Virtual Colonoscopy Not Ready to Replace Traditional Method

Test procedures and the interpretation of test results must be standardized before computed tomography (CT) colonoscopy -- often referred to as "virtual colonoscopy" -- replaces traditional colonoscopies.

Despite these misgivings, CT colonoscopy continues to show significant promise, according to a report recently published in Gastroenterology, the journal of the American Gastroenterological Association. CT procedures use X-rays and computer programs to scan the colon-but the preferred method remains the traditional process of threading a tube with a camera up through the colon.

"No colorectal cancer screening test is perfect. CT colonography is currently not the most accurate or convenient test, but may in the future be included in the mix of colorectal cancer screening options available to patients and physicians," said AGA President Emmet B. Keeffe, MD, in a news release.

In preparing the report, a task force reviewed the results of recent clinical trials and quantitative mathematical models pertaining to CT colonography. One limitation is that the test cannot consistently detect flat polyps or those smaller than one centimeter. In addition, CT screening still requires complete bowel cleansing and a follow-up colonoscopy for positive results.

Currently, there are a number of tests that may be used to screen for colorectal cancer, the second-leading cause of cancer deaths in the United States. Approved tests include barium enema, fecal occult blood test, flexible sigmoidoscopy, and colonoscopy.

"While the virtual aspect of the test sounds appealing, it isn't a panacea," said Keeffe. "Many practical issues still need to be addressed [regarding CT colonography], including standardization of test performance, patient preparation, and interpretation of test results before CT colonoscopy can be recommended for routine clinical practice. The shortage of radiologists in the country confounds the issue of training a sufficient supply of physicians able to deliver care to patients on a widespread and consistent basis."

Source: AAMI

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