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Huang Y, Huang Y, Xiao C, Huang Q, Chai X. Preoperative Evaluation of Neurovascular Relationship in Primary Trigeminal Neuralgia(PTN) by Magnetic Resonance Virtual Endoscopy(MRVE) Combined with 3D-FIESTA-c and 3D-TOF-MRA. J Pain Res 2024; 17:2561-2570. [PMID: 39132295 PMCID: PMC11313606 DOI: 10.2147/jpr.s465956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 07/30/2024] [Indexed: 08/13/2024] Open
Abstract
Objective This study aims to evaluate the effectiveness of Magnetic Resonance Virtual Endoscopy combined with 3D-FIESTA-c and 3D-TOF-MRA in preoperative assessment of MVD for PTN, with a focus on accurately detecting neuromuscular contact. Methods We retrospectively analyzed clinical and imaging data from 240 patients with unilateral primary trigeminal neuralgia undergoing MVD surgery between April 2016 and July 2023. Preoperative scans with 3D-FIESTA-c and 3D-TOF-MRA were performed, and MRVE images were obtained to analyze the relationship between the trigeminal nerve and adjacent vessels. Using the findings during microvascular decompression (MVD) surgery as the gold standard, the diagnostic results of 3D-TOF-MRA + 3D-FIESTA-c were considered as group I, while the combined use of MRVE, 3D-TOF-MRA + 3D-FIESTA-c was considered as group II. Results In 240 cases, group I had a positive rate of 96.25% and an accuracy rate of 86.25% for identifying responsible blood vessels, while group II had a positive rate of 98.3% and an accuracy rate of 94.17%. There were no statistically significant differences in positive rates between group I and group II, group I and MVD, or group II and MVD (P > 0.05). However, there were statistically significant differences in accuracy rates (P < 0.05). The accuracy for single and multiple arteries with group I was 99.38% and 80.0%, respectively, while with group II, it was 100% and 95.0%. No statistically significant difference was found in accuracy for single or multiple arteries (P>0.05). The accuracy of evaluating responsibility veins with or without other vessels was 52.73% and 80.0%, respectively, with a statistically significant difference (P<0.05). Conclusion MRVE combined with 3D-TOF-MRA + 3D-FIESTA-c significantly improves the accuracy of identifying responsibility vessels, especially veins, in preoperative assessment for MVD. This has important clinical implications for preoperative decision-making and surgical planning.
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Affiliation(s)
- Yu Huang
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
| | - Ying Huang
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
| | - Chaoyong Xiao
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
| | - Qingling Huang
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
| | - Xue Chai
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
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Asteria CR, Lucchini G, Guarda L, Ricci P, Pagani M, Boccia L. The detection of interval colorectal cancers following screening by fecal immunochemical test may predict worse outcomes and prompt ethical concerns: a 6-year population-based cohort study in a full district. Eur J Cancer Prev 2019; 28:17-26. [PMID: 29111981 DOI: 10.1097/cej.0000000000000416] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The rates of colorectal cancer (CRC) interval surveyed in screen-detected patients using a fecal immunochemical test (FIT) are not negligible. The aim of this study was to assess the effect of interval cancer on outcomes compared with a population with cancer diagnosed after a positive test result. All patients between 50 and 71 years of age, who were residents of the Mantua district, affected by CRC and operated on from 2005 to 2010 were reviewed. Other than patient-related, disease-related, and treatment-related factors and tumor location, this population was differentiated as either participating or not to screening and then into populations developing interval cancer after a negative FIT result. Mortality was investigated by univariate analysis and by overall survival rates. The mean age of the 975 patients enrolled was 62 years (61.7% males). Most patients (n=575, 59%) were not screen detected, and 400 (41%) were screen detected. Fifty-six (5.7%) patients in the latter group, representing 14% of the participants, developed interval cancer after a negative FIT result. Their cancer was mostly localized in the right colon (41.1%) instead of the left colon and rectum (P=0.02). They also showed higher stages (P=0.001), a moderate degree of differentiation (P=0.001), and overall higher mortality rates than patients with cancer diagnosed after a positive test result (P=0.001). The effect of interval CRC after screening with FIT resulted in worse outcomes compared with the FIT-positive group. With such findings, patients who had negative results for FIT should be informed of the risk of developing cancer within the rounds of screening to independently gain educational skills in the area of health prevention.
