MR colonography with limited bowel preparation: patient acceptance compared with that of full-preparation colonoscopy.
OBJECTIVE
To prospectively evaluate participants' experience and preference of magnetic resonance (MR) colonography with limited bowel preparation compared with full-preparation colonoscopy in participants at increased risk for colorectal cancer.


METHODS
This study had institutional review board approval; all participants gave written informed consent. In this multicenter study, consecutive participants undergoing conventional colonoscopy because of a personal or family history of colorectal cancer or adenomatous polyps underwent MR colonography 2 weeks prior to colonoscopy. They all followed a low-fiber diet and were given lactulose and an oral contrast agent (fecal tagging with gadolinium) 2 days before colonography. Before imaging, spasmolytics were administered intravenously, and a water-gadolinium chelate mixture was administered rectally for distention of the colon. Breath-hold T1- and T2-weighted sequences were performed in the prone and supine positions. Participant experience in terms of, for example, pain and burden was determined by using a five-point scale and was evaluated with a Wilcoxon signed rank test; participant preference was determined by using a seven-point scale and was evaluated with the chi2 statistic after dichotomizing.


RESULTS
Two hundred nine participants (77 women, 132 men; mean age, 58 years; range, 23-84 years) were included. One hundred forty-eight participants received sedatives (midazolam) and/or analgesics (fentanyl) during colonoscopy. Participants rated the MR colonography bowel preparation as less burdensome (P<.001) compared with the colonoscopy bowel preparation (10% and 71% of participants rated the respective examinations moderately to extremely burdensome). Participants also experienced less pain at MR colonography (P<.001) and found MR colonography less burdensome (P<.001). Immediately after both examinations, 69% of participants preferred MR colonography, 22% preferred colonoscopy, and 9% were indifferent (P<.001, 69% vs 22%). After 5 weeks, 65% preferred MR colonography and 26% preferred colonoscopy (P<.001).


CONCLUSIONS
Participants preferred MR colonography without extensive cleansing to colonoscopy immediately after both examinations and 5 weeks later. Experience of the bowel preparation and of the procedure was rated better.
Florie
Jasper
J
Department of Radiology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands. j.florie@amc.uva.nl
Birnie
Erwin
E
van Gelder
Rogier E
RE
Jensch
Sebastiaan
S
Haberkorn
Brigitte
B
Bartelsman
Joep F
JF
van der Sluys Veer
Annet
A
Snel
Pleun
P
van der Hulst
Victor P M
VP
Bonsel
Gouke J
GJ
Bossuyt
Patrick M M
PM
Stoker
Jaap
J
D018256:Adenomatous Polyps / Q000175:diagnosis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002400:Cathartics / Q000008:administration & dosage; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis; D005260:Female; D005682:Gadolinium; D005765:Gastrointestinal Agents / Q000494:pharmacology*; D006801:Humans; D007792:Lactulose / Q000494:pharmacology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011446:Prospective Studies; D011795:Surveys and Questionnaires
D002400:Cathartics; D005765:Gastrointestinal Agents; D007792:Lactulose; D005682:Gadolinium