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Previous Volume 341:1496-1503 November 11, 1999 Number 20 Next

	Full Text PDF Editorial by Bond, J. H. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited Related Article PubMed Citation

ABSTRACT

Background Virtual colonoscopy is a new method of imaging the colon in which thin-section, helical computed tomography (CT) is used to generate high-resolution, two-dimensional axial images. Three-dimensional images of the colon simulating those obtained with conventional colonoscopy are then reconstructed off-line. We compared the performance of virtual and conventional colonoscopy for the detection of colorectal polyps.

Methods We prospectively studied 100 patients at high risk for colorectal neoplasia (60 men and 40 women; mean age, 62 years). We performed virtual colonoscopy immediately before conventional colonoscopy. We inserted a rectal tube and insufflated the colon with air to the maximal level that the patient could tolerate. We administered 1 mg of glucagon intravenously immediately before CT scanning to minimize the degree of smooth-muscle spasm and peristalsis and to reduce the patient's discomfort.

Results The entire colon was clearly seen by virtual colonoscopy in 87 patients and by convention-al colonoscopy in 89. Fifty-one patients had normal findings on conventional colonoscopy. In the other 49, we identified a total of 115 polyps and 3 carcinomas. Virtual colonoscopy identified all 3 cancers, 20 of 22 polyps that were 10 mm or more in diameter (91 percent), 33 of 40 that were 6 to 9 mm (82 percent), and 29 of 53 that were 5 mm or smaller (55 percent). There were 19 false positive findings of polyps and no false positive findings of cancer. Of the 69 adenomatous polyps, 46 of the 51 that were 6 mm or more in diameter (90 percent) and 12 of the 18 that were 5 mm or smaller (67 percent) were correctly identified by virtual colonoscopy. Although discomfort was not specifically recorded, none of the patients requested that virtual colonoscopy be stopped because of discomfort or pain.

Conclusions In patients at high risk for colorectal neoplasia, virtual and conventional colonoscopy have similar efficacy for the detection of polyps 6 mm or more in diameter.

Source Information

From the Departments of Radiology (H.M.F., M.A.B., P.D.C., J.T.F.) and Gastroenterology (D.P.N., P.C.S.), Boston University School of Medicine, Boston Medical Center, Boston.

Address reprint requests to Dr. Barish at the Department of Radiology, Boston University School of Medicine, Boston Medical Center, Boston, MA 02118, or at mbarish{at}virtualcolonoscopy.net.

Full Text of this Article

Related Letters:

Virtual Colonoscopy
Mackenzie S., Vallance R., O'Dwyer P. J., Glick S. N., Anderson J. C., Pollack B. J., Shaw R. D., Morrin M. M., Farrell R. J., Kruskal J. B., Silverman C., Fenlon H. H., Barish M. A., Ferrucci J. T., Bond J. H.
Extract | Full Text  
N Engl J Med 2000; 342:737-739, Mar 9, 2000. Correspondence

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