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Affiliation(s)
| | | | - Linda Guarda
- Department of Epidemiology, Public Health Observatory, ATS Val Padana, Mantua, Italy
| | - Paolo Ricci
- Department of Epidemiology, Public Health Observatory, ATS Val Padana, Mantua, Italy
| | - Mauro Pagani
- Department of Medicine, Medicine Unit Pieve Coriano, Carlo Poma ASST
| | - Luigi Boccia
- Department of Surgery and Orthopaedics, General Surgery Unit
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Current Status of Magnetic Resonance Colonography for Screening and Diagnosis of Colorectal Cancer. Radiol Clin North Am 2018; 56:737-749. [DOI: 10.1016/j.rcl.2018.04.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Tamandl D, Mang T, Ba-Ssalamah A. Imaging of colorectal cancer - the clue to individualized treatment. Innov Surg Sci 2018; 3:3-15. [PMID: 31579761 PMCID: PMC6754048 DOI: 10.1515/iss-2017-0049] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Accepted: 02/20/2018] [Indexed: 12/18/2022] Open
Abstract
Colorectal cancer (CRC) is the most common gastrointestinal neoplasm and the second most common cause for cancer-related death in Europe. Imaging plays an important role both in the primary diagnosis, treatment evaluation, follow-up, and, to some extent, also in prevention. Like in the clinical setting, colon and rectal cancer have to be distinguished as two quite separate entities with different goals of imaging and, consequently, also different technical requirements. Over the past decade, there have been improvements in both more robust imaging techniques and new data and guidelines that help to use the optimal imaging modality for each scenario. For colon cancer, the continued research on computed tomography (CT) colonography (CTC) has led to high-level evidence that puts this technique on eye height to optical colonoscopy in terms of detection of cancer and polyps ≥10 mm. However, also for smaller polyps and thus for screening purposes, CTC seems to be an optimal tool. In rectal cancer, the technical requirements to perform state-of-the art imaging have recently been defined. Evaluation of T-stage, mesorectal fascia infiltration and extramural vascular invasion are the most important prognostic factors that can be identified on MRI. With this information, risk stratification both for local and distal failure is possible, enabling the clinician to tailor the optimal therapeutic approach in non-metastatic rectal cancer. Imaging of metastatic CRC is also covered, although the complex ramifications of treatment options in the metastatic setting are beyond the scope of this article. In this review, the most important recent developments in the imaging of colon and rectal cancer will be highlighted. If used in an interdisciplinary setting, this can lead to an individualized treatment concept for each patient.
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Affiliation(s)
- Dietmar Tamandl
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Thomas Mang
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Ahmed Ba-Ssalamah
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
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Greuter MJE, Berkhof J, Fijneman RJA, Demirel E, Lew JB, Meijer GA, Stoker J, Coupé VMH. The potential of imaging techniques as a screening tool for colorectal cancer: a cost-effectiveness analysis. Br J Radiol 2016; 89:20150910. [PMID: 27194458 DOI: 10.1259/bjr.20150910] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Imaging may be promising for colorectal cancer (CRC) screening, since it has test characteristics comparable with colonoscopy but is less invasive. We aimed to assess the potential of CT colonography (CTC) and MR colonography (MRC) in terms of (cost-effectiveness) using the Adenoma and Serrated pathway to Colorectal CAncer model. METHODS We compared several CTC and MRC strategies with 5- or 10-yearly screening intervals with no screening, 10-yearly colonoscopy screening and biennial faecal immunochemical test (FIT) screening. We assumed trial-based participation rates in the base-case analyses and varied the rates in sensitivity analyses. Incremental lifetime costs and health effects were estimated from a healthcare perspective. RESULTS The health gain of CTC and MRC was similar and ranged from 0.031 to 0.048 life-year gained compared with no screening, for 2-5 screening rounds. Lifetime costs per person for MRC strategies were €60-110 higher than those for CTC strategies with an equal number of screening rounds. All imaging-based strategies were cost-effective compared with no screening. FIT screening was the dominant screening strategy, leading to most LYG and highest cost-savings. Compared with three rounds of colonoscopy screening, CTC with five rounds was found to be cost-effective in an incremental analysis of imaging strategies. Assumptions on screening participation have a major influence on the ordering of strategies in terms of costs and effects. CONCLUSION CTC and MRC have potential for CRC screening, compared with no screening and compared with three rounds of 10-yearly colonoscopy screening. When taking FIT screening as the reference, imaging is not cost-effective. Participation is an important driver of effectiveness and cost estimates. ADVANCES IN KNOWLEDGE This is the first study to assess the cost-effectiveness of MRC screening for CRC.
