology, University of Florida, Gainesville, FL, USA.
Meiri Andreia Maria da SilvaDepartment of Radiology and Diagnostic Imaging, Hospital Moinhos de Vento, Porto Alegre, Brazil.
Gustavo MonjardimDepartment of Radiology, University of Virginia, Charlottesville, VA, USA.
Miriana MariussiDepartment of Interventional Radiology, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil.
Luiza G SchmittDepartment of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Camila Piovesan WiethanDepartment of Radiology and Diagnostic Imaging, Hospital Universitario de Santa Maria, Federal University of Santa Maria, Santa Maria, Brazil.
Tiago Leal GhezziDepartment of Coloproctology, Hospital Moinhos de Vento, Porto Alegre, Brazil.
Caroline Lorenzoni Almeida GhezziDepartment of Radiology and Diagnostic Imaging, Hospital Moinhos de Vento, Porto Alegre, Brazil.
Stephan AltmayerDepartment of Radiology, Stanford University School of Medicine, Stanford, CA, USA.
Adriano Basso DiasUniversity Medical Imaging Toronto; Joint Department of Medical Imaging; University Health Network-Sinai Health System-Women's College Hospital, University of Toronto, Toronto, ON, Canada.
Natally HorvatDepartment of Radiology, Mayo Clinic, Rochester, MN, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo conduct a meta-analysis evaluating the diagnostic accuracy of computed tomography (CT) for identifying T3-T4 colon cancer using histopathology as the reference standard. Secondary objectives included assessing CT's performance for detecting extramural vascular invasion (EMVI) and nodal involvement. MATERIALS AND

methodsThis diagnostic accuracy meta-analysis followed PRISMA-DTA guidelines and searched MEDLINE, EMBASE, and Cochrane Library for studies published up to September 2024. Eligible studies evaluated CT for preoperative T staging (T3 or higher), EMVI, and/or nodal status in primary colon cancer, reporting sensitivity and specificity. Studies on rectal cancer, using specialized CT techniques, or not in English, were excluded. Pooled sensitivity and specificity for T staging, EMVI, and nodal status were calculated using a random-effects model. Subgroup analyses explored sources of heterogeneity.

resultsThirty-two studies, including 222,948 patients (mean age 69 years; 50.5% female), were analyzed. For pT3-T4 staging, pooled sensitivity and specificity were 0.81 (95% CI: 0.76-0.85) and 0.75 (95% CI: 0.66-0.83). For pT3c-T4, sensitivity was 0.71 (95% CI: 0.62-0.79) and specificity was 0.83 (95% CI: 0.74-0.89). EMVI detection showed sensitivity of 0.40 (95% CI: 0.30-0.52) and specificity of 0.80 (95% CI: 0.71-0.87). A reliable pooled estimate for nodal status could not be determined.

conclusionCT shows good diagnostic performance for identifying T3-T4 colon cancer and can detect high-risk features like EMVI. These findings support its role in selecting candidates for neoadjuvant therapies, although EMVI sensitivity remains limited. KEY POINTS: Question How accurate is CT for identifying T3-T4 colon cancer and detecting key prognostic factors like EMVI to support neoadjuvant treatment planning? Findings CT shows good accuracy for T3-T4 staging (sensitivity 0.81; specificity 0.75) and high specificity (0.80) but low sensitivity (0.40) for EMVI. Clinical relevance CT enables reliable identification of locally advanced colon cancer and high-risk features such as EMVI, supporting better patient selection and personalized neoadjuvant treatment planning.

Indexed as

Colonic NeoplasmsTomography, X-Ray ComputedHumansNeoplasm InvasivenessNeoplasm StagingPreoperative CareSensitivity and SpecificityColonic neoplasmsComputed tomographyLymphatic metastasisNeoplasm staging

Identifiers

PMID40767870

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.