title: Predictors of incomplete optical colonoscopy using computed tomographic colonography.
abstract: OBJECTIVE
  Optical colonoscopy (OC) is the primary modality for investigation of colonic pathology. Although there is data on demographic factors for incomplete OC, paucity of data exists for anatomic variables that are associated with an incomplete OC. These anatomic variables can be visualized using computed tomographic colonography (CTC). We aim to retrospectively identify variables associated with incomplete OC using CTC and develop a scoring method to predict the outcome of OC.
  
  
  METHODS
  In this case-control study, 70 cases ( with incomplete OC) and 70 controls (with complete OC) were identified. CTC images of cases and controls were independently reviewed by a single CTC radiologist. Demographic and anatomical parameters were recorded. Data was examined using descriptive linear statistics and multivariate logistic regression model.
  
  
  RESULTS
  On analysis, female gender (80% vs 58.6% P = 0.007), prior abdominal/pelvic surgeries (51.4% vs 14.3% P < 0.001), colonic length (187.6 ± 30.0 cm vs 163.8 ± 27.2 cm P < 0.001), and number of flexures (11.4 ± 3.1 vs 8.4 ± 2.9 P < 0.001) increased the risk for incomplete OC. No significant association was observed for increasing age (P = 0.881) and history of severe diverticulosis (P = 0.867) with incomplete OC. A scoring system to predict the outcome of OC is proposed based on CTC findings.
  
  
  CONCLUSIONS
  Female gender, prior surgery, and increasing colonic length and tortuosity were associated with incomplete OC, whereas increasing age and history of severe diverticulosis were not. These factors may be used in the future to predict those patients who are at risk of incomplete OC.
authors.forename: Reetika
authors.initials: R
authors.lastname: Sachdeva
authors.forename: Salina D
authors.initials: SD
authors.lastname: Tsai
authors.forename: Mohamad H
authors.initials: MH
authors.lastname: El Zein
authors.forename: Alan A
authors.initials: AA
authors.lastname: Tieu
authors.forename: Ahmed
authors.initials: A
authors.lastname: Abdelgelil
authors.forename: Sepideh
authors.initials: S
authors.lastname: Besharati
authors.forename: Mouen A
authors.initials: MA
authors.lastname: Khashab
authors.forename: Anthony N
authors.initials: AN
authors.lastname: Kalloo
authors.affiliation: Department of Medicine, Division of Gastroenterology and Hepatology, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
authors.forename: Vivek
authors.initials: V
authors.lastname: Kumbhari
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D003108:Colonic Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D023881:Colonography, Computed Tomographic / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
references.citation: Gastrointest Endosc. 2006 Oct;64(4):556-62
references.pmid: 16996349
references.citation: Eur Radiol. 2005 Jun;15(6):1192-202
references.pmid: 15702335
references.citation: Radiology. 2007 Aug;244(2):471-8
references.pmid: 17641367
references.citation: AJR Am J Roentgenol. 2007 Oct;189(4):774-9
references.pmid: 17885044
references.citation: N Engl J Med. 2008 Sep 18;359(12):1207-17
references.pmid: 18799557
references.citation: Endoscopy. 2009 Aug;41(8):674-8
references.pmid: 19670134
references.citation: Dig Liver Dis. 2010 Apr;42(4):291-6
references.pmid: 19502116
references.citation: Surg Endosc. 2011 Jul;25(7):2344-9
references.pmid: 21416185
references.citation: Dis Colon Rectum. 2013 May;56(5):593-9
references.pmid: 23575398
references.citation: Eur Radiol. 2013 Oct;23(10):2723-9
references.pmid: 23660775
references.citation: BMC Gastroenterol. 2014;14:56
references.pmid: 24679009
references.citation: Gastrointest Endosc. 2015 Jan;81(1):31-53
references.pmid: 25480100
references.citation: AJR Am J Roentgenol. 1999 Apr;172(4):913-8
references.pmid: 10587120
references.citation: Clin Imaging. 1999 Nov-Dec;23(6):367-74
references.pmid: 10899420
references.citation: AJR Am J Roentgenol. 2001 Apr;176(4):943-5
references.pmid: 11264083
references.citation: Gastrointest Endosc. 2001 Nov;54(5):558-62
references.pmid: 11677470
references.citation: N Engl J Med. 2003 Dec 4;349(23):2191-200
references.pmid: 14657426
references.citation: Clin Radiol. 1995 May;50(5):318-21
references.pmid: 7743720
references.citation: Dis Colon Rectum. 1995 Sep;38(9):964-8
references.pmid: 7656745
references.citation: Gastroenterology. 1997 Jan;112(1):17-23
references.pmid: 8978337
references.citation: Gastroenterology. 2007 Jun;132(7):2297-303
references.pmid: 17570204