VIRTUAL COLONOSCOPY

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Virtual Scope Brings Comfort to Colon Cancer TestReutersFriday, October 26, 2001

By Pam on

LISBON, Oct 25 (Reuters Health) - "Virtual" colonoscopy is not only far more comfortable for patients than traditional colonoscopy, it may also be able to detect abnormalities that the conventional test can't, according to researchers.

In colonoscopy, a flexible tube is inserted into the rectum to view the entire length of the colon. "Even though colonoscopy is an accurate technique, it is highly invasive and patients complain about the discomfort," Dr. Emilio Bria, a fellow in medical oncology at the University of Rome, Italy, told Reuters Health in an interview.

The virtual version uses a noninvasive imaging technique called spiral computed tomography (CT), but still requires the same clearing of the bowel as is needed for conventional colonoscopy. Air must also be pumped into the colon.

Controversy remains over which technique is best for following patients with colorectal cancer. To investigate, Bria and his colleagues used spiral CT to follow 35 patients who had had surgery for colorectal cancer over a 3-year period. The researchers presented their findings here Wednesday at the European Cancer Conference.

The patients had previously been followed with an annual colonoscopy, liver ultrasound and chest x-ray.

The spiral CT exam captures images of the chest, the abdomen and the pelvis. The procedure lasts about 30 seconds, after which the scans are processed by special software that allows doctors to look at the images in both two- and three-dimensional formats.

Over the 3 years in which patients were followed by virtual colonoscopy, 30 had no sign of recurrent or new disease. Cancer spread to the liver in three patients, which was confirmed by standard imaging techniques, and one patient had two nodules in the lung.

Six polyps and one local relapse near the original surgery site were also detected in another five patients. Virtual scans resulted in only one false-positive test.

"Bowel preparation is still a problem for patients, but the comfort level for this procedure is dramatically different from that of colonoscopy," Bria told Reuters Health. "And when we ask patients which procedure they prefer, almost all of them say the CT scan is better."

Bria and his colleagues note that while conventional colonoscopy is still the "gold standard," the virtual CT has advantages, including the ability to perform a liver scan and check for abnormalities outside the colon.

"Our study is still ongoing to subsequently assess if (spiral CT) can be considered as first choice exam in the follow-up of patients surgically treated for (colorectal cancer)," they conclude.

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