title: Reducing the oral contrast dose in CT colonography: evaluation of faecal tagging quality and patient acceptance.
abstract: OBJECTIVE
  To evaluate the minimal iodine contrast medium load necessary for an optimal computed tomography colonography tagging quality.
  
  
  METHODS
  Faecal occult blood test positive patients were randomly selected for one of three iodine bowel preparations: (1) 3 × 50 ml meglumine ioxithalamate (45 g iodine), (2) 4 × 25 ml meglumine ioxithalamate (30 g iodine); or (3) 3 × 25 ml (22.5 g iodine) meglumine ioxithalamate. Two experienced readers assessed the tagging quality per colonic segment on a five-point scale and the presence of adherent stool. Also semi-automatic homogeneity measurements were performed. Patient acceptance was assessed with questionnaires.
  
  
  RESULTS
  Of 70 eligible patients, 45 patients participated (25 males, mean age 62 years). Each preparation group contained 15 patients. The quality of tagging was insufficient (score 1-2) in 0% of segments in group 1; 4% in group 2 (p<0.01 versus group 1); and 5% in group 3 (p=0.06 versus group 1). In group 1 in 11% of the segments adherent stool was present compared with 49% in group 2 and 41% in group 3 (p<0.01, group 2 and 3 versus group 1). Homogeneity was 85, 102 (p<0.01), and 91 SD HU (p=0.26) in groups 1, 2, and 3, respectively. In group 1 two patients experienced no burden after contrast agent ingestion compared to one patient in group 2 and nine patients in group 3 (p=0.017).
  
  
  CONCLUSIONS
  A dose of 3 × 50 ml meglumine ioxithalamate is advisable for an optimal tagging quality despite beneficial effects on the patient acceptance in patients receiving a lower dose.
authors.affiliation: Department of Radiology, Academic Medical Center Amsterdam, Amsterdam, The Netherlands. m.h.liedenbaum@amc.uva.nl
authors.forename: M H
authors.initials: MH
authors.lastname: Liedenbaum
authors.forename: M J
authors.initials: MJ
authors.lastname: Denters
authors.forename: F M
authors.initials: FM
authors.lastname: Zijta
authors.forename: V F
authors.initials: VF
authors.lastname: van Ravesteijn
authors.forename: S
authors.initials: S
authors.lastname: Bipat
authors.forename: F M
authors.initials: FM
authors.lastname: Vos
authors.forename: E
authors.initials: E
authors.lastname: Dekker
authors.forename: J
authors.initials: J
authors.lastname: Stoker
mesh_terms: D000284:Administration, Oral; D002400:Cathartics / Q000008:administration & dosage; D023881:Colonography, Computed Tomographic / Q000379:methods*; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging*; D003287:Contrast Media / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005240:Feasibility Studies; D005243:Feces; D005260:Female; D006801:Humans; D007482:Iothalamate Meglumine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D015203:Reproducibility of Results; D016903:Drug Monitoring
chemical_list: D002400:Cathartics; D003287:Contrast Media; C001694:meglumine ioxithalamate; D007482:Iothalamate Meglumine