2001 Caldwell Lecture: "Colon cancer
Screen with Virtual Colonoscopy: Promise, Polyps, Politics"
This will be a classic
publication for the emerging field of virtual colonoscopy. Dr.
Ferrucci is the God Father of all four International
Symposia On Virtual Colonoscopy (including the ’03 October
Symposium in Boston). This is a MUST
READ reference piece.
H. Fenlon, et al
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11/11/99 New England Journal Of Medicine
“A Comparison Of
Virtual And Conventional Colonoscopy For The Detection Of Colorectal
Polyps”
One of the three early important comparative studies defining the
early accuracy of virtual colonoscopy. The other two articles are
from USCF (Yee) and Mayo Clinic (Johnson).
Johnson & Dachman
Special Review article in Radiology, August 2000
"CT Colonography: The Next Colon screening Examination?"
Like Ferrucci,
these two authors are also charter members of an elite group of
highly respected academic movers and shakers in the VC field.
A. Dachman
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The first
major textbook by a leading VC authority: "Atlas Of Virtual
Colonoscopy"
The very first
CT textbook by PFJ New became a fundamental reference work in the
70's. This one, published in 2003, will become equally important
on the narrow subject of VC.
Fred Anonymous
Observations By A Colorectal Surgeon
This is quite amusing and really worth listening to.....!
Fred Anonymous II
A grateful patient shares his personal colonoscopic experience
This is a very small segment of a very funny comedy performance covering everything from soup to nuts....
E. G. McFarland et al
Gastrointestinal Section Of Radiology February 2001
"Spiral CT Colonography: Reader Agreement and Diagnostic Performance With Two-and
Three-dimensional Image-Display Techniques"
This article documents good agreement between the two approaches...but the reality in 2003 is that virtually all readers are utilizing 2D MPR and not 3D endoluminal interrogation strategies. We will have much more to say on this subject in the context of what could become a better, faster alternative reading alternative, i.e. SFTO (Straightened Filleted Topographic Overview).
A. K. Hara et al
Radiology May 2001: “CT Colonography:
Single-versus
Multi-Detector Row Imaging”
This early article expresses the advantages of
multi-detector row technology at a time when the multi-detector
systems were just emerging. It is not clear from the article whether
a dual detector or a quad detector (or both) were utilized. The point
is that the early advantages noted may be extended with the 16 slice
systems being widely installed in 2003.
M.H.Svensson et al
Gastrointestinal Imaging Section of Radiology February 2002
"Patient Acceptance of CT Colonography and Conventional Colonoscopy: Prospective
Comparative Study In Patient with or Suspected of Having Colorectal Disease"
Gastrointestinal Imaging Section of Radiology
February 2002 — "Patient Acceptance of CT Colonography and Conventional
Colonoscopy: Prospective Comparative study In Patient with or Suspected
of Having Colorectal Disease"
M. Macari et al
Gastrointestinal Imaging Section Of Radiology August 2002
"Colorectal Neoplasms: Prospective Comparison of Thin-Section Low Dose
Multi-Detector Row CT Colonography and Conventional Colonoscopy
for Detection"
A positive,
early statement on emerging advantages of multi-detector
CT systems, again at a stage well in advance of any installed 16
channel systems.
So things may only get better and more encouraging.
Expert 13 Member Panel
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"Colorectal
Cancer Screening and Surveillance:
Clinical Guidelines and Rationale.
Update Based on New Evidence"
This is an amazing document, with very deep roots
in terms of the consortium of national organizations that sponsored
the first recommendations in 1997 and now this second set of guidelines
released 2/03/03. What is so breathtaking is the lopsided, incomplete
nature of such an important endeavor. Please click on the attached
video discussion to learn what good things this expert panel has
done, and conversely, how incomplete is their collective vision of
how to cure CRC with aggressive internet leveraged virtual colonoscopy
screening capabilities. There is
a disturbing message in what this expert panel has not recognized,
for whatever
reason.
J.M.E. Walsh & J. P. Terdiman
Scientific
Review And Clinical Applications in JAMA March 2003:
"Colorectal cancer Screening" Scientific Review
In the first of two companion articles, the various
colon screening methods are reviewed. The authors note that many
eligible adults who need screening remain unscreened (very large
number) and that even though all men and women aged 50 years or older
need screening, the authors cannot support choosing one screening
test over another but that new approaches "such as virtual colonoscopy
or stool based molecular testing, that have the potential to become
important screening tests in the future". Virtual
colonoscopy is not among the current valid screening approaches according
to this article.
J.M.E. Walsh & J. P. Terdiman
Scientific Review And Clinical Applications in JAMA March 2003:
"Colorectal cancer Screening Clinical Applications"
In the second article, the four recommended screening tests (excluding VC) are discussed, noting that "patients frequently want to know which test is best". The authors conclude that "many potential barriers to colorectal cancer screening exist for the patient and the physician......strategies to increased compliance for colorectal cancer screening are proposed". It is now becoming clear that individual patients and/or their private physicians will have to make these choices.
B. Levin et al
In California:
A Cancer Journal for Clinicians January/February 2003 — "Emerging
Technologies in Screening for Colorectal Cancer — CT Colonography,
Immunochemical Fecal Occult Blood Tests, and Stool screening
Using Molecular
Markers"
The authors note that the American Cancer Society's
(ACS) Colorectal Cancer Advisory Group believes "with the exception
of immunochemical stool testing, the ACS has determined that at this
time there is insufficient evidence to recommend these technologies
for routine colorectal cancer screening". While
VC is a "compelling,
emerging technology that shows considerable promise...it has not
yet been studied in a typical screening population....therefore whether
it has comparable or superior performance compared with conventional
tests is unknown".
B. Sarraille
Failure to screen — The Legal Issues
This is a MUST READ for referring physicians. The author discusses generic risk factors that a malpractice claim must address. When those risk factors are applied to CRC screening (or lack thereof), some rather chilling malpractice exposure realities emerge, for which VERY CAREFUL DOCUMENTATION is mandatory.
G. Wiley
In the Technology Economic Review
section of Decisions In Imaging Economics September 2002 — "A Virtual
Standoff".
This short article shows the extent to which insurance "payors
are taking a wait-and-see approach before reimbursing
for virtual colonoscopy, but there is anticipation, even eagerness,
to the waiting". But for today, there is little evidence for VC
screening reimbursement, and this represents a major hurdle to wide
spread compliance for those at risk.
P. Cram et al
The Impact of a Celebrity Spokesperson on Preventive Health Behavior — The Katie Couric Effect
It is one thing for a highly recognized individual
to promote this or that in the media, for whatever commercial or
humanitarian reasons might apply. But for Katie's colon screening
efforts to have a "statistically significant increase in the use
of colonoscopy in two separate data sets" clearly raises the bar
of worthy achievement.
A. K. Hara et al
From Radiology May 2000 — "Incidental Extracolonic Findings at CT Colonography"
The VC exam reader must not only evaluate the colon, but also treat the numerous images as a non contrast CT study of the abdomen and pelvis, requiring different window width/level settings, and additional time for that review and reporting. The authors document an 11% rate of "highly important extracolonic findings", many of which required more studies.
D.K. Rex
From Gastroenterology August 2003 — "Editorial:
Is Virtual Colonoscopy Ready For Widespread Application?"
Comments
ACS (American Cancer Society)
This is a large document containing extensive information about all types of cancer.