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Affiliation(s)
- Marjolein J E Greuter
- 1 Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, Netherlands
| | - Johannes Berkhof
- 1 Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, Netherlands
| | - Remond J A Fijneman
- 2 Department of Pathology, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Erhan Demirel
- 1 Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, Netherlands
| | - Jie-Bin Lew
- 3 Cancer Research Division, Cancer Council NSW, NSW, Australia
| | - Gerrit A Meijer
- 2 Department of Pathology, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Jaap Stoker
- 4 Department of Radiology, Academic Medical Center, Amsterdam, Netherlands
| | - Veerle M H Coupé
- 1 Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, Netherlands
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Towner RA, Smith N, Saunders D, Van Gordon SB, Tyler KR, Wisniewski AB, Greenwood-Van Meerveld B, Hurst RE. Assessment of colon and bladder crosstalk in an experimental colitis model using contrast-enhanced magnetic resonance imaging. Neurogastroenterol Motil 2015; 27:1571-9. [PMID: 26303228 PMCID: PMC4624485 DOI: 10.1111/nmo.12654] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 07/17/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) consists of two chronic remitting-relapsing inflammatory disorders in the colon referred to as ulcerative colitis and Crohn's disease (CD). Inflammatory bowel disease affects about 1.4 million Americans. 2,4,6-trinitrobenzene sulfonic acid (TNBS)-induced colitis is a widely used model of experimental intestinal inflammation with characteristic transmural and segmental lesions that are similar to CD. METHODS Here, we report on the use of contrast-enhanced magnetic resonance imaging (CE-MRI) to monitor in vivo bladder permeability changes resulting from bladder crosstalk following colon TNBS exposure, and TNBS-induced colitis. Changes in MRI signal intensities and histology were evaluated for both colon and bladder regions. KEY RESULTS Uptake of contrast agent in the colon demonstrated a significant increase in signal intensity (SI) for TNBS-exposed rats (p < 0.01) compared to controls. In addition, a significant increase in bladder SI for colon TNBS-exposed rats (p < 0.001) was observed compared to saline controls. Histological damage within the colon was observed, however, bladder histology indicated a normal urothelium in rats with TNBS-induced colitis, despite increased permeability seen by CE-MRI. CONCLUSIONS & INFERENCES Contrast-enhanced MRI was able to quantitatively measure inflammation associated with TNBS-induced colitis, and assess bladder crosstalk measured as an increase in urothelial permeability. Although CE-MRI is routinely used to assess inflammation with IBD, currently there is no diagnostic test to assess bladder crosstalk with this disease, and our developed method may be useful in providing crosstalk information between organ and tissue systems in IBD patients, in addition to colitis.
