Colon Cancer Screening Completed with MRI

One reason patients cite for not complying with screening and preventative health measures is that they are inconvenient or uncomfortable. Colon cancer screening, in particular, is frequently shunned by the general public. New research, however, has provided preliminary validation of magnetic resonance imaging as an acceptable screening method. This alternative may encourage better rates of compliance with screening recommendations.

A study published in the August issue of the medical journal Gut indicates that this screening modality can detect pre-cancerous colon polyps. Researchers in Germany evaluated this imaging modality in a series of 315 patients over age 50. Findings with MRI were compared to colonoscopy and pathology.

Patients drank a tagging solution with meals for 48 hours before the procedure. Before imaging, patients received a water enema.

The technique had a 83 percent specificity rate of for detecting adenomatous polyps larger than 5mm. Total specificity was 90.2 percent and there were 19 false positives. The technique only captured approximately 10 percent of lesions smaller than mm.

There are drawbacks to screening with this modality compared to colonoscopy, which is considered the gold standard for screening by colorectal surgeons. The most important of which is that MRI colonography is less effective in detecting small polyps, particularly smaller than 5mm. An additional concern is that current protocols for fecal tagging may not capture all material, preventing necessary visualization of colon segments.

MRI colongraphy is more comfortable for patients and does not require administration of anaesthesia. Further, it does not require endoscopic approaches nor bowel preparative regimens. Fecal tagging accomplishes the same intent as the intensive 24- 36 hour preps requires for colonoscopy.

Investigation to advance the visualization of MRI to detect colon polyps is required to further determine if this is an appropriate screening method. In light of decreased costs, this may be a superior method to screen the general population for colon cancer. That option, however, requires that the procedure yields adequate sensitivity compared to colonoscopy.

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