Iohexol versus diatrizoate for fecal/fluid tagging during CT colonography performed with cathartic preparation: comparison of examination quality

Kim, Bohyun; Hong, Gil-Sun; Lee, Jong Seok; Kim, Hyun Jin; Kim, Ah Young; Ha, Hyun Kwon

doi:10.1007/s00330-014-3568-0

Cited by 8 publications

(8 citation statements)

References 37 publications

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“…Going forward, we have since adjusted the total volume of iohexol in the preparation to 50 mL (to further reduce residual fluid volumes) with good results. This amount of iohexol matches that used by Kim et al [15]. Future investigation after we have a much larger clinical experience with iohexol at CTC will help determine whether this change results in a slight reduction in residual colonic fluid attenuation.…”

Section: Discussionsupporting

confidence: 66%

“…Going forward, we plan to reassess our larger experience with iohexol after more patients have been evaluated. Another group of investigators have compared oral iohexol and diatrizoate as part of a CTC bowel preparation utilizing polyethylene glycol (PEG) [15]. In this study, Kim et al reported that the iohexol preparation resulted in a higher rate of frothy colonic bubble formation compared with the diatrizoate preparation.…”

Section: Discussionmentioning

confidence: 99%

“…This ionic agent also has a cathartic effect that may further improve cleansing of any solid debris [9]. Nonionic iodinated contrast agents including iohexol (Omnipaque, GE Healthcare) are generally considered safer than ionic agents and are more palatable for oral consumption [15–17]. Furthermore, while nonionic agents were historically more expensive than ionic agents, iohexol now costs less than diatrizoate in our practice.…”

Section: Introductionmentioning

confidence: 99%

“…Kim et al [15] recently reported their experience with diatrizoate versus iohexol for CTC by comparing two separate patient cohorts. Beyond a higher frequency of intraluminal bubbles in the iohexol cohort, examination quality was found to be similar.…”

Section: Introductionmentioning

confidence: 99%

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Objective and Subjective Intrapatient Comparison of Iohexol Versus Diatrizoate for Bowel Preparation Quality at CT Colonography

Johnson

Hinshaw

Robbins

et al. 2016

American Journal of Roentgenology

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Objective To objectively and subjectively compare nonionic iohexol and ionic diatrizoate iodinated oral contrast as part of a cathartic bowel regimen within the same CT colonography (CTC) cohort, with otherwise identical preparations. Materials and Methods In our IRB-approved retrospective study, 46 asymptomatic adults (mean age, 59.4 years; 26M/20F) returning for follow-up CTC over a 9-month interval underwent the same bowel preparation with the exception of 75 ml iohexol 350 (Omnipaque) in place of 60 ml diatrizoate (Gastrografin). All other preparation components (bisacodyl, magnesium citrate, and 2% barium) remained constant. Objective volumetric analysis of residual colonic fluid volume and fluid attenuation was performed. Additionally, two radiologists experienced with CTC, blinded to the specific bowel preparation, scored each of 6 colonic segments for adherent residual solid stool using a previously validated 4-point scale (0 for no stool; 1–3 for increasing residual stool). Paired t-test was used for comparison of the cohorts. Results No clear clinically-meaningful difference was found between the two preparations on overall objective or subjective evaluation. Mean (±SD) residual fluid volume was 173±126 ml with the iohexol preparation and 130±79 ml with the diatrizoate prep (p=0.02). Mean total colonic stool score was 2.5 (0.42/segment) with iohexol and 2.3 (0.38/segment) with diatrizoate (p=0.69). Mean (±SD) fluid attenuation was higher with iohexol (849±270HU) compared with diatrizoate (732±168HU) (p=0.03). Conclusions Based on this direct intra-patient comparison, we found that oral iohexol is a suitable alternative to diatrizoate for fluid tagging as part of a cathartic bowel preparation at CTC. Because this nonionic tagging agent is more palatable, less expensive, and likely safer than ionic diatrizoate, our CTC program now utilizes iohexol as the standard recommended regimen.

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Objective and Subjective Intrapatient Comparison of Iohexol Versus Diatrizoate for Bowel Preparation Quality at CT Colonography

Johnson

Hinshaw

Robbins

et al. 2016

American Journal of Roentgenology

View full text Add to dashboard Cite

show abstract

“…The contrast-enhanced residual material can then be differentiated from the surrounding colonic mucosa. While bowel preparation is required at the present time, CT colonography without a cathartic bowel preparation is also being evaluated [15].…”

Section: Contraindicationsmentioning

confidence: 99%