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European Radiology

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01-12-2020 | Colonoscopy | Computed Tomography

Quality of same-day CT colonography following incomplete optical colonoscopy

Authors: Aileen O’Shea, Ann T. Foran, Timothy E. Murray, Eavan Thornton, Ruth Dunne, Michael J. Lee, Martina M. Morrin

Published in: European Radiology | Issue 12/2020

Abstract

Objectives

Same-day CT colonography (CTC) following incomplete optical colonoscopy allows patients to avoid both a delayed diagnosis and the need for repeat bowel preparation. The aim of our study is to establish the diagnostic quality of same-day CT colonography following an incomplete optical colonoscopy.

Methods

We performed a retrospective review of patients undergoing same-day CT colonography following an incomplete colonoscopy at our center between July 2015 and December 2017 (N = 245). We divided the large bowel into thirteen subsegments in each patient. Using a semiquantitative scoring system, the quality of bowel preparation, adequacy of fecal tagging, and luminal distension were assessed in each subsegment on all views performed. A combined score for each subsection was obtained.

Results

Ninety-nine percent of studies did not require a repeat CTC or optical colonoscopy. Median values for bowel preparation and fecal tagging were satisfactory across the bowel segments for the cohort and luminal distension was acceptable in all but three patients.

Conclusions

Same-day CTC should be considered in centers with capacity, following an incomplete optical colonoscopy. Same-day completion CTCs are of high diagnostic quality and this approach allows patients to avoid repeat bowel cleansing or a delayed diagnosis.

Key Points

• Same-day CT colonography is a high-quality examination that can be performed following incomplete optical colonoscopy.

• Same-day CT colonography should be considered for patients with incomplete optical colonoscopy in centers with the capacity to offer this service.

• Same-day CTC can avoid a delay in diagnosis and avoids repeat bowel preparation.

Franco DL, Leighton JA, Gurudu SR (2017) Approach to incomplete colonoscopy: new techniques and technologies. Gastroenterol Hepatol 13:476–483

Sachdeva R, Tsai S, El Zein M et al (2016) Predictors of incomplete optical colonoscopy using computed tomographic colonography. Gastroenterol Hepatol (N Y) 22:43–49. https://doi.org/10.4103/1319-3767.173758CrossRef

Sim JS, Koo JS (2016) Predictors of inadequate bowel preparation and salvage options on colonoscopy. Clin Endosc 49:346–349CrossRef

Pullens HJ, van Leeuwen MS, Laheij RJF, Vlegaar FP, Siersema PD (2013) CT-colonography after incomplete colonoscopy: what is the diagnostic yield? Dis Colon Rectum 56:593–599. https://doi.org/10.1097/DCR.0b013e3182781668CrossRef

Johnson CD, Chen M-H, Toledano AY et al (2008) Accuracy of CT colonography for detection of large adenomas and cancers. N Engl J Med 359:1207–1217. https://doi.org/10.1056/NEJMoa0800996CrossRef

Kim DH, Pickhardt PJ, Taylor AJ et al (2007) CT Colonography versus colonoscopy for the detection of advanced neoplasia. N Engl J Med 357:1403–1412. https://doi.org/10.1056/NEJMoa070543CrossRef

Levin B, Lieberman DA, McFarland B et al (2008) Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on colorectal cancer, and the American College of Radiology. CA Cancer J Clin 58:130–160. https://doi.org/10.3322/CA.2007.0018CrossRef

Pickhardt PJ, Choi JR, Hwang I et al (2003) Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. N Engl J Med 349:2191–2200. https://doi.org/10.1056/NEJMoa031618CrossRef

Neri E, Halligan S, Hellström M et al (2013) The second ESGAR consensus statement on CT colonography. Eur Radiol 23:720–729. https://doi.org/10.1007/s00330-012-2632-xCrossRef

10.

Lara LF, Avalos D, Huynh H et al (2015) The safety of same-day CT colonography following incomplete colonoscopy with polypectomy. United European Gastroenterol J 3:358–363. https://doi.org/10.1177/2050640615577881CrossRef

11.

Pooler BD, Kim DH, Hassan C, Rinaldi A, Burnside ES, Pickhardt PJ (2013) Variation in diagnostic performance among radiologists at screening CT colonography. Radiology 268:127–134. https://doi.org/10.1148/radiol.13121246CrossRef

12.

Keeling AN, Slattery MM, Leong S et al (2010) Limited-preparation CT colonography in frail elderly patients: a feasibility study. AJR Am J Roentgenol 194:1279–1287. https://doi.org/10.2214/AJR.09.2896CrossRef

13.

Yucel C, Lev-Toaff AS, Moussa N, Durrani H (2008) CT colonography for incomplete or contraindicated optical colonoscopy in older patients. AJR Am J Roentgenol 190:145–150. https://doi.org/10.2214/AJR.07.2633CrossRef

14.

