The first joint ESGAR/ ESPR consensus statement on the technical performance of cross-sectional small bowel and colonic imaging

S A Taylor,C G Cronin,M Zappa,S H Kim,M R Torkzad,F Avni,M Napolitano,A Laghi,G Bhatnagar,J Rimola,C Hoeffel,C A J Puylaert,J Stoker,P Petit,D J Tolan

doi:10.1007/s00330-016-4615-9

Abstract

ObjectivesTo develop guidelines describing a standardised approach to patient preparation and acquisition protocols for magnetic resonance imaging (MRI), computed tomography (CT) and ultrasound (US) of the small bowel and colon, with an emphasis on imaging inflammatory bowel disease.MethodsAn expert consensus committee of 13 members from the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) and European Society of Paediatric Radiology (ESPR) undertook a six-stage modified Delphi process, including a detailed literature review, to create a series of consensus statements concerning patient preparation, imaging hardware and image acquisition protocols.ResultsOne hundred and fifty-seven statements were scored for agreement by the panel of which 129 statements (82 %) achieved immediate consensus with a further 19 (12 %) achieving consensus after appropriate modification. Nine (6 %) statements were rejected as consensus could not be reached.ConclusionsThese expert consensus recommendations can be used to help guide cross-sectional radiological practice for imaging the small bowel and colon.Key points• Cross-sectional imaging is increasingly used to evaluate the bowel• Image quality is paramount to achieving high diagnostic accuracy• Guidelines concerning patient preparation and image acquisition protocols are provided

Highlights

Increased utilisation of cross-sectional techniques to image the bowel has occurred in recent years, in the context10 St James’s University Hospital, Leeds Teaching Hospitals NHS Trust, England, UK11 Department of Radiology, Hôpital Beaujon, AP-HP, Université Paris 7, INSERM CRI U1149, Clichy, France12 Department of Radiology, Academic Medical Centre, University of Amsterdam, Post box 22660, 1105 AZ Amsterdam, The NetherlandsEur Radiol (2017) 27:2570–2582 of inflammatory bowel disease
A large body of evidence supports the use of computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound (US) in this context, and recent expert guidelines recommend cross-sectional imaging as first line in the diagnosis, staging and follow up of inflammatory bowel disease [1]
Standards for interpretation and reporting examinations, together with consideration of clinical indications, diagnostic accuracy and advantages and disadvantages of each modality were beyond the remit of the committee and covered by the recent joint European Crohn’s and Colitis Organisation (ECCO)/European Society of Gastrointestinal and Abdominal Radiology (ESGAR) recommendations for imaging in inflammatory bowel disease [1]

Summary

Introduction

A large body of evidence supports the use of computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound (US) in this context, and recent expert guidelines recommend cross-sectional imaging as first line in the diagnosis, staging and follow up of inflammatory bowel disease [1]. In common with many radiological tests, image quality is paramount to achieving high diagnostic accuracy, and there is a risk that rapid dissemination can occur without sufficient attention to acquisition protocols. This is pertinent when imaging the bowel, a complex, motile organ where non-diagnostic examinations are a particular risk.

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