vjc's Journal: CT colonoscopy

The April 2004 issue of JAMA had an article on CT Colonoscopy. http://radiology.rsnajnls.org/cgi/content/full/216/2/331/

Brief Summary.
Objective:Compare CT colonoscopy to endoscopic colonoscopy.
Design A nonrandomized, evaluator-blinded, noninferiority study design of 615 participants.
Results CT Colonoscopy Sensitivity for lesions > 6 mm was 39.0% and > 10 mm was 55%
conventional colonoscopy sensitivity was 99.0%
Specificity of CT Colonoscopy was 90.5% Specificity of Endoscopic colonoscopy was 100%.

Citation: Cotton PB, Durkalski VL, Pineau BC, et al. Computed tomographic colonography (virtual colonoscopy): a multicenter comparison with standard colonoscopy for detection of colorectal neoplasia. JAMA. 2004;291:1713-9

This articles was initially reviewed by the ACP Journal Club. We would like to open up the discussion to the Radiology and Medical community at large!!

CT colonoscopy vs. Barium Enema

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An earlier, smaller study of CT colonoscopy showed a higher sensitivity of 82% for lesions >6mm (Fenlon et. al 1999). Similar wide ranges of sensitivity are reported for Barium enemas. Perhaps CT colonoscopy should be compared to BE when there is an incomplete colonoscopy or colonoscopy is unavailable or undesired.