CT Colonography and Colonoscopy: Assessment of Patient Preference in a 5-week Follow-up Study

Gelder, Rogier E. van; Birnie, Erwin; Florie, Jasper; Schutter, Michiel P.; Bartelsman, J. F. W. M.; Snel, P.; Laméris, Johan S.; Bonsel, Gouke J.; Stoker, Jaap

doi:10.1148/radiol.2331031208

Cited by 139 publications

(88 citation statements)

References 35 publications

(41 reference statements)

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“…However, at 3 months, they were more satisfied with how results were received (median score of 4 [IQR,[3][4], P , .0005) and less likely to require follow-up colonic investigations (17 of 230 vs 37 of 107, P , .0005). No differences were observed between the tests regarding 3-month psychologic consequences of the diagnostic episode, except for a trend toward a difference (P = .050) in negative affect (unpleasant emotions such as distress), with patients undergoing CT colonography reporting less intense negative affect.…”

Section: Resultsmentioning

confidence: 99%

Patient Acceptability and Psychologic Consequences of CT Colonography Compared with Those of Colonoscopy: Results from a Multicenter Randomized Controlled Trial of Symptomatic Patients

Wagner

Ghanouni²,

Halligan³

et al. 2012

Radiology

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For the SIGGAR Investigators Purpose:To use a randomized design to compare patients' short-and longer-term experiences after computed tomographic (CT) colonography or colonoscopy. Materials and Methods:After ethical approval, the trial was registered. Patients gave written informed consent. Five hundred forty-seven patients with symptoms suggestive of colorectal cancer who had been randomly assigned at a ratio of 2:1 to undergo either colonoscopy (n = 362) or CT colonography (n = 185) received a validated questionnaire to assess immediate test experience (including satisfaction, worry, discomfort, adverse effects) and a 3-month questionnaire to assess psychologic outcomes (including satisfaction with result dissemination and reassurance). Data were analyzed by using Mann-Whitney U, Kruskal-Wallis, and x 2 test statistics. Results:Patients undergoing colonoscopy were less satisfied than those undergoing CT colonography (median score of 61 and interquartile range [IQR] of 55-67 vs median score of 64 and IQR of 58-70, respectively; P = .008) and significantly more worried (median score of 16 [IQR,[12][13][14][15][16][17][18][19][20][21] vs 15 [IQR,[9][10][11][12][13][14][15][16][17][18][19], P = .007); they also experienced more physical discomfort (median score of 39 [IQR, vs 35 [IQR,) and more adverse events (82 of 246 vs 28 of 122 reported feeling faint or dizzy, P = .039). However, at 3 months, they were more satisfied with how results were received (median score of 4 [IQR,[3][4], P , .0005) and less likely to require follow-up colonic investigations (17 of 230 vs 37 of 107, P , .0005). No differences were observed between the tests regarding 3-month psychologic consequences of the diagnostic episode, except for a trend toward a difference (P = .050) in negative affect (unpleasant emotions such as distress), with patients undergoing CT colonography reporting less intense negative affect.

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Section: Resultsmentioning

confidence: 99%

Patient Acceptability and Psychologic Consequences of CT Colonography Compared with Those of Colonoscopy: Results from a Multicenter Randomized Controlled Trial of Symptomatic Patients

Wagner

Ghanouni²,

Halligan³

et al. 2012

Radiology

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“…The questionnaire was designed using questions previously used in evaluation of bowel preparation [20][21][22], using a Likert scale with seven points employed for each question [23]. A variety of potential side-effects from the bowel preparation were interrogated as follows: general disruption to daily life, overall discomfort, abdominal pain, diarrhoea, anal irritation, thirst, hunger, nausea and vomiting.…”

Section: Patient Experiencementioning

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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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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“…However, there have been reports about a possible correlation between nephrogenic fibrosing dermopathy (NFD) and the intravenous administration of gadolinium compounds (20). As far as patient acceptance is concerned, several trials revealed a higher acceptance rate for virtual colonography compared to optical endoscopy (21)(22)(23). The need to undergo bowel cleansing yet is rated as the most unpleasant part of the virtual colonography exam (21-25) and patient discomfort scores can be significantly improved with tagging preparations previously shown for CT colonoscopy (CTC) (26).…”

Section: Discussionmentioning

confidence: 99%

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 and Colonoscopy: Assessment of Patient Preference in a 5-week Follow-up Study

Abstract: Patients preferred CT colonography to colonoscopy; however, this preference decreased in time, while outcome considerations gradually replaced temporary experiences of inconvenience.

Cited by 139 publications

References 35 publications

Patient Acceptability and Psychologic Consequences of CT Colonography Compared with Those of Colonoscopy: Results from a Multicenter Randomized Controlled Trial of Symptomatic Patients

Patient Acceptability and Psychologic Consequences of CT Colonography Compared with Those of Colonoscopy: Results from a Multicenter Randomized Controlled Trial of Symptomatic Patients

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

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

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