Abstract
PURPOSE: Early detection of colorectal cancer (CRC) is crucial for improving patient prognosis and survival outcomes. In contemporary clinical practice, computed tomography (CT) has become an established diagnostic modality and a reference standard for CRC evaluation. This meta-analysis systematically evaluates the diagnostic performance of contrast-enhanced CT imaging in detecting and characterizing colorectal neoplasms, providing evidence-based recommendations to optimize clinical decision-making and therapeutic strategies in CRC management. METHODS: A systematic literature search was performed across multiple electronic databases, including PubMed, Medline, EMBASE, the Cochrane Library, ClinicalTrials.gov, CNKI, Wanfang, and Weipu, covering studies from database inception through November 25, 2024. The search strategy was designed to identify all relevant studies investigating the diagnostic accuracy of contrast-enhanced CT imaging in colorectal neoplasms. For each eligible study, diagnostic performance parameters-specifically, sensitivity and specificity-were extracted and analyzed. All statistical analyses were conducted using RevMan software. RESULTS: A total of nine studies involving 4,857 patients were included. The meta-analysis revealed that the pooled sensitivity of enhanced CT imaging for diagnosing colorectal tumors was 76% [95% confidence interval (CI): 70%-79%] and the pooled specificity reached 87% (95% CI: 84%-89%). Furthermore, the area under the curve for the diagnostic test was 0.89 (95% CI: 0.85-0.92), indicating strong discriminatory capability in differentiating colorectal tumors. Subgroup analysis revealed no statistically significant differences in diagnostic sensitivity and specificity between intravenously administered and orally administered contrast agents in enhanced CT scans. CONCLUSION: Contrast-enhanced CT imaging is an effective and reliable method for the clinical diagnosis of colorectal tumors. CLINICAL SIGNIFICANCE: Contrast-enhanced CT scanning demonstrates high sensitivity and specificity in the diagnosis of CRC.