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05/03/09   |   By

Cancer Society Approves Virtual Colonoscopy | DC Metro Area Medical Malpractice Law Blog

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By Victor E. Long, Esq.

According to Washington Post  the American Cancer Society, finds Virtual Colonoscopy  to be effective at finding large polyps.  Virtual colonoscopy is a procedure used to look for signs of pre-cancerous growths, called polyps; cancer; and other diseases of the large intestine. Images of the large intestine are taken using computerized tomography (CT) or, less often, magnetic resonance imaging (MRI). A computer puts the images together to create an animated, three-dimensional view of the inside of the large intestine.

Invented 16 years ago by a radiologist who got the idea while playing video games on a flight simulator during advanced training at Johns Hopkins, virtual colonoscopy has become an increasingly popular.  However, Medicare has tentatively decided not to pay for virtual colonoscopies.

The benefits and risks of the procedure have been identified as follows:

Benefits

  • This new minimally invasive test provides three-dimensional images that can depict many polyps and other lesions as clearly as when they are directly seen by optical colonoscopy.
  • CT colonography has a markedly lower risk of perforating the colon than conventional colonoscopy. Most of those examined do not have polyps, and can be spared having to undergo a full colonoscopy.
  • CT colonography is an excellent alternative for patients who have clinical factors that increase the risk of complications from colonoscopy, such as treatment with a blood thinner or a severe breathing problem.
  • Elderly patients, especially those who are frail or ill, will tolerate CT colonography better than conventional colonoscopy.
  • CT colonography can be helpful when colonoscopy cannot be completed because the bowel is narrowed or obstructed for any reason, such as by a large tumor.
  • If conventional colonoscopy cannot reach the full length of the colon—which occurs up to 10 percent of the time—CT colonography can be performed on the same day because the colon has already been cleansed.
  • CT colonography provides clearer and more detailed images than does a conventional barium enema x-ray examination.
  • CT colonography is tolerated well. Sedation and pain-relievers are not needed, so there is no recovery period.
  • CT colonography is less costly than colonoscopy.
  • No radiation remains in a patient’s body after a CT examination.
  • X-rays used in CT scans usually have no side effects.

Risks

  • There is a very small risk that inflating the colon with air could injure or perforate the bowel. This has been estimated to happen in fewer than one in 2,000 patients.
  • There is always a slight chance of cancer from excessive exposure to radiation. However, the benefit of an accurate diagnosis far outweighs the risk.
  • The effective radiation dose from this procedure is about 5 mSv, which is about the same as the average person receives from background radiation in 20 months.
  • Women should always inform their physician and x-ray or CT technologist if there is any possibility that they are pregnant.
  • CT scanning is, in general, not recommended for pregnant women unless medically necessary because of potential risk to the baby.
Regan Zambri Long
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