Comparison of three different iodine-based bowel regimens for CT colonography

Campanella, Delia; Morra, Lia; Delsanto, S.; Tartaglia, Vincenzo; Asnaghi, Roberto; Bert, Alberto; Neri, Emanuele; Regge, Daniele

doi:10.1007/s00330-009-1553-9

Cited by 31 publications

(30 citation statements)

References 27 publications

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“…This demonstrates that, as an MRI-based technique, MRA also has a disadvantage in its ability to exclude acute PE, which may be the mainly factor responsible for the inadequate sensitivity of the diagnosis of acute PE using MRI. Cur rently, the intravenous contrast agents used in CT angiography are usually non-ionic iodine-based substances [24]. However, there have been many adverse reactions caused by iodine-based contrast agents, including acute adverse reactions (cardiovascular collapse, laryngeal edema, convulsions and arrhythmias) and late adverse reactions (late skin reactions), some of which may have fatal outcomes [25,26].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of magnetic resonance angiography for acute pulmonary embolism - a systematic review and meta-analysis

Feng²,

et al. 2016

Vasa

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Abstract. Background: The aim of this meta-analysis was to evaluate the diagnostic accuracy of magnetic resonance angiography (MRA) for acute pulmonary embolism (PE). Methods: A systematic literature search was conducted that included studies from January 2000 to August 2015 using the electronic databases PubMed, Embase and Springer link. The summary receiver operating characteristic (SROC) curve, sensitivity, specificity, positive likelihood ratios (PLR), negative likelihood ratios (NLR), and diagnostic odds ratio (DOR) as well as the 95 % confidence intervals (CIs) were calculated to evaluate the diagnostic accuracy of MRA for acute PE. Meta-disc software version 1.4 was used to analyze the data. Results: Five studies were included in this meta-analysis. The pooled sensitivity (86 %, 95 % CI: 81 % to 90 %) and specificity (99 %, 95 % CI: 98 % to 100 %) demonstrated that MRA diagnosis had limited sensitivity and high specificity in the detection of acute PE. The pooled estimate of PLR (41.64, 95 % CI: 17.97 to 96.48) and NLR (0.17, 95 % CI: 0.11 to 0.27) provided evidence for the low missed diagnosis and misdiagnosis rates of MRA for acute PE. The high diagnostic accuracy of MRA for acute PE was demonstrated by the overall DOR (456.51, 95 % CI: 178.38 - 1168.31) and SROC curves (AUC = 0.9902 ± 0.0061). Conclusions: MRA can be used for the diagnosis of acute PE. However, due to limited sensitivity, MRA cannot be used as a stand-alone test to exclude acute PE.

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Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of magnetic resonance angiography for acute pulmonary embolism - a systematic review and meta-analysis

Feng²,

et al. 2016

Vasa

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“…Campanella et al [9] described results of CTC in three different groups: (1) high-dose phopha soda with 100 ml of Gastrografin over 2 days, (2) a mild ''laxative'' (macrogol) with 50 ml of Gastrografin 2 h before the exam and (3) 2 ml kg 21 Gastrografin over 2 days without laxatives. All patients were asked to comply with a lowfibre diet for 2 days before the exam, and to fast on the day.…”

Section: Discussionmentioning

confidence: 99%

Laxative-free CT colonography

Slater¹,

Betts²,

DʼCosta³

2012

The British Journal of Radiology

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Objectives: The aim of this study was to determine if the introduction of faecal tagging to CT colonography (CTC) made the examination easier to tolerate or reduced the number of false-positives. Methods: Our department changed bowel preparation for CT colonography from Picolax (Ferring Pharmaceuticals Ltd, London, UK) to Gastrografin® (Bracco Diagnostics Inc, Princeton, NJ) only with a modified diet. Questionnaires were given to a subgroup of patients within these cohorts. The numbers of false-positives were compared between two cohorts before and after this change. false-positives were defined as lesions reported on CT that were not confirmed by subsequent endoscopic examination. Polyps were matched if they were in the same or adjacent segments, and were within 5 mm of the reported size. Results: 412 patients were identified from the Picolax cohort, and 116 from the Gastrografin cohort. 62 patients in each group completed questionnaires. Gastrografin produced less diarrhoea; 34% had five or more bowel motions in the previous day and night, compared with 77% for Picolax (p<0.001), although more patients found drinking it unpleasant compared with Picolax (85% reported drinking Picolax as “easy” vs 61% for Gastrografin; p=0.002). Picolax produced more non-diagnostic examinations, although this difference was not statistically significant. There was not a significant reduction in the numbers of false-positives (2 out of 112 for Gastrografin group, 14 out of 389 for the Picolax group; p=0.54). Conclusion: Switching from Picolax to Gastrografin as a CTC preparation technique produced less diarrhoea, but did not reduce the number of false-positives.

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“…The latter is the original CT colonography technique used with high-dose laxatives [10,11], essentially transferred from barium enema bowel preparation. A low-fibre diet can be successfully used with faecal tagging [12][13][14][15]. If the diet is not modified, then whichever faecal tagging regimen is used would be expected to result in some untagged faecal material due to the presence of macroscopic fibrous plant residue.…”

Section: Discussionmentioning

confidence: 99%

Gas insufflation of minimal preparation CT of the colon reduces false-positives

Slater

North²,

Hart³

et al. 2012

BJR

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Objectives: Minimal preparation CT of the colon (MPCT colon) is used for investigation of suspected colorectal cancer in frail and/or elderly patients who would be expected to tolerate laxative bowel preparation poorly. Although it has good sensitivity for colorectal cancer it has a poor specificity. We wished to investigate whether distension of the colon with carbon dioxide alone would reduce the number of false-positives, but without making the test arduous or excessively uncomfortable. Methods: 134 patients were recruited and underwent MPCT colon with gas insufflation and antispasmodics. Results were compared with a cohort of 134 patients undergoing standard protocol MPCT colon. The numbers of false-positives were compared, as was reader confidence. All trial patients were given a questionnaire documenting their experience. Results: The number of false-positives was 15% in the control group and 5% in the trial group; this difference was statistically significant, (p50.01). Reader confidence was increased in the trial group. Patient tolerance was good, with 95% saying they would have the test again. Conclusion: Use of gas insufflation and antispasmodics reduces the false-positives from 15% to 5% without adversely affecting patient tolerance.

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Comparison of three different iodine-based bowel regimens for CT colonography

Abstract: Considering preparation quality alone, GFPH was the best regimen, but SD provided the best balance between bowel preparation quality and patient acceptability.

Cited by 31 publications

References 27 publications

Diagnostic accuracy of magnetic resonance angiography for acute pulmonary embolism - a systematic review and meta-analysis

Diagnostic accuracy of magnetic resonance angiography for acute pulmonary embolism - a systematic review and meta-analysis

Laxative-free CT colonography

Gas insufflation of minimal preparation CT of the colon reduces false-positives

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