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November 8, 2009
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Colonoscopy (cont.)

Virtual Colonoscopy

Another alternative to colonoscopy is virtual colonoscopy. Virtual colonoscopy is a technique that uses a CAT scan to construct virtual images of the colon that are similar to the views of the colon obtained by direct observation through optical colonoscopy. 

In preparation for the virtual colonoscopy, the day before the examination, the colon is cleaned-out using laxatives. During the examination a tube is inserted into the anus and is used to inject air into the colon. The CT scans then are performed, and the scans are analyzed and manipulated to form a virtual image of the colon. When properly performed, virtual colonoscopy can be effective. It can even find polyps "hiding" behind folds that occasionally are missed by colonoscopy. 

Nevertheless, virtual colonoscopy has several limitations.

  • Virtual colonoscopy cannot find small polyps (less than 5mm in size) that are easily seen at colonoscopy.
  • Virtual colonoscopy is not as accurate as colonoscopy at finding flat cancers or premalignant lesions that are not protruding, that is, are not polyp-like.
  • Virtual colonoscopy cannot remove polyps. Thirty to forty percent of people have colon polyps. If polyps are found by virtual colonoscopy, then colonoscopy must be done to remove the polyps, therefore, many individuals having virtual colonoscopy will have to undergo a second procedure, colonoscopy. 

Because of these limitations, virtual colonoscopy has not replaced colonoscopy as the primary screening tool for individuals at normal or high risk for polyps or colon cancer. It is currently a good option for individuals who cannot or will not undergo colonoscopy

Final Word

You have been given this information so you would be knowledgeable about colonoscopy. If you have further questions about the need for the procedure, alternative methods, the cost of the procedure and whether covered by your insurance, do not hesitate to speak to your doctor or his/her staff. Most endoscopists are highly trained specialists and welcome your questions regarding their training, credentials, or any other questions you might have.


Last Editorial Review: 5/17/2005


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