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European Radiology

Erschienen in:

01.07.2008 | Gastrointestinal

CT colonography with reduced bowel preparation after incomplete colonoscopy in the elderly

verfasst von: F. Iafrate, C. Hassan, A. Zullo, A. Stagnitti, R. Ferrari, A. Spagnuolo, A. Laghi

Erschienen in: European Radiology | Ausgabe 7/2008

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Abstract

We prospectively assessed the feasibility and acceptance of computerized tomographic colonography (CTC) without bowel cathartic preparation in elderly patients after incomplete colonoscopy. A total of 136 patients underwent CTC without cathartic preparation. The time delay between conventional colonoscopy and CTC ranged between 3 and 20 days, depending on the clinical situation. Before CTC, fecal tagging was achieved by adding diatrizoate meglumine and diatrizoate sodium to regular meals. CTCs were interpreted using a primary two-dimensional (2D) approach and 3D images for further characterization. Patients were interviewed before and 2 weeks after CTC to assess preparation acceptance. CTC was feasible and technically successful in all the 136 patients. Fecal tagging was judged as excellent in 113 (83%) patients and sufficient in 23 (17%). Average CT image interpretation time was 14.8 min. Six (4.4%) cases of colorectal cancer and nine (6.6%) large polyps were detected, as well as 23 (11.3%) extracolonic findings of high clinical importance. No major side effect occurred, although 25% patients reported minor side effects, especially diarrhea. Overall, 76/98 patients replied that they would be willing to repeat the test if necessary. CTC without cathartic preparation is a technically feasible and safe procedure to complete a colonic study in the elderly, prompting its use in clinical practice.

United Nations (1993) World Population Prospects: the 1992 Revision. United Nations, New York

Greenwald DA (2004) Aging, the gastrointestinal tract, and risk of acid-related disease. Am J Med 117(Suppl 5A):S8–S13

Boyle P, Autier P, Bartelink H, Baselga J, Boffetta P, Burn J, Burns HJ, Christensen L, Denis L, Dicato M, Diehl V, Doll R, Franceschi S, Gillis CR, Gray N, Griciute L, Hackshaw A, Kasler M, Kogevinas M, Kvinnsland S, La Vecchia C, Levi F, McVie JG, Maisonneuve P, Martin-Moreno JM, Bishop JN, Oleari F, Perrin P, Quinn M, Richards M, Ringborg U, Scully C, Siracka E, Storm H, Tubiana M, Tursz T, Veronesi U, Wald N, Weber W, Zaridze DG, Zatonski W, zur Hausen H (2003) European Code Against Cancer and scientific justification: third version (2003) Ann Oncol 14:973–1005CrossRefPubMed

Ries LA, Kosary CL, Hankey BF et al (1997) SEER Cancer Statistics Review, 1973–1994. National Institutes of Health, National Cancer Institute, NIH Publication No. 97–2789, Bethesda

Goulston KJ, Cook I, Dent OF (1986) How important is rectal bleeding in the diagnosis of bowel cancer and polyps? Lancet 2:261–265CrossRefPubMed

Obrand DI, Gordon PH (1998) Continued change in the distribution of colorectal carcinoma. Br J Surg 85:246–248CrossRefPubMed

Schmilovitz-Weiss H, Weiss A, Boaz M, Levin I, Chervinski A, Shemesh E (2007) Predictors of failed colonoscopy in nonagenarians: a single-center experience. J Clin Gastroenterol 41:388–393CrossRefPubMed

Ness RM, Manam R, Hoen H, Chalasani N (2001) Predictors of inadequate bowel preparation for colonoscopy. Am J Gastroenterol 96:1797–1802CrossRefPubMed

Chorev N, Chadad B, Segal N, Shemesh I, Mor M, Plaut S, Fraser G, Geller A, Gal E, Niv Y (2007) Preparation for colonoscopy in hospitalized patients. Dig Dis Sci 52:835–839CrossRefPubMed

10.

Wexner SD, Beck DE, Baron TH, Fanelli RD, Hyman N, Shen B, Wasco KE (2006) A consensus document on bowel preparation before colonoscopy: prepared by a task force from the American Society of Colon and Rectal Surgeons (ASCRS), the American Society for Gastrointestinal Endoscopy (ASGE), and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). Dis Colon Rectum 49:792–809CrossRefPubMed

11.

Morini S, Zullo A, Hassan C (2007) Endoscopy or radiology in nonagenarians? J Clin Gastroenterol 41:343–344CrossRefPubMed

12.

