A prospective trial of the use of CT colonography to screen for colonic neoplasia in patients prior to liver transplantation.

Patients with end-stage liver failure entering into a transplant program are
screened for the presence of colonic neoplasia. This is currently performed
using colonoscopy. However, CT colonography has developed to the point where it
is diagnostically equivalent. This patient group also undergoes 4-phase CT of
the liver as part of the pre-transplantation screening process and
theoretically could be combined with CT colonography in one scanning session.
Furthermore colonoscopy in this patient group involves increased risks when
compared to the general population, tipping the balance of benefit versus risk
towards choosing a non-invasive screening modality that requires no sedation in
this patient group. This study aims to show that CT colonography is feasible
in combination with 4-phase CT of the liver in one session, has good diagnostic
accuracy and is associated with fewer complications and is therefore the
investigation of choice in these patients.

This study aims to show that CT colonography is feasible in combination with
4-phase CT of the liver in one session, has good diagnostic accuracy and is
associated with fewer complications and is therefore the investigation of
choice in these patients.

Fifty consecutive patients with end stage liver failure due to undergo
screening prior to being placed on the waiting list for liver transplant at the
department of Gastroenterology and Hepatology, Leiden University Medical Center
and who fulfil the following criteria and who consent to the study will be
investigated with CTC and 4-phase CT of the liver on the same day.

Bowel preparation necessary for the CT colonography
Limited extra radiation exposure due to scanning the whole abdomen and not just
the liver.