Dietary Fecal Tagging as a Cleansing Method before CT Colonography: Initial Results—Polyp Detection and Patient Acceptance

Lefere, Philippe; Gryspeerdt, Stefaan; Dewyspelaere, J; Baekelandt, Marc; Holsbeeck, Bartel G. van

doi:10.1148/radiol.2241011222

Cited by 278 publications

(157 citation statements)

References 48 publications

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“…Improvement may result from the use of a less extensive or even "dry" bowel preparation (e.g., Fleet Phospho Soda® the day prior to the study, the use of fecal tagging (3,5,20), etc.) in conjunction with a single breathhold 2D or 3D T1w sequence after distention of the colon with air, covering the entire abdomen in one acquisition.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have addressed the use of different imaging modalities and parameter settings for virtual colonoscopy, as well as the corresponding detection rate for small tumors and polyps (2)(3)(4)(5)(6). The participation rate of the target population is often neglected, even though all current techniques require a specific preparation protocol that is associated with definite discomfort for the patient (7).…”

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confidence: 99%

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Clinical validation of high‐resolution fast spin‐echo MR colonography after colon distention with air

Bielen

Bosmans

Wever

et al. 2005

Magnetic Resonance Imaging

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To evaluate the feasibility of MR colonography (MRC) with air using two-dimensional (2D) T1-weighted fast spin-echo (T1wFSE) in patients scheduled for conventional colonoscopy (CC) after classic bowel preparation, and assess the ability of the technique to detect colonic lesions. The distention was sufficient for diagnosis, and the technique provided adequate delineation of the wall in the majority of segments. Residual fluid obscured the wall in different segments, especially in the ascending and descending colon (supine position) and in the cecum, transverse, and sigmoid colon (prone position). These findings were consistent with CT colonography. MRC visualized three lesions, missed one lesion Ͼ10 mm, visualized none of four lesions Ͻ5 mm, and yielded one false-positive lesion (5-10 mm). Missed lesions can be due to inconsistency in the slice positions between consecutive breath-holds, which is inherent to the multishot technique. Residual fluid may have obscured the smaller lesions. The shortcomings of the technique are limited coverage and signal drop-off at the borders of the field of view (FOV). Before multishot 2D T1wFSE colonography can become a valid screening method, improved patient preparation and a more practical technique are needed.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Clinical validation of high‐resolution fast spin‐echo MR colonography after colon distention with air

Bielen

Bosmans

Wever

et al. 2005

Magnetic Resonance Imaging

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“…It is noteworthy to mention that at present several 3D software packages, including the newer version of the one used in this study, enable the matching of lesions in the prone and supine position. The use of oral contrast agents [17] and scanning with thinner slices [18] are two other measures that may reduce the number of false positive findings. Another explanation for the lower number of small (≤5 mm) false positive results for the primary 2D review may be that small colon wall abnormalities are simply not seen with axial interpretation, and thus not reported.…”

Section: Discussionmentioning

confidence: 99%

“…The effect of other developments, such as use of low dose scan technique [24] or the use of oral or intravenous contrast agents [17,25,26] on the use of primary 3D and 2D review techniques have not been addressed in the present study and remain subjects for future studies.…”

Section: Discussionmentioning

confidence: 99%

A comparison of primary two- and three-dimensional methods to review CT colonography