Rex DK, Lieberman D (2006) ACG colorectal cancer prevention action plan: update on CT-colonography. Am J Gastroenterol 101(7):1410–1413CrossRefPubMed

13.

Mulhall BP, Veerappan GR, Jackson JL (2005) Meta-analysis: computed tomographic colonography. Ann Intern Med 142:635–650PubMed

14.

Halligan S, Altman DG, Taylor SA, Mallett S, Deeks JJ, Bartram CI, Atkin W (2005) CT colonography in the detection of colorectal polyps and cancer: systematic review, meta-analysis, and proposed minimum data set for study level reporting. Radiology 237:893–904CrossRefPubMed

15.

Callstrom MR, Johnson CD, Fletcher JG, Reed JE, Ahlquist DA, Harmsen WS, Tait K, Wilson LA, Corcoran KE (2001) CT colonography without cathartic preparation: feasibility study. Radiology 219:693–698PubMed

16.

Zalis ME, Hahn PF (2001) Digital subtraction bowel cleansing in CT colonography. AJR Am J Roentgenol 176:646–648PubMed

17.

Lefere PA, Gryspeerdt SS, Dewyspelaere J, Baekelandt M, Van Holsbeeck BG (2002) Dietary fecal tagging as a cleansing method before CT colonography: initial results polyp detection and patient acceptance. Radiology 224:393–403CrossRefPubMed

18.

Thomeer M, Carbone I, Bosmans H, Kiss G, Bielen D, Vanbeckevoort D, Van Cutsem E, Rutgeerts P, Marchal G (2003) Stool tagging applied in thin-slice multidetector computed tomography colonography. J Comput Assist Tomogr 27:132–139CrossRefPubMed

19.

Zalis ME, Perumpillichira J, Del Frate C, Hahn PF (2003) CT colonography: digital subtraction bowel cleansing with mucosal reconstruction initial observations. Radiology 226:911–917CrossRefPubMed

20.

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 13:453–458PubMed

21.

Iannaccone R, Laghi A, Catalano C, Mangiapane F, Lamazza A, Schillaci A, Sinibaldi G, Murakami T, Sammartino P, Hori M, Piacentini F, Nofroni I, Stipa V, Passariello R (2004) Computed tomographic colonography without cathartic preparation for the detection of colorectal polyps. Gastroenterology 127:1300–1311CrossRefPubMed

22.

Taylor SA, Laghi A, Lefere P, Halligan S, Stoker J (2007) European society of gastrointestinal and abdominal radiology (ESGAR): consensus statement on CT colonography. Eur Radiol 17:575–579CrossRefPubMed

23.

Bruzzi JF, Moss AC, Brennan DD, MacMathuna P, Fenlon HM (2003) Efficacy of IV Buscopan as a muscle relaxant in CT colonography. Eur Radiol 13:2264–2270; erratum: Eur Radiol 2004 14:756CrossRefPubMed

24.

Macari M, Milano A, Lavelle M, Berman P, Megibow AJ (2000) Comparison of time-efficient CT colonography with two- and three-dimensional colonic evaluation for detecting colorectal polyps. AJR Am J Roentgenol 174:1543–1549PubMed

25.

Zalis ME, Barish MA, Choi JR, Dachman AH, Fenlon HM, Ferrucci JT, Glick SN, Laghi A, Macari M, McFarland EG, Morrin MM, Pickhardt PJ, Soto J, Yee J (2005) Working Group on Virtual Colonoscopy CT colonography reporting and data system: a consensus proposal. Radiology 236:3–9CrossRefPubMed

26.

Hara AK, Johnson CD, MacCarty RL, Welch TJ (2000) Incidental extracolonic findings at CT colonography. Radiology 215:353–357PubMed

27.

Gluecker TM, Johnson CD, Wilson LA, MacCarty RL, Welch TJ, Vanness DJ, Ahlquist DA (2003) Extracolonic findings at CT colonography: evaluation of prevalence and cost in a screening population. Gastroenterology 124:911–916CrossRefPubMed

28.

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

29.

Gluecker TM, Johnson CD, Harmsen WS, Offord KP, Harris AM, Wilson LA, Ahlquist DA (2003) Colorectal cancer screening with CT colonography, colonoscopy, and double-contrast barium enema examination: prospective assessment of patient perceptions and preferences. Radiology 227:378–384CrossRefPubMed

30.

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

31.

Lefere P, Gryspeerdt S, Baekelandt M, Dewyspelaere J, van Holsbeeck B (2003) Diverticular disease in CT colonography. Eur Radiol 13(Suppl 4):L62–L74CrossRefPubMed

32.

