Utility of Intravenously Administered Contrast Material at CT Colonography

Morrin, Martina; Farrell, Richard J.; Kruskal, Jonathan B.; Reynolds, Kevin; McGee, James B.; Raptopoulos, Vassilios

doi:10.1148/radiology.217.3.r00nv42765

Cited by 185 publications

(63 citation statements)

References 18 publications

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“…Enhancement of colorectal masses following the intravenous administration of contrast has been documented before in conjunction with MR-colonography [10] and CT colonography [11]. The use of intravenously administered contrast material had significantly improved reader confidence in the assessment of bowel wall conspicuity and the ability of CT colonography to depict medium polyps in suboptimally prepared colons.…”

Section: Discussionmentioning

confidence: 93%

Dark lumen MR-Colonography: initial experience

Lauenstein¹,

Herborn²,

Vogt³

et al. 2001

Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr

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Section: Discussionmentioning

confidence: 93%

Dark lumen MR-Colonography: initial experience

Lauenstein¹,

Herborn²,

Vogt³

et al. 2001

Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2006

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The aim of our study was to compare primary three-dimensional (3D) and primary two-dimensional (2D) review methods for CT colonography with regard to polyp detection and perceptive errors. CT colonography studies of 77 patients were read twice by three reviewers, first with a primary 3D method and then with a primary 2D method. Mean numbers of true and false positives, patient sensitivity and specificity and perceptive errors were calculated with colonoscopy as a reference standard. A perceptive error was made if a polyp was not detected by all reviewers. Mean sensitivity for large (≥10 mm) polyps for primary 3D and 2D review was 81% (14.7/18) and 70% (12.7/18), respectively (p-values ≥0.25). Mean numbers of large false positives for primary 3D and 2D were 8.3 and 5.3, respectively. With primary 3D and 2D review 1 and 6 perceptive errors, respectively, were made in 18 large polyps (p=0.06). For mediumsized (6-9 mm) polyps these values were for primary 3D and 2D, respectively: mean sensitivity: 67%(11.3/17) and 61%(10.3/17; p-values≥ 0.45), number of false positives: 33.3 and 15.6, and perceptive errors : 4 and 6 (p= 0.53). No significant differences were found in the detection of large and medium-sized polyps between primary 3D and 2D review.

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“…We think that this small number validates the policy of not giving intravenous contrast routinely for this investigation, thus saving time, money and the risk of contrast reactions. It is not known whether giving intravenous contrast would increase the detection of colonic lesions or reduce the number of false-positives, although there is some evidence from CT colonography that contrast increases the identification of medium-sized polyps [18].…”

Section: Double Reporting Of Minimal Preparation Ct Colonmentioning

confidence: 99%

Reduction of perception error by double reporting of minimal preparation CT colon

Murphy

Slater²,

Uberoi³

et al. 2010

BJR

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ABSTRACT. Minimal preparation CT colon (MPCTC) is a useful test for frail elderly patients, who tolerate full bowel preparation poorly, and has the potential advantage of identifying extra-colonic pathology. Double reporting has been shown to reduce perception errors in a variety of radiological investigations, and we sought to determine its usefulness for MPCTC. A prospective consecutive cohort of 186 patients undergoing MPCTC for lower gastrointestinal symptoms was double reported. Radiologists were blinded to each report. Data for each report were divided into colonic and extra-colonic findings, with the latter being graded as clinically relevant or irrelevant. Discrepancies between the two reports were identified. A positive colonic lesion was defined as one where direct endoscopic visualisation was recommended. A clinically relevant extra-colonic lesion was defined as one that could impact on future patient management. 13% (24/186) of patients had a significant colonic lesion; 7 of these were identified only by 1 observer, although only 1 was confirmed endoscopically to be cancer. The positive predictive value for colon cancer was 69% for single reporting and 54.5% for double reporting. There were 67 clinically relevant extracolonic lesions, and 25 of these were reported only by only 1 observer. In conclusion, double reporting found one extra-colonic cancer, but at the expense of five unnecessary endoscopic procedures. This seems a reasonable trade-off and we would therefore recommend double reporting. However, implementation would have a significant impact on manpower and service delivery. Minimal preparation CT colon (MPCTC) is a useful, non-invasive, sensitive method for investigation of the colon for carcinoma in frail elderly patients [1][2][3], and has the advantage of being easy to tolerate [4]. Extracolonic organs are inevitably also imaged, which may provide an advantage over the competing modalities of endoscopy and barium enema [5][6][7].It has been shown that double reporting reduces perception error in a number of radiological investigations, including double contrast barium enemas, neuroradiology and mammography [8][9][10][11]. We perform a large number of MPCTC investigations in our institution and, because the colonic result can be easily dichotomised, we felt that the advantages of double reporting could easily be investigated. Methods and materialsLocal ethics committee approval was obtained. A prospective cohort of consecutive patients was included in this study in a single unit over 5 months. These patients were referred for MPCTC for investigation of suspected large bowel carcinoma. Local referral guidelines are that patients over 75 years of age, or younger patients in whom it is thought that full colonic cleansing would be poorly tolerated owing to comorbidity, should have MPCTC.Four consultant radiologists with experience in this technique (8, 5, 4 and 2 years' experience of reporting at consultant level) reported the images. Before starting the study, potential pathologies were divi...

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Utility of Intravenously Administered Contrast Material at CT Colonography

Abstract: The use of intravenously administered contrast material significantly improved reader confidence in the assessment of bowel wall conspicuity and the ability of CT colonography to depict medium polyps in suboptimally prepared colons.

Cited by 185 publications

References 18 publications

Dark lumen MR-Colonography: initial experience

Dark lumen MR-Colonography: initial experience

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

Reduction of perception error by double reporting of minimal preparation CT colon

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