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Evidence-Based Medicine 2004; 9:123
© 2004 BMJ Publishing Group Ltd.

Diagnosis

Virtual colonoscopy detected colorectal polyps in asymptomatic patients with average risk of colorectal neoplasia

Pickhardt PJ, Choi JR, Hwang I, et al. Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. N Engl J Med 2003;349:2191–200.[Abstract/Free Full Text]

Q In asymptomatic patients with average risk for colorectal neoplasia, what is the accuracy of virtual colonoscopy for detecting colorectal polyps?

Clinical impact ratings GP/FP/Primary care ******{star} IM/Ambulatory care ******* Gastroenterology *******

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

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

METHODS
Design: blinded comparison of virtual colonoscopy (VC) with optical colonoscopy (OC).

Setting: 3 medical centres in the US.

Patients: 1233 patients (mean age 58 y, 59% men) with average risk of colorectal cancer. Exclusion criteria included positive result on guaiac based test of stool <=6 months before referral; iron deficiency anaemia in the previous 6 months; rectal bleeding or haematochezia or unintentional weight loss >4.5 kg in the previous 12 months; OC in the previous 10 years; barium enema in the previous 5 years; history of adenomatous polyps, colorectal cancer, or inflammatory bowel disease; and pregnancy.

Description of tests: VC was done before OC using a computed tomography (CT) protocol wherein pneumocolon was produced by insufflating room air through a rectal catheter immediately before scanning. A 4 or 8 channel CT scanner (GE LightSpeed or LightSpeed Ultra, General Electric Medical Systems) generated 2 and 3 dimensional (3 D) endoluminal displays . . . [Full text of this article]

Robert H Fletcher, MD, MSc

Harvard Medical School
Boston, Massachusetts, USA






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