CT colonography with fecal tagging after incomplete colonoscopy

Abstract

The objective of this study was to evaluate dietary fecal tagging (FT) as a cleansing method prior to CT colonography (CTC) in patients with incomplete conventional colonoscopy (CC). After written informed consent was obtained, 24 patients had standard colonoscopic preparation (ScCl), and 25 patients had FT as cleansing method. Segmental distention, fluid levels, fecal residues, tagged appearance of fluid levels, and residual stool were evaluated. Mann-Whitney U test was used to test for significant differences between FT and ScCl groups. Compared with ScCl, FT improved distention (p=0.001), reduced the amount of fluid (p=0.043), but suffered from residual stool (p=0.046). A clear correlation was found between distention and fluid. No differences were found in stool size between FT and ScCl. FT showed a good labeling of fecal residues, and acceptable labeling of fluid levels. Compared with ScCl, FT reduces fluid, favors distention, but suffers from fecal residues. The tagged nature of these residues, however, allows differentiation from polyps.

A comparison of primary two- and three-dimensional methods to review CT colonography

“…The effect of other developments, such as use of low dose scan technique [24] or the use of oral or intravenous contrast agents [17,25,26] on the use of primary 3D and 2D review techniques have not been addressed in the present study and remain subjects for future studies.…”

“…These patients were scheduled to undergo a colonoscopy at the endoscopy departments of the Academic Medical Center and the Slotervaart Hospital of Amsterdam because of a personal or family history of colorectal polyps or cancer (increased risk) and were included between October 29, 2000 and September 25,2002.…”

CT colonography after incomplete colonoscopy in subjects with positive faecal occult blood test

“…Previous studies on CTC after incomplete colonoscopy have been conducted [6][7][8][9][10] . These studies were inhomogeneous regarding the patients' selection, because they included asymptomatic as well as symptomatic subjects.…”

“…The use of faecal tagging should reduce the number of false positive, enabling a better distinction between polyps and faecal residues, as showed in a series of CTC after incomplete colonoscopies [9] . Our study had limitations.…”

“…In order to complete evaluation of the colon, radiological examinations can be performed such as double contrast barium enema (DCBE) [5] and computed tomography colonography (CTC). In particular, several studies have shown that CTC is a valuable tool to evaluate the proximal colon after incomplete colonoscopy [6][7][8][9][10] , and the American Gastroenterologists Association (AGA) recognized that CTC is indicated for adults with failed colonoscopy [11] . We report the results of CTC systematically performed in subjects with positive FOBT and incomplete colonoscopy in the context of a population-based screening programme for CRC with FOBT.…”