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Affiliation(s)
- Rheal A. Towner
- Advanced Magnetic Resonance Center, Oklahoma Medical Research Foundation, Oklahoma University Health Sciences Center, Oklahoma City, OK, USA,Corresponding Author: Rheal A. Towner, Ph.D., Director, Advanced Magnetic Resonance Center, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104 USA, , Phone: 405-272-7383
| | - Nataliya Smith
- Advanced Magnetic Resonance Center, Oklahoma Medical Research Foundation, Oklahoma University Health Sciences Center, Oklahoma City, OK, USA
| | - Debra Saunders
- Advanced Magnetic Resonance Center, Oklahoma Medical Research Foundation, Oklahoma University Health Sciences Center, Oklahoma City, OK, USA
| | - Samuel B. Van Gordon
- Department of Urology, Oklahoma University Health Sciences Center, Oklahoma City, OK, USA
| | - Karl R. Tyler
- Department of Physiology, Oklahoma University Health Sciences Center, Oklahoma City, OK, USA
| | - Amy B. Wisniewski
- Department of Urology, Oklahoma University Health Sciences Center, Oklahoma City, OK, USA
| | | | - Robert E. Hurst
- Department of Urology, Oklahoma University Health Sciences Center, Oklahoma City, OK, USA
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Zhao C, Yang J, Gan Y, Liu J, Tan Z, Liang G, Meng X, Sun L, Cao W. Application of MR virtual endoscopy in children with hydrocephalus. Magn Reson Imaging 2015; 33:1205-1211. [PMID: 26248269 DOI: 10.1016/j.mri.2015.07.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 07/29/2015] [Indexed: 01/13/2023]
Abstract
PURPOSE To evaluate the performance of MR virtual endoscopy (MRVE) in children with hydrocephalus. MATERIALS AND METHODS Clinical and imaging data were collected from 15 pediatric patients with hydrocephalus and 15 normal control children. All hydrocephalus patients were confirmed by ventriculoscopy or CT imaging. The cranial 3D-T1 weighted imaging data from fast spoiled gradient echo scan (FSPGR) were transported to working station. VE images of cerebral ventricular cavity were constructed with Navigator software. RESULTS Cerebral ventricular MRVE can achieve similar results as ventriculoscopy in demonstrating the morphology of ventricular wall or intracavity lesion. In addition, MRVE can observe the lesion from distal end of obstruction, as well as other areas that are inaccessible to ventriculoscopy. MRVE can also reveal the pathological change of ventricular inner wall surface, and help determine patency of the cerebral aqueduct and fourth ventricle outlet. CONCLUSION MR virtual endoscopy provides a non-invasive diagnostic modality that can be used as a supplemental approach to ventriculoscopy. However, its sensitivity and specificity need to be determined in the large study.
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Affiliation(s)
- Cailei Zhao
- Department of Radiology, The first affiliated hospital of Xi'an jiaotong university, No. 277, Yantaxi Road, Xi'an, 710061, China; Department of Radiology, Shenzhen children's Hospital, No. 7019, Yitian Road, Shenzhen, 518038, China; The Key Laboratory of Biomedical Information Engineering, Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, P.R. China
| | - Jian Yang
- Department of Radiology, The first affiliated hospital of Xi'an jiaotong university, No. 277, Yantaxi Road, Xi'an, 710061, China; Department of Radiology, Shenzhen children's Hospital, No. 7019, Yitian Road, Shenzhen, 518038, China.
