Skip to main content

Advertisement

SpringerLink
Log in

Fecal tag CT colonography with a limited 2-day bowel preparation following incomplete colonoscopy

  • Original Article
  • Published:
Japanese Journal of Radiology Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to assess the feasibility and patient tolerance of a 2-day limited fecal tag bowel preparation in computed tomographic colonography (CTC) performed for incomplete conventional colonoscopy (CC) patients.

Materials and methods

Seventy-five patients who underwent a CTC examination fbecause of incomplete CC were included. A low-residue diet was given for 2 days before CTC. Fecal tagging (FT) was done using a barium sulfate suspension. The quality of the preparation, success of tagging and patient experience with the bowel preparation were investigated.

Results

Four hundred fifty bowel segments were evaluated. The number of solid stool balls of 6–9 mm size was 284; the corresponding figure was 93 for solid stool balls ≥10 mm. Residual fluid was present in about one-third of the segments. The fecal tagging efficacy for ≥6 mm residual stool balls was 92 %. Overall, 16 (21.3 %) patients presented with colonic lesions at CTC. Three out of four colonic mass lesions had not been diagnosed with CC. Most patients reported mild discomfort.

Conclusion

FT-CTC performed after a limited 2-day bowel preparation seems to be a technically feasible, safe and acceptable procedure that allows a complete a colonic study in incomplete CC patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Espey DK, Wu XC, Swan J, Wiggins C, Jim MA, Ward E, et al. Annual report to the nation on the status of cancer, 1975–2004, featuring cancer in American Indians and Alaska Natives. Cancer. 2007;110:2119–52.

    Article  PubMed  Google Scholar 

  2. Smith RA, Cokkinides V, von Eschenbach AC, Levin B, Cohen C, Runowicz CD, et al. American Cancer Society guidelines for the early detection of cancer. CA Cancer J Clin. 2002;52:8–22.

    Article  PubMed  Google Scholar 

  3. Ransohoff DF, Sandler RS. Clinical practice. Screening for colorectal cancer. N Engl J Med. 2002;346:40–4.

    Article  PubMed  Google Scholar 

  4. Schrock TR. Colonoscopy for colorectal cancer: too much, too little, just right. ASGE distinguished lecture 1993. Gastrointest Endosc. 1993;39:848–51.

    Article  CAS  PubMed  Google Scholar 

  5. Yucel C, Lev-Toaff AS, Moussa N, Durrani H. CT colonography for incomplete or contraindicated optical colonoscopy in older patients. AJR Am J Roentgenol. 2008;190:145–50.

    Article  PubMed  Google Scholar 

  6. Kim JH, Kim WH, Kim TI, Kim NK, Lee KY, Kim MJ, et al. Incomplete colonoscopy in patients with occlusive colorectal cancer: usefulness of CT colonography according to tumor location. Yonsei Med J. 2007;48:934–41.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  7. Schmilovitz-Weiss H, Weiss A, Boaz M, Levin I, Chervinski A, Shemesh E. Predictors of failed colonoscopy in nonagenarians: a single-center experience. J Clin Gastroenterol. 2007;41:388–93.

    Article  PubMed  Google Scholar 

  8. Gollub MJ, Flaherty F. Barium enema following incomplete colonoscopy. Clin Imaging. 1999;23:367–74.

    Article  CAS  PubMed  Google Scholar 

  9. Mitchell RM, McCallion K, Gardiner KR, Watson RG, Collins JS. Successful colonoscopy; completion rates and reasons for incompletion. Ulster Med J. 2002;71:34–7.

    CAS  PubMed Central  PubMed  Google Scholar 

  10. Wexner SD, Beck DE, Baron TH, Fanelli RD, Hyman N, Shen B, et al. A consensus document on bowel preparation before colonoscopy: prepared by a task force from the American Society of Colon and Rectal Surgeons (ASCRS), the American Society for Gastrointestinal Endoscopy (ASGE), and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). Dis Colon Rectum. 2006;49:792–809.

    Article  PubMed  Google Scholar 

  11. Macari M, Berman P, Dicker M, Milano A, Megibow AJ. Usefulness of CT colonography in patients with incomplete colonoscopy. AJR Am J Roentgenol. 1999;173:561–4.

    Article  CAS  PubMed  Google Scholar 

  12. Stracci F, Zorzi M, Grazzini G. Colorectal cancer screening: tests, strategies, and perspectives. Front Public Health. 2014;2:210.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Pickhardt PJ. Virtual colonoscopy for primary screening. The future is now. Minerva Chir. 2005;60:139–50.

    CAS  Google Scholar 

  14. Fenlon HM, Nunes DP, Schroy PC 3rd, Barish MA, Clarke PD, Ferrucci JT. A comparison of virtual and conventional colonoscopy for the detection of colorectal polyps. N Engl J Med. 1999;341:1496–503.

    Article  CAS  PubMed  Google Scholar 

  15. Yee J, Akerkar GA, Hung RK, Steinauer-Gebauer AM, Wall SD, McQuaid KR. Colorectal neoplasia: performance characteristics of CT colonography for detection in 300 patients. Radiology. 2001;219:685–92.

    Article  CAS  PubMed  Google Scholar 

  16. Bouzas Sierra R. Optical colonoscopy and virtual colonoscopy: the current role of each technique. Radiologia. 2015;57:95–100.

    Article  CAS  PubMed  Google Scholar 

  17. Rex DK, Lieberman D. Acg. ACG colorectal cancer prevention action plan: update on CT-colonography. Am J Gastroenterol. 2006;101:1410–3.

    Article  PubMed  Google Scholar 

  18. Taylor SA, Halligan S, Saunders BP, Bassett P, Vance M, Bartram CI. Acceptance by patients of multidetector CT colonography compared with barium enema examinations, flexible sigmoidoscopy, and colonoscopy. AJR Am J Roentgenol. 2003;181:913–21.

    Article  PubMed  Google Scholar 

  19. van Gelder RE, Birnie E, Florie J, Schutter MP, Bartelsman JF, Snel P, et al. CT colonography and colonoscopy: assessment of patient preference in a 5-week follow-up study. Radiology. 2004;233:328–37.

    Article  PubMed  Google Scholar 

  20. Lefere P, Gryspeerdt S, Marrannes J, Baekelandt M, Van Holsbeeck B. CT colonography after fecal tagging with a reduced cathartic cleansing and a reduced volume of barium. AJR Am J Roentgenol. 2005;184:1836–42.

    Article  PubMed  Google Scholar 

  21. Taylor SA, Slater A, Burling DN, Tam E, Greenhalgh R, Gartner L, et al. CT colonography: optimisation, diagnostic performance and patient acceptability of reduced-laxative regimens using barium-based faecal tagging. Eur Radiol. 2008;18:32–42.

    Article  PubMed Central  PubMed  Google Scholar 

  22. Iafrate F, Hassan C, Zullo A, Stagnitti A, Ferrari R, Spagnuolo A, et al. CT colonography with reduced bowel preparation after incomplete colonoscopy in the elderly. Eur Radiol. 2008;18:1385–95.

    Article  CAS  PubMed  Google Scholar 

  23. Lefere PA, Gryspeerdt SS, Dewyspelaere J, Baekelandt M, Van Holsbeeck BG. Dietary fecal tagging as a cleansing method before CT colonography: initial results polyp detection and patient acceptance. Radiology. 2002;224:393–403.

    Article  PubMed  Google Scholar 

  24. Nagata K, Singh AK, Sangwaiya MJ, Nappi J, Zalis ME, Cai W, et al. Comparative evaluation of the fecal-tagging quality in CT colonography: barium vs. iodinated oral contrast agent. Acad Radiol. 2009;16:1393–9.

    Article  PubMed  Google Scholar 

  25. Zalis ME, Barish MA, Choi JR, Dachman AH, Fenlon HM, Ferrucci JT, et al. CT colonography reporting and data system: a consensus proposal. Radiology. 2005;236:3–9.

