A Comparison of Virtual and Conventional Colonoscopy for the Detection of Colorectal Polyps

Fenlon, Helen M.; Nunes, David; Schroy, Paul C.; Barish, Matthew A.; Clarke, Peter D.; Ferrucci, Joseph T.

doi:10.1056/nejm199911113412003

Cited by 686 publications

(284 citation statements)

References 44 publications

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“…Computed tomographic colonography (CTC) is increasingly used as a relatively non-invasive method of colonic investigation both for colorectal cancer (CRC) screening [1][2][3] and for patients with symptoms suggestive of CRC [4][5][6][7]. Data from large studies on screening cohorts have suggested that CTC and conventional colonoscopy have similar sensitivity for polyps ≥6-mm in diameter [8,9].…”

Section: Introductionmentioning

confidence: 99%

Adverse events of computed tomography colonography: An Italian National Survey

Iafrate¹,

Iussich²,

Correale³

et al. 2013

Digestive and Liver Disease

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a b s t r a c tAim: To retrospectively study the frequency and magnitude of complications associated with computed tomography (CT) colonography in clinical practice. Methods: A questionnaire on complications of CT colonography was sent to Italian public radiology departments identified as practicing CT colonography with a reasonable level of training. The frequency of complications and possible risk factors were retrospectively determined. Responses were collated and row frequencies determined. A multivariate analysis of the factors causing adverse events was also performed. Results: 40,121 examinations were performed in13 centers during the study period. No deaths were reported. Bowel perforations occurred in 0.02% (7 exams). All perforations were asymptomatic and occurred in patients undergoing manual insufflation. Five perforations (71%) occurred in procedures performed following a recent colonoscopy. There was no significant difference between perforations associated with rectal balloon (0.017%) and those that were not (0.02%). Complications related to vasovagal reaction (either with or without spasmolytic) occurred in 0.16% (63 exams). All vasovagal reactions resolved in less than 3 h, without any sequelae. Conclusions: Perforation rate at CT colonography in Italy is comparable with elsewhere in the world, occurring regardless of the experience of radiology centers. Although the risk is very small, it may not be negligible when compared with the risk of diagnostic colonoscopy.

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Section: Introductionmentioning

confidence: 99%

Adverse events of computed tomography colonography: An Italian National Survey

Iafrate¹,

Iussich²,

Correale³

et al. 2013

Digestive and Liver Disease

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“…Cross sectional imaging techniques including magnetic resonance imaging (MRI) and computed tomography (CT) are increasingly being considered as alternative imaging modalities for colorectal screening [1,2]. Using thin section axial images and assigned software both techniques allow the generation of three-dimensional views of the colon, simulating those obtained with conventional colonoscopy.…”

Section: Introductionmentioning

confidence: 99%

“…A recent study comparing single-slice CT colonography and conventional colonoscopy suggests similar efficacy Colorectal polyps: Detection with multi-slice CT colonography for detection of polyps 6 mm or more in diameter (82 ± 91 %). However, restrictions in spatial resolution resulted in a low sensitivity for polyps smaller 6 mm (55 %) and frequent false positive findings [1].…”

Section: Introductionmentioning

confidence: 99%

Colorectal polyps: Detection with multi-slice CT colonography

Weßling

Fischbach²,

Domagk³

et al. 2001

Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr

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Summary. Purpose: To compare the performance of virtual and conventional colonoscopy for the detection of colorectal polyps using a multislice spiral CT scanner (MSCT). Materials and Methods: 48 patients (20 women, 28 men, mean age 61.5 years) with clinical indication for conventional colonoscopy were prospectively studied using a MSCT (Somatom Volume Zoom, Siemens, Forchheim). Examination was performed after standard oral preparation for colonoscopy and colonic distension with room air and i. v. butylscopolamin. Images were obtained in prone and supine position using a detector configuration of 4 1 mm, a table feed of 5 mm/rotation at 140 mAs and 120 kV. Slice thickness and reconstruction increment were 3 and 1.5 mm, respectively. CT data were assessed by two blinded radiologists on a Vitrea workstation (Vital Images, USA) using a software with multiplanar and volume-rendering capabilities. Results: 33 patients had normal findings on conventional colonoscopy. In 15 patients a total of 30 polyps and one carcinoma with stenosis were identified. MSCT-colonography identified the carcinoma and 23 polyps (77 %). 3 of 3 polyps were 10 mm or more (100 %), 6 of 7 were 5.1 to 9.9 mm (86 %) and 14 of 20 were 5 mm or smaller (70 %). There were 13 false positive findings for polyps (10 lesions < 6 mm in 5 patients) and no false positive finding of carcinoma. Conclusions: MSCT colonography allows accurate detection of polyps larger than 10 mm. Compared to published results of single-slice CT, multislice CT colonography increases the rate of detection of small colorectal polyps in particular. However, false positive results still remain a problem. Schlüsselwörter: Polypen ± Computertopographie ± Kolographie ± Mehrschicht-CT

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“…Key words: Magnetic resonance imaging (MRI) ± Virtual endoscopy ± Colon ± Contrast medias highly sensitive for detecting colorectal polyps exceeding 8 mm in size [5,6]. Despite high diagnostic accuracy, the considerable exposure to ionising radiation casts a shadow over the future of CT colonography as a screening exam for colorectal cancer [7].…”

Section: Discussionmentioning

confidence: 99%