| | - Yungen Gan
- Department of Radiology, The first affiliated hospital of Xi'an jiaotong university, No. 277, Yantaxi Road, Xi'an, 710061, China; Department of Radiology, Shenzhen children's Hospital, No. 7019, Yitian Road, Shenzhen, 518038, China
| | - Jiangang Liu
- Department of Radiology, The first affiliated hospital of Xi'an jiaotong university, No. 277, Yantaxi Road, Xi'an, 710061, China; Department of Neurosurgery, Shenzhen children's Hospital, No. 7019, Yitian Road, Shenzhen, 518038, China
| | - Zhen Tan
- Department of Radiology, The first affiliated hospital of Xi'an jiaotong university, No. 277, Yantaxi Road, Xi'an, 710061, China; Department of Neurosurgery, Shenzhen children's Hospital, No. 7019, Yitian Road, Shenzhen, 518038, China
| | - Guohua Liang
- Department of Radiology, The first affiliated hospital of Xi'an jiaotong university, No. 277, Yantaxi Road, Xi'an, 710061, China; Department of Radiology, Shenzhen children's Hospital, No. 7019, Yitian Road, Shenzhen, 518038, China
| | - Xianlei Meng
- Department of Radiology, The first affiliated hospital of Xi'an jiaotong university, No. 277, Yantaxi Road, Xi'an, 710061, China; Department of Radiology, Shenzhen children's Hospital, No. 7019, Yitian Road, Shenzhen, 518038, China
| | - Longwei Sun
- Department of Radiology, The first affiliated hospital of Xi'an jiaotong university, No. 277, Yantaxi Road, Xi'an, 710061, China; Department of Radiology, Shenzhen children's Hospital, No. 7019, Yitian Road, Shenzhen, 518038, China
| | - Weiguo Cao
- Department of Radiology, The first affiliated hospital of Xi'an jiaotong university, No. 277, Yantaxi Road, Xi'an, 710061, China; Department of Radiology, Shenzhen children's Hospital, No. 7019, Yitian Road, Shenzhen, 518038, China
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Quon JS, Quon PR, Lim CS, Abdeen N, Schieda N. Magnetic resonance enterography in post-operative inflammatory bowel disease. ACTA ACUST UNITED AC 2015; 40:1034-49. [PMID: 25776203 DOI: 10.1007/s00261-015-0392-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To describe the role of magnetic resonance enterography (MRE) in patients with inflammatory bowel disease (IBD), and to review the expected post-operative appearance, as well as, potential surgical complications in this unique patient population. CONCLUSION MRE compares favorably to CT Enterography (CTE) in terms of overall diagnostic accuracy and may provide better functional assessment of the small bowel through cine-MRI, diffusion-weighted imaging and dynamic contrast-enhancement. In the post-operative population, MRE provides critical information including: normal post-surgical anatomy, chronic strictures vs. active inflammation and disease/treatment-related complications. The post-operative IBD patient undergoes frequent repeated imaging and MRE may significantly reduce cumulative radiation dose while providing similar or improved diagnostic accuracy compared to CTE. MRE should be considered as an alternative imaging modality in this population.
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Affiliation(s)
- Jeffrey S Quon
- Department of Medical Imaging, The Ottawa Hospital, The University of Ottawa, 1053 Carling Avenue, Ottawa, ON, K1Y 4E9, Canada,
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9
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de Haan MC, Pickhardt PJ, Stoker J. CT colonography: accuracy, acceptance, safety and position in organised population screening. Gut 2015; 64:342-50. [PMID: 25468258 DOI: 10.1136/gutjnl-2014-308696] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Colorectal cancer (CRC) is the second most common cancer and second most common cause of cancer-related deaths in Europe. The introduction of CRC screening programmes using stool tests and flexible sigmoidoscopy, have been shown to reduce CRC-related mortality substantially. In several European countries, population-based CRC screening programmes are ongoing or being rolled out. Stool tests like faecal occult blood testing are non-invasive and simple to perform, but are primarily designed to detect early invasive cancer. More invasive tests like colonoscopy and CT colonography (CTC) aim at accurately detecting both CRC and cancer precursors, thus providing for cancer prevention. This review focuses on the accuracy, acceptance and safety of CTC as a CRC screening technique and on the current position of CTC in organised population screening. Based on the detection characteristics and acceptability of CTC screening, it might be a viable screening test. The potential disadvantage of radiation exposure is probably overemphasised, especially with newer technology. At this time-point, it is not entirely clear whether the detection of extracolonic findings at CTC is of net benefit and is cost effective, but with responsible handling, this may be the case. Future efforts will seek to further improve the technique, refine appropriate diagnostic algorithms and study cost-effectiveness.