    Article  PubMed  Google Scholar 

  26. Neerincx M, Terhaar sive Droste JS, Mulder CJ, Rakers M, Bartelsman JF, Loffeld RJ, et al. Colonic work-up after incomplete colonoscopy: significant new findings during follow-up. Endoscopy. 2010;42:730–5.

    Article  CAS  PubMed  Google Scholar 

  27. Neri E, Lefere P, Gryspeerdt S, Bemi P, Mantarro A, Bartolozzi C. Bowel preparation for CT colonography. Eur J Radiol. 2013;82:1137–43.

    Article  PubMed  Google Scholar 

  28. Taylor SA, Laghi A, Lefere P, Halligan S, Stoker J. European Society of Gastrointestinal and Abdominal Radiology (ESGAR): consensus statement on CT colonography. Eur Radiol. 2007;17:575–9.

    Article  PubMed  Google Scholar 

  29. Gryspeerdt S, Lefere P, Herman M, Deman R, Rutgeerts L, Ghillebert G, et al. CT colonography with fecal tagging after incomplete colonoscopy. Eur Radiol. 2005;15:1192–202.

    Article  CAS  PubMed  Google Scholar 

  30. Copel L, Sosna J, Kruskal JB, Raptopoulos V, Farrell RJ, Morrin MM. CT colonography in 546 patients with incomplete colonoscopy. Radiology. 2007;244:471–8.

    Article  PubMed  Google Scholar 

  31. Gschwantler M, Kriwanek S, Langner E, Goritzer B, Schrutka-Kolbl C, Brownstone E, et al. High-grade dysplasia and invasive carcinoma in colorectal adenomas: a multivariate analysis of the impact of adenoma and patient characteristics. Eur J Gastroenterol Hepatol. 2002;14:183–8.

    Article  PubMed  Google Scholar 

  32. Church JM. Clinical significance of small colorectal polyps. Dis Colon Rectum. 2004;47:481–5.

    Article  PubMed  Google Scholar 

  33. Keeling AN, Slattery MM, Leong S, McCarthy E, Susanto M, Lee MJ, et al. Limited-preparation CT colonography in frail elderly patients: a feasibility study. AJR Am J Roentgenol. 2010;194:1279–87.

    Article  PubMed  Google Scholar 

  34. Shinners TJ, Pickhardt PJ, Taylor AJ, Jones DA, Olsen CH. Patient-controlled room air insufflation versus automated carbon dioxide delivery for CT colonography. AJR Am J Roentgenol. 2006;186:1491–6.

    Article  PubMed  Google Scholar 

  35. Kanazawa H, Utano K, Kijima S, Sasaki T, Miyakura Y, Horie H, et al. A comparative study of degree of colorectal distention with manual air insufflation or automated CO(2) insufflation at CT colonography as a preoperative examination. Jpn J Radiol. 2014;32:274–81.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors thank their colleagues, Zeynep Gamze Kilicoglu and Can Gonen, for their kind assistance in the preparation of the manuscript.

Ethical standard

All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Radiology, Haydarpaşa Numune Training and Research Hospital, Tibbiye Caddesi No: 40, 34668, Uskudar, Istanbul, Turkey

    Kaan Meric, Sibel Aydin & Masum Simsek

  2. Department of Radiology, Zeynep Kamil Training and Research Hospital, Istanbul, Turkey

    Nuray Bakal

  3. Department of Gastroenterology, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey

    Atakan Yesil

  4. Department of General Surgery, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey

    Kemal Tekesin

Authors
  1. Kaan Meric
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nuray Bakal
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sibel Aydin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Atakan Yesil
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kemal Tekesin
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Masum Simsek
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kaan Meric.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Meric, K., Bakal, N., Aydin, S. et al. Fecal tag CT colonography with a limited 2-day bowel preparation following incomplete colonoscopy. Jpn J Radiol 33, 329–335 (2015). https://doi.org/10.1007/s11604-015-0421-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11604-015-0421-6

Keywords

Search

Navigation