Colorectal screening with single scan CT colonography in children

Abstract

The purpose of this study was to evaluate the feasibility of single scan CT colonography (CTC) using polyethylene glycol electrolyte solution with contrast medium (PEG-C) bowel preparation in children. Seven patients suspected of colorectal elevated lesions were subjected to CTC. All patients underwent bowel preparation using polyethylene glycol electrolyte solution (PEG) at a dose of 32 +/- 3 ml/kgBW before the day of CTC. The water-soluble contrast agent was given to the patients at a dose of 0.6 +/- 0.1 ml/kgBW the next morning. After colonic air insufflation, the patient was scanned axially with a single run. After evaluation of multiplanar reformation images, 3-dimensional images (CT enema and virtual endoscopy image) were reconstructed. CT enema image was composed from air image and contrast-medium image. All studies were performed without complications. CTC showed the entire colon without blind spots in all patients with only single scan. In conclusion, the single scan CTC using PEG-C preparation is safe and less invasive compared to conventional CTC due to the shorter examination time and lower radiation dose.

Minimum-invasive early diagnosis of colorectal cancer with CT colonography: techniques and clinical value

“…Beginning on the day before CT scanning, the patient is limited to a clear liquid diet. Single-dose (45 ml) NaP is administered as a cathartic cleanser at 15.00 -17.00 h. The patient then drinks a diluted 250 ml of 2% barium mixture for tagging of residual stool at 18.00 -20.00 h, and 60 ml of sodium amidotrizoate for tagging of residual fl uid at 21.00 -23.00 h. PEG plus contrast-medium (PEG-C) bowel preparation • ( Figure 2 ) [39,41] . The diet is unrestricted, including fi ber-rich food, until the day before the procedure.…”

“…The same polyp was diagnosed as adenoma and resected by optical colonoscopy. In this patient, fecal tagging was performed by PEG-C bowel preparation [39,41] . (i.e., patient's intolerance, insufflation of 2 -4 l of gas depending on the patient's individual colorectal anatomy, or a consistent rectal pressure above 25 mmHg when an automated insufflation device is used).…”

“…Labeling of residual feces, namely, fecal tagging, is achieved by ingestion of a small amount of contrast medium and is regarded as an important factor contributing to the excellent performance and successes of clinical CTC ( Figure 2 ) [12, [38][39][40][41] . Both the ease of data analysis and the good specificity of CTC in the detection of colorectal polyps are attributed to the efficient labeling of residual fluid/stool because of its improved differentiation from polyps [42] .…”

Colonic polyps: inheritance, susceptibility, risk evaluation, and diagnostic management

“…Single-acquisition protocols are currently discussed (eg, in the pediatric population), which would actually halve radiation exposure. 37 According to the radiological risk figures of the International Commission on Radiological Protection, 38 an average effective dose value of around 2 mSv for CTC is associated with a theoretical 0.005% risk of lethal radiation-induced malignancy, which further decreases with increasing patient age. Thus, CTC is an important CRC screening tool especially in middle-aged and elderly patients, in whom the potential benefit of early diagnosis of CRC far outweighs the risk associated with radiation exposure.…”