CT colonography a suitable alternative to colonoscopy for ulcerative colitis patients

CT colonography is effective at assessing patients with ulcerative colitis who are in remission, according to a study published in the March issue of Academic Radiology.

Recurrent colonoscopy examinations are currently required for patients with ulcerative colitis to determine the existence and extent of the disease as well as to monitor for signs of cancer. Using CT colonography as an alternative evaluation method to colonoscopy, however, is less invasive and gives doctors the ability to image the entire colon without the presence of blind areas while providing a more complete picture of overall colon health.

Researchers from the Post-Graduate Institute of Medical Education and Research in Chandigarh, India, set out to determine how the use of CT colonography in patients with ulcerative colitis who are in remission compared to colonoscopy in evaluating the state of the disease. “To the best of our knowledge, this is the first study in English literature which evaluates the use of 64-slice [CT colonography] in patients with ulcerative colitis,” wrote lead author Nidhi Prabhakar, MD, and colleagues.

Twenty patients (eight women and 12 men varying in age from 18 to 65 years) who had their ulcerative colitis confirmed through biopsy and were in a clinical state of remission underwent CT colonography and colonoscopy procedures over the course of one week. Researchers conducting each procedure were blinded to the results of the corresponding tests, with both evaluating granular appearance and the presence of pseudopolyps in the colon of each of the subjects tested.

Their results showed that CT colonography sensitivity and specificity for detecting granular appearance were 81 percent and 74 percent, respectively, while sensitivity and specificity for detecting pseudopolyps using CT colonography were 82 percent and 85 percent, respectively. Both sets of data showed good correlation with the use of colonoscopy, with patients reporting a significant reduction in abdominal pain and loss of sense of dignity when undergoing CT colonography testing. In fact, 75 percent of patients preferred CT colonography, while the remaining patients reported no preference; none of the subjects articulated a preference for colonoscopy.

The research team concluded that CT colonography is effective as an alternative to colonoscopy in the patients who participated in the study. “[CT colonography] may be used as a substitute for [colonoscopy] for evaluating patients with ulcerative colitis who are not in the acute phase,” wrote Prabhakar and colleagues. “It is an ‘all-in-one’ technique and provides information about the bowel lumen, bowel wall, and extraluminal abnormalities in these patients.”

For more information on CT colonography, including its potential in detecting and preventing colorectal cancers, read the feature article “CT Colonography Gets Another Look,” from the November/December issue of Health Imaging.