title: National CT colonography trial (ACRIN 6664): comparison of three full-laxative bowel preparations in more than 2500 average-risk patients.
abstract: OBJECTIVE
  The purpose of our study was to compare the effect of three different full-laxative bowel preparations on patient compliance, residual stool and fluid, reader confidence, and polyp detection at CT colonography (CTC).
  
  
  METHODS
  A total of 2531 patients underwent CTC followed by colonoscopy for the American College of Radiology Imaging Network (ACRIN) National CTC Trial. Of this total, 2525 patients used one of three bowel preparations with bisacodyl tablets and stool and fluid tagging: 4 L of polyethylene glycol (PEG); 90 mL of phosphosoda; or 300 mL of magnesium citrate. Patients reported percent compliance with the bowel preparation and radiologists graded each CTC examination for the amount of residual fluid and stool on a scale from 1 (none) to 4 (nondiagnostic). Reader confidence for true-positive findings was reported on a 5-point scale: 1 (low) to 5 (high). Sensitivity and specificity for detecting polyps ≥ 6 mm and ≥ 1 cm compared with colonoscopy were calculated for each preparation.
  
  
  RESULTS
  The most commonly prescribed preparation was phosphosoda (n = 1403) followed by PEG (n = 1020) and magnesium citrate (n = 102). Phosphosoda had the highest patient compliance (p = 0.01), least residual stool (p < 0.001), and highest reader confidence versus PEG for examinations with polyps (p = 0.06). Magnesium citrate had significantly more residual fluid compared with PEG and phosphosoda (p = 0.006). The sensitivity and specificity for detecting colon polyps ≥ 6 mm and ≥ 1 cm did not differ significantly between preparations.
  
  
  CONCLUSIONS
  Polyp detection was comparable for all three preparations, although phosphosoda had significantly higher patient compliance and the least residual stool.
authors.affiliation: Department of Diagnostic Radiology, Mayo Clinic Scottsdale, AZ 85259, USA. hara.amy@mayo.edu
authors.forename: Amy K
authors.initials: AK
authors.lastname: Hara
authors.forename: Mark D
authors.initials: MD
authors.lastname: Kuo
authors.forename: Meridith
authors.initials: M
authors.lastname: Blevins
authors.forename: Mei-Hsiu
authors.initials: MH
authors.lastname: Chen
authors.forename: Judy
authors.initials: J
authors.lastname: Yee
authors.forename: Abraham
authors.initials: A
authors.lastname: Dachman
authors.forename: Christine O
authors.initials: CO
authors.lastname: Menias
authors.forename: Betina
authors.initials: B
authors.lastname: Siewert
authors.forename: Jugesh I
authors.initials: JI
authors.lastname: Cheema
authors.forename: Richard G
authors.initials: RG
authors.lastname: Obregon
authors.forename: Jeff L
authors.initials: JL
authors.lastname: Fidler
authors.forename: Peter
authors.initials: P
authors.lastname: Zimmerman
authors.forename: Karen M
authors.initials: KM
authors.lastname: Horton
authors.forename: Kevin
authors.initials: K
authors.lastname: Coakley
authors.forename: Revathy B
authors.initials: RB
authors.lastname: Iyer
authors.forename: Robert A
authors.initials: RA
authors.lastname: Halvorsen
authors.forename: Giovanna
authors.initials: G
authors.lastname: Casola
authors.forename: C Daniel
authors.initials: CD
authors.lastname: Johnson
mesh_terms: D002400:Cathartics; D019343:Citric Acid; D003111:Colonic Polyps / Q000000981:diagnostic imaging*; D023881:Colonography, Computed Tomographic; D004573:Electrolytes; D005260:Female; D005751:Gastric Lavage; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009942:Organometallic Compounds; D010710:Phosphates; D011092:Polyethylene Glycols; D011237:Predictive Value of Tests; D014481:United States
chemical_list: D002400:Cathartics; D004573:Electrolytes; C033608:Golytely; D009942:Organometallic Compounds; D010710:Phosphates; D019343:Citric Acid; D011092:Polyethylene Glycols; C110422:magnesium citrate; C018279:sodium phosphate