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The Role of Contrast Media in CTC: Types, Usage, Allergic Reactions and Patient Safety

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CT Colonography for Radiographers

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Abstract

It must be remembered that CT colonography (CTC) is an interventional procedure, and there are many stages to produce the best results for both the patients and the medical teams: the referral, bowel preparation, CTC training and technique, patient aftercare and the final report. Throughout these stages, patient safety must be considered by the radiographer, advanced practitioner and radiologist. A CTC radiographer should consider whether the procedure is appropriate and will the patients cope with the oral medications to cleanse and tag their bowel. Consideration should also be given to whether the department has the correct documentation for the administration of carbon dioxide (CO2,) for colonic distension, intravenous contrast and antispasmolytic injections.

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References

  1. Edwards JT, Mendelson RM, Fritschi L. Colorectal neoplasia screening with CT Colonography in average-risk asymptomatic subjects: community based study. Radiology. 2004;230:459–64.

    Article  PubMed  Google Scholar 

  2. Burling D, Halligan S, Slater A, Noakes MJ, Taylor SA. Potentially serious adverse events at CT colonography in symptomatic patients: national survey of the United Kingdom. Radiology. 2006;239:464–71. doi:10.1148/radiol.2392051101.

    Article  PubMed  Google Scholar 

  3. NHS Bowel Cancer Screening Imaging Guidelines. No 5: guidelines for the use of imaging in the NHS Bowel Cancer Screening Programme. 2nd ed. Sheffield: NHS Cancer Screening Programmes; 2012. (Cited 1 June 2015). Available from: http://www.cancerscreening.nhs.uk/bowel/publications/.

  4. Atkin W, Dadswell E, Wooldrage K, Kralj-Hans I, von Wagner C, Edwards R, Yao G, et al. Computed tomographic colonography versus colonoscopy for investigation of patients with symptoms suggestive of colorectal cancer (SIGGAR): a multicentre randomised trial. Lancet. 2013;381:1194–202.

    Article  PubMed  Google Scholar 

  5. Lung P, Burling D, Kallarackel L, Muckian J, Ilangovan R, Gupta A, Marshall M, Shorvon P, Halligan S, Bhatnagar G, et al. Implementation of a new CT colonography service: 5 year experience. Clin Radiol. 2014;69:597–605.

    Article  CAS  PubMed  Google Scholar 

  6. Bayer plc. Gastrografin® Gastroenteral solution summary of product characteristics, Revised April 2015. Available from: http://www.mhra.gov.uk/home/groups/spcpil/documents/spcpil/con1440738619790.pdf.

  7. British Society of Gastrointestinal and Abdominal Radiology (BSGAR) and The Royal College of Radiologists. BFCR (14)9. Guidance on the use of CT colonography for suspected colorectal cancer. London: The Royal College of Radiologists; 2014.

    Google Scholar 

  8. Park SH, Yee J, Kim SH, Kim YH. Fundamental elements for successful performance of CT colonography (virtual colonoscopy). Korean J Radiol. 2007;8:264–75. doi:10.3348/kjr.2007.8.4.264.

    Article  PubMed  PubMed Central  Google Scholar 

  9. ACR-SAR-SCBT-MR practice parameter for the performance of computed tomography (CT) colonography in adults – revised 2014. (Cited 3 June 2015). Available from http://www.acr.org/~/media/ACR/Documents/PGTS/guidelines/CT_Colonography.pdf.

  10. Spada C, Stoker J, Alarcon O, et al. Clinical indications for computed tomographic colonography: ESGE and ESGAR Guideline. Endoscopy. 2014;46:897–908. (Cited 28 May 2015). Available from: http://www.esge.com/assets/downloads/pdfs/guidelines/042_10-1055-s-0034-1378092.pdf. (Accessed 28 May 2015).

    Google Scholar 

  11. Lefere PA, Gryspeerdt SS, Dewyspelaere J, Baekelandt M, Van Holsbeeck BG. Dietary fecal tagging as a cleansing method before CT colonography: initial results polyp detection and patient acceptance. Radiology. 2002;224:393–403. doi:10.1148/radiol.2241011222.

    Article  PubMed  Google Scholar 

  12. NHS National Patient Safety Agency: Rapid Response Report NPSA/2009/RRR012: Reducing risk of harm from oral Bowel cleansing solutions. 2009. (Cited 15 May 2015). Available from: http://www.nrls.npsa.nhs.uk/resources/?entryid45=59869.

  13. EMC. Picolax. (Cited 1 June 2015). Available from: https://www.medicines.org.uk/emc/medicine/670.

  14. The Royal College of Radiologists. Standards for intravascular contrast agent administration to adult patients. 3rd ed. London: The Royal College of Radiologists; 2015. BFCR(15)1. (Cited 10 June 2015). Available from: https://www.rcr.ac.uk/sites/default/files/Intravasc_contrast_web.pdf.

  15. Zalis ME, Perumpillichira JJ, Magee C, Kohlberg G, Hahn PF. Tagging-based, electronically cleansed CT colonography: evaluation of patient comfort and image readability. Radiology. 2006;239:149–59.

