Dietary fecal tagging as a cleansing method before CT colonography: initial results polyp detection and patient acceptance.
OBJECTIVE
To compare reduced colonic cleansing based on dietary fecal tagging (FT) with standard (non-FT) colonic cleansing with regard to patient acceptance, sensitivity, and specificity.


METHODS
In 50 patients (FT group), FT was performed by means of diet, magnesium citrate, and a barium suspension. In another 50 patients (non-FT group), preparation was based on polyethylene glycol administration. All patients underwent conventional colonoscopy after computed tomographic (CT) colonography. Sensitivity and specificity for polyp detection were calculated by using conventional colonography as the reference standard. At CT colonography, fecal residue was evaluated. Patients were interviewed to determine discomfort, side effects, sleep quality, final opinion on examination comfort, and whether they would be reluctant to undergo the same examination again.


RESULTS
FT left more fecal residue but improved differentiation from polyps (FT specificity, 88% [30 of 34 patients]; non-FT, 77% [23 of 30 patients]). Sensitivities were comparable: FT, 88% (14 of 16 patients); non-FT, 85% (17 of 20 patients). FT significantly reduced discomfort, side effects, and sleep disturbance, and resulted in an improved final opinion of how comfortable the examination was (P <.05). Although FT improved patient willingness to repeat the examination, this improvement was not statistically significant (P >.05).


CONCLUSIONS
FT offers the patient a well-tolerated preparation and improves specificity, with improved differentiation of polyps from residual stool.
Lefere
Philippe A
PA
Department of Radiology, Stedelijk Ziekenhuis, Bruggesteenweg 90, 8800 Roeselare, Belgium. radiologie@skynet.be
Gryspeerdt
Stefaan S
SS
Dewyspelaere
Jef
J
Baekelandt
Marc
M
Van Holsbeeck
Bartel G
BG
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017609:Barium Compounds / Q000009:adverse effects; D001726:Bisacodyl / Q000008:administration & dosage; D002400:Cathartics / Q000008:administration & dosage* / Q000009:adverse effects; D019343:Citric Acid / Q000008:administration & dosage; D003106:Colon / Q000000981:diagnostic imaging*; D003111:Colonic Polyps / Q000175:diagnosis / Q000000981:diagnostic imaging*; D003113:Colonoscopy; D003287:Contrast Media / Q000008:administration & dosage* / Q000009:adverse effects; D004032:Diet; D005243:Feces; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds / Q000008:administration & dosage; D010349:Patient Compliance; D017060:Patient Satisfaction; D011092:Polyethylene Glycols / Q000008:administration & dosage; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013488:Suppositories; D014057:Tomography, X-Ray Computed / Q000379:methods
D017609:Barium Compounds; D002400:Cathartics; D003287:Contrast Media; D009942:Organometallic Compounds; D013488:Suppositories; D001726:Bisacodyl; D019343:Citric Acid; D011092:Polyethylene Glycols; C110422:magnesium citrate