Colon, colonography, and conservatism.
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Barium Sulfate↗
Biomedical subjects
B Ginnerup Pedersen
Publications and source records attributed to B Ginnerup Pedersen.
Colonoscopy and multidetector-array computed-tomographic colonography: detection rates and feasibility.
BACKGROUND AND STUDY AIMS: Computed-tomographic (CT) colonography has been introduced as a minimally invasive colon examination for the detection of colorectal neoplasms. The aim of this study was to compare the performance characteristics of multidetector-array CT colonography (MDCTC) and conventional colonoscopy in a prospective, blinded design. PATIENTS AND METHODS: Sixty-six symptomatic patients, 75 patients undergoing polyp and cancer surveillance, and seven patients undergoing preoperative colonoscopy due to colorectal cancer (CRC) were examined with MDCTC and subsequent colonoscopy. The gold standard was colonoscopy. If MDCTC was positive and the first-pass colonoscopy was negative, a second-pass colonoscopy served as the gold standard. RESULTS: Complete colonoscopy was achieved in 91% of the patients, while technically satisfying MDCTC was obtained in 76% of the patients (P < 0.01), insufficient air distension in the sigmoid colon being the main problem. MDCTC and colonoscopy both detected all 11 carcinomas. Overall detection rates for polypoid lesions 6 mm or larger in size were 81% (95% CI, 70% to 90%) for MDCTC and 87% (95% CI, 77% to 94%) for colonoscopy (P = 0.52), with a significant difference with regard to the detection of polyps 6-9 mm in size in favor of colonoscopy (P = 0.008). The specificity of MDCTC at a 6-mm level was 97% (95% CI, 92% to 99%). CONCLUSIONS: MDCTC and colonoscopy show equal overall sensitivity for the detection of polypoid lesions 6 mm or larger in size, but more patients are inadequately examined when MDCTC is used.
Adult↗
Extracolonic findings at computed tomography colonography are a challenge.
AIM: Our aim was to perform a prospective evaluation of the frequency and diagnostic consequences of extracolonic findings at multidetector array computed tomography colonography (MDCTC) in asymptomatic patients undergoing surveillance for former colorectal polyps or cancer. PATIENTS AND METHODS: Seventy five consecutive patients undergoing surveillance for former colorectal cancer (CRC) or large bowel adenoma were examined with MDCTC. Two independent observers evaluated the images with regard to extracolonic findings. Patient records and radiological information systems were reviewed to determine the results and consequences of the workup derived from MDCTC. RESULTS: Sixty five per cent (95% confidence interval (CI) 55-73%) of patients had extracolonic abnormalities and in 12% (CI 7-18%) of patients additional workup was indicated. Two patients (3% (CI 1-6%)) underwent surgery because of the findings (one) or because of complications of the workup (one). CONCLUSION: MDCTC identifies a large number of extracolonic findings. Approximately 12% of asymptomatic patients undergo additional workup, of benefit to only a few. The high prevalence of extracolonic findings may make MDCTC a problematic colorectal screening tool for both ethical and economic reasons.
Adenoma↗
Bowel cleansing methods prior to CT colonography.
PURPOSE: To compare the cleansing effect, ease of preparation and side-effects of two cleansing regimens containing either polyethylene glycol solution (PEG) or phospho-soda (Na-P) solution prior to CT colonography in a prospective, randomized, radiologist-blinded design. MATERIAL AND METHODS: Fifty persons were randomized to receive either a PEG preparation or a Na-P preparation prior to CT colonography. On axial 2D images, the rectum, the sigmoid, the descending, the transverse and the cecum/ascending colon were scored semiquantitatively as to cleanness by two radiologists blinded to the bowel preparation regimen. Quality scores in the two groups were compared. Ease of preparation and side-effects were assessed by a questionnaire. RESULTS: The overall quality of the bowel preparation with the Na-P preparation was better than with the PEG preparation with significantly better cleansing scores for the rectum, the sigmoid, the descending and the transverse colon. The Na-P preparation was significantly better tolerated than the PEG preparation with significantly less nausea and significantly less fecal incontinence. CONCLUSION: The quality of the bowel preparation was better with the Na-P preparation than with the PEG preparation prior to CT colonography. Moreover, the Na-P preparation was better tolerated and with fewer side-effects.
Aged↗