    Article  PubMed  Google Scholar 

  16. Kim MJ, Park SH, Lee SS, et al. Efficacy of barium-based fecal tagging for CT colonography: a comparison between the use of high and low density barium suspensions in a Korean population – a preliminary study. Korean J Radiol. 2009;10:25–33. doi:10.3348/kjr.2009.10.1.25.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Blakeborough A, Sheridan MB, Chapman AH. Complications of barium enema examinations: a survey of UK Consultant Radiologists 1992 to 1994. Clin Radiol. 1997;52:142–8.

    Article  CAS  PubMed  Google Scholar 

  18. Pickhardt PJ. Incidence of colonic perforation at CT colonography: review of existing data and implications for screening of asymptomatic adults. Radiology. 2006;239:313–6.

    Article  PubMed  Google Scholar 

  19. Burling D. International collaboration for CT colonography standards. CT colonography Standards. Clin Radiol. 2010;65:474–80. doi:10.1016/j.crad.2009.12.003.

    Article  PubMed  Google Scholar 

  20. Shinners TJ, Pickhardt PJ, Taylor AJ, Jones DA, Olsen CH. Patient-controlled room air insufflation versus automated carbon dioxide delivery for CT colonography. AJR. 2006;186:1491–6.

    Article  PubMed  Google Scholar 

  21. Nagata K, Fujiwara M, Shimamoto T, Iida N, Mogi T, Mitsushima T. Colonic distention at CT colonography: randomized evaluation of both IV hyoscine butylbromide and automated carbon dioxide insufflation. AJR. 2015;204:76–82. doi:10.2214/AJR.14.12772.

    Article  PubMed  Google Scholar 

  22. Fenton AM, Hammill SC, Rea RF, Low PA, Shen WK. Vasovagal syncope. Ann Intern Med. 2000;133:714–25.

    Article  CAS  PubMed  Google Scholar 

  23. Neri E, Caramella D, Vannozzi F, Turini F, Cerri F, Bartolozzi C. Vasovagal reactions in CT colonography. Abdom Imaging. 2007;32:552–5.

    Article  PubMed  Google Scholar 

  24. De Gonzalez AB, Kim KP, Yee J. CT colonography: perforation rates and potential radiation risks. Gastrointest Endosc Clin N Am. 2010;20:279–91. doi:10.1016/j.giec.2010.02.003.

    Article  PubMed Central  Google Scholar 

  25. Harned RK, Consigny PM, Cooper NB, Williams SM, Woltjen AJ. Barium enema examination following biopsy of the rectum or colon. Radiology. 1982;145:11–6.

    Article  CAS  PubMed  Google Scholar 

  26. Kozarek RA, Earnest DI, Silverstein ME, Smith RG. Air-pressure-induced colon injury during diagnostic colonoscopy. Gastroenterology. 1980;78:7–14.

    CAS  PubMed  Google Scholar 

  27. Tzelepis GE, Nasiff L, McCooL FD, Hammond J. Transmission of pressure within the abdomen. J Appl Physiol. 1996;81:1111–4.

    CAS  PubMed  Google Scholar 

  28. Woltjen JA. A retrospective analysis of cecal barotrauma caused by colonoscope air flow and pressure. Gastrointest Endosc. 2005;61:37–45.

    Article  PubMed  Google Scholar 

  29. Sosna J, Blachar A, Amitai M, Barmeir E, Peled N, Goldberg SN, Bar-Ziv J. Colonic perforation at CT colonography: assessment of risk in a multicenter large cohort. Radiology. 2006;239:457–63.

    Article  PubMed  Google Scholar 

  30. Sosna J, Bar-Ziv J, Libson E, Eligulashvili M, Blachar A. CT colonography: positioning order and intracolonic pressure. AJR. 2008;191:175–80. doi:10.2214/AJR.07.3303.

    Article  Google Scholar 

  31. Bellini D, Rengo M, De Cecco CN, Iafrate F, Hassan C, Laghi A. Perforation rate in CT colonography: a systematic review of the literature and meta-analysis. Eur Radiol. 2014;24:1487–96. doi:10.1007/s00330-014-3190-1.

    Article  PubMed  Google Scholar 

  32. NHS Bowel Cancer Screening Imaging Guidelines. No 6: quality assurance guidelines for colonoscopy. Sheffield: NHS Cancer Screening Programmes; 2011. (Cited 1 June 2015). Available from: http://www.cancerscreening.nhs.uk/bowel/publications/nhsbcsp06.pdf.

  33. Baccaro LM, Markelov A, Wilhelm J, Bloch R. Pneumoperitoneum after virtual colonoscopy: causes, risk factors, and management. Am Surg. 2014;80:549–54.

    PubMed  Google Scholar 

  34. Taylor SA, Halligan S, Goh V, Morley S, Bassett P, Atkin W, Bartram CL. Optimizing colonic distention for multi–detector row CT colonography: effect of hyoscine butylbromide and rectal balloon catheter. Gastrointest Imaging. 2003; 229:1. http://dx.doi.org/10.1148/radiol.2291021151.

