Tags

Type your tag names separated by a space and hit enter

A comparison of virtual and conventional colonoscopy for the detection of colorectal polyps.
N Engl J Med. 1999 Nov 11; 341(20):1496-503.NEJM

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 conventional 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 a group of patients at high risk for colorectal neoplasia, virtual and conventional colonoscopy had similar efficacy for the detection of polyps that were 6 mm or more in diameter.

Authors+Show Affiliations

Department of Radiology, Boston University School of Medicine, Boston Medical Center, MA 02118, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10559450

Citation

Fenlon, H M., et al. "A Comparison of Virtual and Conventional Colonoscopy for the Detection of Colorectal Polyps." The New England Journal of Medicine, vol. 341, no. 20, 1999, pp. 1496-503.
Fenlon HM, Nunes DP, Schroy PC, et al. A comparison of virtual and conventional colonoscopy for the detection of colorectal polyps. N Engl J Med. 1999;341(20):1496-503.
Fenlon, H. M., Nunes, D. P., Schroy, P. C., Barish, M. A., Clarke, P. D., & Ferrucci, J. T. (1999). A comparison of virtual and conventional colonoscopy for the detection of colorectal polyps. The New England Journal of Medicine, 341(20), 1496-503.
Fenlon HM, et al. A Comparison of Virtual and Conventional Colonoscopy for the Detection of Colorectal Polyps. N Engl J Med. 1999 Nov 11;341(20):1496-503. PubMed PMID: 10559450.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A comparison of virtual and conventional colonoscopy for the detection of colorectal polyps. AU - Fenlon,H M, AU - Nunes,D P, AU - Schroy,P C,3rd AU - Barish,M A, AU - Clarke,P D, AU - Ferrucci,J T, PY - 1999/11/24/pubmed PY - 2000/5/20/medline PY - 1999/11/24/entrez SP - 1496 EP - 503 JF - The New England journal of medicine JO - N. Engl. J. Med. VL - 341 IS - 20 N2 - 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 conventional 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 a group of patients at high risk for colorectal neoplasia, virtual and conventional colonoscopy had similar efficacy for the detection of polyps that were 6 mm or more in diameter. SN - 0028-4793 UR - https://www.unboundmedicine.com/medline/citation/10559450/A_comparison_of_virtual_and_conventional_colonoscopy_for_the_detection_of_colorectal_polyps_ L2 - http://www.nejm.org/doi/full/10.1056/NEJM199911113412003?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -