CT Colonography With Decreased Purgation: Balancing Preparation, Performance, and Patient Acceptance

Mahgerefteh, Shmuel; Fraifeld, Shifra; Blachar, Arye; Sosna, Jacob

doi:10.2214/ajr.09.2342

Cited by 28 publications

(14 citation statements)

References 54 publications

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“…Patients of both groups expressed a preference for CT colonography over optical colonoscopy as a screening examination, which has been reported previously ( 16,20,43 ). This observation supports the likelihood that CT colonography with reduced bowel preparation will increase patient compliance with colorectal cancer screening recommendations ( 44 ). There were several limitations of this study.…”

Section: Gastrointestinal Imaging: Reduced Bowel Preparation For Ct Csupporting

confidence: 83%

Reduced Cathartic Bowel Preparation for CT Colonography: Prospective Comparison of 2-L Polyethylene Glycol and Magnesium Citrate

Keedy¹,

Yee²,

Aslam³

et al. 2011

Radiology

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Purpose:To prospectively compare adequacy of colonic cleansing, adequacy of solid stool and fl uid tagging, and patient acceptance by using reduced-volume, 2-L polyethylene glycol (PEG) versus magnesium citrate bowel preparations for CT colonography. Materials and Methods:This study was approved by the institutional Committee on Human Research and was compliant with HIPAA; all patients provided written consent. In this randomized, investigatorblinded study, 50 patients underwent oral preparation with either a 2-L PEG or a magnesium citrate solution, tagging with oral contrast agents, and subsequent CT colonography and segmentally unblinded colonoscopy .

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Section: Gastrointestinal Imaging: Reduced Bowel Preparation For Ct Csupporting

confidence: 83%

Reduced Cathartic Bowel Preparation for CT Colonography: Prospective Comparison of 2-L Polyethylene Glycol and Magnesium Citrate

Keedy¹,

Yee²,

Aslam³

et al. 2011

Radiology

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“…When adopting this approach to bowel preparation, it is imperative to ensure that residual material is thoroughly and homogeneously tagged, and that this can be readily differentiated from normal and abnormal mucosa. Employing this technique enables a reduction in the amount of bowel catharsis necessary to be able to accurately identify mucosal anomalies, and thus increase patient acceptability and willingness to undergo the examination [16,17].…”

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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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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“…CTC without using laxatives has also been used by some authors wherein the bowel cleansing is performed digitally, using advanced software [39][40][41][42][43][44][45] . Although this offers a great option, especially for the frail patients, this has to be balanced against the greater diagnostic accuracy that is likely to be achieved with a more rigorous bowel preparation.…”

Section: Ctc Techniquementioning

confidence: 99%

Virtual colonoscopy: Utility, impact and overview

Ganeshan¹

2013

WJR

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Computed tomography (CT) colonoscopy is a well-established technique for evaluation of colorectal cancer. Significant advances have been made in the technique of CT colonoscopy since its inception. Excellent results can be achieved in detecting both colorectal cancer and significant sized polyps as long as a meticulous technique is adopted while performing CT colonoscopy. Furthermore, it is important to realize that there is a learning curve involved in interpreting these studies and adequate experience is essential to achieve high sensitivity and specificity with this technique. Indications, contraindications, technique and interpretation, including potential pitfalls in CT colonoscopy imaging, are reviewed in this article. Recent advances and the current role of CT colonoscopy in colorectal cancer screening are also discussed.

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CT Colonography With Decreased Purgation: Balancing Preparation, Performance, and Patient Acceptance

Abstract: The nine studies reviewed showed moderate-to-good performance for decreased-purgation CTC; however, data are limited, and study design and data presentation are inconsistent. Further study of decreased-purgation CTC and standardization of terminology are needed.

Cited by 28 publications

References 54 publications

Reduced Cathartic Bowel Preparation for CT Colonography: Prospective Comparison of 2-L Polyethylene Glycol and Magnesium Citrate

Reduced Cathartic Bowel Preparation for CT Colonography: Prospective Comparison of 2-L Polyethylene Glycol and Magnesium Citrate

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

Virtual colonoscopy: Utility, impact and overview

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