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Iohexol versus diatrizoate for fecal/fluid tagging during CT colonography performed with cathartic preparation: comparison of examination quality

  • Gastrointestinal
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Abstract

Objective

We aimed to compare iohexol vs. diatrizoate as fecal/fluid tagging agents for computed tomography colonography (CTC) regarding examination quality.

Methods

Forty prospective patients (M:F = 23:17; 63 ± 11.6 years) received CTC using 50 mL (350 mgI/mL) oral iohexol for tagging. Forty other indication-matched, age-matched, and sex-matched patients who underwent CTC using 100 mL diatrizoate for tagging and otherwise the same technique, were retrospectively identified. Two groups were compared regarding overall examination quality, per-patient and per-segment scores of colonic bubbles (0 [no bubbles] to 5 [the largest amount]), and the volume, attenuation, and homogeneity (untagged, layered, and homogeneous) of the residual colonic fluid.

Results

The iohexol group demonstrated a greater amount of colonic bubbles than the diatrizoate group: mean per-patient scores ± SD of 1.2 ± 0.8 vs. 0.7 ± 0.6, respectively (p = 0.003); and rates of segments showing ≥ grade 3 bubbles of 12.9 % (85/659) vs. 1.6 % (11/695), respectively (p = 0.001). Residual colonic fluid amount standardized to the colonic volume did not significantly differ: 7.2 % ± 4.2 vs. 7.8 % ± 3.7, respectively (p = 0.544). Tagged fluid attenuation was mostly comparable between groups and the fluid was homogeneously tagged in 98.7 % (224/227) vs. 99.5 % (218/219) segments, respectively (p = 0.344). Iohexol caused more colonic bubbles when used during cathartic CTC. Otherwise, examination quality was similarly adequate with both iohexol and diatrizoate.

Key Points

• When used for tagging, iohexol caused significantly more colonic bubbles than diatrizoate.

• The residual colonic fluid amount did not significantly differ between iohexol and diatrizoate.

• The quality of fluid tagging was similarly adequate in both iohexol and diatrizoate.

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Acknowledgments

The scientific guarantor of this publication is Dr. Hyun Kwon Ha. Seong Ho Park received research grants from GE Healthcare for the present study and Dongkook Pharmaceutical for work unrelated to the present study. 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. This study was supported by GE Healthcare and the Technology Innovation Program (no.10043072), which is funded by the Ministry of Trade, Industry and Energy (MOTIE, Korea). Seong Ho Park has significant statistical expertise. Approval by the Institutional Review Board of the Asan Medical Center was obtained. Written informed consent was obtained from all relevant patients in this study. Methodology: retrospective, observational, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea

    Bohyun Kim, Seong Ho Park, Gil-Sun Hong, Jong Seok Lee, Hyun Jin Kim, Ah Young Kim & Hyun Kwon Ha

  2. Department of Radiology, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, Korea

    Ju Hee Lee

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  1. Bohyun Kim
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Correspondence to Seong Ho Park.

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Kim, B., Park, S.H., Hong, GS. et al. Iohexol versus diatrizoate for fecal/fluid tagging during CT colonography performed with cathartic preparation: comparison of examination quality. Eur Radiol 25, 1561–1569 (2015). https://doi.org/10.1007/s00330-014-3568-0

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