Aileen O'Shea1, Ann T Foran2, Timothy E Murray3, Eavan Thornton4, Ruth Dunne2, Michael J Lee2, Martina M Morrin2. 1. Department of Radiology, Division of Abdominal Imaging, Massachusetts General Hospital, Boston, MA, 02114, USA. aoshea1@mgh.harvard.edu. 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.
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. Same-day 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.
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. Same-day 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.