MR Colonography with Limited Bowel Preparation: Patient Acceptance Compared with That of Full-Preparation Colonoscopy

Florie, Jasper; Birnie, Erwin; Gelder, Rogier E. van; Jensch, Sebastiaan; Haberkorn, Brigitte C M; Bartelsman, J. F. W. M.; Veer, A. Van Der Sluys; Snel, P.; Hulst, Victor P. M. van der; Bonsel, Gouke J.; Bossuyt, Patrick M.; Stoker, Jaap

doi:10.1148/radiol.2451061244

Cited by 35 publications

(14 citation statements)

References 24 publications

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“…Achiam et al [2] used a five-point pain scale and indicated significantly greater discomfort during CC than MRC, a similar finding to Florie et al [4] who also grouped pain into five categories from ''none'' to ''extreme''. In our qualitative study, pain was mentioned more frequently with CC than MRC.…”

Section: Discussionmentioning

confidence: 68%

“…Patient acceptance is influenced by several factors, including test expectations, comfort, overall satisfaction and diagnostic performance. While it is assumed that patient acceptance of MRC is higher than colonoscopy, this is based on a limited number of studies [2][3][4][5][6][7]. For example, Achiam et al [2] reported that, in a cohort of 64 patients, 71% expressed preference for MRC as a future examination because it was less painful and unpleasant than CC.…”

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confidence: 99%

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Patient experiences of MR colonography and colonoscopy: a qualitative study

Hafeez

Wagner²,

Smith³

et al. 2012

BJR

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Objectives: The aim of this study was to apply qualitative techniques to assimilate data on patient experience and attitudes during MR colonography (MRC) and colonoscopy (CC). Methods: 18 patients (11 male, 8 female, median age 40.5 years), 10 of whom had known colonic inflammatory bowel disease (IBD) and 8 who were under investigation for suspected colonic neoplasia (non-IBD), underwent MRC and conventional CC. Semistructured interviews were performed to assimilate test experiences and preferences, and themes were extracted using thematic analysis. Results: Thematic analysis identified three main themes: (i) physical experience, (ii) information provision and (iii) overall preference. Patients expressed mixed views about the physical experience of MRC but specifically identified water filling, breath holding and lying still as problematic. Anxiety was expressed regarding potential incontinence. Scanner noise interfered with the understanding of instructions, particularly amongst non-IBD patients. Non-IBD patients expressed greater anxiety over the delay in receiving the MRC report than IBD patients. In general MRI was considered as the more informative and safer investigation. Patients reported more physical discomfort during CC (notably IBD patients) related to air insufflation and colonoscopic manipulation but were more satisfied with the feedback they received. 10 patients (56%) stated an overall preference for MRC and 5 (28%) preferred CC. Reasons for preferences stated by the patients included discomfort, speed of the test, safety, perceived diagnostic ability and the ability to take biopsies. Conclusion: Experiences of MRC and CC are complex and influenced by clinical indication. Individuals place different weightings on the relative importance of test attributes including discomfort, noise, immobility, feedback, safety and fear of incontinence and this defines overall preference. Colonoscopy (CC) remains the reference standard for diagnosing colonic inflammatory bowel disease (IBD) and neoplasia. However there is considerable interest in potentially less invasive radiological alternatives with reduced risk of serious complications. Recent data suggest that MR colonography (MRC) achieves adequate sensitivity for detection and grading of inflammation [1] and is proposed as a safer, less invasive alternative to colonoscopy for monitoring and restaging of IBD.Although diagnostic performance is the major determinant for uptake of any radiological investigation, acceptability to patients is also an important consideration. This is especially relevant in IBD, given the need for repeated colonic examinations over the course of the disease. Patient acceptance is influenced by several factors, including test expectations, comfort, overall satisfaction and diagnostic performance. While it is assumed that patient acceptance of MRC is higher than colonoscopy, this is based on a limited number of studies [2][3][4][5][6][7]. For example, Achiam et al [2] reported that, in a cohort of 64 patients, 71% expressed preferen...

