T1232 Use of Image Analysis Software to Evaluate the Correction Factor for BRAVO Capsule Placement

Abstract

Background: Computed tomography colonography (CTC) has been recommended as a CRC screening test for average risk individuals. Like colonoscopy, the diagnostic accuracy of CTC depends upon adequate bowel preparation. Sodium phosphate tablets (SPT) have been shown to be better tolerated and to provide similar quality of cleansing when compared to sodium phosphate liquid (SPL) preparations for colonoscopy. There are no data, however, comparing the cleansing efficacy of SPT to SPL for patients undergoing CTC. We report the first data regarding the efficacy and potential renal effects of SPT compared to SPL for colon cleansing in patients undergoing CTC. Methods: In this prospective, randomized, single-blinded, investigator initiated trial, 82 patients without a history of kidney, liver or cardiac disease undergoing CTC for average risk CRC screening were randomly allocated one of three sodium phosphate regimens: SPT (Osmoprep-Salix Pharmaceuticals) in either a split-dose or night-prior regimen or SPL (Phospho Soda-C.B. Fleet Co.) in a night-prior regimen. On the day of the examination CTC radiologists rated the quality of the bowel preparation using a binary rating scale as well as a standardized residual stool scale. Patients completed a survey designed to evaluate their opinion of the preparation and their willingness to undergo the same preparation in the future. They also provided blood samples 2-6 weeks after the CTC to compare preand post-preparation serum electrolytes and renal function indices. Results: 82 people have participated (48% female, mean age 56.1 years) and primary endpoint data was evaluable in 76/82. Both the SPL and the SPT night-prior regimens appeared to provide superior preparation compared to the SPT-split dosing (76.9% excellent or good preparation vs. 25%, respectively, p=0.001). The only difference in tolerability reported was taste which was rated as more unacceptable in the SPL group compared to both SPT groups (p= 0.03). The only statistically significant change in serum electrolytes or renal function that was noted was a decrease of serum phosphate by 0.30 mg/dL (7.52%) in the SPT split-dose regimen after bowel preparation. Conclusion: Our preliminary data indicate that sodium phosphate tablets can provide adequate CTC preparation and are better tolerated than the solution form of sodium phosphate. Dosing the evening before appears to provide a better colon preparation. No patients were noted to have clinically significant changes in renal function or electrolyte values as a result of sodium phosphate preparation.