National CT Colonography Trial (ACRIN 6664)

Comparison of three full-laxative bowel preparations in more than 2500 average-risk patients

Amy K. Hara, Mark D. Kuo, Meridith Blevins, Mei Hsiu Chen, Judy Yee, Abraham Dachman, Christine O. Menias, Betina Siewert, Jugesh I. Cheema, Richard G. Obregon, Jeff L. Fidler, Peter Zimmerman, Karen M. Horton, Kevin Coakley, Revathy B. Iyer, Robert A. Halvorsen, Giovanna Casola, C. Daniel Johnson

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

OBJECTIVE. The purpose of our study was to compare the effect of three different full-laxative bowel preparations on patient compliance, residual stool and fluid, reader confidence, and polyp detection at CT colonography (CTC). SUBJECTS AND METHODS. A total of 2531 patients underwent CTC followed by colonoscopy for the American College of Radiology Imaging Network (ACRIN) National CTC Trial. Of this total, 2525 patients used one of three bowel preparations with bisacodyl tablets and stool and fluid tagging: 4 L of polyethylene glycol (PEG); 90 mL of phosphosoda; or 300 mL of magnesium citrate. Patients reported percent compliance with the bowel preparation and radiologists graded each CTC examination for the amount of residual fluid and stool on a scale from 1 (none) to 4 (nondiagnostic). Reader confidence for true-positive findings was reported on a 5-point scale: 1 (low) to 5 (high). Sensitivity and specificity for detecting polyps ≥ 6 mm and ≥ 1 cm compared with colonoscopy were calculated for each preparation. RESULTS. The most commonly prescribed preparation was phosphosoda (n = 1403) followed by PEG (n = 1020) and magnesium citrate (n = 102). Phosphosoda had the highest patient compliance (p = 0.01), least residual stool (p < 0.001), and highest reader confidence versus PEG for examinations with polyps (p = 0.06). Magnesium citrate had significantly more residual fluid compared with PEG and phosphosoda (p = 0.006). The sensitivity and specificity for detecting colon polyps ≥ 6 mm and ≥ 1 cm did not differ significantly between preparations. CONCLUSION. Polyp detection was comparable for all three preparations, although phosphosoda had significantly higher patient compliance and the least residual stool.

Original languageEnglish (US)
Pages (from-to)1076-1082
Number of pages7
JournalAmerican Journal of Roentgenology
Volume196
Issue number5
DOIs
StatePublished - May 1 2011
Externally publishedYes

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Computed Tomographic Colonography
Laxatives
Polyps
Radiology
Patient Compliance
Colonoscopy
Bisacodyl
Sensitivity and Specificity
Tablets
Colon
magnesium citrate

Keywords

  • Bowel preparation
  • CT
  • CT colonography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

National CT Colonography Trial (ACRIN 6664) : Comparison of three full-laxative bowel preparations in more than 2500 average-risk patients. / Hara, Amy K.; Kuo, Mark D.; Blevins, Meridith; Chen, Mei Hsiu; Yee, Judy; Dachman, Abraham; Menias, Christine O.; Siewert, Betina; Cheema, Jugesh I.; Obregon, Richard G.; Fidler, Jeff L.; Zimmerman, Peter; Horton, Karen M.; Coakley, Kevin; Iyer, Revathy B.; Halvorsen, Robert A.; Casola, Giovanna; Johnson, C. Daniel.

In: American Journal of Roentgenology, Vol. 196, No. 5, 01.05.2011, p. 1076-1082.

Research output: Contribution to journalArticle

Hara, AK, Kuo, MD, Blevins, M, Chen, MH, Yee, J, Dachman, A, Menias, CO, Siewert, B, Cheema, JI, Obregon, RG, Fidler, JL, Zimmerman, P, Horton, KM, Coakley, K, Iyer, RB, Halvorsen, RA, Casola, G & Johnson, CD 2011, 'National CT Colonography Trial (ACRIN 6664): Comparison of three full-laxative bowel preparations in more than 2500 average-risk patients', American Journal of Roentgenology, vol. 196, no. 5, pp. 1076-1082. https://doi.org/10.2214/AJR.10.4334
Hara, Amy K. ; Kuo, Mark D. ; Blevins, Meridith ; Chen, Mei Hsiu ; Yee, Judy ; Dachman, Abraham ; Menias, Christine O. ; Siewert, Betina ; Cheema, Jugesh I. ; Obregon, Richard G. ; Fidler, Jeff L. ; Zimmerman, Peter ; Horton, Karen M. ; Coakley, Kevin ; Iyer, Revathy B. ; Halvorsen, Robert A. ; Casola, Giovanna ; Johnson, C. Daniel. / National CT Colonography Trial (ACRIN 6664) : Comparison of three full-laxative bowel preparations in more than 2500 average-risk patients. In: American Journal of Roentgenology. 2011 ; Vol. 196, No. 5. pp. 1076-1082.
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abstract = "OBJECTIVE. The purpose of our study was to compare the effect of three different full-laxative bowel preparations on patient compliance, residual stool and fluid, reader confidence, and polyp detection at CT colonography (CTC). SUBJECTS AND METHODS. A total of 2531 patients underwent CTC followed by colonoscopy for the American College of Radiology Imaging Network (ACRIN) National CTC Trial. Of this total, 2525 patients used one of three bowel preparations with bisacodyl tablets and stool and fluid tagging: 4 L of polyethylene glycol (PEG); 90 mL of phosphosoda; or 300 mL of magnesium citrate. Patients reported percent compliance with the bowel preparation and radiologists graded each CTC examination for the amount of residual fluid and stool on a scale from 1 (none) to 4 (nondiagnostic). Reader confidence for true-positive findings was reported on a 5-point scale: 1 (low) to 5 (high). Sensitivity and specificity for detecting polyps ≥ 6 mm and ≥ 1 cm compared with colonoscopy were calculated for each preparation. RESULTS. The most commonly prescribed preparation was phosphosoda (n = 1403) followed by PEG (n = 1020) and magnesium citrate (n = 102). Phosphosoda had the highest patient compliance (p = 0.01), least residual stool (p < 0.001), and highest reader confidence versus PEG for examinations with polyps (p = 0.06). Magnesium citrate had significantly more residual fluid compared with PEG and phosphosoda (p = 0.006). The sensitivity and specificity for detecting colon polyps ≥ 6 mm and ≥ 1 cm did not differ significantly between preparations. CONCLUSION. Polyp detection was comparable for all three preparations, although phosphosoda had significantly higher patient compliance and the least residual stool.",
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AU - Kuo, Mark D.

