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

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 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 ★★★★★★☆ IM/Ambulatory care ★★★★★★★ Gastroenterology ★★★★★★★


Embedded ImageDesign:

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

Embedded ImageSetting:

3 medical centres in the US.

Embedded ImagePatients:

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.

Embedded ImageDescription 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 of the colon and rectum while the patient held his or her breath in the supine …

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  • For correspondence: Dr P J Pickhardt, University of Wisconsin Medical School, Madison, WI, USA.

  • Source of funding: Department of Defense.

  • Abstract and commentary also appear in ACP Journal Club.