CT Colonography After Fecal Tagging with a Reduced Cathartic Cleansing and a Reduced Volume of Barium

Lefere, Philippe; Gryspeerdt, Stefaan; Marrannes, J; Baekelandt, Marc; Holsbeeck, B Van

doi:10.2214/ajr.184.6.01841836

Cited by 103 publications

(65 citation statements)

References 10 publications

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“…Likewise, the optimal timing and volumes of these agents remains to be optimised. Some authors have concluded that barium preferentially tags solid faecal material, leaving appreciable volumes of colonic fluid untagged [18]. Larger volumes of administered barium seem to tag a greater proportion of colonic fluid, but with layering [19].…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of two minimal-preparation regimes for CT colonography: optimising image quality and patient acceptability

Pollentine¹,

Mortimer²,

McCoubrie³

et al. 2012

The British Journal of Radiology

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Objective: To compare a 2 day bowel preparation regime of barium, iodine and a mild stimulant laxative with a 1 day iodine-only regime for CT colonography (CTC). Methods: 100 consecutive patients underwent CTC. The first 50 patients (Regime 1) ingested 1 bisacodyl tablet twice a day 3 days before CTC and 1 dose each of 50 ml of barium and 20 ml of iodinated contrast per day starting 2 days before CTC. The second 50 patients (Regime 2) ingested 3 doses of iodinated contrast over 24 h prior to CTC. Volumes of residual stool and fluid, and the effectiveness of stool and fluid tagging, were graded according to methods established by Taylor et al (Taylor S, Slaker A, Burling D, Tam E, Greenhalgh R, Gartner L, et al. CT colonography: optimisation, diagnostic performance and patient acceptability of reduced-laxative regimens using barium-based faecal tagging. Eur Radiol 2008; 18: 32-42). A 3 day low-residue diet was taken by both cohorts. Questionnaires rating the side-effects and burden of the bowel preparation were compared to a control cohort of patients undergoing barium enema. Results: The proportion of colons producing none/scattered stool (score 1) was 90.3% with Regime 1 and 65.0% with Regime 2 (p,0.005). Any residual stool was significantly better tagged with Regime 1 (score 5), with 91.7% of Regime 1 exhibiting optimum tagging vs 71.3% of Regime 2 (p,0.05). No significant differences in side-effects between the bowel preparation regimes for CTC were elicited. Bowel preparation for barium enema was tolerated significantly worse than both of the CTC bowel preparation regimes. Conclusion: Regime 1, containing a 3 day preparation of a mild laxative, barium and iodine, produced a significantly better prepared colon, with no difference in patient acceptability.

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Section: Discussionmentioning

confidence: 99%

“…Some authors believe that barium predominately tags the more solid elements of the retained colonic residue [18]. Hyperosmolar iodine-based contrast agents promote stool softening by inducing colonic fluid secretion.…”

mentioning

confidence: 99%

Evaluation of two minimal-preparation regimes for CT colonography: optimising image quality and patient acceptability

Pollentine¹,

Mortimer²,

McCoubrie³

et al. 2012

The British Journal of Radiology

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“…Research into noncathartic approaches to minimize the bowel preparation is underway, but this technique has not yet been validated in a multicenter screening trial. [159][160][161] However, under conditions where same-day or next-day referral for colonoscopy would be possible, one drawback of noncathartic CTC is that a cathartic bowel preparation would still be required prior to removal of polyps.…”

Section: Ctcmentioning

confidence: 99%

Screening and Surveillance for the Early Detection of Colorectal Cancer and Adenomatous Polyps, 2008: A Joint Guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology

Levin

Lieberman

McFarland

et al. 2008

CA: A Cancer Journal for Clinicians

1,557

916

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In the United States, colorectal cancer (CRC) is the third most common cancer diagnosed among men and women and the second leading cause of death from cancer. CRC largely can be prevented by the detection and removal of adenomatous polyps, and survival is significantly better when CRC is diagnosed while still localized. In 2006 to 2007, the American Cancer Society, the US Multi Society Task Force on Colorectal Cancer, and the American College of Radiology came together to develop consensus guidelines for the detection of adenomatous polyps and CRC in asymptomatic average-risk adults. In this update of each organization's guidelines, screening tests are grouped into those that primarily detect cancer early and those that can detect cancer early and also can detect adenomatous polyps, thus providing a greater potential for prevention through polypectomy. When possible, clinicians should make patients aware of the full range of screening options, but at a minimum they should be prepared to offer patients a choice between a screening test that is effective at both early cancer detection and cancer prevention through the detection and removal of polyps and a screening test that primarily is effective at early cancer detection. It is the strong opinion of these 3 organizations that colon cancer prevention should be the primary goal of screening. (CA Cancer J Clin 2008;58:130-160.)

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“…One could argue that tagging effectiveness actually should be vice versa, exhibiting better results in the more proximal bowel segments,because the tagging agent might not have reached distal bowel parts in patients with decreased transit times. However, Lefere et al (30) reported similar observations …”

Section: Discussionmentioning

confidence: 78%

MR colonography with fecal tagging: Do individual patient characteristics influence image quality?

Kinner¹,

Kuehle²,

Langhorst³

et al. 2007

Magnetic Resonance Imaging

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Purpose:To evaluate if different patient characteristics influence performance of fecal tagging (a new MR colonography (MRC) technique to label stool to avoid bowel cleansing) and, consecutively, MR image quality. Materials and Methods:A total of 333 patients (mean age ϭ 61 years) underwent MRC with fecal tagging. Four segments of the large bowel (ascending, transverse, descending, and sigmoid colon) were assessed as for the presence of nontagged stool particles, which can impede an assessment of the colonic wall. Ratings were correlated with patients' characteristics including patient age (Ͻ55 vs. Ն55 years), body mass index (BMI) (Ͻ25 vs. Ն25), gender, and acceptance levels for fecal tagging. Statistical analysis was performed using a Mann-Whitney U-test.Results: A total of 1332 colonic segments were evaluated. Among them, 327 segments (25%) did not contain any visible stool particles. Considerably reduced image quality was found in 61 segments (5%). Best image quality was found in the sigmoid colon (mean value ϭ 1.9), while image quality of the ascending colon turned out to be worst (mean value ϭ 2.6). Fecal tagging effectiveness showed a reverse correlation with patient age. However, all other characteristics did not have a statistically significant influence on fecal tagging outcome.Conclusion: MRC in conjunction with barium-based fecal tagging led to diagnostic image quality in 95% of all colonic segments. Since tagging results were significantly decreased in patients Ն55 years, tagging protocols should to be modified in this group, i.e., by increasing the time interval of tagging administration.

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CT Colonography After Fecal Tagging with a Reduced Cathartic Cleansing and a Reduced Volume of Barium

Abstract: In the present study, CT colonography after fecal tagging with 50 mL of barium combined with a reduced cathartic cleansing was feasible.

Cited by 103 publications

References 10 publications

Evaluation of two minimal-preparation regimes for CT colonography: optimising image quality and patient acceptability

Evaluation of two minimal-preparation regimes for CT colonography: optimising image quality and patient acceptability

Screening and Surveillance for the Early Detection of Colorectal Cancer and Adenomatous Polyps, 2008: A Joint Guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology

MR colonography with fecal tagging: Do individual patient characteristics influence image quality?

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