Gryspeerdt S, Lefere P, Herman M, Deman R, Rutgeerts L, Ghillebert G, Baert F, Baekelandt M, Van Holsbeeck B (2005) CT colonography with fecal tagging after incomplete colonoscopy. Eur Radiol 15:1192–1202CrossRefPubMed

33.

Laghi A (2005) Virtual colonoscopy: clinical application. Eur Radiol 15(Suppl 4):D138–D141PubMed

34.

Copel L, Sosna J, Kruskal JB, Raptopoulos V, Farrell RJ, Morrin MM (2007) CT colonography in 546 patients with incomplete colonoscopy. Radiology 244:471–478CrossRefPubMed

35.

Wegener M, Borsch G, Schmidt G (1986) Colorectal adenomas. Distribution, incidence of malignant transformation, and rate of recurrence. Dis Colon Rectum 29:383–387CrossRefPubMed

36.

Gschwantler M, Kriwanek S, Langner E, Goritzer B, Schrutka-Kolbl C, Brownstone E, Feichtinger H, Weiss W (2002) High-grade dysplasia and invasive carcinoma in colorectal adenomas: a multivariate analysis of the impact of adenoma and patient characteristics. Eur J Gastroenterol Hepatol 14:183–188CrossRefPubMed

37.

Church JM (2004) Clinical significance of small colorectal polyps. Dis Colon Rectum 47:481–485CrossRefPubMed

38.

Butterly LF, Chase MP, Pohl H, Fiarman GS (2006) Prevalence of clinically important histology in small adenomas. Clin Gastroenterol Hepatol 4:343–348CrossRefPubMed

39.

Pickhardt PJ, Hassan C, Laghi A, Zullo A, Kim DH, Iafrate F, Morini S (2008) Small and diminutive polyps detected at screening CT colonography: a decision analysis for referral to colonoscopy. AJR Am J Roentgenol 190:136–144CrossRefPubMed

40.

Spreng A, Netzer P, Mattich J, Dinkel HP, Vock P, Hoppe H (2005) Importance of extracolonic findings at IV contrast medium-enhanced CT colonography versus those at non-enhanced CT colonography. Eur Radiol 15:2088–2095CrossRefPubMed

41.

Pickhardt PJ, Choi JR, Hwang I, Butler JA, Puckett ML, Hildebrandt HA, Wong RK, Nugent PA, Mysliwiec PA, Schindler WR (2003) Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. N Engl J Med 349:2191–2200CrossRefPubMed

42.

Burling D, Halligan S, Altman DG, Atkin W, Bartram C, Fenlon H, Laghi A, Stoker J, Taylor S, Frost R, Dessey G, De Villiers M, Florie J, Foley S, Honeyfield L, Iannaccone R, Gallo T, Kay C, Lefere P, Lowe A, Mangiapane F, Marrannes J, Neri E, Nieddu G, Nicholson D, O’Hare A, Ori S, Politi B, Poulus M, Regge D, Renaut L, Rudralingham V, Signoretta S, Vagli P, Van der Hulst V, Williams-Butt J (2006) CT colonography interpretation times: effect of reader experience, fatigue, and scan findings in a multi-centre setting. Eur Radiol 16:1745–1749CrossRefPubMed

43.

Taylor SA, Halligan S, Burling D, Morley S, Bassett P, Atkin W, Bartram CI (2004) CT colonography: effect of experience and training on reader performance. Eur Radiol 14:1025–1033CrossRefPubMed

44.

Gluecker T, Meuwly JY, Pescatore P, Schnyder P, Delarive J, Jornod P, Meuli R, Dorta G (2002) Effect of investigator experience in CT colonography. Eur Radiol 12:1405–1409CrossRefPubMed

45.

Burling D, Taylor SA, Halligan S, Gartner L, Paliwalla M, Peiris C, Singh L, Bassett P, Bartram C (2006) Automated insufflation of carbon dioxide for MDCT colonography: distension and patient experience compared with manual insufflation. AJR Am J Roentgenol 186:96–103CrossRefPubMed

Titel: CT colonography with reduced bowel preparation after incomplete colonoscopy in the elderly
verfasst von: F. Iafrate
C. Hassan
A. Zullo
A. Stagnitti
R. Ferrari
A. Spagnuolo
A. Laghi
Publikationsdatum: 01.07.2008
Verlag: Springer-Verlag
Erschienen in: European Radiology / Ausgabe 7/2008
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-008-0892-2

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