AU - Blevins, Meridith

AU - Chen, Mei Hsiu

AU - Yee, Judy

AU - Dachman, Abraham

AU - Menias, Christine O.

AU - Siewert, Betina

AU - Cheema, Jugesh I.

AU - Obregon, Richard G.

AU - Fidler, Jeff L.

AU - Zimmerman, Peter

AU - Horton, Karen M.

AU - Coakley, Kevin

AU - Iyer, Revathy B.

AU - Halvorsen, Robert A.

AU - Casola, Giovanna

AU - Johnson, C. Daniel

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N2 - OBJECTIVE. The purpose of our study was to compare the effect of three different full-laxative bowel preparations on patient compliance, residual stool and fluid, reader confidence, and polyp detection at CT colonography (CTC). SUBJECTS AND METHODS. A total of 2531 patients underwent CTC followed by colonoscopy for the American College of Radiology Imaging Network (ACRIN) National CTC Trial. Of this total, 2525 patients used one of three bowel preparations with bisacodyl tablets and stool and fluid tagging: 4 L of polyethylene glycol (PEG); 90 mL of phosphosoda; or 300 mL of magnesium citrate. Patients reported percent compliance with the bowel preparation and radiologists graded each CTC examination for the amount of residual fluid and stool on a scale from 1 (none) to 4 (nondiagnostic). Reader confidence for true-positive findings was reported on a 5-point scale: 1 (low) to 5 (high). Sensitivity and specificity for detecting polyps ≥ 6 mm and ≥ 1 cm compared with colonoscopy were calculated for each preparation. RESULTS. The most commonly prescribed preparation was phosphosoda (n = 1403) followed by PEG (n = 1020) and magnesium citrate (n = 102). Phosphosoda had the highest patient compliance (p = 0.01), least residual stool (p < 0.001), and highest reader confidence versus PEG for examinations with polyps (p = 0.06). Magnesium citrate had significantly more residual fluid compared with PEG and phosphosoda (p = 0.006). The sensitivity and specificity for detecting colon polyps ≥ 6 mm and ≥ 1 cm did not differ significantly between preparations. CONCLUSION. Polyp detection was comparable for all three preparations, although phosphosoda had significantly higher patient compliance and the least residual stool.

AB - OBJECTIVE. The purpose of our study was to compare the effect of three different full-laxative bowel preparations on patient compliance, residual stool and fluid, reader confidence, and polyp detection at CT colonography (CTC). SUBJECTS AND METHODS. A total of 2531 patients underwent CTC followed by colonoscopy for the American College of Radiology Imaging Network (ACRIN) National CTC Trial. Of this total, 2525 patients used one of three bowel preparations with bisacodyl tablets and stool and fluid tagging: 4 L of polyethylene glycol (PEG); 90 mL of phosphosoda; or 300 mL of magnesium citrate. Patients reported percent compliance with the bowel preparation and radiologists graded each CTC examination for the amount of residual fluid and stool on a scale from 1 (none) to 4 (nondiagnostic). Reader confidence for true-positive findings was reported on a 5-point scale: 1 (low) to 5 (high). Sensitivity and specificity for detecting polyps ≥ 6 mm and ≥ 1 cm compared with colonoscopy were calculated for each preparation. RESULTS. The most commonly prescribed preparation was phosphosoda (n = 1403) followed by PEG (n = 1020) and magnesium citrate (n = 102). Phosphosoda had the highest patient compliance (p = 0.01), least residual stool (p < 0.001), and highest reader confidence versus PEG for examinations with polyps (p = 0.06). Magnesium citrate had significantly more residual fluid compared with PEG and phosphosoda (p = 0.006). The sensitivity and specificity for detecting colon polyps ≥ 6 mm and ≥ 1 cm did not differ significantly between preparations. CONCLUSION. Polyp detection was comparable for all three preparations, although phosphosoda had significantly higher patient compliance and the least residual stool.

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