Fluid Tagging for CT Colonography

Chang, Kevin J.; Rekhi, Satinder S.; Anderson, Stephan W.; Soto, Jorge A.

doi:10.1097/rct.0b013e3181f5a610

Cited by 29 publications

(7 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

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“…Visual analysis confirmed that in 11% of same-day patients, no contrast had progressed into the colon, and only 56% of patients had contrast extending to the rectum. These findings are concordant with findings by other authors using a similar regimen (17), who nonetheless concluded that adequate colonic opacification was achieved. However, that study lacked comparison to a cohort who underwent standard CTC bowel preparation on a separate day, as in our study.…”

Section: Discussionsupporting

confidence: 92%

“…The first and most common is same-day CTC utilizing the prior OC prep, often supplemented with oral contrast after recovery from OC (17). This is often the more convenient option for the patient as they do not have to undergo further cathartic bowel preparation (assuming bowel prep for OC was adequate) and return on a separate day.…”

Section: Introductionmentioning

confidence: 99%

“…One prior study assessed colonic transit of oral contrast (diatrizoate) after incomplete OC at same-day CTC, but there was no cohort for comparison (17). To our knowledge, no objective comparison exists for same-day versus deferred separate-day strategies for CTC following incomplete OC.…”

Section: Introductionmentioning

confidence: 99%

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CT colonography after incomplete optical colonoscopy: bowel preparation quality at same-day vs. deferred examination

et al. 2015

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Purpose To objectively compare the volume, density, and distribution of luminal fluid for same-day oral-contrast-enhanced CTC following incomplete optical colonoscopy (OC) versus deferred CTC on a separate day utilizing a dedicated CTC bowel preparation. Methods HIPAA-compliant, IRB-approved retrospective study compared 103 same-day CTC studies after incomplete OC (utilizing 30 ml oral diatrizoate) against 151 CTC examinations performed on a separate day after failed OC using a dedicated CTC bowel preparation (oral magnesium citrate/dilute barium/diatrizoate the evening before). A subgroup of 15 patients who had both same-day CTC and separate-day routine CTC was also identified and underwent separate analysis. CTC exams were analyzed for opacified fluid distribution within the GI tract, as well as density and volume. Data was analyzed utilizing Kruskal-Wallis and Wilcoxon Signed Rank tests. Results Opacified luminal fluid extended to the rectum in 56% (58/103) of same-day CTC versus 100% (151/151) of deferred separate-day CTC (p<0.0001). For same-day CTC, contrast failed to reach the colon in 11% (11/103) and failed to reach the left colon in 26% (27/103). Volumetric colonic fluid segmentation for fluid analysis (successful in 80 same-day and 147 separate-day cases) showed significantly more fluid in the same-day cohort (mean, 227 ml vs. 166 ml; p<0.0001); the actual difference is underestimated due to excluded cases. Mean colonic fluid attenuation was significantly lower in the same-day cohort (545 HU vs. 735 HU; p<0.0001). Similar findings were identified in the smaller cohort with direct intra-patient CTC comparison. Conclusions Dedicated CTC bowel preparation on a separate day following incomplete OC results in a much higher quality examination compared with same-day CTC.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

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CT colonography after incomplete optical colonoscopy: bowel preparation quality at same-day vs. deferred examination

et al. 2015

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“…Tagging can be performed with an iodinated contrast agent following incomplete colonoscopy using a shortened interval protocol. In a study of 144 patients who ingested 20-30mL of iodinated contrast 2 hours prior to CT colonography and following incomplete colonosocopy, results showed that over 70% of patients had adequate tagging with contrast reaching the distal colon21.…”

Section: Useful Technical Tips For Ctc Performancementioning

confidence: 99%

Advances in CT Colonography for Colorectal Cancer Screening and Diagnosis

Yee¹,

Weinstein²,

Morgan³

et al. 2013

J. Cancer

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CT colonography (CTC) is a validated colorectal cancer test that provides an additional minimally-invasive screening option which is likely to be preferred by some patients. Important examination prerequisites include adequate colonic cleansing and distention. Tagging of residual material aids in the differentiation of true polyps from stool. Low radiation dose technique should be employed routinely for screening studies. Readers must be skilled in the use of both 2D and 3D interpretation methods.

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“…For same-day CTC following incomplete OC, administering a small oral dose (20–30 mL) of Gastrografin often results in excess luminal fluid but is this opacification is still preferable to the alternative of not tagging. 17 The issue of residual solid stool related to “minimal prep” or non-cathartic approaches is important, as it may limit interpretation to a primary 2D approach, which results in suboptimal detection relative to a combined 3D/2D detection strategy (Fig 2). 12,18 …”

Section: Missed Lesions At Ctc (False-negative Interpretation)mentioning

confidence: 99%

Missed lesions at CT colonography: lessons learned

Pickhardt

2012

Abdom Imaging

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Misinterpretation at CT colonography (CTC) can result in either a colorectal lesion being missed (false negative) or a false-positive diagnosis. This review will largely focus on potential missed lesions – and ways to avoid such misses. The general causes of false-negative interpretation at CTC can be broadly characterized and grouped into discrete categories related to suboptimal study technique, specific lesion characteristics, anatomic location, and imaging artifacts. Overlapping causes further increase the likelihood of missing a clinically relevant lesion. In the end, if the technical factors of bowel preparation, colonic distention, and robust CTC software are adequately addressed on a consistent basis, and the reader is aware of all the potential pitfalls at CTC, important lesions will seldom be missed.

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Fluid Tagging for CT Colonography

Cited by 29 publications

References 20 publications

CT colonography after incomplete optical colonoscopy: bowel preparation quality at same-day vs. deferred examination

CT colonography after incomplete optical colonoscopy: bowel preparation quality at same-day vs. deferred examination

Advances in CT Colonography for Colorectal Cancer Screening and Diagnosis

Missed lesions at CT colonography: lessons learned

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