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CT Colonography: An audit of pre-COVID19 BHSCT practice in 2020
EP34394
Poster Title: CT Colonography: An audit of pre-COVID19 BHSCT practice in 2020
Submitted on 07 Nov 2020
Author(s): Timothy Patterson, Wendy Coalter, Raghuram Sathyanarayana, Scott Gillespie, Siobhan Spiers
Affiliations: The Royal Victoria Hospital, Belfast, Northern Ireland
This poster was presented at BIR2020
Poster Views: 214
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Poster Information
Abstract: Background:
During the initial COVID-19 surge all screening CTC examinations were ceased within the Belfast Health and Social Care Trust (BHSCT). The British Society of Gastrointestinal and Abdominal Radiology (BSGAR) published guidance on performing CTC in the recovering phase of COVID-19 in May 2020. This led to a dedicated CTC COVID-19 recovery phase protocol. The aim of this study was to evaluate the CTC service changes and technical adequacy within the BHSCT.

Methods:
Twenty-eight consecutive patients who underwent CTC between recommencement of services on 24th June and the end of August 2020 were evaluated using the Royal College of Radiologists (RCR) CTC audit tool. The main service change being imaging in the left and right decubitus positions as opposed to supine and prone, or lateral decubitus. This was compared with audit data for one-hundred patients collected immediately pre-COVID-19. Radiation does (mGy/cm2) were also recorded for each series. Additionally, service changes due to the COVID-19 pandemic were reviewed with departmental leads.

Results:
The rate of series with complete bowel distension was significantly improved following the new protocol (4% vs. 23% , p = 0.030). Adequacy of faecal tagging, rate of anti-spasmotic prescription and combined radiation (415.82 vs. 366.92 mGy/cm2 respectively) were statistically unchanged. Departmental leads highlighted an increase in waiting lists, more time needed per patient and high ‘did not attend’ rate.

Conclusion:
Changes to patient positioning have had a positive effect on the technical adequacy of studies. Continuous reassessment of services is essential now services have recommenced.
Summary: Title: Improvement of technical adequacy of CT colonography (CTC) following the COVID-19 pandemic: a full audit cycle of a Northern Irish radiology department.

This full audit cycle displayed a significantly increased rate of full bowel distension following implementation of COVID-19 recovery phase protocols. Specifically the positioning of a patient in the left and right lateral decubitus position as opposed to supine and prone.
References: 1) Audit to assess adequacy of CT Colonoscopy. 2016. Available from https://www.rcr.ac.uk/audit/audit-assess-adequacy-ct-colonography [Accessed 30th June 2020]

2) NHS Cancer Screening Programmes. Guidelines for the use of imaging in the NHS Bowel Cancer Screening Programme, Second edition. NHSBCSP Publication No 5, Sheffield: NHS Cancer Screening Programmes. 2012. Available from.  https://www.gov.uk/government/publications/bowel-cancer-screening-imaging-use [Accessed 30th June 2020]

3) Neri, E, Halligan, S, Hellström, M, et. al. The second ESGAR consensus statement on CT colonography. 2013. Eur Radiol 2013;23(3):720-729

4) Burling D (on behalf of the International Collaboration for CT colonography Standards) CT colonography standards. Clin Radiol 2010; 65: 474–480. 

5) Haycock, A, Burling, D, Wylie, P, et al. CT colonography training for radiographers – a formal evaluation. Clin Radiol 2010; 65: 997 – 1004.

6) Belfast Health and Social Care
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