TITLE:
The Impact of Enteric Contrast on Radiologist Confidence in Intravenously Enhanced MDCT of the Abdomen and Pelvis: A Randomized Controlled Trial
AUTHORS:
Christopher M. Garcia, Steven Boe, Bret Coughlin, David M. O’Sullivan, Douglas Moote, Michael T. O’Loughlin, Devika Jajoo, Steve Lee
KEYWORDS:
Enteric Contrast, Outpatient CT, Confidence, Oral Contrast
JOURNAL NAME:
Advances in Computed Tomography,
Vol.3 No.2,
June
9,
2014
ABSTRACT: After
Institutional Review Board approval, 109 patients ≥ 18 years old undergoing
intravenously enhanced Computed Tomography (CT) of the abdomen and pelvis were
prospectively enrolled and randomized into two arms. Patients with a history of
inflammatory bowel disease, Crohn disease and ulcerative colitis were excluded.
The control arm received routine enteric contrast and intravenous contrast. The
experimental arm did not receive oral contrast, but received the standard dose
of intravenous (IV) contrast. One of four experienced body radiologists
reviewed the studies and rated his/her confidence on a scale of 1 (no
confidence) to 10 (all confident findings have been made). Confidence levels
were compared between groups. The 109 subjects were distributed 54 (49.5%) in
the control arm and 55 (50.5%) in the experimental arm. The average confidence
level in the control arm was 8.7 ± 0.9 versus 8.4 ± 1.1 in the experimental arm, which is not statistically significant (p
value = 0.09). Among radiologists, the average confidence levels ranged from 6
- 10 in the control arm and 7 - 10 in the experimental arm. No examinations
were repeated for technical considerations in either group. No studies were
repeated in the experimental group in order to administer oral contrast. When
each radiologist was compared to the others, there were no differences in
confidence level between pairs in the control arm; however, there were
statistically significant differences in confidence level among three pairs of
radiologists for the experimental arm. There was no statistically significant
difference in radiologist confidence level between intravenously enhanced
abdomen and pelvis CTs with enteric contrast and without enteric contrast.