. 2017 Dec;27(12):4970-4978.

doi: 10.1007/s00330-017-4920-y. Epub 2017 Jul 3.

Adverse events during CT colonography for screening, diagnosis and preoperative staging of colorectal cancer: a Japanese national survey

Koichi Nagata^{1

2

3}, Ken Takabayashi^{4

5

6}, Takaaki Yasuda^{4

5

7}, Michiaki Hirayama^{4

8}, Shungo Endo^{4

9}, Ryoichi Nozaki^{10

4

11}, Takenobu Shimada^{10

12}, Hidenori Kanazawa^{5

13}, Masanori Fujiwara^{4

14}, Norihito Shimizu^{4

15}, Tatema Iwatsuki^{4

16}, Teruaki Iwano^{4

17}, Hiroshi Saito^{10

18}

Affiliations

¹ Committee for Quality Assessment of Colorectal Cancer Screening, Japanese Society of Gastrointestinal Cancer Screening, Tokyo, Japan. Nagata7@aol.com.
² Gastrointestinal Advanced Imaging Academy, Tochigi, Japan. Nagata7@aol.com.
³ Division of Screening Technology, Centre for Public Health Sciences, National Cancer Centre, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan. Nagata7@aol.com.
⁴ Gastrointestinal Advanced Imaging Academy, Tochigi, Japan.
⁵ Division of Screening Technology, Centre for Public Health Sciences, National Cancer Centre, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
⁶ Department of Radiology, Hokkaido Gastroenterology Hospital, Honcho 1-jo, 1-chome, Higashi-ku, Sapporo, 065-0041, Japan.
⁷ Department of Radiology, Nagasaki Kamigoto Hospital, 1549-11, Aokatago, Shinkamigoto, Minami-matsuura, Nagasaki, 857-4404, Japan.
⁸ Department of Gastroenterology, Tonan Hospital, 3-8, Kita 4-jo Nishi 7-chome, Chuo-ku, Sapporo, 060-0004, Japan.
⁹ Department of Coloproctology, Aizu Medical Centre, Fukushima Medical University, 21-2, Aza, Maeda, Tanisawa, Kawahigashi-machi, Aizu-Wakamatsu, Fukushima, 969-3492, Japan.
¹⁰ Committee for Quality Assessment of Colorectal Cancer Screening, Japanese Society of Gastrointestinal Cancer Screening, Tokyo, Japan.
¹¹ Coloproctology Centre, Takano Hospital, 4-2-88, Obiyama, Chuo-ku, Kumamoto, 862-0924, Japan.
¹² Cancer Detection Centre of the Miyagi Cancer Society, 5-7-30, Kamisugi, Aoba-ku, Sendai, Miyagi, 980-0011, Japan.
¹³ Department of Radiology, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
¹⁴ Radiology Section, Kameda Medical Centre Makuhari, 1-3, Nakase, Mihama-ku, Chiba, 261-8501, Japan.
¹⁵ Radiology Section, Matsuoka Clinic, 2-9-15, Oji, Oji-cho, Kita-Katsuragi-gun, Nara, 636-0002, Japan.
¹⁶ Radiology Section, Matsuda Hospital, 753 Irinocho, Nishi-ku, Hamamatsu, Shizuoka, 432-8061, Japan.
¹⁷ Radiology Section, Tokushima Kensei Hospital, 4-9, Shimosuketo-cho, Tokushima, 770-0805, Japan.
¹⁸ Division of Screening Assessment & Management, Centre for Public Health Sciences, National Cancer Centre, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.

PMID: 28674967
DOI: 10.1007/s00330-017-4920-y

Adverse events during CT colonography for screening, diagnosis and preoperative staging of colorectal cancer: a Japanese national survey

Koichi Nagata et al. Eur Radiol. 2017 Dec.

. 2017 Dec;27(12):4970-4978.

doi: 10.1007/s00330-017-4920-y. Epub 2017 Jul 3.

