Comparison between CT Colonography and Double-Contrast Barium Enema for Colonic Evaluation in Patients with Renal Insufficiency

Abstract

ObjectiveTo compare the CT colonography (CTC) and double-contrast barium enema (DCBE) for colonic evaluation in patients with renal insufficiency.Materials and MethodsTwo sequential groups of consecutive patients with renal insufficiency who had a similar risk for colorectal cancer, were examined by DCBE (n = 182; mean ± SD in age, 51 ± 6.4 years) and CTC (n = 176; 50 ± 6.7 years), respectively. CTC was performed after colon cleansing with 250-mL magnesium citrate (n = 87) or 4-L polyethylene glycol (n = 89) and fecal tagging. DCBE was performed after preparation with 250-mL magnesium citrate. Patients with colonic polyps/masses of ≥ 6 mm were subsequently recommended to undergo a colonoscopy. Diagnostic yield and positive predictive value (PPV) for colonic polyps/masses, examination quality, and examination-related serum electrolyte change were retrospectively compared between the two groups.ResultsBoth the CTC and DCBE were positive for colonic polyps/masses in 28 (16%) of 176 and 11 (6%) of 182 patients, respectively (p = 0.004). Among patients with positive findings, 17 CTC and six DCBE patients subsequently underwent a colonoscopy and yielded a PPV of 88% (15 of 17 patients) and 50% (3 of 6 patients), respectively (p = 0.089). Thirteen patients with adenomatous lesions were detected in the CTC group (adenocarcinoma [n = 1], advanced adenoma [n = 6], and non-advanced adenoma [n = 6]), as compared with two patients (each with adenocarcinoma and advanced adenoma) in the DCBE group (p = 0.003). Six (3%) of 176 CTC and 16 (9%) of 182 DCBE examinations deemed to be inadequate (p = 0.046). Electrolyte changes were similar in the two groups.ConclusionIn patients with renal insufficiency, CTC has a higher diagnostic yield and a marginally higher PPV for detecting colorectal neoplasia, despite a similar diagnostic yield for adenocarcinoma, and a lower rate of inadequate examinations as compared with DCBE.

Does the Reporting Quality of Diagnostic Test Accuracy Studies, as Defined by STARD 2015, Affect Citation?

“…All 63 articles reported more than 50% of the items (total STARD score > 13.5), and 13 articles (20.6%) (16171819202122232425262728) reported more than 80% (total STARD score > 21.6). The mean ± SD QUADAS-2-related STARD score (maximum of 15 points) was 11.4 ± 1.7 (range 7–15).…”

“…Of these, 60 were excluded because they were letters, editorials, or abstracts instead of a full article (n = 1), a case report or series (n = 2), a review article (n = 16), or not in the field of interest (n = 41). Thus, 63 articles fulfilled the eligibility criteria ( 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 ).…”

“…The mean ± SD QUADAS-2-related STARD score (maximum of 15 points) was 11.4 ± 1.7 (range 7–15). Sixty-one articles (96.8%) reported more than 50% of the items (QUADAS-2-related STARD score > 7.5), and 20 articles (31.7%) ( 16 17 18 19 21 22 23 24 25 26 27 34 58 59 61 63 67 71 75 78 ) reported more than 80% (QUADAS-2-related STARD score > 12).…”

Accuracy of Combined Computed Tomography Colonography and Dual Energy Iiodine Map Imaging for Detecting Colorectal masses using High-pitch Dual-source CT

“…The main challenge of CTC is the difficulty in distinguishing the remnant stool from polyps due to inadequate preparation. The patients are required to supine and prone positions during traditional CTC 11 . If the position of the masses change with the changes in posture, the masses are considered to be stool or liquid.…”

Selection and Reporting of Statistical Methods to Assess Reliability of a Diagnostic Test: Conformity to Recommended Methods in a Peer-Reviewed Journal

“…Regarding the DTA studies, one reviewer experienced in DTA studies selected eligible articles according to criteria established elsewhere ( 9 ) with additional confirmation by another DTA expert in cases of ambiguity. Of the initial 124 candidate articles, 63 articles ( 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 ) were finally included. Regarding the studies that analyzed reliability, eligible articles were chosen by consensus after review by two of four independent reviewers experienced in the relevant methodology.…”