Tagging-based, Electronically Cleansed CT Colonography: Evaluation of Patient Comfort and Image Readability

Zalis, Michael E.; Perumpillichira, James; Magee, Cordula; Kohlberg, Gavriel D.; Hahn, Peter F.

doi:10.1148/radiol.2383041308

Cited by 102 publications

(82 citation statements)

References 15 publications

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“…This is surprising, and other studies using this technique have produced poor results [12]. This is likely to be due to the insolubility of barium and its tendency to accumulate at the base of pools of fluid.…”

Section: Discussionmentioning

confidence: 92%

Laxative-free CT colonography

Slater¹,

Betts²,

DʼCosta³

2012

The British Journal of Radiology

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Objectives: The aim of this study was to determine if the introduction of faecal tagging to CT colonography (CTC) made the examination easier to tolerate or reduced the number of false-positives. Methods: Our department changed bowel preparation for CT colonography from Picolax (Ferring Pharmaceuticals Ltd, London, UK) to Gastrografin® (Bracco Diagnostics Inc, Princeton, NJ) only with a modified diet. Questionnaires were given to a subgroup of patients within these cohorts. The numbers of false-positives were compared between two cohorts before and after this change. false-positives were defined as lesions reported on CT that were not confirmed by subsequent endoscopic examination. Polyps were matched if they were in the same or adjacent segments, and were within 5 mm of the reported size. Results: 412 patients were identified from the Picolax cohort, and 116 from the Gastrografin cohort. 62 patients in each group completed questionnaires. Gastrografin produced less diarrhoea; 34% had five or more bowel motions in the previous day and night, compared with 77% for Picolax (p<0.001), although more patients found drinking it unpleasant compared with Picolax (85% reported drinking Picolax as “easy” vs 61% for Gastrografin; p=0.002). Picolax produced more non-diagnostic examinations, although this difference was not statistically significant. There was not a significant reduction in the numbers of false-positives (2 out of 112 for Gastrografin group, 14 out of 389 for the Picolax group; p=0.54). Conclusion: Switching from Picolax to Gastrografin as a CTC preparation technique produced less diarrhoea, but did not reduce the number of false-positives.

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Section: Discussionmentioning

confidence: 92%

Laxative-free CT colonography

Slater¹,

Betts²,

DʼCosta³

2012

The British Journal of Radiology

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“…However, Johnson et al [16] report good results with no diet modification or laxative and barium faecal tagging, in particular a high specificity (100%) for large adenomas. This is surprising, and other studies using this technique have produced poor results [17]. Most practitioners using barium tagging would combine it with at least a reduced dose of laxatives [18,19].…”

Section: Discussionmentioning

confidence: 99%

Gas insufflation of minimal preparation CT of the colon reduces false-positives

Slater

North²,

Hart³

et al. 2012

BJR

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Objectives: Minimal preparation CT of the colon (MPCT colon) is used for investigation of suspected colorectal cancer in frail and/or elderly patients who would be expected to tolerate laxative bowel preparation poorly. Although it has good sensitivity for colorectal cancer it has a poor specificity. We wished to investigate whether distension of the colon with carbon dioxide alone would reduce the number of false-positives, but without making the test arduous or excessively uncomfortable. Methods: 134 patients were recruited and underwent MPCT colon with gas insufflation and antispasmodics. Results were compared with a cohort of 134 patients undergoing standard protocol MPCT colon. The numbers of false-positives were compared, as was reader confidence. All trial patients were given a questionnaire documenting their experience. Results: The number of false-positives was 15% in the control group and 5% in the trial group; this difference was statistically significant, (p50.01). Reader confidence was increased in the trial group. Patient tolerance was good, with 95% saying they would have the test again. Conclusion: Use of gas insufflation and antispasmodics reduces the false-positives from 15% to 5% without adversely affecting patient tolerance.

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“…This has additional potential implications in electronic bowel cleansing and computeraided detection applications. The potential downside of this effect in terms of abdominopelvic CT is an increase in diarrhoea experienced by patients [20]. Conversely, this cathartic side effect is beneficial in the setting of CTC, reducing the volume of colonic residue and resulting in a "cleaner" colon.…”

Section: Discussionmentioning

confidence: 99%

Acceptability of oral iodinated contrast media: a head-to-head comparison of four media

Pollentine

Ngan-Soo²,

McCoubrie³

2013

BJR

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Objective: To assess the palatability of iodinated oral contrast media commonly used in abdominopelvic CT and CT colonography (CTC).Methods: 80 volunteers assessed the palatability of a 20-ml sample of a standard 30 mg ml 21 dilution of Omnipaque® (iohexol; GE Healthcare, Cork, Ireland), Telebrix® (meglumine ioxithalamate; Guerbet, Aulnay-sous-Bois, France), Gastromiro® (iopamidol; Bracco, High Wycombe, UK) and Gastrografin® (sodium diatrizoate and meglumine diatrizoate; Bayer, Newbury, UK) in a computer-generated random order.Results: Gastrografin is rated significantly less palatable than the remaining media (p,0.005). Omnipaque and Telebrix are significantly more palatable than Gastromiro.No difference existed between Omnipaque and Telebrix. 39% of participants would refuse to consume the quantities of Gastrografin required for a CTC examination compared with Telebrix (7%) and Omnipaque (9%) (p,0.05). Conclusion:Omnipaque and Telebrix are significantly more palatable than both Gastromiro and Gastrografin, with participants more willing to ingest them in larger quantities as well as being less expensive. Advances in knowledge:Omnipaque and Telebrix are significantly more palatable iodinated oral contrast media than both Gastromiro and Gastrografin, which has potential implications in compliance with both abdominopelvic CT and CTC.

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Tagging-based, Electronically Cleansed CT Colonography: Evaluation of Patient Comfort and Image Readability

Cited by 102 publications

References 15 publications

Laxative-free CT colonography

Laxative-free CT colonography

Gas insufflation of minimal preparation CT of the colon reduces false-positives

Acceptability of oral iodinated contrast media: a head-to-head comparison of four media

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