Nihon Shoukaki Gan Kenshin Gakkai zasshi
Online ISSN : 2185-1190
Print ISSN : 1880-7666
ISSN-L : 1880-7666
Original article
Modified dry preparation for CT colonography: is it possible to perform CT colonography without laxative?
Teppei MIKAMIKoichi NAGATAAtsushi IYAMANoriaki TAKAHASHIKenichi UTANOShungo ENDOKazutomo TOGASHIHiroshi SAITOTakahisa MATSUDA
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JOURNAL FREE ACCESS

2019 Volume 57 Issue 3 Pages 356-366

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Abstract

The purpose of this study was to evaluate the examination quality of non-laxative computed tomography colonography (CTC) with modified dry preparation. Seven hundred sixty-four consecutive subjects who received a CTC were enrolled. Accuracy and bowel preparation quality were assessed retrospectively in non-laxative CTC. For the purpose of accuracy evaluation, we assessed the overall compliance rate to colonoscopy of CTC-positive subjects, positive predictive values, and inadequate study rate due to inadequate preparation or inadequate insufflation. For the purpose of quality evaluation, the volume of residual fluid or solid stool was graded by two blinded readers from 0 (no feces) to 3 (much amount of feces) in each colonic segment. The CT attenuation values of tagged residual stool or fluid were measured manually by recording the minimum attenuation values (in HU) in each colonic segment. The overall compliance rate to colonoscopy of CTC-positive subjects was 70.5%. The by-subject positive predictive value for CTC-detected lesions ≥6 mm was 64.1%, and inadequate study rate was 3.7%. As far as the subjects who could be reached and were followed up were concerned, the overall compliance rate to colonoscopy was 90.2%, and the by-subject positive predictive value was 90.9%. The percentages of segments that were assigned scores of 3 for residual stool and fluid were 10.5% and 4.5%, respectively. The mean CT attenuation values of tagging was 617.2 HU. Although non-laxative CTC had good accuracy with adenomas 6 mm or larger, a primary three-dimensional interpretation could be difficult because of much amount of solid stool in the endoluminal images.

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© 2019 The Japanese Society of Gastrointestinal Cancer Screening
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