Macari M, Berman P, Dicker M, Milano A, Megibow AJ (1999) Usefulness of CT colonography in patients with incomplete colonoscopy. AJR Am J Roentgenol 173:561–564. https://doi.org/10.2214/ajr.173.3.10470879CrossRef

15.

Theis J, Kim DH, Lubner MG, del Rio AM, Pickhardt PJ (2016) CT colonography after incomplete optical colonoscopy: bowel preparation quality at same-day vs. deferred examination. Abdom Radiol (NY) 41:10–18. https://doi.org/10.1007/s00261-015-0595-5CrossRef

16.

Liedenbaum MH, de Vries AH, Gouw CIBF 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 20:367–376. https://doi.org/10.1007/s00330-009-1570-8CrossRef

17.

O’Shea A, Murray T, Morrin MM, Lee MJ, Thornton E (2019) Incidence of clinically significant perforation at low dose non-contrast CT and its value prior to same day CT colonography following incomplete colonoscopy. Abdom Radiol (NY) 45:1044–1048. https://doi.org/10.1007/s00261-019-02062-8CrossRef

18.

Slater A, Taylor SA, Burling D, Gartner L, Scarth J, Halligan S (2006) Colonic polyps: effect of attenuation of tagged fluid and viewing window on conspicuity and measurement - in vitro experiment with porcine colonic specimen. Radiology 240:101–109. https://doi.org/10.1148/radiol.2401050984CrossRef

19.

Shah HA, Paszat LF, Saskin R, Stukel TA, Rabeneck L (2007) Factors associated with incomplete colonoscopy: a population-based study. Gastroenterology 132:2297–2303. https://doi.org/10.1053/j.gastro.2007.03.032CrossRef

20.

Baltes P, Bota M, Albert J et al (2018) PillCamColon2 after incomplete colonoscopy - a prospective multicenter study. World J Gastroenterol 24:3556–3566. https://doi.org/10.3748/wjg.v24.i31.3556CrossRef

21.

Anderson JC, Gonzalez JD, Messina CR, Pollack BJ (2000) Factors that predict incomplete colonoscopy: thinner is not always better. Am J Gastroenterol 95:2784–2787. https://doi.org/10.1111/j.1572-0241.2000.03186.xCrossRef

22.

Zafar HM, Yang J, Armstrong K, Groeneveld P (2015) Cost differences after initial CT colonography versus optical colonoscopy in the elderly. Acad Radiol 22:807–813. https://doi.org/10.1016/j.acra.2015.03.002CrossRef

23.

Pickhardt PJ, KimDH (2013) CT Colonography: Pitfalls in Interpretation. Radiol Clin North Am 51:69–88. https://doi.org/10.1016/j.rcl.2012.09.005

24.

Mlambo NE, Dlamini NNM, Urry RJ (2018) Correlation between radiological and histopathological findings in patients undergoing nephrectomy for presumed renal cell carcinoma on computed tomography scan at Grey's Hospital. SA J Radiol 22(1):1339. https://doi.org/10.4102/sajr

25.

Saluja S, Gaikstas G, Sapundzieski M (2017) Optimal timing for faecal tagging in same day CT colonography for patients with failed colonoscopy. Radiography (Lond) 23:e47–e49. https://doi.org/10.1016/j.radi.2016.10.006

26.

Chang KJ, Rekhi SS, Anderson SW, Soto JA (2011) Fluid Tagging for CT Colonography: Effectiveness of a 2-hour Iodinated Oral Preparation After Incomplete Optical Colonoscopy. J Comput Assist Tomogr 35:91–95. https://doi.org/10.1097/RCT.0b013e3181f5a610

27.

Sakamoto T, Utsunomiya D, Mitsuzaki K et al (2014) Colonic distention at screening CT colonography: role of spasmolytic agents and body habitus. Kurume Med J 61:9–15. https://doi.org/10.2739/kurumemedj.MS64002CrossRef

28.

East JE, Saunders BP, Boone D, Burling D, Halligan S, Taylor SA (2007) Effect of antispasmodic on colonic surface area visualisation at CT simulated optical colonoscopy. Gastrointest Endosc 65:AB268. https://doi.org/10.1016/j.gie.2007.03.640CrossRef

Title: Quality of same-day CT colonography following incomplete optical colonoscopy
Authors: Aileen O’Shea
Ann T. Foran
Timothy E. Murray
Eavan Thornton
Ruth Dunne
Michael J. Lee
Martina M. Morrin
Publication date: 01-12-2020
Publisher: Springer Berlin Heidelberg
Keyword: Colonoscopy
Published in: European Radiology / Issue 12/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-020-06979-3

At a glance: The STEP trials

Springer Medicine

Quality of same-day CT colonography following incomplete optical colonoscopy

Abstract

Objectives

Methods

Results

Conclusions

Key Points

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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