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Prospective study on bright lumen magnetic resonance colonography in comparison with conventional colonoscopy

¹ Department of Diagnostic, Interventional and Pediatric Radiology, University Hospital of Berne, Inselspital, Switzerland, ² Department of Internal Medicine II, Technische Universitaet of Munich, Germany, ³ Department of Radiology, Technische Universitaet of Munich, Germany, ⁴ Department of Radiology and Nuclear Medicine, Hospital Dritter Orden, Munich, Germany, ⁵ Department of Medicine, Division of Hepatology and Gastroenterology, Charité Medical Center, Virchow Hospital, Medical School of Berlin, Berlin, Germany

Correspondence: Dr Bettina Saar, Department of Diagnostic, Interventional and Pediatric Radiology, University Hospital of Berne, Inselspital, CH-3010 Berne, Switzerland. E-mail: bettina.saar{at}insel.ch

The aim of this prospective trial was to evaluate sensitivity and specificity of bright lumen magnetic resonance colonography (MRC) in comparison with conventional colonoscopy (CC). A total of 120 consecutive patients with clinical indications for CC were prospectively examined using MRC (1.5 Tesla) which was then followed by CC. Prior to MRC, the cleansed colon was filled with a gadolinium–water solution. A 3D GRE sequence was performed with the patient in the prone and supine position, each acquired during one breathhold period. After division of the colon into five segments, interactive data analysis was carried out using three-dimensional post-processing, including a virtual intraluminal view. The results of CC served as a reference standard. In all patients MRC was performed successfully and no complications occurred. Image quality was diagnostic in 92% (574/620 colonic segments). On a per-patient basis, the results of MRC were as follows: sensitivity 84% (95% CI 71.7–92.3%), specificity 97% (95% CI 89.0–99.6%). Five flat adenomas and 6/16 small polyps (5 mm) were not identified by MRC. MRC offers high sensitivity and excellent specificity rates in patients with clinical indications for CC. Improved MRC techniques are needed to detect small polyps and flat adenomas.