Dear AuntMinnie Member,
Virtual colonoscopy may finally be ready for prime time. Preliminary study results presented at last week's American College of Radiology Imaging Network (ACRIN) meeting show the technique achieving a sensitivity that rivals that of optical colonoscopy.
ACRIN researchers enrolled more than 2,500 patients in 15 centers to assess the effectiveness of virtual colonoscopy, an imaging-based technique that proponents believe could be used in place of optical colonoscopy for many screening exams. Virtual colonoscopy is somewhat less invasive and risky than the colonoscopy alternative, according to an article in our Virtual Colonoscopy Digital Community by staff writer Eric Barnes.
But seesawing sensitivity results in smaller multicenter trials over the years led some, particularly gastroenterologists, to question VC's ability to match the optical exam in finding precancerous lesions. Detractors held out the wavering results (which radiologists attributed to lack of training and poor study design) as evidence that VC remained unreliable for detecting clinically significant lesions.
The ACRIN study was designed to address these concerns with a multicenter study design that emphasized current technology and adequate training of the radiologists reviewing the images. The careful preparation paid off, with researchers reporting a per-patient sensitivity of 90% for adenomas 1 cm and larger, and a per-adenoma sensitivity of 84% for polyps 1 cm and larger. Sensitivity was high for medium-sized lesions as well. Click here for details of the study you won't find elsewhere.
What happens next? VC proponents are looking forward to inclusion of VC in colorectal screening guidelines by the American Cancer Society and other organizations that hold the keys to eventual colorectal cancer screening reimbursement by CMS and third-party payors.
The ACRIN results may even spur gastroenterologists to give up their resistance to the technique, and begin buying CT scanners themselves in an effort to retain control of colon screening. VC proponents may have won a battle, but the war is far from over.
Get the rest of the details, as well as a new article on VC computer-aided detection, in our Virtual Colonoscopy Digital Community, at vc.auntminnie.com.
