Comparison of single-dose and split-dose fecal tagging with iohexol in computed tomographic colonography | doi.page

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Comparison of single-dose and split-dose fecal tagging with iohexol in computed tomographic colonography

Digital Diagnostics2025Vol. 6(3), pp. 452–463

A. I. Meshcheryakov, N. Yu. Gurova, O. G. Pugacheva, Alina V. Yakovleva, Irina N. Kieva, Ekaterina A. Kurmyshova

Abstract

BACKGROUND: Proper fecal tagging allows for high-quality computed tomography colonography. However, there is no single tagging scheme. Therefore, the effects of a contrast enhancement regimen on fecal tagging should be evaluated. AIM: This study aimed to compare the quality of single-dose fecal tagging with that of split-dose fecal tagging with iohexol during computed tomographic colonography and to assess the impact of these regimens on procedure tolerability. METHODS: In this retrospective, selective, single-center study, the patients were divided into two groups based on whether they received single-dose (group 1) or split-dose (group 2) fecal tagging. Both groups received 50 mL of the iodine-containing contrast agent iohexol, with iodine concentration of 350 mg/mL. The residual liquid density was assessed using three parameters: maximum, minimum, and mean values. Additionally, the residual fluid homogeneity was assessed by calculating the mean standard deviation within the region of interest. Tolerability of preparation for colonography was assessed using a 10-point visual analog scale. RESULTS: The final sample included 338 patients: 116 in group 1 and 222 in group 2. The mean, minimum, and maximum density values in group 2 were significantly higher than those in group 1: 943 [722; 1245], 753 [525; 1082], and 1079 HU [801; 1456] versus 681 [420; 907], 570 [374; 820], and 825 HU [496; 1154], respectively (p 0.001). The residual fluid homogeneity was significantly higher in group 2 than in group 1: 59 [46; 78] versus 67 HU [54; 81] (р = 0.012). Group 2 showed a significantly lower subjective difficulty of preparation than did group 1: 4 [2; 6] and 5 [4; 7], respectively (p = 0.004). CONCLUSION: A single dose of 50 mL of iohexol (iodine concentration: 350 mg/mL) provides higher-quality fecal tagging than a split-dose provides because of higher residual fluid density with maintained homogeneity. Moreover, single-dose tagging was found to be more tolerable.