title: CT colonography with reduced bowel preparation after incomplete colonoscopy in the elderly.
abstract: We prospectively assessed the feasibility and acceptance of computerized tomographic colonography (CTC) without bowel cathartic preparation in elderly patients after incomplete colonoscopy. A total of 136 patients underwent CTC without cathartic preparation. The time delay between conventional colonoscopy and CTC ranged between 3 and 20 days, depending on the clinical situation. Before CTC, fecal tagging was achieved by adding diatrizoate meglumine and diatrizoate sodium to regular meals. CTCs were interpreted using a primary two-dimensional (2D) approach and 3D images for further characterization. Patients were interviewed before and 2 weeks after CTC to assess preparation acceptance. CTC was feasible and technically successful in all the 136 patients. Fecal tagging was judged as excellent in 113 (83%) patients and sufficient in 23 (17%). Average CT image interpretation time was 14.8 min. Six (4.4%) cases of colorectal cancer and nine (6.6%) large polyps were detected, as well as 23 (11.3%) extracolonic findings of high clinical importance. No major side effect occurred, although 25% patients reported minor side effects, especially diarrhea. Overall, 76/98 patients replied that they would be willing to repeat the test if necessary. CTC without cathartic preparation is a technically feasible and safe procedure to complete a colonic study in the elderly, prompting its use in clinical practice.
authors: Department of Radiological Sciences, "Sapienza" University of Rome, Viale Regina Elena 324, 00161 Rome, Italy. francoiafrate@tin.it
authors: F
authors: F
authors: Iafrate
authors: C
authors: C
authors: Hassan
authors: A
authors: A
authors: Zullo
authors: A
authors: A
authors: Stagnitti
authors: R
authors: R
authors: Ferrari
authors: A
authors: A
authors: Spagnuolo
authors: A
authors: A
authors: Laghi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D023881:Colonography, Computed Tomographic; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging*; D003287:Contrast Media; D003973:Diatrizoate; D003974:Diatrizoate Meglumine; D005240:Feasibility Studies; D005243:Feces; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008297:Male; D011446:Prospective Studies; D011857:Radiographic Image Interpretation, Computer-Assisted; D018709:Statistics, Nonparametric
chemical_list: D003287:Contrast Media; D003973:Diatrizoate; D003974:Diatrizoate Meglumine