et al. 2006

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The aim of our study was to compare primary three-dimensional (3D) and primary two-dimensional (2D) review methods for CT colonography with regard to polyp detection and perceptive errors. CT colonography studies of 77 patients were read twice by three reviewers, first with a primary 3D method and then with a primary 2D method. Mean numbers of true and false positives, patient sensitivity and specificity and perceptive errors were calculated with colonoscopy as a reference standard. A perceptive error was made if a polyp was not detected by all reviewers. Mean sensitivity for large (≥10 mm) polyps for primary 3D and 2D review was 81% (14.7/18) and 70% (12.7/18), respectively (p-values ≥0.25). Mean numbers of large false positives for primary 3D and 2D were 8.3 and 5.3, respectively. With primary 3D and 2D review 1 and 6 perceptive errors, respectively, were made in 18 large polyps (p=0.06). For mediumsized (6-9 mm) polyps these values were for primary 3D and 2D, respectively: mean sensitivity: 67%(11.3/17) and 61%(10.3/17; p-values≥ 0.45), number of false positives: 33.3 and 15.6, and perceptive errors : 4 and 6 (p= 0.53). No significant differences were found in the detection of large and medium-sized polyps between primary 3D and 2D review.

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“…However, many patients perceive laxative bowel preparation as the worst aspect of the test 4,5 and the addition of 'faecal tagging' may add additional burden. Quantitative studies of acceptability have found non-laxative preparation to be equivalent or superior to full-laxative preparation in terms of its acceptability [6][7][8][9][10] . However, although non-laxative CTC is likely to be better tolerated, its diagnostic accuracy compared to full-laxative studies is currently uncertain and so this preparation is generally reserved for patients considered unfit for full catharsis 11 .…”

Section: Introductionmentioning

confidence: 99%

An interview study analysing patients' experiences and perceptions of non-laxative or full-laxative preparation with faecal tagging prior to CT colonography

et al. 2013

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An interview study analysing patients' experiences and perceptions of non-laxative or full-laxative preparation with faecal tagging prior to CT colonography. Clin Radiol , 68 (5) pp. 472-478. 10.1016/j.crad.2012.10.012. ArticleAn interview study analysing patients' experiences and perceptions of non-laxative or full-laxative preparation with faecal tagging prior to CT colonography Classifications: Gastrointestinal; CT AbstractAim: This study compared patients' experiences of either non-or full-laxative bowel preparation with additional faecal tagging and subsequent CT colonography using in-depth interviews to elicit detailed responses.Materials and Methods: Patients who received CT colonography after non-(N = 9) or full-laxative (N = 9) preparation participated in a semi-structured telephone interview at least two days after investigation. Full-laxative preparation consisted of magnesium citrate and sodium picosulphate administered at home (or polyethylene glycol, if contraindicated), followed by hospital-based faecal tagging with iohexol. Non-laxative preparation was home-based barium sulphate for faecal tagging.Interviews were transcribed and thematically analysed to identify recurrent themes on patients' perceptions and experiences.Results: Experiences of full-laxative preparation were usually negative and characterised by pretest diarrhoea that caused significant interference with daily routine. Post-test flatus was common. Non-laxative preparation was well-tolerated; patients reported no or minimal changes to bowel habit and rapid return to daily routine. Patients reported worry and uncertainty about the purpose of hospital-based faecal tagging. This also added burden from waiting before testing.Conclusion: Patients' responses supported previous findings that non-laxative preparation is more acceptable than full-laxative preparation but both can be improved. Faecal tagging used in combination with laxative preparation is poorly understood, adding burden and worry. Home-based non-laxative preparation is also poorly understood and patients require better information on the purpose and mechanism in order to give fully informed consent. This may also optimise adherence to instructions. Allowing home-based self-administration of all types of preparation would prevent waiting before testing.

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Dietary Fecal Tagging as a Cleansing Method before CT Colonography: Initial Results—Polyp Detection and Patient Acceptance

Abstract: FT offers the patient a well-tolerated preparation and improves specificity, with improved differentiation of polyps from residual stool.

Cited by 278 publications

References 48 publications

Clinical validation of high‐resolution fast spin‐echo MR colonography after colon distention with air

Clinical validation of high‐resolution fast spin‐echo MR colonography after colon distention with air

A comparison of primary two- and three-dimensional methods to review CT colonography

An interview study analysing patients' experiences and perceptions of non-laxative or full-laxative preparation with faecal tagging prior to CT colonography

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