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Section: Discussionmentioning

confidence: 68%

mentioning

confidence: 99%

Patient experiences of MR colonography and colonoscopy: a qualitative study

Hafeez

Wagner²,

Smith³

et al. 2012

BJR

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“…Although Mannitol was used in this study for clear visual confirmation of the effect of glucagon, the tagging sequence provides its own contrast and the method of motion sampling does not require bowel distention. Combined with the ability to sample motion during free breathing the low dependence on bowel preparation schemes will increase the patient acceptance of the method, as bowel preparation is often considered burdensome (19,20). Furthermore, bowel motion can be sampled during all motility periods related to the complete digestive process and during both wake and sleeping states with relative ease.…”

Section: Discussionmentioning

confidence: 99%

Use of continuously MR tagged imaging for automated motion assessment in the abdomen: A feasibility study

Sprengers

Paardt

Zijta

et al. 2012

Magnetic Resonance Imaging

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Purpose: To investigate the feasibility of measuring motion in the abdomen using a continuously tagged magnetic resonance imaging sequence. Materials and Methods:To assess (nonperiodic) motion in the abdomen, a nontriggered, continuously tagged transient field echo (TFE) sequence was implemented that acquires one complete 3D dataset per prepulse after a fixed delay. In postprocessing, a frequency analysis approach was developed for compact reviewing of the data and noise suppression. For proof of principle, a simulation was made and one free-breathing dynamic in vivo scan was acquired in a healthy volunteer. During the dynamic scan the volunteer received glucagon intravenously. Results:The simulation showed that this frequency analysis enables the extraction of motion at low signal-tonoise ratio levels. Motion information was successfully gathered from the in vivo scan. The decline in bowel motion caused by the administration of glucagon could be quantitatively measured using the continuously tagged sequence. Conclusion:Continuously tagged imaging in the abdomen for the purpose of automated gathering of motion information is feasible and could aid the study of bowel motion.

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“…Overall, MR colonography had a sensitivity of 93% and a specificity of 99% for polyp detection. In an MRC study of Florie et al (26) conducted through administering lactulose and gadolinium-containing oral contrast medium beginning from 48 hours prior to the study, the sensitivity was 77% in lesions 10 mm and above. The majority of studies in the past decade has focused on the role of dark-lumen MR colonography.…”

Section: Discussionmentioning

confidence: 99%

The sensitivity of MR colonography using dark lumen technique for detection of colonic lesions

Acay

Bayramoğlu²,

Acay³

2020

Turk J Gastroenterol

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Background/Aims: To assess the detectability of the lesions with magnetic resonance (MR) colonography using dark lumen technique that had been detected on conventional colonoscopy. Materials and Methods: A total of 38 patients who were suspected to have a colorectal mass between April 2008 and June 2010 were included in this prospective study. Warm tap water was administered via a rectal tube to the patients in prone position. Then, axial T2 true-fast imaging with steady-state precession (FISP), axial T2 half-Fourier acquisition single-shot turbo spin-echo (HASTE), diffusion-weighted images, and T1 vibe fat suppression coronal sequences were obtained. T1 vibe fat suppression sequences on axial coronal planes were repeated after gadolinium contrast medium intravenous injection. MR images were analyzed by two radiologists concurrently. Assessments were done by comparing with conventional colonoscopy and histopathologic findings. Results: Thirteen out of 20 lesions that had been detected on conventional colonoscopy were correctly obtained by MR colonography. None of the three lesions 5 mm or below was seen on MR colonography. Two out of 4 lesions measuring 6-9 mm were seen on MR colonography (50%). Eleven out of 13 lesions 10 mm and above were correctly detected on MR colonography (84.6%). Sensitivity was estimated as 65% when all lesions were evaluated together. Conclusion: MR colonography has a high sensitivity in the diagnosis of colonic pathologies without ionizing radiation. Future investigation will likely lead to wider acceptance of this method to detect colonic pathologies, including perhaps their use in colon cancer screening programs.

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MR Colonography with Limited Bowel Preparation: Patient Acceptance Compared with That of Full-Preparation Colonoscopy

Abstract: Participants preferred MR colonography without extensive cleansing to colonoscopy immediately after both examinations and 5 weeks later. Experience of the bowel preparation and of the procedure was rated better.

Cited by 35 publications

References 24 publications

Patient experiences of MR colonography and colonoscopy: a qualitative study

Patient experiences of MR colonography and colonoscopy: a qualitative study

Use of continuously MR tagged imaging for automated motion assessment in the abdomen: A feasibility study

The sensitivity of MR colonography using dark lumen technique for detection of colonic lesions

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