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 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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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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