Skip to main content
Top
Published in: European Radiology 1/2010

Open Access 01-01-2010 | Gastrointestinal

CT colonography with limited bowel preparation: prospective assessment of patient experience and preference in comparison to optical colonoscopy with cathartic bowel preparation

Authors: Sebastiaan Jensch, Shandra Bipat, Jan Peringa, Ayso H. de Vries, Anneke Heutinck, Evelien Dekker, Lubbertus C. Baak, Alexander D. Montauban van Swijndregt, Jaap Stoker

Published in: European Radiology | Issue 1/2010

Login to get access

Abstract

The purpose of this study was to prospectively compare participant experience and preference of limited preparation computed tomography colonography (CTC) with full-preparation colonoscopy in a consecutive series of patients at increased risk of colorectal cancer. CTC preparation comprised 180 ml diatrizoate meglumine, 80 ml barium and 30 mg bisacodyl. For the colonoscopy preparation 4 l of polyethylene glycol solution was used. Participants’ experience and preference were compared using the Wilcoxon signed rank test and the chi-squared test, respectively. Associations between preference and experience parameters for the 173 participants were determined by logistic regression. Diarrhoea occurred in 94% of participants during CTC preparation. This side effect was perceived as severely or extremely burdensome by 29%. Nonetheless, the total burden was significantly lower for the CTC preparation than for colonoscopy (9% rated the CTC preparation as severely or extremely burdensome compared with 59% for colonoscopy; p < 0.001). Participants experienced significantly more pain, discomfort and total burden with the colonoscopy procedure than with CTC (p < 0.001). After 5 weeks, 69% preferred CTC, 8% were indifferent and 23% preferred colonoscopy (p < 0.001). A burdensome colonoscopy preparation and pain at colonoscopy were associated with CTC preference (p < 0.04). In conclusion, participants’ experience and preference were rated in favour of CTC with limited bowel preparation compared with full-preparation colonoscopy.
Appendix
Available only for authorised users
Literature
1.
go back to reference Johnson CD, Chen MH, Toledano AY et al (2008) Accuracy of CT colonography for detection of large adenomas and cancers. N Engl J Med 359:1207–1217CrossRefPubMed Johnson CD, Chen MH, Toledano AY et al (2008) Accuracy of CT colonography for detection of large adenomas and cancers. N Engl J Med 359:1207–1217CrossRefPubMed
2.
go back to reference Kim DH, Pickhardt PJ, Taylor AJ et al (2007) CT colonography versus colonoscopy for the detection of advanced neoplasia. N Engl J Med 357:1403–1412CrossRefPubMed Kim DH, Pickhardt PJ, Taylor AJ et al (2007) CT colonography versus colonoscopy for the detection of advanced neoplasia. N Engl J Med 357:1403–1412CrossRefPubMed
3.
go back to reference Smith RA, Cokkinides V, Brawley OW (2009) Cancer screening in the United States, 2009: a review of current American Cancer Society guidelines and issues in cancer screening. CA Cancer J Clin 59:27–41CrossRefPubMed Smith RA, Cokkinides V, Brawley OW (2009) Cancer screening in the United States, 2009: a review of current American Cancer Society guidelines and issues in cancer screening. CA Cancer J Clin 59:27–41CrossRefPubMed
4.
go back to reference Nelson N (2008) Virtual colonoscopy accepted as primary colon cancer screening Test. JNCI 100:1492–1494PubMed Nelson N (2008) Virtual colonoscopy accepted as primary colon cancer screening Test. JNCI 100:1492–1494PubMed
5.
go back to reference Ristvedt SL, McFarland EG, Weinstock LB, Thyssen EP (2003) Patient preferences for CT colonography, conventional colonoscopy, and bowel preparation. Am J Gastroenterol 98:578–585CrossRefPubMed Ristvedt SL, McFarland EG, Weinstock LB, Thyssen EP (2003) Patient preferences for CT colonography, conventional colonoscopy, and bowel preparation. Am J Gastroenterol 98:578–585CrossRefPubMed
6.
go back to reference van Gelder RE, Birnie E, Florie J et al (2004) CT colonography and colonoscopy: assessment of patient preference in a 5-week follow-up study. Radiology 233:328–337CrossRefPubMed van Gelder RE, Birnie E, Florie J et al (2004) CT colonography and colonoscopy: assessment of patient preference in a 5-week follow-up study. Radiology 233:328–337CrossRefPubMed
7.
go back to reference 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 82:666–671CrossRefPubMed 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 82:666–671CrossRefPubMed
8.
