Barium

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Dark Lumen MR Colonography Based on Fecal Tagging For Detection of Colorectal Masses: Accuracy And Patient Acceptance

Journal Title, Volume, Page: 
Abdom Imaging. 2005 Sep-Oct;30(5):576-83. Epub 2005 Mar 4
Year of Publication: 
2005
Authors: 
S. C. Goehde
Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, Essen, 45122, Germany
E. Descher
Private practice for gastroenterology, I Hagen 26, Essen, 45127, Germany
A. Boekstegers
Private practice for gastroenterology, I Hagen 26, Essen, 45127, Germany
T. Lauenstein
Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, Essen, 45122, Germany
C. Kühle
Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, Essen, 45122, Germany
S. G. Ruehm
Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, Essen, 45122, Germany
W. Ajaj
Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, Essen, 45122, Germany
Current Affiliation: 
Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
Preferred Abstract (Original): 

BACKGROUND: Magnetic resonance colonography (MRC) with fecal tagging has recently been investigated in clinical studies for the detection of polyps. We assessed fecal tagging MRC in a field trial.
METHODS: Forty-two patients in a private gastroenterologic practice underwent MRC with barium-based fecal tagging (150 mL of 100% barium at each of 6 main meals before MRC) and conventional colonoscopy. Diagnostic accuracy of MRC and patient acceptance were assessed and compared with the respective results of conventional colonoscopy.
RESULTS: Eighteen percent of all MRC examinations showed a remaining high stool signal in the colon that impeded a reliable inclusion or exclusion of polyps. On a lesion-by-lesion basis, sensitivities for polyp detection were 100% for polyps larger than 2 cm (n = 1), 40% for polyps between 10 and 19 mm, 16.7% for polyps between 6 and 9 mm, and 9.1% for polyps smaller than 6 mm. The main reason for the low acceptance of MRC was the barium preparation, which was rated worse than the bowel cleaning procedure with conventional colonoscopy. CONCLUSION: MRC with fecal tagging must be further optimized. The large amount of barium resulted in poor patient acceptance, and barium according to this protocol did not provide sufficient stool darkening. Other strategies, such as increasing the hydration of stool, must be developed. 

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Impact of Diet On Stool Signal In Dark Lumen Magnetic Resonance Colonography

Journal Title, Volume, Page: 
JOURNAL OF MAGNETIC RESONANCE IMAGING 20:272–278 (2004)
Year of Publication: 
2004
Authors: 
Susanne C. Goehde
Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany
Waleed Ajaj
Department of Diagnostic and Interventional Radiology, University Hospital Essen, Essen, Germany
Current Affiliation: 
Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
Thomas Lauenstein
Department of Diagnostic and Interventional Radiology, University Hospital Essen, Essen, Germany
Joerg F. Debatin
Department of Diagnostic and Interventional Radiology, University Hospital Essen, Essen, Germany
Mark E. Ladd
Department of Diagnostic and Interventional Radiology, University Hospital Essen, Essen, Germany
Preferred Abstract (Original): 

Purpose: To examine the magnetic resonance (MR) properties of different foods and their effect on the colonic stool signal to potentially support fecal tagging strategies for dark lumen MR colonography (MRC).
Materials and Methods: T1 relaxation times of 120 different foods (partially diluted with sufficient water) were determined by use of a multi-flip-angle two-dimensional gradient echo (GRE) sequence and correlated to the foods’ signal in a three-dimensional GRE volumetric interpolated breath-hold examination (VIBE) sequence. Different dilutions of six foods were examined. VIBE stool signal was determined in six volunteers under two different conditions: after a three-day diet of short T1 food and of long T1 food, respectively.
Results: Most foods exhibit short to very short T1 relaxation times. T1 correlates well with the fat-saturated VIBE signal except for fatty products. Diluted food exhibits T1 times similar to water; concentrated food strongly varies according to their T1 values. No significant difference in stool signal could be found in the in vivo examination comparing the two diets.
Conclusion: According to our results, a restricted diet strategy to reduce fecal signal for dark lumen MRC is unlikely to be successful. Moreover, the stool signal reduction found in the other fecal tagging studies can be explained at least to a great extent by the relative content of other material with long T1 relaxation times, such as water or oral barium.

w.ajaj's picture

Dark Lumen MR Colonography Based on Fecal Tagging For Detection of Colorectal Masses: Accuracy And Patient Acceptance

Journal Title, Volume, Page: 
Abdom Imaging (2005) 30:576–583
Year of Publication: 
2005
Authors: 
S. C. Goehde
Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, Essen, 45122, Germany
E. Descher
Private practice for gastroenterology, I Hagen 26, Essen, 45127, Germany
A. Boekstegers
Private practice for gastroenterology, I Hagen 26, Essen, 45127, Germany
T. Lauenstein
Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, Essen, 45122, Germany
C. Kuhle
Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany
S. G. Ruehm
Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany
W. Ajaj
Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, Essen, 45122, Germany
Current Affiliation: 
Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
Preferred Abstract (Original): 

Background: Magnetic resonance colonography (MRC) with fecal tagging has recently been investigated in clinical studies for the detection of polyps. We assessed fecal tagging MRC in a field trial.
Methods: Forty-two patients in a private gastroenterologic practice underwent MRC with barium-based fecal tagging (150 mL of 100% barium at each of 6main meals before MRC) and conventional colonoscopy. Diagnostic accuracy of MRC and patient acceptance were assessed and compared with the respective results of conventional colonoscopy.
Results: Eighteen percent of all MRC examinations showed a remaining high stool signal in the colon that impeded a reliable inclusion or exclusion of polyps. On a lesion-by-lesion basis, sensitivities for polyp detection were 100% for polyps larger than 2 cm (n = 1), 40% for polyps between 10 and 19 mm, 16.7% for polyps between 6and 9 mm, and 9.1% for polyps smaller than 6mm. The main reason for the low acceptance of MRC was the barium preparation, which was rated worse than the bowel cleaning procedure with conventional colonoscopy.
Conclusion: MRC with fecal tagging must be further optimized. The large amount of barium resulted in poor patient acceptance, and barium according to this protocol did not provide sufficient stool darkening. Other strategies, such as increasing the hydration of stool, must be developed.

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