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Supine/left decubitus scanning: a valuable alternative to supine/prone scanning in CT colonography

  • Gastrointestinal
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Abstract

The purpose was to evaluate supine/left decubitus as an alternative to supine/prone scanning in computed tomographic colonography (CT colonography). Fifty patients were randomised to supine/prone, another 50 to supine/left decubitus scanning. Patients were scanned using a single-slice CT scanner. The colon was divided into eight segments. Comparisons of distension, breathing artefacts, residus and polyp detection were made between the two groups as well as between the different positions. Adequate distension was found in approximately 85, 97 and 95% of segments in the supine, prone and left decubitus positions, respectively. Combined scanning increased the percentage of adequate distension to 98.5% for prone-supine and 97.7% for left decubitus-supine scanning (P<0.0005 compared to supine, P=0.001 compared to left decubitus and P=0.046 compared to prone scanning). Absence of residual material was found in approximately 62.7, 69.7 and 64% of segments in the supine, prone and left decubitus positions, respectively. Combined scanning increased this percentage to approximately 99% for both groups. No significant differences towards distension or residual material were found between combined supine-prone or supine-left decubitus scanning. In the supine-prone group, combined scanning additionally revealed four lesions and improved conspicuity in two cases of stalked polyps. In the supine-left decubitus group, combined scanning additionally revealed two lesions and improved conspicuity in one stalked polyp. There were significantly fewer breathing artefacts with left decubitus scanning than prone scanning (P=0.005). A strong positive correlation was found between breathing artefacts and the age of patients in both patient groups. Colonic distension and preparation is improved by using supine and prone or supine and left decubitus scanning in combination, with a subsequent improved polyp detection. There were no significant differences between the two scanning protocols. Prone scanning, however, is hampered by breathing artefacts, especially in the elderly. Therefore, supine-left decubitus scanning is considered a valuable alternative to supine-prone scanning for the elderly.

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References

  1. Bruzzi JF, Moss AC, Fenlon HM (2001) Clinical results of CT colonoscopy. Eur Radiol 11:2188–2194

    CAS  PubMed  Google Scholar 

  2. Fletcher JG, Luboldt W (2000) CT colonography and MR colonography: current status, research directions and comparison. Eur Radiol 10:786–801

    CAS  PubMed  Google Scholar 

  3. Morrin MM, Kruskal JB, Farrell RJ, Goldberg SN, Mc Gee JB, Raptapoulos C (1999) Endoluminal CT colonography utility after an incomplete endoscopic colonoscopy. Am J Roentgenol 172:913–918

    CAS  Google Scholar 

  4. Kiss G, Van Cleynenbreughel J, Thomeer M, Suetens P, Marchal G (2002) Computer-aided diagnosis in virtual colonography via combination of surface normal and sphere fitting methods. Eur Radiol 12:77–81

    Article  PubMed  Google Scholar 

  5. Luboldt W, Mann C, Tryon CL et al. (2002) Computer-aided diagnosis in contrast-enhanced CT colonography: an approach based on contrast. Eur Radiol 12:2236–2241

    PubMed  Google Scholar 

  6. Laghi A, Iannaccone R, Bria E et al (2003) Contrast-enhanced computed tomographic colonography in the follow-up of colorectal cancer patients: a feasibility study. Eur Radiol 13:883–889

    PubMed  Google Scholar 

  7. Oto A, Gelebek V, Oguz BS, Sivri B, Deger A, Akhan O, Besim A (2003) CT attenuation of colorectal polypoid lesions: evaluation of contrast enhancement in CT colonography. Eur Radiol 13:1657–1663

    Article  PubMed  Google Scholar 

  8. Fletcher JG, Johnson CD, Welch TJ et al (2000) Optimization of CT colonography technique: prospective trial in 180 patients. Radiology 216:704–711

    PubMed  Google Scholar 

  9. Fletcher JG, Johnson CD, MacCarthy RL, Welch TJ, Reed JE, Hara AK (1999) CT colonography: potential pitfalls and problem-solving techniques. Am J Roentgenol 172:1271–1278

    CAS  Google Scholar 

  10. Luboldt W, Fletcher JG, Vogl TJ (2002) Colonography: current status, research directions and challenges. Eur Radiol 12:502–524

    PubMed  Google Scholar 

  11. Yee J, Hung RK, Akerkar GA, Wall SD (1999) The usefulness of glucagon hydrochloride for colonic distension in CT colonography. Am J Roentgenol 173:169–172

    CAS  Google Scholar 

  12. Morrin MM, Farrell RJ, Keogan MT, Kruskal JB, Yam CS, Raptapoulos V (2000) CT colonography: colonic distension improved by dual positioning but not intravenous glucagon. Eur Radiol 12:525–530