go back to reference Callstrom MR, Johnson CD, Fletcher JG et al (2001) CT colonography without cathartic group: feasibility study. Radiology 219:693–698PubMed Callstrom MR, Johnson CD, Fletcher JG et al (2001) CT colonography without cathartic group: feasibility study. Radiology 219:693–698PubMed
9.
go back to reference Lefere P, Gryspeerdt S, Marrannes J et al (2005) CT colonography after fecal tagging with a reduced cathartic cleansing and a reduced volume of barium. AJR Am J Roentgenol 184:1836–1842PubMed Lefere P, Gryspeerdt S, Marrannes J et al (2005) CT colonography after fecal tagging with a reduced cathartic cleansing and a reduced volume of barium. AJR Am J Roentgenol 184:1836–1842PubMed
10.
go back to reference Thomeer M, Carbone I, Bosmans H et al (2003) Stool tagging applied in thin-slice multidetector computed tomography colonography. J Comput Assist Tomogr 27:132–139CrossRefPubMed Thomeer M, Carbone I, Bosmans H et al (2003) Stool tagging applied in thin-slice multidetector computed tomography colonography. J Comput Assist Tomogr 27:132–139CrossRefPubMed
11.
go back to reference Bielen D, Thomeer M, Vanbeckevoort D et al (2003) Dry group for virtual CT colonography with fecal tagging using water-soluble contrast medium initial results. Eur Radiol 13:453–458PubMed Bielen D, Thomeer M, Vanbeckevoort D et al (2003) Dry group for virtual CT colonography with fecal tagging using water-soluble contrast medium initial results. Eur Radiol 13:453–458PubMed
12.
go back to reference Jensch S, de Vries AH, Pot D et al (2008) Image quality and patient acceptance of four regimens with different amounts of mild laxatives for CT colonography. AJR Am J Roentgenol 191:158–167CrossRefPubMed Jensch S, de Vries AH, Pot D et al (2008) Image quality and patient acceptance of four regimens with different amounts of mild laxatives for CT colonography. AJR Am J Roentgenol 191:158–167CrossRefPubMed
13.
go back to reference Lefere PA, Gryspeerdt SS, Dewyspelaere J et al (2002) Dietary fecal tagging as a cleansing method before CT colonography: initial results polyp detection and patient acceptance. Radiology 224:393–403CrossRefPubMed Lefere PA, Gryspeerdt SS, Dewyspelaere J et al (2002) Dietary fecal tagging as a cleansing method before CT colonography: initial results polyp detection and patient acceptance. Radiology 224:393–403CrossRefPubMed
14.
go back to reference Zalis ME, Perumpillichira JJ, Magee C, Kohlberg G, Hahn PF (2006) Tagging-based, electronically cleansed CT colonography: evaluation of patient comfort and image readability. Radiology 239:149–159CrossRefPubMed Zalis ME, Perumpillichira JJ, Magee C, Kohlberg G, Hahn PF (2006) Tagging-based, electronically cleansed CT colonography: evaluation of patient comfort and image readability. Radiology 239:149–159CrossRefPubMed
15.
go back to reference Taylor SA, Slater A, Burling DN et al (2008) CT colonography: optimisation, diagnostic performance and patient acceptability of reduced-laxative regimens using barium-based faecal tagging. Eur Radiol 18:32–42CrossRefPubMed Taylor SA, Slater A, Burling DN et al (2008) CT colonography: optimisation, diagnostic performance and patient acceptability of reduced-laxative regimens using barium-based faecal tagging. Eur Radiol 18:32–42CrossRefPubMed
16.
go back to reference Iannaccone R, Laghi A, Catalano C et al (2004) Computed tomographic colonography without cathartic group for the detection of colorectal polyps. Gastroenterology 127:300–1311CrossRef Iannaccone R, Laghi A, Catalano C et al (2004) Computed tomographic colonography without cathartic group for the detection of colorectal polyps. Gastroenterology 127:300–1311CrossRef
17.
go back to reference Jensch S, de Vries AH, Peringa J et al (2008) CT colonography with limited bowel preparation: performance characteristics in an increased-risk population. Radiology 247:122–132CrossRefPubMed Jensch S, de Vries AH, Peringa J et al (2008) CT colonography with limited bowel preparation: performance characteristics in an increased-risk population. Radiology 247:122–132CrossRefPubMed
18.
go back to reference Florie J, Jensch S, Nievelstein RA et al (2007) MR colonography with limited bowel preparation compared with optical colonoscopy in patients at increased risk for colorectal cancer. Radiology 243:122–131CrossRefPubMed Florie J, Jensch S, Nievelstein RA et al (2007) MR colonography with limited bowel preparation compared with optical colonoscopy in patients at increased risk for colorectal cancer. Radiology 243:122–131CrossRefPubMed
19.