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Affiliation(s)
- Margriet C de Haan
- Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands Department of Radiology, University Medical Center, Utrecht, The Netherlands
| | - Perry J Pickhardt
- Department of Radiology, University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin, USA
| | - Jaap Stoker
- Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
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Laghi A, Bellini D, Petrozza V, Piccazzo R, Santoro GA, Fabbri C, van der Paardt MP, Stoker J. Imaging of colorectal polyps and early rectal cancer. Colorectal Dis 2015; 17 Suppl 1:36-43. [PMID: 25511860 DOI: 10.1111/codi.12820] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- A Laghi
- Department of Radiological Sciences, Oncology and Pathology, "SAPIENZA" University of Rome, I.C.O.T. Hospital, Latina, Italy
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11
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van der Paardt MP, Boellaard TN, Zijta FM, Baak LC, Depla ACTM, Dekker E, Nederveen AJ, Bipat S, Stoker J. Magnetic resonance colonography with a limited bowel preparation and automated carbon dioxide insufflation in comparison to conventional colonoscopy: patient burden and preferences. Eur J Radiol 2014; 84:19-25. [PMID: 25455410 DOI: 10.1016/j.ejrad.2014.10.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 10/05/2014] [Accepted: 10/09/2014] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To evaluate patient burden and preferences for MR colonography with a limited bowel preparation and automated carbon dioxide insufflation in comparison to conventional colonoscopy. METHODS Symptomatic patients were consecutively recruited to undergo MR colonography with automated carbon dioxide insufflation and a limited bowel preparation followed within four weeks by colonoscopy with a standard bowel cleansing preparation. Four questionnaires regarding burden (on a five-point scale) and preferences (on a seven-point scale) were addressed after MR colonography and colonoscopy and five weeks after colonoscopy. RESULTS Ninety-nine patients (47 men, 52 women; mean age 62.3, SD 8.7) were included. None of the patients experienced severe or extreme burden from the MR colonography bowel preparation compared to 31.5% of the patients for the colonoscopy bowel preparation. Colonoscopy was rated more burdensome (25.6% severe or extreme burden) compared to MR colonography (5.2% severe or extreme burden) (P<0.0001). When discarding the bowel preparations, the examinations were rated equally burdensome (P=0.35). The majority of patients (61.4%) preferred MR colonography compared to colonoscopy (29.5%) immediately after the examinations and five weeks later (57.0% versus 39.5%). CONCLUSION MR colonography with a limited bowel preparation and automated carbon dioxide insufflation demonstrated less burden compared to colonoscopy. The majority of patients preferred MR colonography over colonoscopy.
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Affiliation(s)
- M P van der Paardt
- Department of Radiology, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
| | - T N Boellaard
- Department of Radiology, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
| | - F M Zijta
- Department of Radiology, Medisch Centrum Haaglanden, Den Haag, The Netherlands.
| | - L C Baak
- Department of Gastroenterology and Hepatology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
| | - A C T M Depla
- Department of Gastroenterology and Hepatology, Slotervaartziekenhuis, Amsterdam, The Netherlands.
| | - E Dekker
- Department of Gastroenterology and Hepatology, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
| | - A J Nederveen
- Department of Radiology, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
| | - S Bipat
- Department of Radiology, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
| | - J Stoker
- Department of Radiology, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
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Tutticci N, Bourke MJ. Advances in colonoscopy. CURRENT TREATMENT OPTIONS IN GASTROENTEROLOGY 2014; 12:119-139. [PMID: 24615389 DOI: 10.1007/s11938-014-0009-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Colonoscopy with polypectomy has been established as the major prevention and detection strategy for colorectal cancer for over a decade. Over this period advances in colonoscopic imaging, polyp detection, prediction of histopathology and polypectomy techniques have all been seen; however, the true magnitude of the limitations of colonoscopy has only recently been widely recognized. The rate and location of missed or interval cancers after complete colonoscopy appears to be influenced by the operator-dependency of colonoscopy and failure of conventional practices to detect and treat adenomatous, and possibly more importantly, non-adenomatous colorectal cancer precursors. Consequently, studies that expand our understanding of these factors and advances that aim to improve colonoscopy, polypectomy, and cancer protection are of critical importance.
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Affiliation(s)
- Nicholas Tutticci
- Department of Gastroenterology and Hepatology, Westmead Hospital, 106A/151 Hawkesbury Road, Westmead, NSW, 2145, Australia,
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