Diagnostic accuracy of MR colonography with fecal tagging

MR colonography (MRC) is a non-invasive method of examining the colon, but it is still only used in a few specialized centers on a daily basis. The purpose of this study was to evaluate the performance of MRC with improved fecal tagging vs. conventional colonoscopy (CC). Between March 2006 and February 2007, consecutive patients who received first-time referrals to CC were asked to participate in the study. Two days prior to MRC, a new contrast mixture (barium/ferumoxsil) was ingested together with four meals each day. Standard bowel cleansing was performed before CC. MRC was evaluated by two blinded observers. MRC results were compared with CC. A total of 56 patients were included. The per-polyp sensitivity was 85.7% for polyps 6-10 mm and 81.3% for polyps > 10 mm. The per-patient sensitivity/specificity was 100%/80% for polyps > 6 mm and 100%/91.4% for polyps > 10 mm. MRC showed acceptable per-patient sensitivities, but the per-polyp sensitivities are still compromised by the fecal tagging. MRC may be implemented, but at the present time MRC with fecal tagging is not ready for widespread use, although it remains a very promising diagnostic tool.