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A virtual trip through your colon

by Dr. Randy

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A high-tech solution to the ignominious rite of colonoscopy may provide an alternative for those health care consumers who are concerned about screening for colon cancer but squeamish about the test. Researchers in the multicenter study published their findings this week in the New England Journal of Medicine. They demonstrated that a virtual trip through the colon using a specialized 3D CT scanner can provide even better detection of polyps (a cancer precursor) and colon cancer than the standard colonoscopy. This is an amazing technology that allows doctors to view a virtual computerized tour of the colon. Once this technology is perfected it can eliminate some other potentially dangerous procedures also such as bronchoscopy (looking into the airways in the lungs), and enable similar virtual tours of the esophagus, stomach, and bladder.

The new test sounds attractive, and relatively painless. Colon cleansing and inflation of the colon are still necessary, but the new test eliminates the sedation, discomfort during the procedure, the dangers of bowel perforation, and the recovery period following a traditional colonoscopy. But before you run out to get the new virtual colonoscopy consider some other issues. A CT scan involves a significant amount of x-ray radiation exposure. If polyps are found on the CT scan, then a follow-up traditional colonoscopy will be required to remove them, which then involves a second procedure and double the expense. The new virtual colonoscopy may not be covered by insurance providers (cost approximately $2,000). During an optical colonoscopy relatively small polyps are routinely removed for biopsy. So if a CT scan is performed, then a surgeon must decide if removal of the polyps is necessary. Polyps grow very slowly and most are benign. The test is probably not yet available at your local medical center, but it will be soon. Now if they could do this with an MRI and eliminate the x-ray exposure…

Computed Tomographic Virtual Colonoscopy to Screen for Colorectal Neoplasia in Asymptomatic Adults. Perry J. Pickhardt, M.D., J. Richard Choi, Sc.D., M.D., Inku Hwang, M.D., James A. Butler, M.D., Michael L. Puckett, M.D., Hans A. Hildebrandt, M.D., Roy K. Wong, M.D., Pamela A. Nugent, M.D., Pauline A. Mysliwiec, M.D., M.P.H., and William R. Schindler, D.O. New England Journal of Medicine 2003; 349:2191-2200.

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