OBJECTIVE: To determine whether intravenous contrast (IVC) is necessary for detection of extracolonic findings (ECFs) in patients undergoing CT colonography (CTC). METHODS: We performed a retrospective review of CT findings in 179 cases of CTC studies performed over 18 months where both pre-contrast (NECT) and post-contrast (CECT) scans were performed in the prone and supine positions, respectively, in the same patients. All ECFs were recorded on a per patient basis and graded according to the colonography reporting and data system classification. RESULTS: There was no significant change in E grade for the cohort (p = 0.171) between the NECT and CECT scans. On the CECT scans, additional findings were detected in 49.1% of patients. Overall, there were 27/179 (15.1%) patients graded E3 and 18/179 (10.1%) patients graded E4 on the CECT study. Compared with the NECT study, there was a decrease of 12.9% of patients graded E3 and no change in the number of patients graded E4. CONCLUSION: With IVC administration, additional ECFs are detected in nearly half of all patients. However, there was no increase in the number of patients with clinically significant lesions. The risk-benefit ratio of routine IVC administration for CTC in symptomatic patients thus requires further evaluation. ADVANCES IN KNOWLEDGE: This study reviews the utility of IVC in CTC and is thus relevant to current clinical practice at many institutions.
OBJECTIVE: To determine whether intravenous contrast (IVC) is necessary for detection of extracolonic findings (ECFs) in patients undergoing CT colonography (CTC). METHODS: We performed a retrospective review of CT findings in 179 cases of CTC studies performed over 18 months where both pre-contrast (NECT) and post-contrast (CECT) scans were performed in the prone and supine positions, respectively, in the same patients. All ECFs were recorded on a per patient basis and graded according to the colonography reporting and data system classification. RESULTS: There was no significant change in E grade for the cohort (p = 0.171) between the NECT and CECT scans. On the CECT scans, additional findings were detected in 49.1% of patients. Overall, there were 27/179 (15.1%) patients graded E3 and 18/179 (10.1%) patients graded E4 on the CECT study. Compared with the NECT study, there was a decrease of 12.9% of patients graded E3 and no change in the number of patients graded E4. CONCLUSION: With IVC administration, additional ECFs are detected in nearly half of all patients. However, there was no increase in the number of patients with clinically significant lesions. The risk-benefit ratio of routine IVC administration for CTC in symptomatic patients thus requires further evaluation. ADVANCES IN KNOWLEDGE: This study reviews the utility of IVC in CTC and is thus relevant to current clinical practice at many institutions.
Authors: Michael E Zalis; Matthew A Barish; J Richard Choi; Abraham H Dachman; Helen M Fenlon; Joseph T Ferrucci; Seth N Glick; Andrea Laghi; Michael Macari; Elizabeth G McFarland; Martina M Morrin; Perry J Pickhardt; Jorge Soto; Judy Yee Journal: Radiology Date: 2005-07 Impact factor: 11.105
Authors: Steve Halligan; Douglas G Altman; Stuart A Taylor; Susan Mallett; Jonathan J Deeks; Clive I Bartram; Wendy Atkin Journal: Radiology Date: 2005-12 Impact factor: 11.105
Authors: Jacob Sosna; Martina M Morrin; Jonathan B Kruskal; Richard J Farrell; Imad Nasser; Vassilios Raptopoulos Journal: Radiology Date: 2003-05-29 Impact factor: 11.105
Authors: Emanuele Neri; Steve Halligan; Mikael Hellström; Philippe Lefere; Thomas Mang; Daniele Regge; Jaap Stoker; Stuart Taylor; Andrea Laghi Journal: Eur Radiol Date: 2012-09-15 Impact factor: 5.315