Magnetic resonance imaging and computed tomography : applications in colorectal cancer surveillance and evaluation of Crohn's disease
Year: 2007
Type: other
Abstract: Purpose: To prospectively evaluate patient experience and preference of MR colonography using limited bowel preparation compared to full preparation colonoscopy in patients at increased risk for colorectal cancer. Materials and methods: The institutional review board approved our study. All patients gave written informed consent. In this multicenter study, consecutive patients undergoing colonoscopy because of a personal or family history of colorectal cancer or adenomatous polyps underwent MR colonography two weeks prior to colonoscopy. They all had a low-fiber diet, lactulose and an oral contrast agent (fecal tagging with gadolinium) 2 days prior to colonography. Before scanning spasmolytics were administered intravenously and a water/gadolinium mixture was administered rectally for distension of the colon. Breath hold T1and T2-weighted sequences were performed in prone and supine position. Patient experience (pain, burden, 5-point scale, Wilcoxon signed rank test) and preference (7-point scale, Chi-square test statistic after dichotomizing) were determined. Results: 209 patients (77 female, mean age 58, range 23-84) were included. 148 patients received sedatives (midazolam) and/or analgesics (fentanyl) during colonoscopy. Patients rated the MR colonography bowel preparation as less burdensome (P<0.001) when compared to colonoscopy bowel preparation (respectively 10% and 1% rated it moderately to extremely burdensome). Patients also experienced less pain at MR colonography (P<0.001) and MR colonography was less burdensome (P<0.001). Directly after both examinations 69% preferred MR colonography, 22% colonoscopy and 9% was indifferent (P<0.001, 69% versus 22%). After five weeks 65% preferred MR colonography, 26% preferred colonoscopy (P<0.001). Conclusions: Patients preferred MR colonography without extensive cleansing to colonoscopy directly after both examinations and five weeks later. Experience of both the bowel preparation and the procedure were rated better.
Author: Florie, J.
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2103500249