go back to reference Pickhardt PJ (2005) CT Colonography without catharsis: the ultimate study or useful additional option? Gastroenterology 128:521–522CrossRefPubMed Pickhardt PJ (2005) CT Colonography without catharsis: the ultimate study or useful additional option? Gastroenterology 128:521–522CrossRefPubMed
20.
go back to reference Davis GS, Santa Ana CA, Morawski SG, Fordtran JS (1980) Development of a lavage solution associated with minimal water and electrolyte absorption or secretion. Gastroenterology 78:991–995PubMed Davis GS, Santa Ana CA, Morawski SG, Fordtran JS (1980) Development of a lavage solution associated with minimal water and electrolyte absorption or secretion. Gastroenterology 78:991–995PubMed
21.
go back to reference Ell C, Fischbach W, Keller R et al (2003) A randomized, blinded, prospective trial to compare the safety and efficacy of three bowel-cleansing solutions for colonoscopy. Endoscopy 35:300–304CrossRefPubMed Ell C, Fischbach W, Keller R et al (2003) A randomized, blinded, prospective trial to compare the safety and efficacy of three bowel-cleansing solutions for colonoscopy. Endoscopy 35:300–304CrossRefPubMed
22.
go back to reference Bitoun A, Ponchon T, Barthet M et al (2006) Results of a prospective randomised multicentre controlled trial comparing a new 2-L ascorbic acid plus polyethylene glycol and electrolyte solution vs. sodium phosphate solution in patients undergoing elective colonoscopy. Aliment Pharmacol Ther 24:1631–1642CrossRefPubMed Bitoun A, Ponchon T, Barthet M et al (2006) Results of a prospective randomised multicentre controlled trial comparing a new 2-L ascorbic acid plus polyethylene glycol and electrolyte solution vs. sodium phosphate solution in patients undergoing elective colonoscopy. Aliment Pharmacol Ther 24:1631–1642CrossRefPubMed
23.
go back to reference Poon CM, Lee DW, Mak SK et al (2002) Two liters of polyethylene glycol-electrolyte lavage solution versus sodium phosphate as bowel cleansing regimen for colonoscopy: a prospective randomized controlled trial. Endoscopy 34:560–563CrossRefPubMed Poon CM, Lee DW, Mak SK et al (2002) Two liters of polyethylene glycol-electrolyte lavage solution versus sodium phosphate as bowel cleansing regimen for colonoscopy: a prospective randomized controlled trial. Endoscopy 34:560–563CrossRefPubMed
24.
go back to reference Ginnerup Pedersen B, Møller Christiansen TE, Viborg Mortensen F, Christensen H, Laurberg S (2002) Bowel cleansing methods prior to CT colonography. Acta Radiol 43:306–311CrossRefPubMed Ginnerup Pedersen B, Møller Christiansen TE, Viborg Mortensen F, Christensen H, Laurberg S (2002) Bowel cleansing methods prior to CT colonography. Acta Radiol 43:306–311CrossRefPubMed
25.
go back to reference Curran MP, Plosker GL (2004) Oral sodium phosphate solution: a review of its use as a colorectal cleanser. Drugs 64:1697–1714CrossRefPubMed Curran MP, Plosker GL (2004) Oral sodium phosphate solution: a review of its use as a colorectal cleanser. Drugs 64:1697–1714CrossRefPubMed
26.
go back to reference Tan HL, Liew QY, Loo S, Hawkins R (2002) Severe hyperphosphataemia and associated electrolyte and metabolic derangement following the administration of sodium phosphate for bowel preparation. Anaesthesia 57:478–483CrossRefPubMed Tan HL, Liew QY, Loo S, Hawkins R (2002) Severe hyperphosphataemia and associated electrolyte and metabolic derangement following the administration of sodium phosphate for bowel preparation. Anaesthesia 57:478–483CrossRefPubMed
27.
go back to reference von Wagner C, Halligan S, Atkin WS et al (2009) Choosing between CT colonography and colonoscopy in the diagnostic context: a qualitative study of influences on patient preferences. Health Expect 12:18–26CrossRef von Wagner C, Halligan S, Atkin WS et al (2009) Choosing between CT colonography and colonoscopy in the diagnostic context: a qualitative study of influences on patient preferences. Health Expect 12:18–26CrossRef
Metadata
Title
CT colonography with limited bowel preparation: prospective assessment of patient experience and preference in comparison to optical colonoscopy with cathartic bowel preparation
Authors
Sebastiaan Jensch
Shandra Bipat
Jan Peringa
Ayso H. de Vries
Anneke Heutinck
Evelien Dekker
Lubbertus C. Baak
Alexander D. Montauban van Swijndregt
Jaap Stoker
Publication date
01-01-2010
Publisher
Springer-Verlag
Published in
European Radiology / Issue 1/2010
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-009-1517-0

Other articles of this Issue 1/2010

European Radiology 1/2010 Go to the issue