Fecal tagging

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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: 
  1. S. C. Goehde
    Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, Essen, 45122, Germany
  2. E. Descher
    Private practice for gastroenterology, I Hagen 26, Essen, 45127, Germany
  3. A. Boekstegers
    Private practice for gastroenterology, I Hagen 26, Essen, 45127, Germany
  4. T. Lauenstein
    Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, Essen, 45122, Germany
  5. C. Kühle
    Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, Essen, 45122, Germany
  6. S. G. Ruehm
    Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, Essen, 45122, Germany
  7. 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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MR Colonography With Parallel Acquisition Techniques To Increase Spatial Resolution: A Feasibility Study

Journal Title, Volume, Page: 
Proc. Intl. Soc. Mag. Reson. Med. 13 (2005)
Year of Publication: 
2005
Authors: 
  1. C. A. Kuehle
    Institute of Diagnostic and Interventional Radiology, University Hospital of Essen, Essen, NRW, Germany
  2. Waleed Ajaj
    Institute of Diagnostic and Interventional Radiology, University Hospital of Essen, Essen, NRW, Germany
    Current Affiliation: 
    Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
  3. K. Reiter
    Institute of Diagnostic and Interventional Radiology, University Hospital of Essen, Essen, NRW, Germany
  4. S. Maderwald
    Institute of Diagnostic and Interventional Radiology, University Hospital of Essen, Essen, NRW, Germany
  5. S. C. Ladd
    Institute of Diagnostic and Interventional Radiology, University Hospital of Essen, Essen, NRW, Germany
  6. J. Barkhausen
    Institute of Diagnostic and Interventional Radiology, University Hospital of Essen, Essen, NRW, Germany
  7. T. C. Lauenstein
    Institute of Diagnostic and Interventional Radiology, University Hospital of Essen, Essen, NRW, Germany
Preferred Abstract (Original): 

Magnet resonance colonography (MRC) is a promising method for the depiction of colorectal pathologies. For colorectal masses exceeding 10mm, high accuracy values (92% to 100%) have been reported (1). However, due to limited spatial resolution, the detection rate of smaller pathologies is only fair. Another limitation of current MRC protocols is related to relatively long data acquisition of up to 25 seconds, which need to be performed under breath-hold conditions. Especially in elderly patients or patients with diseases of the respiratory tract, this can result in severe motion artefacts hampering a reliable assessment of the colon. The underlying problems may be solved by new image acquisition techniques providing a higher spatial resolution and / or a decreased acquisition time. These parallel acquisition techniques (PAT) have recently been successfully applied for MR colonography in an in-vitro study (2). Aim of the current trial was to prove the practicability of PAT imaging for MR colonography in-vivo.

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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: 
  1. Susanne C. Goehde
    Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany
  2. 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
  3. Thomas Lauenstein
    Department of Diagnostic and Interventional Radiology, University Hospital Essen, Essen, Germany
  4. Joerg F. Debatin
    Department of Diagnostic and Interventional Radiology, University Hospital Essen, Essen, Germany
  5. 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.

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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) 30:576–583
Year of Publication: 
2005
Authors: 
  1. S. C. Goehde
    Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, Essen, 45122, Germany
  2. E. Descher
    Private practice for gastroenterology, I Hagen 26, Essen, 45127, Germany
  3. A. Boekstegers
    Private practice for gastroenterology, I Hagen 26, Essen, 45127, Germany
  4. T. Lauenstein
    Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, Essen, 45122, Germany
  5. C. Kuhle
    Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany
  6. S. G. Ruehm
    Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany
  7. 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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Dark-lumen MR colonography

Journal Title, Volume, Page: 
Abdominal Imaging July 2004, Volume 29, Issue 4, pp 429-433
Year of Publication: 
2004
Authors: 
  1. W. Ajaj
    Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, D-45122 Essen, Germany
    Current Affiliation: 
    Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
  2. J. F. Debatin
    Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, D-45122 Essen, Germany
  3. T. Lauenstein
    Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, D-45122 Essen, Germany
Preferred Abstract (Original): 
Magnetic resonance colonography (MRC) has been shown to be an appropriate diagnostic tool for the detection of colorectal pathologies. Recently, dark-lumen MRC has been introduced. This technique is based on the acquisition of a T1-weighted sequence after the administration of water enema and the intravenous administration of paramagnetic contrast. This report describes the underlying techniques of dark-lumen MRC concerning data acquisition and image interpretation. Furthermore, it points out the advantages of this approach as compared with conventional endoscopy or other MR methods. Possible improvements in the future such as the implementation of fecal tagging strategies to avoid bowel cleansing are discussed.
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MR Imaging of The Colon: “Technique, Indications, Results And Limitations”

Journal Title, Volume, Page: 
European Journal of Radiology 61 (2007) 415–423
Year of Publication: 
2007
Authors: 
  1. Waleed Ajaj
    University Medical Center Hamburg-Eppendorf, Hamburg, Germany
    Current Affiliation: 
    Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
  2. Mathias Goyen
    University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Preferred Abstract (Original): 

In the last few years virtual colonography using MR imaging has shown a proceeding development regarding detection and quantification of colorectal pathologies. Dark-lumen MR colonography (MRC) has been a leading tool for the diagnosis of the entire colon and their pathologies. This review article describes some of the underlying techniques of MRC concerning data acquisition, the need for intravenously applied paramagnetic contrast agent, as well as indications, results and limitations of MRC for the detection of colorectal pathologies. In addition, new techniques to improve patient acceptance are discussed.

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