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

Keedy, Alexander W.; Yee, Judy; Aslam, Rizwan; Weinstein, Stefanie; Landeras, Luis; Shah, Janak N.; McQuaid, Kenneth R.; Yeh, Benjamin M.

doi:10.1148/radiol.11110217

Cited by 20 publications

(8 citation statements)

References 44 publications

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“…On the other hand, less residual fluid is generally preferable for CTC data interpretation [ 15 , 16 ] since it results in shorter interpretation times [ 16 ]. Furthermore, in accordance with previous studies [ 10 , 17 ] we found that the left colon was significantly better prepared than the right colon independent of the dietregimens.…”

Section: Discussionsupporting

confidence: 93%

Comparison of a 4-Day versus 2-Day Low Fiber Diet Regimen in Barium Tagging CT Colonography in Incomplete Colonoscopy Patients

Meriç

Bakal

Şenateş

et al. 2015

Gastroenterology Research and Practice

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Our aim was to compare the amount of residual feces, residual fluid, the tagging quality, and patient compliance using 4-day versus 2-day low fiber diet regimen in barium tagging CT colonography in incomplete colonoscopy patients. Methods. A total of 101 patients who underwent CT colonography were assigned to 2-day diet group (n = 56) and 4-day diet group (n = 45). Fecal tagging was achieved with barium sulphate while bisacodyl and sennoside B were used for bowel preparation. Residual solid stool was divided into two groups measuring <6 mm and ≥6 mm. We graded the residual fluid, tagging quality for solid stool, and fluid per bowel segment. We performed a questionnaire to assess patient compliance. Results. 604 bowel segments were evaluated. There was no significant difference between 2-day and 4-day diet groups with respect to residual solid stool, residual fluid, tagging quality for stool, and fluid observed in fecal tag CT colonography (P > 0.05). The prevalence of moderate discomfort was significantly higher in 4-day group (P < 0.001). Conclusion. Our study shows that 2-day limited bowel preparation regimen for fecal tag CT colonography is a safe and reasonable technique to evaluate the entire colon, particularly in incomplete conventional colonoscopy patients.

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Section: Discussionsupporting

confidence: 93%

Comparison of a 4-Day versus 2-Day Low Fiber Diet Regimen in Barium Tagging CT Colonography in Incomplete Colonoscopy Patients

Meriç

Bakal

Şenateş

et al. 2015

Gastroenterology Research and Practice

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“…However, those attempts provided primarily linear diameter assessment in defined colonic segments and not a true volumetric analysis of the entire colon. As for manual semi-quantitative subjective studies assessing residual fluid (8, 14, 15, 19, 28), the percentage of colonic cross-sectional surface area covered by fluid was used, a value that is highly dependent on luminal distension. The present automatically calculated volumetric data are objective, more robust, less error prone, and more sensitive to change compared with random samples and/or linear measures.…”

Section: Discussionmentioning

confidence: 99%

Intra-individual comparison of magnesium citrate and sodium phosphate for bowel preparation at CT colonography: Automated volumetric analysis of residual fluid for quality assessment

et al. 2014

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AIM To perform an objective, intra-individual comparison of residual colonic fluid volume and attenuation associated with the current front-line laxative magnesium citrate (MgC) versus the former front-line laxative sodium phosphate (NaP) at CT colonography (CTC). MATERIALS AND METHODS This retrospective Health Insurance and Portability and Accountability Act-compliant study had institutional review board approval; informed consent was waived. The study cohort included 250 asymptomatic adults (mean age at index 56.1 years; 124 male/126 female) who underwent CTC screening twice over a 5 year interval. Colon catharsis at initial and follow-up screening employed single-dose NaP and double-dose MgC, respectively, allowing for intra-patient comparison. Automated volumetric analysis of residual colonic fluid volume and attenuation was performed on all 500 CTC studies. Colonic fluid volume <200 ml and mean attenuation between 300–900 HU were considered optimal. Paired t-test and McNemar’s test were used to compare differences. RESULTS Residual fluid volumes <200 ml were recorded in 192 examinations (76.8%) following MgC and in 204 examinations (81.6%) following NaP (p=0.23). The mean total residual fluid volume was 155±114 ml for MgC and 143±100 ml for NaP (p=0.01). The attenuation range of 300–900 HU was significantly more frequent for MgC (n=220, 88%) than for NaP (n=127, 50.8%; p<0.001). Mean fluid attenuation was significantly lower for MgC (700±165 HU) than for NaP (878±155 HU; p<0.001). Concomitant presence of both optimal fluid volume and attenuation was significantly more frequent for MgC 65.2% than for NaP (38%; p<0.001). CONCLUSIONS Objective intra-individual comparison using automated volumetric analysis suggests that the replacement of NaP by MgC as the front-line laxative for CTC has not compromised overall examination quality.

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“…Lower dose cleansing regimens resulted in improved patient acceptance rates. In another study half volume polyethylene glycol (two liters) was compared to magnesium citrate in patients undergoing CTC15. Adequate cleansing with better tagging and shorter interpretation times were found in the patients who received the reduced volume PEG.…”

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

Cited by 20 publications

References 44 publications

Comparison of a 4-Day versus 2-Day Low Fiber Diet Regimen in Barium Tagging CT Colonography in Incomplete Colonoscopy Patients

Comparison of a 4-Day versus 2-Day Low Fiber Diet Regimen in Barium Tagging CT Colonography in Incomplete Colonoscopy Patients

Intra-individual comparison of magnesium citrate and sodium phosphate for bowel preparation at CT colonography: Automated volumetric analysis of residual fluid for quality assessment

Advances in CT Colonography for Colorectal Cancer Screening and Diagnosis

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