    Google Scholar 

  35. Bortz JH. An approach for performing a successful computed tomography colonography examination. S Afr J Rad 2014;18(1); Art. #607, 11 pages. http://dx.doi/org/10.4102/sajr. v18i1.607 SAJR 2014.

  36. Kristev AD, Sirakov NV, Getova DP, Katcarov VI, Sirakov VN, Stefanov RS, Turiiski VI, Velkova KG. Comparing hyoscine and drotaverine effects on colon in CT colonography. Cent Eur J Med. 2011;6:234–42.

    CAS  Google Scholar 

  37. Morrin MM, Farrell RJ, Keogan MT, Kruskal JB, Yam CS, Raptopoulos V. CT colonography: colonic distention improved by dual positioning but not intravenous glucagon. Eur Radiol. 2002;12:525–30.

    Article  PubMed  Google Scholar 

  38. Joint Formulary Committee. Antispasmodics. In: Mehta DK, editor. The British national formulary. 41st ed. London: Royal Pharmaceutical Society of Great Britain and British Medical Association; 2001. p. 34–5.

    Google Scholar 

  39. Bruzzi JF, Moss AC, Brennan DD, MacMathuna P, Fenlon HM. Effect of iv Buscopan as a muscle relaxant in CT colonography. Eur Radiol. 2003;13:364–70.

    Article  Google Scholar 

  40. Sakamoto T, Utsunomiya D, Mitsuzaki K, Matsuda K, Kawakami M, Yamamura S, Urata J, Arakawa A, Yamashita Y. Colonic distention at screening CT colonography: role of spasmolytic agents and body habitus. Kurume Med J. 2014;61:9–15. https://www.jstage.jst.go.jp/article/kurumemedj/61/1.2/61_MS64002/_pdf

    Google Scholar 

  41. Ingelheim B. Professional leaflet: buscopan® ampoules 20 mg/ml solution for injection. Last revised Aug 2008.

    Google Scholar 

  42. Amin Z, Boulos PB, Lees WR. Technical report: spiral CT pneumocolon for suspected colonic neoplasms. Clin Radiol. 1996;51:56–61.

    Article  CAS  PubMed  Google Scholar 

  43. Neri E, Halligan S, Hellström M, Lefere P, Mang T, Regge D, Stoker J, Taylor S, Laghi A, ESGAR CT Colonography Working Group. The second ESGAR consensus statement on CT colonography. Eur Radiol. 2013;23:720–9. doi:10.1007/s00330-012-2632-x.

    Article  PubMed  Google Scholar 

  44. Morrin MM, Farrell RJ, Kruskal JB, Reynolds K, McGee JB, Raptopoulos V. Utility of intravenously administered contrast material at CT colonography. Radiology. 2000;217:765–71.

    Article  CAS  PubMed  Google Scholar 

  45. Yau TY, Alkandari LA, Haaland B, Low W, Tan CH. Is intravenous contrast necessary for detection of clinically significant extracolonic findings in patients undergoing CT colonography? BJR. 2014;87(1036):20130667.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. GE Healthcare. Professional leaflet: Visipaque ® Iodixanol. Last revised Feb 2013.

    Google Scholar 

  47. Kurabayashi T, Ida M, Fukayama H, Ohbayashi N, Yoshino N, Sasaki T. Adverse reactions to nonionic iodine in contrast-enhanced computed tomography: usefulness of monitoring vital signs. Dentomaxillofac Radiol. 1998;27:199–202.

    Article  CAS  PubMed  Google Scholar 

  48. Yasuda R, Munechika H. Delayed adverse reactions to nonionic monomeric contrast-enhanced media. Invest Radiol. 1998;33:1–5.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Intestinal Imaging Unit, London North West Healthcare NHS Trust – St Marks Hospital, Watford Road, Harrow, Middlesex, HA1 3UJ, UK

    Rachel Baldwin-Cleland BSc (Hons) & Stephen Wilson BSc (Hons) Diag.Rad, PG Cert CTC

Authors
  1. Rachel Baldwin-Cleland BSc (Hons)
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  2. Stephen Wilson BSc (Hons) Diag.Rad, PG Cert CTC
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Correspondence to Rachel Baldwin-Cleland BSc (Hons) .

Editor information

Editors and Affiliations

  1. LSG Imaging, Los Angeles, California, USA

    Joel H. Bortz

  2. Diagnostic Radiography and Imaging, University of Hertfordshire, Hertfordshire, United Kingdom

    Aarthi Ramlaul

  3. Formerly School of Radiography, King Edward VIII Hospital, Durban, KZN, South Africa

    Leonie Munro

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Baldwin-Cleland, R., Wilson, S. (2016). The Role of Contrast Media in CTC: Types, Usage, Allergic Reactions and Patient Safety. In: Bortz, J., Ramlaul, A., Munro, L. (eds) CT Colonography for Radiographers. Springer, Cham. https://doi.org/10.1007/978-3-319-29379-0_8

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  • DOI: https://doi.org/10.1007/978-3-319-29379-0_8

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-29377-6

  • Online ISBN: 978-3-319-29379-0

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