Comparison of two Meglumine-Diatrizoate based bowel preparations for computed tomography colonography: Comparison of patient symptoms and bowel preparation quality

Purpose This study was designed to evaluate whether a bowel preparation used for computed tomography (CT) colonography could also be suitable for same-day colonoscopy regardless of which test was done first. Method Six different endoscopists working at 3 separate hospitals evaluated 75 patients who underwent colonoscopy after receiving a bowel preparation that contained contrast material used to tag fecal and fluid material to facilitate CT colonography. This bowel preparation has been used in more than 1500 CT colonography studies. Evaluation included assessment of whether the colon was clean and dry, and whether the contrast material caused any impairment of visualization or clogging of the endoscopes. Some of the patients had first undergone CT colonography followed by same-day colonoscopy, whereas other patients had colonoscopy as their initial test. Results Although the contrast material was sometimes perceptible, the volumes were very small, and caused no impairment of mucosal visualization and no clogging of the endoscopes. The bowel preparation was well tolerated. Same-day CT colonography and colonoscopy with fecal tagging was technically possible. Conclusion A simple, fairly low cost 1-day bowel preparation with fluid and fecal tagging is suitable for CT colonography and colonoscopy done the same day in either order. However, the preferences of individual endoscopists and difficulties with making oral contrast agents readily available are challenges to widespread adoption of a common bowel preparation regimen.

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Bowel Preparation Regimen for Computed Tomography Colonography

Canadian Association of Radiologists Journal ◽

10.1016/j.carj.2009.12.008 ◽

2010 ◽

Vol 61 (5) ◽

pp. 280-285 ◽

Cited By ~ 2

Author(s):

Carola Behrens ◽

Richard Eddy ◽

Giles Stevenson ◽

Louise Audet ◽

John Mathieson

Keyword(s):

Computed Tomography ◽

Bowel Preparation ◽

Solid Material ◽

Oral Contrast ◽

Fecal Matter ◽

Computed Tomography Colonography ◽

Group Assignment ◽

Residual Material ◽

To Come ◽

Trained Observers

Purpose This study was designed to determine whether a reduction in oral contrast dose and a change in timing of administration will result in less residual material in the colonic lumen. Method We retrospectively assessed, in a blinded fashion, the amount and nature of residual material in the colon in 40 patients who received computed tomography colonography. Half of the cohort received the standard bowel-preparation regimen, whereas a sex- and age-matched test arm received the modified regimen. A scoring system that consisted of metrics to quantify the nature and extent of residual fluid and solid material was defined. Image analysis was conducted with the investigators blinded to the group assignment of each patient. Three different trained observers independently reviewed and scored the 6 colonic segments in supine and prone positions for each patient in the cohort. In cases in which interobserver discrepancies existed, the observers reanalyzed the images together to come to an agreement on scores. Results The new bowel-preparation regimen resulted in significantly less “sticky coat” ( P < .005), a problematic phenomenon in which the colonic mucosa is covered in a thin coating of residual contrast and fecal material. There was no difference in the amount of residual fluid. Fewer masses of stool were noted with the new preparation, but this was not found to be statistically significant. Conclusion A new bowel-preparation regimen that consisted of lower quantities of contrast administered earlier in the day preceding computed tomography colonography resulted in a lower incidence of adherent contrast and fecal matter. The reduction of this “sticky coat” problem not only improved radiologic analysis of the colon but may permit same-day therapy via colonoscopy if indicated on imaging.

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Experience of Low Volume Split-dose Bowel Preparation for Computed Tomography Colonography

Japanese Journal of Radiological Technology ◽

10.6009/jjrt.2014_jsrt_70.7.676 ◽

2014 ◽

Vol 70 (7) ◽

pp. 676-683 ◽

Cited By ~ 1

Author(s):

Teruaki Iwano ◽

Masahide Tominaga ◽

Hideyo Yamashita ◽

Takashi Egawa ◽

Junji Ueno

Keyword(s):

Computed Tomography ◽

Bowel Preparation ◽

Split Dose ◽

Computed Tomography Colonography ◽

Low Volume

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Feasibility study of computed tomography colonography using limited bowel preparation at normal and low-dose levels study

European Radiology ◽

10.1007/s00330-007-0668-0 ◽

2007 ◽

Vol 17 (12) ◽

pp. 3112-3122 ◽

Cited By ~ 40

Author(s):

Jasper Florie ◽

Rogier E. van Gelder ◽

Michiel P. Schutter ◽

Adrienne van Randen ◽

Henk W. Venema ◽

...

