Quality of same-day CT colonography following incomplete optical colonoscopy
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COMPUTED TOMOGRAPHY
Quality of same-day CT colonography following incomplete optical colonoscopy Aileen O’Shea 1 & Ann T. Foran 2 & Timothy E. Murray 3 & Eavan Thornton 4 & Ruth Dunne 2 & Michael J. Lee 2 & Martina M. Morrin 2 Received: 18 February 2020 / Revised: 17 April 2020 / Accepted: 25 May 2020 # European Society of Radiology 2020
Abstract Objectives Same-day CT colonography (CTC) following incomplete optical colonoscopy allows patients to avoid both a delayed diagnosis and the need for repeat bowel preparation. The aim of our study is to establish the diagnostic quality of same-day CT colonography following an incomplete optical colonoscopy. Methods We performed a retrospective review of patients undergoing same-day CT colonography following an incomplete colonoscopy at our center between July 2015 and December 2017 (N = 245). We divided the large bowel into thirteen subsegments in each patient. Using a semiquantitative scoring system, the quality of bowel preparation, adequacy of fecal tagging, and luminal distension were assessed in each subsegment on all views performed. A combined score for each subsection was obtained. Results Ninety-nine percent of studies did not require a repeat CTC or optical colonoscopy. Median values for bowel preparation and fecal tagging were satisfactory across the bowel segments for the cohort and luminal distension was acceptable in all but three patients. Conclusions Same-day CTC should be considered in centers with capacity, following an incomplete optical colonoscopy. Sameday completion CTCs are of high diagnostic quality and this approach allows patients to avoid repeat bowel cleansing or a delayed diagnosis. Key Points • Same-day CT colonography is a high-quality examination that can be performed following incomplete optical colonoscopy. • Same-day CT colonography should be considered for patients with incomplete optical colonoscopy in centers with the capacity to offer this service. • Same-day CTC can avoid a delay in diagnosis and avoids repeat bowel preparation. Keywords Colorectal neoplasms . Colonic polyps . Colonoscopy . Colonography, computed tomography
Abbreviations CO2 Carbon dioxide CTC Computed tomography colonography HU Hounsfield unit
OC PACS ROI
Optical colonoscopy Picture Archiving and Communication Service Region-of-interest
Drs. A Foran and A O’Shea are equal first authors. * Aileen O’Shea [email protected] 1
Department of Radiology, Division of Abdominal Imaging, Massachusetts General Hospital, Boston, MA 02114, USA
2
Department of Radiology, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland
3
Department of Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada
4
Department of Radiology, Bons Secours Hospital, Glasnevin Hill, Botanic, Dublin 9 D09 YN97, Ireland
Eur Radiol
Introduction Estimated rates of incomplete colonoscopy vary between 4 and 24% [1]. Factors which can contribute to an increased likelihood of incomplete colonoscopy include anatomic factors (e.g., colonic tortuosity, benign and malignant str
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