    Google Scholar 

  13. Chen SC, Lu DSK, Hecht JR, Kadell BM (1999) Ct Colonography: value of scanning in both the supine and prone positions. Am J Roentgenol 172:595–599

    Google Scholar 

  14. Thomeer M, Bielen D, Vanbeckevoort D, Dymarkorwski S, Gevers A, Rutgeerts P, Hiele M, Van Vutsem E, Marchal G (2002) Patient acceptance for CT colonography: what is the real issue? Eur Radiol 12:1410–1415

    Article  CAS  PubMed  Google Scholar 

  15. Yee J, Kumar NN, Hung RK, Akerkar GA, Kumar PRG, Wall SD (2003) Comparison of supine and prone scanning separately and in combination at CT colonography. Radiology 226:653–661

    PubMed  Google Scholar 

  16. Rubesin SE, Levine MS, Laufer I, Herlinger H (2000) Double-contrast barium enema examination technique. Radiology 215:642–650

    PubMed  Google Scholar 

  17. Jolles H, Cole TJ, Coppage L 1994 The Glenn Face Down Pillow: an aid to performance of prone radiologic procedures. J Thorac Imaging 9:273–274

    Google Scholar 

  18. Messerole E, Peine P, Wittkopp S, Marini JJ, Albert RK (2002) The pragmatics of prone positioning. Am J Respir Crit Care Med 165:1359–1363

    Article  PubMed  Google Scholar 

  19. Lefere P, Gryspeerdt S, Dewyspelaere J, Baekelandt M, Van Holsbeeck B (2002) Dietary fecal tagging as a cleansing method prior to computed tomographic colonography: initial results—polyp detection and patient acceptance. Radiology 224:393–403

    PubMed  Google Scholar 

  20. Lefere P, Gryspeerdt S, Baekelandt M, Dewyspelaere J, Van Holsbeeck B (2003) Diverticular disease in CT colonography. Eur Radiol 13 [Suppl 4]:L62

    Google Scholar 

  21. Lefere P, Gryspeerdt S, Baekelandt M, Van Holsbeeck B (2003) Technical development: CT colonography without cthartic cleansing and with barium as the sole fecal tagging agent. Am J Roentegenol 180 [Suppl]:55

    Google Scholar 

  22. Kirchgatterer A, Hubner D, Aschl G, Hinterreiter M, Stadler B, Knoflach P (2002) Colonoscopy and sigmoidoscopy in patients aged 80 years or older. Z Gastroenterol 40:951–956

    Article  CAS  PubMed  Google Scholar 

  23. Dixon AK, Freeman AH, Coni NK (1995) CT of the colon in the frail elderly patients. Semin Ultrasound CT MR 16:165–172

    PubMed  Google Scholar 

  24. Obuchowski NA, Graham RJ, Baker ME, Powell KA (2000) Ten criteria for effective screening. Am J Roentgenol 176:1357–1362

    Google Scholar 

  25. Rubesin SE, Furth EE, Rose D, Levine MS, Laufer I (1995) The effects of distension of the colon during air-contrast barium enema on colonic morphology: anatomic correlation. Am J Roentgenol 164:1387–1389

    CAS  Google Scholar 

  26. Gryspeerdt S, Lefere P, Van Holsbeeck B, Baekelandt M, Dewyspelaere J (2000) Dietary fecal tagging enables reduced colon cleansing and improves diagnosis in virtual CT colonoscopy. Radiology 217:170

    Google Scholar 

  27. Hara AK, Johnson CD, MacCarty RL, Welch TJ, McCollough CH, Harmsen WS (2001) CT colonography: single vs multidetector row imaging. Radiology 219:461–465

    PubMed  Google Scholar 

  28. Bielen D, Thomeer M, Vanbeckevoort D, Kiss G, Maes F, Marchal G, Rutgeerts P (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 

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Authors and Affiliations

  1. Department of Radiology, Stedelijk Ziekenhuis, Bruggesteenweg 90, 8800, Roeselare, Belgium

    Stefaan S. Gryspeerdt, Murielle J. Herman, Marc A. Baekelandt, Bartel G. van Holsbeeck & Philippe A. Lefere

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  1. Stefaan S. Gryspeerdt
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  2. Murielle J. Herman
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  3. Marc A. Baekelandt
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  4. Bartel G. van Holsbeeck
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  5. Philippe A. Lefere
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Correspondence to Stefaan S. Gryspeerdt.

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Gryspeerdt, S.S., Herman, M.J., Baekelandt, M.A. et al. Supine/left decubitus scanning: a valuable alternative to supine/prone scanning in CT colonography. Eur Radiol 14, 768–777 (2004). https://doi.org/10.1007/s00330-004-2264-x

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  • DOI: https://doi.org/10.1007/s00330-004-2264-x

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