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Bowel cleansing before CT colonography: comparison between two minimal-preparation regimens

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Abstract

Aim

To compare two regimens of reduced bowel preparation and faecal tagging for CT colonography.

Materials and methods

Single centre, prospective, randomized, noninferiority study, in which 52 consecutive adults underwent routine CT colonography. Patients, following a three-day low-fibre diet, received one of the two reduced preparations: 1-L polyethylene glycol and four tablets of bisacodyl in association with 90 mL of Iopamidol for faecal tagging administered on the same day as CTC examination (group 1); or a standard "iodine-only" preparation, consisting in 180 ml of Iopamidol the day before the examination (group 2). Primary outcome was the overall quality of bowel preparation.

Results

Twenty-six patients per group were included. Per segment analysis showed preparation of diagnostic quality in 97.4 % of segments in group 1 and in 95.5 % in group 2 (p = ns). Per-patient analysis showed optimal quality of preparation in 76.9 % of patients in group 1 and in 84.6 % in group 2 (p = ns). Patient tolerability to both preparations was not different.

Conclusion

A limited bowel preparation consisting of 1-L PEG and four tablets of bisacodyl in association with 90 mL of Iodine for faecal tagging administered on the same day as CTC examination is feasible and offers bowel cleansing comparable to "iodine-only" preparation.

Key Points

Low-dose PEG bisacodyl and Iopamidol preparation is feasible, providing adequate bowel cleansing.

Faecal tagging is not different from the two limited preparations.

Patient tolerability to the two colon cleansing regimens is similar.

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References

  1. Pickhardt PJ (2013) Computed tomography colonography: emerging evidence to further support clinical effectiveness. Curr Opin Gastroenterol 29:55–9

    Article  PubMed Central  PubMed  Google Scholar 

  2. Von Wagner C, Ghanouni A, Halligan S et al (2012) Patient acceptability and psychologic consequences of CT colonography compared with those of colonoscopy: results from a multicenter randomized controlled trial of symptomatic patients. Radiology 263:723–31

    Article  Google Scholar 

  3. Neri E, Halligan S, Hellström M et al (2013) The second ESGAR consensus statement on CT colonography. Eur Radiol 23:720–9

    Article  PubMed Central  PubMed  Google Scholar 

  4. Beebe TJ, Johnson CD, Stoner SM, Anderson KJ, Limburg PJ (2007) Assessing attitudes toward laxative preparation in colorectal cancer screening and effects on future testing: potential receptivity to computed tomographic colonography. Mayo Clin Proc 82:666–71

    Article  PubMed  Google Scholar 

  5. Ristvedt SL, McFarland EG, Weinstock LB, Thyssen EP (2003) Patient preferences for CT colonography, conventional colonoscopy, and bowel preparation. Am J Gastroenterol 98:578–85

    Article  PubMed  Google Scholar 

  6. Liedenbaum MH, Denters MJ, de Vries AH et al (2010) Low-fiber diet in limited bowel preparation for CT colonography: Influence on image quality and patient acceptance. AJR Am J Roentgenol 195:W31–W37

    Article  PubMed  Google Scholar 

  7. Bielen D, Thomeer M, Vanbeckevoort D et al (2003) Dry preparation for virtual CT colonography with fecal tagging using water-soluble contrast medium: initial results. Eur Radiol 13:453–458

    PubMed  Google Scholar 

  8. Lefere P, Gryspeerdt S, Marrannes J, Baekelandt M, Van Holsbeeck B (2005) CT colonography after fecal tagging with a reduced cathartic cleansing and a reduced volume of barium. AJR Am J Roentgenol 184:1836–1842

    Article  PubMed  Google Scholar 

  9. Iannaccone R, Laghi A, Catalano C et al (2004) Computed tomographic colonography without cathartic preparation for the detection of colorectal polyps. Gastroenterology 127:1300–1311

    Article  PubMed  Google Scholar 

  10. Hara AK, Kuo MD, Blevins M et al (2011) (National CT colonography trial (ACRIN 6664): comparison of three full-laxative bowel preparations in more than 2500 average-risk patients. AJR Am J Roentgenol 196:1076–82

    Article  PubMed Central  PubMed  Google Scholar 

  11. Liedenbaum MH, de Vries AH, Gouw CI et al (2010) CT colonography with minimal bowel preparation: evaluation of tagging quality, patient acceptance and diagnostic accuracy in two iodine-based preparation schemes. Eur Radiol 20:367–76

    Article  PubMed Central  PubMed  Google Scholar 

  12. Zalis ME, Blake MA, Cai W et al (2012) Diagnostic accuracy of laxative-free computed tomographic colonography for detection of adenomatous polyps in asymptomatic adults: a prospective evaluation. Ann Intern Med 156:692–702

    Article  PubMed  Google Scholar 

  13. Iafrate F, Hassan C, Ciolina M et al (2011) High positive predictive value of CT colonography in a referral centre. Eur J Radiol 80:289–92

    Article  Google Scholar 

  14. Iafrate F, Hassan C, Zullo A et al (2008) CT colonography with reduced bowel preparation after incomplete colonoscopy in the elderly. Eur Radiol 18:1385–95

    Article  CAS  PubMed  Google Scholar 

  15. Katayama H, Yamaguchi K, Kozuka T, Takashima T, Seez P, Matsuura K (1990) Adverse reactions to ionic and nonionic contrast media. A report from the Japanese Committee on the Safety of Contrast Media. Radiology 175:621–8

    Article  CAS  PubMed  Google Scholar 

  16. Ridley LJ (1998) Allergic reactions to oral iodinated contrast agents: reactions to oral contrast. Australas Radiol 42(2):114–7

    Article  CAS  PubMed  Google Scholar 

  17. "Guideline for Good Clinical Practice". International Conference on Harmonisation of Technical Requirements for the Registration of Pharmaceuticals for Human Use. 1996-06-10

  18. Pollentine A, Mortimer A, McCoubrie P, Archer L (2012) Evaluation of two minimal-preparation regimes for CT colonography: optimising image quality and patient acceptability. Br J Radiol 85

  19. Wewers ME, Lowe NK (1990) A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health 13:227–236

    Article  CAS  PubMed  Google Scholar 

  20. Stoop EM, de Haan MC, de Wijkerslooth TR et al (2012) Partecipation and yield of colonoscopy versus non-cathartic CT colonography in population-based screening for colorectal cancer: a randomized controlled trial. Lancet Oncol 13:55–64

    Article  PubMed  Google Scholar 

  21. Seymour CW, Pryor JP, Gupta R et al (2004) Anaphylactoid reaction to oral contrast for computed tomography. J Trauma 57:1105–07

    Article  PubMed  Google Scholar 

  22. Keeling AN, Slattery MM, Leong S et al (2010) Limited-preparation CT colonography in frail elderly patients: a feasibility study. AJR Am J Roentgenol 194:1279–1287

    Article  PubMed  Google Scholar 

  23. Park SS, Sinn DH, Kim YH et al (2010) Efficacy and tolerability of split-dose magnesium citrate: low-volume (2 liters) polyethylene glycol vs. single- or split-dose polyethylene glycol bowel preparation for morning colonoscopy. Am J Gastroenterol 105:1319–1326

    Article  CAS  PubMed  Google Scholar 

  24. Borden ZS, Pickhardt PJ, Kim DH, Lubner MG, Agriantonis DJ, Hinshaw JL (2010) Bowel preparation for CT colonography: blinded comparison of magnesium citrate and sodium phosphate for catharsis. Radiology 254:138–144

    Article  PubMed  Google Scholar 

  25. Keedy AW, Yee J, Aslam R, Weinstein S et al (2011) Reduced cathartic bowel preparation for CT colonography: prospective comparison of 2-L polyethylene glycol and magnesium citrate. Radiology 261:156–64

    Article  PubMed Central  PubMed  Google Scholar 

  26. Neri E, Turini F, Cerri F, Vagli P, Bartolozzi C (2009) CT colonography: same-day tagging regimen with iodixanol and reduced cathartic preparation. Abdom Imaging 34:642–7

    Article  PubMed  Google Scholar 

  27. Campanella D, Morra L, Delsanto S et al (2010) Comparison of three different iodine-based bowel regimens for CT colonography. Eur Radiol 20:348–58

    Article  PubMed  Google Scholar 

  28. Manabe N, Cremonini F, Camilleri M, Sandborn WJ, Burton DD (2009) Effects of bisacodyl on ascending colon emptying and overall colonic transit in healthy volunteers. Aliment Pharmacol Ther 30:930–6

    Article  CAS  PubMed Central  PubMed  Google Scholar 

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Acknowledgements

The scientific guarantor of this publication is Andrea Laghi. The authors of this manuscript declare relationships with the following companies: Bracco Imaging, GE Healthcare. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, randomised controlled trial, performed at one institution.

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Correspondence to F. Iafrate.

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Iafrate, F., Iannitti, M., Ciolina, M. et al. Bowel cleansing before CT colonography: comparison between two minimal-preparation regimens. Eur Radiol 25, 203–210 (2015). https://doi.org/10.1007/s00330-014-3345-0

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  • DOI: https://doi.org/10.1007/s00330-014-3345-0

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