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Published in: European Radiology 1/2015

01-01-2015 | Gastrointestinal

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

Authors: F. Iafrate, M. Iannitti, M. Ciolina, P. Baldassari, A. Pichi, A. Laghi

Published in: European Radiology | Issue 1/2015

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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.
Literature
1.
2.
go back to reference 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 263:723–31CrossRef 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 263:723–31CrossRef
4.
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 82:666–71PubMedCrossRef 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 82:666–71PubMedCrossRef
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 98:578–85PubMedCrossRef Ristvedt SL, McFarland EG, Weinstock LB, Thyssen EP (2003) Patient preferences for CT colonography, conventional colonoscopy, and bowel preparation. Am J Gastroenterol 98:578–85PubMedCrossRef
6.
go back to reference 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–W37PubMedCrossRef 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–W37PubMedCrossRef
7.
go back to reference 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 13:453–458PubMed 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 13:453–458PubMed
8.
go back to reference 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 184:1836–1842PubMedCrossRef 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 184:1836–1842PubMedCrossRef
9.
go back to reference Iannaccone R, Laghi A, Catalano C et al (2004) Computed tomographic colonography without cathartic preparation for the detection of colorectal polyps. Gastroenterology 127:1300–1311PubMedCrossRef Iannaccone R, Laghi A, Catalano C et al (2004) Computed tomographic colonography without cathartic preparation for the detection of colorectal polyps. Gastroenterology 127:1300–1311PubMedCrossRef
10.
go back to reference 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 196:1076–82PubMedCentralPubMedCrossRef 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 196:1076–82PubMedCentralPubMedCrossRef
11.
go back to reference 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 20:367–76PubMedCentralPubMedCrossRef 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 20:367–76PubMedCentralPubMedCrossRef
12.
go back to reference 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 156:692–702PubMedCrossRef 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 156:692–702PubMedCrossRef
13.
go back to reference Iafrate F, Hassan C, Ciolina M et al (2011) High positive predictive value of CT colonography in a referral centre. Eur J Radiol 80:289–92CrossRef Iafrate F, Hassan C, Ciolina M et al (2011) High positive predictive value of CT colonography in a referral centre. Eur J Radiol 80:289–92CrossRef
14.
go back to reference Iafrate F, Hassan C, Zullo A et al (2008) CT colonography with reduced bowel preparation after incomplete colonoscopy in the elderly. Eur Radiol 18:1385–95PubMedCrossRef Iafrate F, Hassan C, Zullo A et al (2008) CT colonography with reduced bowel preparation after incomplete colonoscopy in the elderly. Eur Radiol 18:1385–95PubMedCrossRef
15.
go back to reference 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 175:621–8PubMedCrossRef 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 175:621–8PubMedCrossRef
16.
go back to reference Ridley LJ (1998) Allergic reactions to oral iodinated contrast agents: reactions to oral contrast. Australas Radiol 42(2):114–7PubMedCrossRef Ridley LJ (1998) Allergic reactions to oral iodinated contrast agents: reactions to oral contrast. Australas Radiol 42(2):114–7PubMedCrossRef
17.
go back to reference "Guideline for Good Clinical Practice". International Conference on Harmonisation of Technical Requirements for the Registration of Pharmaceuticals for Human Use. 1996-06-10 "Guideline for Good Clinical Practice". International Conference on Harmonisation of Technical Requirements for the Registration of Pharmaceuticals for Human Use. 1996-06-10
18.
go back to reference 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 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.
go back to reference Wewers ME, Lowe NK (1990) A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health 13:227–236PubMedCrossRef Wewers ME, Lowe NK (1990) A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health 13:227–236PubMedCrossRef
20.
go back to reference 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 13:55–64PubMedCrossRef 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 13:55–64PubMedCrossRef
21.
go back to reference Seymour CW, Pryor JP, Gupta R et al (2004) Anaphylactoid reaction to oral contrast for computed tomography. J Trauma 57:1105–07PubMedCrossRef Seymour CW, Pryor JP, Gupta R et al (2004) Anaphylactoid reaction to oral contrast for computed tomography. J Trauma 57:1105–07PubMedCrossRef
22.
go back to reference Keeling AN, Slattery MM, Leong S et al (2010) Limited-preparation CT colonography in frail elderly patients: a feasibility study. AJR Am J Roentgenol 194:1279–1287PubMedCrossRef Keeling AN, Slattery MM, Leong S et al (2010) Limited-preparation CT colonography in frail elderly patients: a feasibility study. AJR Am J Roentgenol 194:1279–1287PubMedCrossRef
23.
go back to reference 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 105:1319–1326PubMedCrossRef 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 105:1319–1326PubMedCrossRef
24.
go back to reference 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 254:138–144PubMedCrossRef 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 254:138–144PubMedCrossRef
25.
go back to reference 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 261:156–64PubMedCentralPubMedCrossRef 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 261:156–64PubMedCentralPubMedCrossRef
26.
go back to reference 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 34:642–7PubMedCrossRef 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 34:642–7PubMedCrossRef
27.
go back to reference Campanella D, Morra L, Delsanto S et al (2010) Comparison of three different iodine-based bowel regimens for CT colonography. Eur Radiol 20:348–58PubMedCrossRef Campanella D, Morra L, Delsanto S et al (2010) Comparison of three different iodine-based bowel regimens for CT colonography. Eur Radiol 20:348–58PubMedCrossRef
28.
go back to reference 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 30:930–6PubMedCentralPubMedCrossRef 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 30:930–6PubMedCentralPubMedCrossRef
Metadata
Title
Bowel cleansing before CT colonography: comparison between two minimal-preparation regimens
Authors
F. Iafrate
M. Iannitti
M. Ciolina
P. Baldassari
A. Pichi
A. Laghi
Publication date
01-01-2015
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 1/2015
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-014-3345-0

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