Document Detail

Comparison study of different bowel preparation regimens and different fecal-tagging agents on tagging efficacy, patients' compliance, and diagnostic performance of computed tomographic colonography: preliminary study.
MedLine Citation:
PMID:  19820488     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To compare and find the optimal combination of bowel preparation regimens and different concentrations of barium-based fecal-tagging agents on computed tomographic colonography in terms of tagging efficacy, patients' compliance, and diagnostic performance. MATERIALS AND METHODS: Sixty-nine consecutive patients were prospectively enrolled and randomly divided into 4 groups according to a combination of bowel preparation regimens (sodium phosphate [Colclean] vs magnesium citrate [LoSoPrep]) and different concentrations of barium-based fecal-tagging agents (Tagitol V [thick, 40% wt/vol] 60 mL vs EasyCT [thin, 4.6% wt/vol] 600 mL). Patients who received Colclean and EasyCT were designated as group 1; Colclean and Tagitol V as group 2; LoSoPrep and EasyCT, group 3; and LoSoPrep and Tagitol V, group 4. For objective analysis, the volume of tagged feces and fluid was semiautomatically calculated using a threshold of 150 Hounsfield units. The volume of untagged feces and fluid was also calculated using the seeded region-growing method. The tagging efficacy was then calculated and compared using the analysis of variance test. For subjective analysis, 2 radiologists visually determined the overall tagging efficacy on a segmental basis. The numbers of homogeneously tagged, heterogeneously tagged, heterogeneously untagged, and homogeneously untagged feces greater than or equal to 6 mm and fluid were counted in each segment. The rates of homogeneously tagged stool and fluid were compared between the groups using the chi test. Patients' compliance for taking the regimens was recorded and compared using the Kruskal-Wallis test. Per-polyp and per-patient sensitivity for polyps greater than or equal to 6 mm were analyzed and compared using the chi or Fisher exact test. RESULTS: Objective analysis showed that tagging efficacy was significantly lower in group 1 than in the other 3 groups. In a subjective analysis, overall tagging efficacy was significantly higher in group 4 than in the other groups. The rate of homogeneously tagged fluid was significantly higher in group 4 than in the other groups. The rate of homogeneously tagged feces was significantly higher in the thick barium group than in the thin barium group. Patients' compliance was significantly worse in group 1 than in the other 3 groups. Per-polyp and per-patient sensitivities for polyps greater than or equal to 6 mm were not significantly different among all groups. However, per-patient specificity for lesions greater than or equal to 10 mm was significantly lower in group 2 than in the other groups. CONCLUSIONS: With better tagging efficacy and compliance while maintaining comparable diagnostic performance, it is our belief that the best combination of bowel preparation and fecal-tagging regimen is a combination of magnesium citrate and a high concentration of a barium tagging agent.
Soon Ho Yoon; Se Hyung Kim; Sang Gyun Kim; Soo Jin Kim; Jeong Min Lee; Jae Young Lee; Joon Koo Han; Byung Ihn Choi
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of computer assisted tomography     Volume:  33     ISSN:  1532-3145     ISO Abbreviation:  J Comput Assist Tomogr     Publication Date:    2009 Sep-Oct
Date Detail:
Created Date:  2009-10-12     Completed Date:  2009-11-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7703942     Medline TA:  J Comput Assist Tomogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  657-65     Citation Subset:  IM    
Department of Radiology, Institute of Radiation Medicine, Seoul National University Hospital, Seoul, Korea.
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MeSH Terms
Administration, Oral
Barium / administration & dosage,  diagnostic use*
Bisacodyl / administration & dosage
Cathartics / administration & dosage*,  adverse effects
Citric Acid / administration & dosage*,  adverse effects
Colonic Polyps / pathology,  radiography*
Colonography, Computed Tomographic / methods*
Contrast Media
Dyspepsia / chemically induced
Feces / chemistry*
Magnesium / administration & dosage
Middle Aged
Organometallic Compounds / administration & dosage*,  adverse effects
Patient Compliance / statistics & numerical data*
Phosphates / administration & dosage,  adverse effects
Prospective Studies
Video Recording
Reg. No./Substance:
0/Cathartics; 0/Contrast Media; 0/Organometallic Compounds; 0/Phosphates; 0/magnesium citrate; 603-50-9/Bisacodyl; 7439-95-4/Magnesium; 7440-39-3/Barium; 7632-05-5/sodium phosphate; 77-92-9/Citric Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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