The pros and cons of virtual colonoscopies

March 5, 2010 12:00:00 AM PST
When President Obama had his annual check-up this week, it included a screening known as a "virtual colonoscopy." It's a technology that's becoming more common, but the technology has its pros and cons.

Richard Mazze is awaiting the results of a screening for polyps in his colon. But rather than a traditional colonoscopy, doctors at Stanford Hospital used a non-invasive alternative, known as a virtual colonoscopy.

"It's very quick, the regular colonoscopy is much longer," he said.

Instead of using an endoscopic camera, that's typically snaked through the lower digestive tract, the virtual system employs a CT scanner that takes the images from outside the body.

From a control room next door, Dr. Peter Poullos watches as the CT scanner begins feeding back sectional images. The animation is so precise, doctors can scan it visually for polyps or potentially cancerous abnormalities.

"There was a 2008 study, which showed a 90 percent sensitivity for significant lesions," Poullos said.

While traditional colonoscopy is still the gold standard, Poullos points to technological advancements providing increased accuracy over the last several years with virtual colonoscopy.

And for patients like Mazze, at-risk of perforation from the traditional scope; the new technology offers another option.

"It's much more convenient for the patient, no I.V. is required because there's no sedation involved," Poullos said.

But there are downsides: Doctors performing regular colonoscopies can screen and treat during the same procedure and Medicare pays for colorectal screening, but not virtual colonoscopy.

Also, this type of CT scan has the same radiation of about 50 chest X-rays and the procedure isn't completely pain free. Just like a regular colonoscopy, the colon has to be inflated with a small tube, producing some discomfort and patients do have to fast before the procedure.

But patients typically return to normal a few minutes after the exam, compared to the day and a half recovery time with the traditional procedure.

"It was OK, as you said it is no fun getting a colonoscopy. This was relatively more comfortable," Mazze said.

Although the procedure is growing more common, insurance coverage is still spotty. It's typically covered if ordered for diagnostic evaluation, but not always for screening. The price is $2,500, but Stanford Hospital offers a $1,000 cash deduction.


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