title: Magnetic resonance colonography with automated carbon dioxide insufflation: Diagnostic accuracy and distension.
abstract: OBJECTIVE
  To evaluate the diagnostic performance of MR colonography using automated carbon dioxide (CO2) insufflation for colonic distension, with colonoscopy serving as the reference standard.
  
  
  METHODS
  Ninety-eight symptomatic patients underwent MR colonography with faecal tagging and automated CO2 insufflation. Three readers (one expert (reader 1), and two less experienced (readers 2 and 3)) evaluated the images for the presence of colorectal lesions. Bowel distension was evaluated on a 4-point scale. Results were verified with colonoscopy and histopathological analysis.
  
  
  RESULTS
  Per-patient sensitivity for lesions ≥10mm was 91.7% (11 of 12) (reader 1), 75.0% (9 of 12) (reader 2), and 75% (9 of 12) (reader 3). Specificity was 96.5% (82 of 85) (reader 1), 97.7% (83 of 85) (reader 2), 95.3% (81 of 85) (reader 3). Per-patient sensitivity for lesions ≥6mm was 85.7% (18 of 21) (reader 1), 57.1% (12 of 21) (reader 2), and 57.1% (12 of 21) (reader 3). Specificity was 86.8% (66 of 76), 98.7% (75 of 76), 90.8% (69 of 76), respectively. Per-patient sensitivity for advanced neoplasia of ≥10mm and ≥6mm was 88.9% (8 of 9) for all readers. Specificity for ≥10mm and ≥6mm was 98.9% (87 of 88) (reader 1), 97.7% (86 of 88) (reader 2), 96.6% (85 of 88) (reader 3). 94.4% of the colon segments were adequate to optimal distended with dual positioning.
  
  
  CONCLUSIONS
  MR colonography can accurately detect lesions ≥10mm, and advanced neoplasia ≥6mm. Sufficient distension was achieved using automated CO2 insufflation for colonic distension in MR colonography.
authors.affiliation: Department of Radiology, Academic Medical Center Amsterdam, Amsterdam, the Netherlands. Electronic address: m.p.vanderpaardt@amc.uva.nl.
authors.forename: M P
authors.initials: MP
authors.lastname: van der Paardt
authors.affiliation: Department of Radiology, Academic Medical Center Amsterdam, Amsterdam, the Netherlands; Department of Radiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands; Department of Radiology, Medisch Centrum Haaglanden, Den Haag, the Netherlands. Electronic address: fmzijta@yahoo.com.
authors.forename: F M
authors.initials: FM
authors.lastname: Zijta
authors.affiliation: Department of Radiology, Academic Medical Center Amsterdam, Amsterdam, the Netherlands. Electronic address: t.n.boellaard@amc.uva.nl.
authors.forename: T N
authors.initials: TN
authors.lastname: Boellaard
authors.affiliation: Department of Radiology, Sint Lucas-Andreas Ziekenhuis, Amsterdam, the Netherlands. Electronic address: s.jensch@slaz.nl.
authors.forename: S
authors.initials: S
authors.lastname: Jensch
authors.affiliation: Department of Gastroenterology and Hepatology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands. Electronic address: l.c.baak@olvg.nl.
authors.forename: L C
authors.initials: LC
authors.lastname: Baak
authors.affiliation: Department of Gastroenterology and Hepatology, Slotervaartziekenhuis, Amsterdam, the Netherlands. Electronic address: actm.depla@slz.nl.
authors.forename: A C T M
authors.initials: AC
authors.lastname: Depla
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center Amsterdam, Amsterdam, the Netherlands. Electronic address: e.dekker@amc.uva.nl.
authors.forename: E
authors.initials: E
authors.lastname: Dekker
authors.affiliation: Department of Radiology, Academic Medical Center Amsterdam, Amsterdam, the Netherlands. Electronic address: a.j.nederveen@amc.uva.nl.
authors.forename: A J
authors.initials: AJ
authors.lastname: Nederveen
authors.affiliation: Department of Radiology, Academic Medical Center Amsterdam, Amsterdam, the Netherlands. Electronic address: s.bipat@amc.uva.nl.
authors.forename: S
authors.initials: S
authors.lastname: Bipat
authors.affiliation: Department of Radiology, Academic Medical Center Amsterdam, Amsterdam, the Netherlands. Electronic address: j.stoker@amc.uva.nl.
authors.forename: J
authors.initials: J
authors.lastname: Stoker
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002245:Carbon Dioxide / Q000008:administration & dosage; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007327:Insufflation / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016037:Single-Blind Method
chemical_list: D002245:Carbon Dioxide
keywords: Carbon dioxide (CO(2)); Colorectal neoplasm; Insufflation; MRI; Virtual colonoscopy