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Virtual colonoscopy performed poorly in detecting colorectal neoplasia

Clinical impact ratings GP/FP/Primary care IM/Ambulatory care Gastroenterology

Key Words: colonography (computed tomographic) • colonoscopy • colorectal neoplasms

The first 150 words of the full text of this article appear below.

METHODS
Design: blinded, non-inferiority comparison of VC with conventional colonoscopy.

Setting: 8 clinical centres in the US and 1 centre in the UK.

Patients: 615 patients (mean age 61 y, 55% women) presenting for colonoscopy because of overt and occult rectal bleeding, change in stool habit, abdominal pain, or surveillance after polypectomy. Patients who had had colonoscopy within the past 3 years were excluded.

Description of tests: the colon was insufflated with room air or carbon dioxide. VC was done using 2 and 4 section CT scanners with nominal slice thicknesses of 2.5 or 5 mm and reconstruction increments of 1.5 or 1 mm, depending on equipment. Scans were read in 2 dimensional slices and 3 dimensional snapshot reconstructions when necessary. Radiologist interpretations were recorded in a sealed envelope for each colon segment. Conventional colonoscopy was done within 2 hours of VC. Endoscopists were blinded to VC results during insertion of . . . [Full text of this article]

Robert H Fletcher, MD, MSc

Harvard Medical School
Boston, Massachusetts, USA