Optimization of CT colonography technique: Prospective trial in 180 patients

Joel Garland Fletcher, C. Daniel Johnson, T. J. Welch, R. L. MacCarty, D. A. Ahlquist, J. E. Reed, W. S. Harmsen, L. A. Wilson

Research output: Contribution to journalArticle

298 Citations (Scopus)

Abstract

PURPOSE: To assess the added benefits of prone positioning in addition to supine positioning and oral iodinated contrast medium for help in the detection of colonic polyps at computed tomographic (CT) colonography. MATERIALS AND METHODS: CT colonography was performed in prone and supine positions in 180 patients with polyps or risk factors for colonic neoplasia. Patients were randomly assigned to receive a standard bowel preparation or a standard preparation plus oral iodinated contrast medium. One radiologist interpreted supine images alone, and another analyzed supine and prone images. All patients subsequently underwent colonoscopy. RESULTS: At colonoscopy, 121 large (≥1-cm-diameter) polyps and 142 smaller (0.5-0.9-cm) polyps were identified. Prone positioning resulted in increased sensitivity for identification of patients with large (≥1-cm) polyps (increase from 70% to 85%, P = .004) and of patients with polyps 0.5 cm or larger (increase from 75% to 88%, P < .005), with no change in specificity. Use of oral contrast medium did not significantly improve polyp detection even in the subset of patients in whom colonic fluid attenuation was markedly increased. CONCLUSION: Acquisition and review of supine and prone CT colonographic images significantly improves the ability to identify patients with polyps 0.5 cm in diameter or larger. Administration of oral iodinated contrast medium does not significantly improve polyp detection.

Original languageEnglish (US)
Pages (from-to)704-711
Number of pages8
JournalRadiology
Volume216
Issue number3
StatePublished - 2000
Externally publishedYes

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Computed Tomographic Colonography
Polyps
Contrast Media
Colonoscopy
Colonic Polyps
Prone Position
Supine Position
Oral Administration

Keywords

  • Colon neoplasms
  • Colon, CT
  • Computed tomography (CT), image display and recording
  • Computed tomography, image processing

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Fletcher, J. G., Johnson, C. D., Welch, T. J., MacCarty, R. L., Ahlquist, D. A., Reed, J. E., ... Wilson, L. A. (2000). Optimization of CT colonography technique: Prospective trial in 180 patients. Radiology, 216(3), 704-711.

Optimization of CT colonography technique : Prospective trial in 180 patients. / Fletcher, Joel Garland; Johnson, C. Daniel; Welch, T. J.; MacCarty, R. L.; Ahlquist, D. A.; Reed, J. E.; Harmsen, W. S.; Wilson, L. A.

In: Radiology, Vol. 216, No. 3, 2000, p. 704-711.

Research output: Contribution to journalArticle

Fletcher, JG, Johnson, CD, Welch, TJ, MacCarty, RL, Ahlquist, DA, Reed, JE, Harmsen, WS & Wilson, LA 2000, 'Optimization of CT colonography technique: Prospective trial in 180 patients', Radiology, vol. 216, no. 3, pp. 704-711.
Fletcher JG, Johnson CD, Welch TJ, MacCarty RL, Ahlquist DA, Reed JE et al. Optimization of CT colonography technique: Prospective trial in 180 patients. Radiology. 2000;216(3):704-711.
Fletcher, Joel Garland ; Johnson, C. Daniel ; Welch, T. J. ; MacCarty, R. L. ; Ahlquist, D. A. ; Reed, J. E. ; Harmsen, W. S. ; Wilson, L. A. / Optimization of CT colonography technique : Prospective trial in 180 patients. In: Radiology. 2000 ; Vol. 216, No. 3. pp. 704-711.
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AB - PURPOSE: To assess the added benefits of prone positioning in addition to supine positioning and oral iodinated contrast medium for help in the detection of colonic polyps at computed tomographic (CT) colonography. MATERIALS AND METHODS: CT colonography was performed in prone and supine positions in 180 patients with polyps or risk factors for colonic neoplasia. Patients were randomly assigned to receive a standard bowel preparation or a standard preparation plus oral iodinated contrast medium. One radiologist interpreted supine images alone, and another analyzed supine and prone images. All patients subsequently underwent colonoscopy. RESULTS: At colonoscopy, 121 large (≥1-cm-diameter) polyps and 142 smaller (0.5-0.9-cm) polyps were identified. Prone positioning resulted in increased sensitivity for identification of patients with large (≥1-cm) polyps (increase from 70% to 85%, P = .004) and of patients with polyps 0.5 cm or larger (increase from 75% to 88%, P < .005), with no change in specificity. Use of oral contrast medium did not significantly improve polyp detection even in the subset of patients in whom colonic fluid attenuation was markedly increased. CONCLUSION: Acquisition and review of supine and prone CT colonographic images significantly improves the ability to identify patients with polyps 0.5 cm in diameter or larger. Administration of oral iodinated contrast medium does not significantly improve polyp detection.

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