Radiographic Studies Unreliable for Polyp Detection in Patients With Incomplete Colonoscopy
Douglas K. Rex, MD, FASGE, reviewing Parsa N, et al. Gastrointest Endosc 2020 Feb 4.
In a single U.S. center with a large experience performing colonoscopy in patients with previous incomplete colonoscopies, 65 patients were identified with a radiographic study (either CT colonography [CTC] or barium enema [BE]) within 3 years of the repeat colonoscopy. The radiographic studies were generally performed at the outlying community hospital where the incomplete colonoscopy had been performed. All examinations were complete to the cecum at the referral hospital.
For patients with adenomas, the per-patient sensitivity was 70% with CTC and 26.7% for BE. The overall per-polyp sensitivity for the radiographic exams was 19.2% (54 of 281 lesions detected at repeat colonoscopy were identified by radiology). This metric was worse for both CTC and BE in the right side of the colon compared to the left, and both imaging studies missed substantial numbers of lesions ≥10 mm in size.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
Douglas K. Rex, MD, FASGE
Parsa N, Vemulapalli KC, Rex DK. Performance of radiographic imaging after incomplete colonoscopy for nonmalignant causes in clinical practice. Gastrointest Endosc 2020 Feb 4. (Epub ahead of print) (https://doi.org/10.1016/j.gie.2020.01.043)