A Novel Volume-reduced CT Colonography Regimen Using Hypertonic Laxative (polyethylene Glycol with Ascorbic Acid): Randomized Controlled Trial

Overview

Journal Eur Radiol

Specialty Radiology

Date 2019 Mar 24

PMID 30903329

Citations 1

Authors

Kenichi Utano

Daisuke Takayanagi

Koichi Nagata

Masato Aizawa

Shungo Endo

Tetsutaro Nemoto

Daiki Nemoto

Noriyuki Isohata

Alan Kawarai Lefor

Kazutomo Togashi

Affiliations

Soon will be listed here.

Abstract

Objectives: The aim of this study is to investigate the feasibility of bowel preparation using a hypertonic laxative (polyethylene glycol with ascorbic acid, PEG + Asc) for CT colonography (CTC) and to examine the volume limit of laxative.

Methods: In one institution, patients who met the indications for CTC were enrolled and randomly assigned to CTC with regimen A (800 ml PEG + Asc), B (600 ml PEG + Asc), or C (400 ml PEG + Asc). Sodium diatrizoate was given orally for fecal tagging. On the previous day, patients ate low-residue meals and took the assigned lavage solution after dinner. A reader blinded to the preparation graded residual stool/fluid and fecal tagging quality in six segments of the colorectum. The primary outcome was a proportion of colon segments without stool. One hundred twenty segments in 20 patients with each regimen were needed to show a non-inferiority margin of 15%, assuming 85% of no stool.

Results: A total of 360 segments in 60 patients were analyzed. There were 83% of segments with no stool in regimen A, 89% in regimen B, and 88% in regimen C. Using the delta method, the 95% confidence interval of the risk difference (6.7%) between regimens A and B was - 2.2% to 15.6%, and the risk difference (5.0%) between regimens A and C was - 4.1% to 14%, both within the non-inferiority margin. Residual fluid and fecal tagging quality were also within the non-inferiority margin. No adverse events occurred.

Conclusions: A novel CTC regimen using hypertonic laxative demonstrated optimal colon cleansing effectiveness even with the lowest volume of laxative (UMIN000022851).

Key Points: • A novel CTC regimen using a hypertonic laxative is feasible. • The lowest volume of laxative provides excellent colon imaging. • However, the lowest volume of laxative did not improve patient acceptance.

Citing Articles

Low-volume reduced bowel preparation regimen for CT colonography: a randomized noninferiority trial.

Bellini D, Panvini N, Vicini S, Rengo M, Lucchesi P, Caruso D Abdom Radiol (NY). 2021; 46(10):4556-4566.

PMID: 34143258 DOI: 10.1007/s00261-021-03176-8.

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