CT colonography without cathartic preparation: positive predictive value and patient experience in clinical practice
- Carmen Zueco ZuecoAffiliated withComplexo Hospitalario Universitario de Vigo - CHUVI Email author
- , Carolina Sobrido SampedroAffiliated withComplexo Hospitalario Universitario de Vigo - CHUVI
- , Juan D. CorrotoAffiliated withComplexo Hospitalario Universitario de Vigo - CHUVI
- , Paula Rodriguez FernándezAffiliated withComplexo Hospitalario Universitario de Vigo - CHUVI
- , Manuela Fontanillo FontanilloAffiliated withComplexo Hospitalario Universitario de Vigo - CHUVI
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To determine the positive predictive value (PPV) for polyps ≥6 mm detected at CT colonography (CTC) performed without cathartic preparation, with low-dose iodine faecal tagging regimen and to evaluate patient experience.
1920 average-risk patients underwent CTC without cathartic preparation. Faecal tagging was performed by diatrizoate meglumine and diatrizoate sodium at a total dose of 60 ml (22.2 g of iodine).The standard interpretation method was primary 3D with 2D problem solving. We calculated per-patient and per-polyp PPV in relation to size and morphology. All colonic segments were evaluated for image quality (faecal tagging, amount of liquid and solid residual faeces and luminal distension). Patients completed a questionnaire before and after CTC to assess preparation and examination experience.
Per-polyp PPV for detected lesions of ≥6 mm, 6–9 mm, ≥10 mm and ≥30 mm were 94.3%, 93.1%, 94.7% and 98%, respectively. Per-polyp PPV, according to lesion morphology, was 94.6%, 97.3% and 85.1% for sessile, pedunculated and flat polyps, respectively. Per-patient PPV was 92.8%. Preparation without frank cathartics was reported to cause minimal discomfort by 78.9% of patients.
CTC without cathartic preparation and low-dose iodine faecal tagging may yield high PPVs for lesions ≥6 mm and is well accepted by patients.
• Computed tomographic colonography (CTC) without cathartic preparation is well accepted by patients
• Cathartic-free faecal tagging CTC yields high positive predictive values
• CTC without cathartic preparation could improve uptake of colorectal cancer screening
KeywordsCT-colonography Faecal tagging Patient acceptance Colorectal cancer Bowel preparation colorectal polyp Adenoma
- CT colonography without cathartic preparation: positive predictive value and patient experience in clinical practice
Volume 22, Issue 6 , pp 1195-1204
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- Faecal tagging
- Patient acceptance
- Colorectal cancer
- Bowel preparation colorectal polyp
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- Author Affiliations
- 1. Complexo Hospitalario Universitario de Vigo - CHUVI, c/Pizarro 22, 36204, Vigo, Pontevedra, Spain
- 2. Complexo Hospitalario Universitario de Vigo - CHUVI, H Meixoeiro, 2ªpl. s/n, 36214, Vigo, Pontevedra, Spain