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Q In patients presenting for colonoscopy, what is the accuracy of computed tomographic (CT) colonoscopy (virtual colonoscopy [VC]) in detecting colororectal neoplasia?
Clinical impact ratings GP/FP/Primary care ★★★★☆☆☆ IM/Ambulatory care ★★★★★★☆ Gastroenterology ★★★★★☆☆
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 …
Footnotes
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For correspondence: Dr P B Cotton, Medical University of South Carolina, Charleston, SC, USA. cottonpmusc.edu
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Source of funding: Office of Naval Research, US Department of Defense.
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Abstract and commentary also appear in ACP Journal Club.