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July 28, 2004

Virtual Colonoscopy

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2004;292(4):431-433. doi:10.1001/jama.292.4.431-b

To the Editor: Dr Cotton and colleagues1 reported that computed tomographic colonography (CTC), also known as virtual colonoscopy, had much lower sensitivity for detecting colonic neoplasms than did conventional colonoscopy. We have several concerns about the authors' methods.

First, their technology appears to be outdated. Some of the 9 institutions in the study used thick CT slice collimation (5 mm). This contrasts the current practice standard of 3 mm or less. Thicker slices may degrade anatomic detail, especially of small polyps. Furthermore, the authors did not describe their visualization software. Since their study was conducted between April 17, 2000, and October 3, 2001, the software was likely outdated compared with that currently available.

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