The comparison of virtual and endoscopic colonoscopy in detection of colorectal malignancies and colonic polyps
DOI:
https://doi.org/10.5281/zenodo.19242255Keywords:
Virtual colonoscopy, Computed tomography, Conventional colonoscopy, colorectal polypAbstract
Aim: The purpose is to show the importance of the virtual colonoscopy in the colorectal lesion imaging technique with the aid of the corelation with the conventional colonoscopy results.
Materia land Method: Over a period of approximately two years, a total of 54 patients with clinically suspected or presenting colorectal lesions underwent virtual colonoscopy on the same day as conventional colonoscopy.
We inserted a foley catheter and insufflated the colon with air to the maximal level the patient could tolerate. After that helical CT imaging of the abdomen and pelvis was performed. In order to minimize the radiation dose, only views are in the prone position are acquired. Then, these images are assessed in another machine, which is capable of 3D reconstruction, using the axial, 2D reformat and endoluminal imaging techniques. Spiral CT colonography results are compared with the results of conventional colonoscopy.
Results: Conventional colonoscopy could have been completed in 51 of 54 patients (%94.4). The 3 patients with uncompleted colonoscopy have colon cancer. 3 of the 54 patients are found to be normal in both techniques. With the conventional technique a total of 45 polyps and 19 colon cancer are diagnosed. 19 of 45 polyps are between 1-5 mm, 13 of them are between 6-9 mm and 13 of them are 10 mm or above. The sensitivity of virtual colonoscopy disregarding the dimension for all the polyps is 66.6%. Sensitivity is 84.6% for polyps larger than 10 mm, 76.9% for polyps between 6-9 mm and 47.3% for polyps between 1-5 mm. All of the 19 adenocancer could have been diagnosed in virtual colonoscopy.
Conclusion Since virtual colonoscopy has high sensitivity for diagnosis of colorectal cancer and polyps greater than 1 cm, it can be a good alternative to colorectal scan techniques. However, to be able to use spiral CT colonography as a scaning technique, its diagnosal effectiveness should be assesed for the groups having an average risk of colorectal cancer.
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