Keyword(s):

Computed Tomography ◽

Feasibility Study ◽

Bowel Preparation ◽

Low Dose ◽

Computed Tomography Colonography ◽

Dose Levels

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An approach for performing a successful computed tomography colonography examination

South African Journal of Radiology ◽

10.4102/sajr.v18i1.607 ◽

2014 ◽

Vol 18 (1) ◽

Cited By ~ 11

Author(s):

Joel H. Bortz

Keyword(s):

Colorectal Cancer ◽

Computed Tomography ◽

Carbon Dioxide ◽

Minimally Invasive ◽

Bowel Preparation ◽

Carbon Dioxide Insufflation ◽

Computed Tomography Colonography ◽

Screening Examination ◽

3D Scans

Computed tomography colonography (CTC) is a minimally invasive, fast, safe and accurate screening examination for colorectal cancer. It also allows evaluation of structures outside the colon. A successful CTC examination requires good bowel preparation, adequate patient hydration, tagging agents, the use of automated carbon dioxide insufflation, and correct positioning for two view and additional view scans. Knowledge of polyp morphology and measurement of polyps are important when interpreting 2D or 3D scans.

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Computed tomography colonography: Retrospective comparison of laxative plus barium tagging versus iodinated contrast only for bowel preparation and faecal tagging

Journal of Medical Imaging and Radiation Oncology ◽

10.1111/1754-9485.12860 ◽

2019 ◽

Vol 63 (2) ◽

pp. 203-211

Author(s):

Elisa Perry ◽

Helen Moore ◽

Jane Reeve

Keyword(s):

Computed Tomography ◽

Bowel Preparation ◽

Computed Tomography Colonography ◽

Iodinated Contrast ◽

Retrospective Comparison ◽

Faecal Tagging

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Computed Tomography Colonography as a Sensible Option for Colorectal Cancer Screening: Evidence Based on Metanalysis

Journal of Coloproctology ◽

10.1055/s-0041-1726079 ◽

2021 ◽

Vol 41 (01) ◽

pp. 087-095

Author(s):

Ingrid Chaves de Souza Borges ◽

Natália Costa Resende Cunha ◽

Amanda Marsiaj Rassi ◽

Marcela Garcia de Oliveira ◽

Jacqueline Andréia Bernardes Leão-Cordeiro ◽

...

Keyword(s):

Colorectal Cancer ◽

Computed Tomography ◽

Cancer Screening ◽

Literature Search ◽

Web Of Science ◽

Screening Method ◽

Colorectal Polyp ◽

Evidence Based ◽

Polyp Detection ◽

Computed Tomography Colonography

Abstract Objective This metanalysis aimed to evaluate the sensitivity and specificity of computed tomography colonography in colorectal polyp detection. Methods A literature search was performed in the PubMed and Web of Science databases. Results A total of 1,872 patients (males 57.2%, females 42.8%) aged 49 to 82 years old (mean age 59.7 ± 5.3 years) were included in this metanalysis. The estimated sensitivity of computed tomography colonography was 88.4% (46.3–95.7%, coefficient of variation [CV] = 28.5%) and the estimated specificity was 73.6% (47.4–100.0%, CV = 37.5%). For lesions up to 9 mm, the sensitivity was 82.5% (62.0–99.9%, CV = 25.1%) and the specificity was 79.2% (32.0–98.0%, CV = 22.9%). For lesions > 9 mm, the sensitivity was 90.2% (64.0–100.0%, CV = 7.4%) and the specificity was 94.7% (80.0–100.0%, CV = 6.2%). No statistically significant differences in sensitivity according to the size of the lesion were found (p = 0.0958); however, the specificity was higher for lesions > 9 mm (p < 0.0001). Conclusions Most of the studies analyzed in the present work were conducted before 2010, which is about a decade after computed tomography colonography started being indicated as a screening method by European and American guidelines. Therefore, more studies aimed at analyzing the technique after further technological advancements are necessary, which could lead to the development of more modern devices.

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