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CT colonography without cathartic preparation: positive predictive value and patient experience in clinical practice.
MedLine Citation:
PMID:  22246146     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To determine the positive predictive value (PPV) for polyps ≥6 mm detected at CT colonography (CTC) performed without cathartic preparation, with low-dose iodine faecal tagging regimen and to evaluate patient experience. METHODS: 1920 average-risk patients underwent CTC without cathartic preparation. Faecal tagging was performed by diatrizoate meglumine and diatrizoate sodium at a total dose of 60 ml (22.2 g of iodine).The standard interpretation method was primary 3D with 2D problem solving. We calculated per-patient and per-polyp PPV in relation to size and morphology. All colonic segments were evaluated for image quality (faecal tagging, amount of liquid and solid residual faeces and luminal distension). Patients completed a questionnaire before and after CTC to assess preparation and examination experience. RESULTS: Per-polyp PPV for detected lesions of ≥6 mm, 6-9 mm, ≥10 mm and ≥30 mm were 94.3%, 93.1%, 94.7% and 98%, respectively. Per-polyp PPV, according to lesion morphology, was 94.6%, 97.3% and 85.1% for sessile, pedunculated and flat polyps, respectively. Per-patient PPV was 92.8%. Preparation without frank cathartics was reported to cause minimal discomfort by 78.9% of patients. CONCLUSION: CTC without cathartic preparation and low-dose iodine faecal tagging may yield high PPVs for lesions ≥6 mm and is well accepted by patients. KEY POINTS : • Computed tomographic colonography (CTC) without cathartic preparation is well accepted by patients • Cathartic-free faecal tagging CTC yields high positive predictive values • CTC without cathartic preparation could improve uptake of colorectal cancer screening.
Authors:
Carmen Zueco Zueco; Carolina Sobrido Sampedro; Juan D Corroto; Paula Rodriguez Fernández; Manuela Fontanillo Fontanillo
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-14
Journal Detail:
Title:  European radiology     Volume:  -     ISSN:  1432-1084     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9114774     Medline TA:  Eur Radiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Complexo Hospitalario Universitario de Vigo - CHUVI, c/Pizarro 22, 36204, Vigo, Pontevedra, Spain, carmen.zueco.zueco@sergas.es.
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