DCBE DCBE also requires a preprocedural bowel cleansing preparation. The study is performed by administration of a liquid barium-based contrast agent and air-insufflation of the colon via a tube inserted into the rectum. Images are acquired with the patient in different obliquities and at different table angulations ranging from supine to standing. Performance of DCBE is dependent on optimal patient positioning because patient anatomy varies. The Colorectal Cancer Screening perforation rate during DCBE is approximately 1 in 25,000 [56] as compared to 1 in 22,000 for CTC and 1 in 1,000 for diagnostic colonoscopy [38,39]. Additional data on the effectiveness of the DCBE for detecting colorectal cancer comes from studies in which the imaging history of patients with colorectal cancer was reviewed. In many of these studies, the risk level of patients undergoing DCBE was not reported. Based on this methodology, the sensitivity of DCBE ranges from 75% to 95% [64-66]. This correlates with a large, population-based study that found the overall rate of new or missed cancers following a DCBE was 22% [67]. SCBE Single-contrast barium enema (SCBE) studies are performed by administration of liquid barium via a rectal tube. Unlike a DCBE, the colon is not insufflated with air. SCBE studies are generally performed when patients are unable to tolerate a DCBE (eg, patients unable to stand upright) and a CTC cannot be performed. A minority of studies have suggested that a SCBE has the potential to be as sensitive as a DCBE for detecting cancer and large polyps. The reported sensitivity for cancer ranges from 82% to 95% [65,66] and is approximately 95% for large polyps [69]. In a retrospective evaluation of individuals diagnosed with colorectal cancer who had undergone a prior DCBE or SCBE, the cancer miss rate was 4.8% for SCBE and 4.7% for DCBE [65].
Colorectal Cancer Screening. DCBE DCBE also requires a preprocedural bowel cleansing preparation. The study is performed by administration of a liquid barium-based contrast agent and air-insufflation of the colon via a tube inserted into the rectum. Images are acquired with the patient in different obliquities and at different table angulations ranging from supine to standing. Performance of DCBE is dependent on optimal patient positioning because patient anatomy varies. The Colorectal Cancer Screening perforation rate during DCBE is approximately 1 in 25,000 [56] as compared to 1 in 22,000 for CTC and 1 in 1,000 for diagnostic colonoscopy [38,39]. Additional data on the effectiveness of the DCBE for detecting colorectal cancer comes from studies in which the imaging history of patients with colorectal cancer was reviewed. In many of these studies, the risk level of patients undergoing DCBE was not reported. Based on this methodology, the sensitivity of DCBE ranges from 75% to 95% [64-66]. This correlates with a large, population-based study that found the overall rate of new or missed cancers following a DCBE was 22% [67]. SCBE Single-contrast barium enema (SCBE) studies are performed by administration of liquid barium via a rectal tube. Unlike a DCBE, the colon is not insufflated with air. SCBE studies are generally performed when patients are unable to tolerate a DCBE (eg, patients unable to stand upright) and a CTC cannot be performed. A minority of studies have suggested that a SCBE has the potential to be as sensitive as a DCBE for detecting cancer and large polyps. The reported sensitivity for cancer ranges from 82% to 95% [65,66] and is approximately 95% for large polyps [69]. In a retrospective evaluation of individuals diagnosed with colorectal cancer who had undergone a prior DCBE or SCBE, the cancer miss rate was 4.8% for SCBE and 4.7% for DCBE [65].