Screening Colonoscopy: Endoscopic or Virtual

  • Nora A. Royer
  • Tracey D. Arnell
  • Srinath C. Yeshwant
  • Ronald M. Summers

With improvements in computed tomography (CT) scan resolution, virtual colonoscopy using reconstructed CT images has emerged as a potential alternative to endoscopy. This chapter explores the role of this alternative to traditional colonoscopic examination.


Bowel Preparation Compute Tomography Colonography Virtual Colonoscopy Optical Colonoscopy Polyp Detection 


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  1. Cotton PB, Durkalski VL, Benoit PC, et al. Computed tomographic colonography (virtual colonoscopy)—a multicenter comparison with standard colonoscopy for detection of colorectal neoplasia. JAMA 2004;291:1713–1719.CrossRefPubMedGoogle Scholar
  2. Halligan S, Altman DG, Taylor SA, et al. CT colonography in the detection of colorectal polyps and cancer: systematic review, meta-analysis, and proposed minimum data set for study level reporting. Radiology 2005;237:893–904.CrossRefPubMedGoogle Scholar
  3. Macari M, Milano A, Lavelle M, Berman P, Megibow AJ. Comparison of time-efficient CT colonography with two- and three- dimensional colonic evaluation for detecting colorectal polyps. AJR Am J Roentgenol 2000;174:1543–1549.PubMedGoogle Scholar
  4. Mulhall BP, Veerappan GR, Jackson JL. Meta-Analysis: Computed tomographic colonography. Ann Intern Med 2005;142:635–650.PubMedGoogle Scholar
  5. Pickhardt PJ, Choi JR, Hwang I, et al. Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. N Engl J Med 2003;349:2191–2200.CrossRefPubMedGoogle Scholar
  6. Rockey DC, Paulson E, Niedzwiecki D, et al. Analysis of air contrast barium enema, computed tomographic colonography, and colonoscopy: prospective comparison. Lancet 2005;365:305–311.PubMedGoogle Scholar

Suggested Readings

  1. Callstrom MR, Johnson CD, Fletcher JG, et al. CT colonography without cathartic preparation: feasibility study. Radiology 2001;219:693–698.PubMedGoogle Scholar
  2. Fenlon HM, Barish MA, Clarke PD, Ferrucci JT. Virtual colonoscopy in occlusive colon carcinoma: preoperative evaluation of the proximal colon. Radiology 1998;209P:689.Google Scholar
  3. Hixson LJ, Fennerty MB, Samplinger RE, Garewal HS. Prospective blinded trial of the colonoscopic miss-rate of large colorectal polyps. Gastrointestinal Endoscopy 1991;37:125–7.CrossRefPubMedGoogle Scholar
  4. Iannaccone R, Laghi A, Catalano C, et al. Detection of colorectal lesions: lower-dose multi-detector row helical CT colonography compared with conventional colonoscopy. Radiology 2003;229:775–781.CrossRefPubMedGoogle Scholar
  5. Johnson CD, Toledano AY, Herman BA, et al. Computerized tomographic colonography: performance evaluation in a retrospective multicenter setting. Gastroenterology 2003;125:688–695.CrossRefPubMedGoogle Scholar
  6. Lefere PA, Gryspeerdt SS, Dewyspelaere J, Baekelandt M, Van Holsbeeck BG. Dietary fecal tagging as a cleansing method before CT colonography: initial results polyp detection and patient acceptance. Radiology 2002;224:393–403.CrossRefPubMedGoogle Scholar
  7. Lieberman DA, Weiss DG, Bond JH, Ahnen DJ, Garewal H, Chejec G. Use of colonoscopy to screen asymptomatic adults for colorectal cancer. N Engl J Med 2000;83:162–169.CrossRefGoogle Scholar
  8. Macari M, Berman P, Dicker M, Milano A, Megibow AJ. Usefulness of CT colonography in patients with incomplete colonoscopy. AJR Am J Roentgenol 1999;173:561–564.PubMedGoogle Scholar
  9. Pickhardt PJ, Choi JR, Hwang I, Schindler WR. Nonadenomatous polyps at CT colonography: prevalence, size distribution, and detection rates. Radiology 2004;232:784–790.CrossRefPubMedGoogle Scholar
  10. Pickhardt PJ, Nugent PA et al. Location of adenomas missed by optical colonoscopy. Ann Intern Med 2004;141:352–359.PubMedGoogle Scholar
  11. Rex DK, Cutler CS, Lemmet GT, Rahmani EY, et al. Colonoscopic miss rates of adenomas determined by back-to-back colonoscopies. Gastroenterology 1997;112:24–28.CrossRefPubMedGoogle Scholar
  12. Summers RM, Yao J, Pickhardt PJ, et al. Computed tomographic virtual colonoscopy computer-aided polyp detection in a screening population. Gastroenterology 2005;129:1832–1844.CrossRefPubMedGoogle Scholar
  13. van Gelder RE, Venema HW, Serlie IW, et al. CT colonography at different radiation dose levels: feasibility of dose reduction. Radiology 2002;224:25–33.CrossRefPubMedGoogle Scholar
  14. Zalis ME, Hahn PF. Digital subtraction bowel cleansing in CT colonography. AJR Am J Roentgenol 2001;176:646–648.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Nora A. Royer
    • 1
  • Tracey D. Arnell
    • 2
  • Srinath C. Yeshwant
    • 3
  • Ronald M. Summers
    • 3
  1. 1.Department of SurgeryUniversity of Iowa Hospitals and ClinicsIowa CityUSA
  2. 2.NewYork-Presbyterian Hospital/ColumbiaNew YorkUSA
  3. 3.National Institutes of Health Clinical CenterBethesdaUSA

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