European Radiology

, Volume 29, Issue 5, pp 2457–2464 | Cite as

Patients’ experience of screening CT colonography with reduced and full bowel preparation in a randomised trial

  • Lapo SaliEmail author
  • Leonardo Ventura
  • Grazia Grazzini
  • Alessandra Borgheresi
  • Silvia Delsanto
  • Massimo Falchini
  • Beatrice Mallardi
  • Paola Mantellini
  • Stefano Milani
  • Stefano Pallanti
  • Marco Zappa
  • Mario Mascalchi



To assess patients’ experience of bowel preparation and procedure for screening CT colonography with reduced (r-CTC) and full cathartic preparation (f-CTC) that showed similar detection rate for advanced neoplasia in a randomised trial.


Six hundred seventy-four subjects undergoing r-CTC and 612 undergoing f-CTC in the SAVE trial were asked to complete two pre-examination questionnaires—(1) Life Orientation Test - Revised (LOT-R) assessing optimism and (2) bowel preparation questionnaire—and a post-examination questionnaire evaluating overall experience of CTC screening test. Items were analysed with chi-square and t test separately and pooled.


LOT-R was completed by 529 (78%) of r-CTC and by 462 (75%) of f-CTC participants and bowel preparation questionnaire by 531 (79%) subjects in the r-CTC group and by 465 (76%) in the f-CTC group. Post-examination questionnaire was completed by 525 (78%) subjects in the r-CTC group and by 453 (74%) in the f-CTC group. LOT-R average score was not different between r-CTC (14.27 ± 3.66) and f-CTC (14.54 ± 3.35) (p = 0.22). In bowel preparation questionnaire, 88% of r-CTC subjects reported no preparation-related symptoms as compared to 70% of f-CTC subjects (p < 0.001). No interference of bowel preparation with daily activities was reported in 80% of subjects in the r-CTC group as compared to 53% of subjects in the f-CTC group (p < 0.001). In post-examination questionnaire, average scores for discomfort of the procedure were not significantly different between r-CTC (3.53 ± 0.04) and f-CTC (3.59 ± 0.04) groups (p = 0.84).


Reduced bowel preparation is better tolerated than full preparation for screening CT colonography.

Key Points

• Reduced bowel preparation is better tolerated than full preparation for screening CT colonography.

• Procedure-related discomfort of screening CT colonography is not influenced by bowel preparation.

• Males tolerate bowel preparation and CT colonography screening procedure better than females.


CT colonography Virtual colonoscopy Questionnaire 



Confidence interval


Colorectal cancer


CT colonography


Full cathartic preparation CT colonography


Faecal immunochemical test


Life Orientation Test - Revised


Optical colonoscopy


Odds ratio


Reduced cathartic preparation CT colonography



We acknowledge Dr. Matteo Cuccuini, Dr. Giacomo Gabbani, Dr. Giulia Grazzini, Dr. Giulia Scarpini, and Dr. Ilaria Vitali from Florence, Italy, for data collection.

The results of this study were presented at ECR 2018 (B-0521).


This study has received funding by Tuscany Region, Italy (POR CREO FESR 2007–2013 LINEA D’INTERVENTO 1.1c, grant number 009DUA000000000089835900120000000002), and by the Cassa di Risparmio di Firenze Foundation (grant number 2012.0742A2202.3931).

Compliance with ethical standards


The scientific guarantor of this publication is Professor Mario Mascalchi.

Conflict of interest

One author of this manuscript (Silvia Delsanto) declares relationships with the following company: Im3D, Turin, Italy.

All other authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was obtained from all subjects in this study.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

Socio-demographic characteristics of the SAVE trial invitees and participants, as well as participation rate and detection rate for advanced neoplasia after the first screening round, were previously reported in Sali L, Mascalchi M, Falchini M, et al Reduced and full-preparation CT colonography, fecal immunochemical test, and colonoscopy for population screening of colorectal cancer: a randomized trial. J Natl Cancer Inst 2015;108: 319.


• Prospective

• Randomised controlled trial

• Performed at one institution

Supplementary material

330_2018_5808_MOESM1_ESM.pdf (101 kb)
ESM 1 (PDF 100 kb)


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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  • Lapo Sali
    • 1
    • 2
    Email author
  • Leonardo Ventura
    • 3
  • Grazia Grazzini
    • 3
  • Alessandra Borgheresi
    • 4
  • Silvia Delsanto
    • 5
  • Massimo Falchini
    • 1
  • Beatrice Mallardi
    • 3
  • Paola Mantellini
    • 3
  • Stefano Milani
    • 1
  • Stefano Pallanti
    • 6
  • Marco Zappa
    • 3
  • Mario Mascalchi
    • 1
  1. 1.Department of Biomedical, Experimental and Clinical Sciences “Mario Serio”University of FlorenceFlorenceItaly
  2. 2.IFCA HospitalFlorenceItaly
  3. 3.Institute for Cancer Research, Prevention and Oncological Network (ISPRO)FlorenceItaly
  4. 4.School of RadiologyUniversità Politecnica delle MarcheAnconaItaly
  5. 5.im3D S.p.ATurinItaly
  6. 6.Department of Health SciencesUniversity of FlorenceFlorenceItaly

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