Authors

Affiliations

¹ Committee for Quality Assessment of Colorectal Cancer Screening, Japanese Society of Gastrointestinal Cancer Screening, Tokyo, Japan. Nagata7@aol.com.
² Gastrointestinal Advanced Imaging Academy, Tochigi, Japan. Nagata7@aol.com.
³ Division of Screening Technology, Centre for Public Health Sciences, National Cancer Centre, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan. Nagata7@aol.com.
⁴ Gastrointestinal Advanced Imaging Academy, Tochigi, Japan.
⁵ Division of Screening Technology, Centre for Public Health Sciences, National Cancer Centre, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
⁶ Department of Radiology, Hokkaido Gastroenterology Hospital, Honcho 1-jo, 1-chome, Higashi-ku, Sapporo, 065-0041, Japan.
⁷ Department of Radiology, Nagasaki Kamigoto Hospital, 1549-11, Aokatago, Shinkamigoto, Minami-matsuura, Nagasaki, 857-4404, Japan.
⁸ Department of Gastroenterology, Tonan Hospital, 3-8, Kita 4-jo Nishi 7-chome, Chuo-ku, Sapporo, 060-0004, Japan.
⁹ Department of Coloproctology, Aizu Medical Centre, Fukushima Medical University, 21-2, Aza, Maeda, Tanisawa, Kawahigashi-machi, Aizu-Wakamatsu, Fukushima, 969-3492, Japan.
¹⁰ Committee for Quality Assessment of Colorectal Cancer Screening, Japanese Society of Gastrointestinal Cancer Screening, Tokyo, Japan.
¹¹ Coloproctology Centre, Takano Hospital, 4-2-88, Obiyama, Chuo-ku, Kumamoto, 862-0924, Japan.
¹² Cancer Detection Centre of the Miyagi Cancer Society, 5-7-30, Kamisugi, Aoba-ku, Sendai, Miyagi, 980-0011, Japan.
¹³ Department of Radiology, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
¹⁴ Radiology Section, Kameda Medical Centre Makuhari, 1-3, Nakase, Mihama-ku, Chiba, 261-8501, Japan.
¹⁵ Radiology Section, Matsuoka Clinic, 2-9-15, Oji, Oji-cho, Kita-Katsuragi-gun, Nara, 636-0002, Japan.
¹⁶ Radiology Section, Matsuda Hospital, 753 Irinocho, Nishi-ku, Hamamatsu, Shizuoka, 432-8061, Japan.
¹⁷ Radiology Section, Tokushima Kensei Hospital, 4-9, Shimosuketo-cho, Tokushima, 770-0805, Japan.
¹⁸ Division of Screening Assessment & Management, Centre for Public Health Sciences, National Cancer Centre, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.

PMID: 28674967
DOI: 10.1007/s00330-017-4920-y

Abstract

Objectives: To retrospectively evaluate the frequencies and magnitudes of adverse events associated with computed tomographic colonography (CTC) for screening, diagnosis and preoperative staging of colorectal cancer.

Methods: A Japanese national survey on CTC was administered by use of an online survey tool in the form of a questionnaire. The questions covered mortality, colorectal perforation, vasovagal reaction, total number of examinations, and examination procedures. The survey data was collated and raw frequencies were determined. Fisher's exact test was used to determine differences in event rates between groups.

Results: At 431 institutions, 147,439 CTC examinations were performed. No deaths were reported. Colorectal perforations occurred in 0.014% (21/147,439): 0.003% (1/29,823) in screening, 0.014% (13/91,007) in diagnosis and 0.028% (7/25,330) in preoperative staging. The perforation risk was significantly lower in screening than in preoperative staging CTC procedures (p = 0.028). Eighty-one per cent of perforation cases (17/21) did not require emergency surgery. Vasovagal reaction occurred in 0.081% (120/147,439): 0.111% (33/29,823) in screening, 0.088% (80/91,007) in diagnosis and 0.028% (7/25,330) in preoperative staging.

Conclusions: The risk of colorectal perforation and vasovagal reaction in CTC is low. The frequency of colorectal perforation associated with CTC is least in the screening group and greatest in the preoperative-staging group.

Key points: • The colorectal perforation rate during preoperative-staging CTC was 0.028 %. • The perforation rates for screening and diagnosis were 0.003 % and 0.014 %, respectively. • The perforation risk is significantly lower in screening than in preoperative staging. • Eighty-one per cent of perforation cases did not require emergency surgery. • Use of an automatic colon insufflator can reduce the risk of bowel perforation.

Keywords: Colonography; Computed tomography; Intestinal perforation; Vasovagal syncope; Virtual colonoscopy.

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Adverse events during CT colonography for screening, diagnosis and preoperative staging of colorectal cancer: a Japanese national survey

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Adverse events during CT colonography for screening, diagnosis and preoperative staging of colorectal cancer: a Japanese national survey

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