Virtual Colonoscopy - Fremont CA
CT colonography is an advanced type of x-ray exam that uses computed tomography (CT or “CAT”) scanning to obtain an interior view of the colon (the large intestine) that can ordinarily only be seen with an endoscope inserted into the rectum. This new minimally invasive test provides three-dimensional images that can depict many polyps and other lesions as clearly as when they are directly seen by optical colonoscopy.
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Polyps are growths on the lining of the colon that can mutate and grow into a cancerous tumor mass. By the time one notices blood in the fecal stool or changes in the in bowel movements, or experiences of pain, colon cancer may have spread outside the intestine to other organs. At that point, the disease may be untreatable.
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Virtual Colonoscopy vs. Standard Colonoscopy
A standard colonoscopy requires about 45 minutes for the procedure and up to an hour for recovery. Typically a sedative is given, so the patient must have someone drive them home, and the patient likely will miss an entire day of work.
Virtual colonography is a test with about 5 minutes of discomfort and a half hour of recovery. The patient could return to work after the test.
Virtual colonoscopy can also detect abnormalities located outside of the colon in which traditional colonoscopy cannot image.
Advantages of Virtual Colonoscopy
- Less invasive than traditional colonoscopy
- Decreased risk of perforating the colon
- Ability to show abnormalities outside the colon, which would otherwise be missed
- No sedation
- Provides clearer, more detailed images than a conventional Barium Enema x-ray examination
- Ideal for patients with an increased risk of complications or elderly patients who cannot tolerate a colonoscopy
- Helpful when colonoscopy cannot be completed when the bowel is too narrow or obstructed
Current Role of Virtual Colonoscopy
Currently there are several clinical situations in which virtual colonoscopy may play an important role in the evaluation of patients' colons.
- These include evaluation of the colon after an incomplete conventional colonoscopic examination or evaluation of the colon near an obstructing growth.
- Another potential use for virtual colonoscopy is evaluation of the colon in patients who are clinically unfit for conventional colonoscopy, such as those with chronic obstructive pulmonary disease, patients with a bleeding disorder or those on coumadin, and patients who have previously had an allergic reaction to sedation.
- Finally, in the future, virtual colonoscopy may contribute to colorectal screening by providing a safe, effective, and rapid examination that evaluates the entire colon.
Failed Colonoscopy
An incomplete colonoscopy examination may occur in up to 5-10% of cases and may be due to patient discomfort, a colon with many twists, postoperative adhesions, or hernias. Traditionally, double-contrast barium enema has been used to evaluate the colon in these situations. However, after an incomplete colonoscopy, a double-contrast barium enema may be difficult to perform because of air blockage from gas remaining from the recently performed colonoscopy. In addition, fluid left from a polyethylene glycol preparation may prevent optimal coating of the colon wall with barium.
Two studies have demonstrated the usefulness of virtual colonoscopy after an incomplete traditional colonoscopy. In one of these studies, virtual colonoscopy was better able to evaluate the colon than was a barium enema. A virtual colonoscopy performed on the same day as an incomplete colonoscopy takes advantage of the single bowel preparation and the fact that the colon is often well distended with gas from the previous colonoscopy, thus requiring only a small amount of additional gas to be pumped in. In this situation, the virtual colonoscopy is clearly better tolerated than a double-contrast barium enema.
FREQUENTLY ASKED QUESTIONS
What Happens During a Virtual Colonoscopy?
First, a radiology technologist inserts a tube into your rectum and air is pumped into the colon until it is fully distended. Then you are asked to hold your breath while lying on your back and a CT scan is performed. You then turn over onto your stomach and again hold your breath while a second CT scan of the abdomen and pelvis is performed.
What Happens After the Test?
If the radiologist finds any polyps, they will refer you to a Gastroenterologist to have a standard colonoscopy in order to either biopsy or remove the polyps. Polyp locations will be mapped out and your physician will only need to go in directly to biopsy or remove.
Is Virtual Colonoscopy an Accurate Test?
One recent study using special methodology found that Virtual Colonoscopy was able to detect colon polyps as well as regular colonoscopy. In addition, Virtual Colonoscopy can detect abnormalities outside the colon.
RELATED ARTICLES
American Cancer Society
 Software Improves Accuracy of Virtual Colonoscopy
National Institutes of Health, December 1, 2005
Computer-Aided Polyp Detection Software in Combination with Virtual Colonoscopy is as Effective as Traditional Optical Colonoscopy
National Cancer Institute, December 8, 2003
Virtual Colonoscopy An Effective Screening Alternative for Colorectal Cancer
Is it Paid for by Insurance?
Virtual Colonoscopy as a screening method is not currently covered by Medicare. However, some private insurance companies are covering this exam for patients with failed or incomplete traditional Colonoscopies. It is recommended that you contact your insurance carrier to verify this coverage.
How Often Should Virtual Colonoscopy be Repeated?
No one knows the answer to this question. In order to be cost-effective, it should be performed no more often than the interval recommended for regular colonoscopy, which is every 10 years.
Are There Risks to Virtual Colonoscopy?
The risk of perforation or making a hole in the colon from Virtual Colonoscopy is probably very low. One risk that has not been fully evaluated is radiation exposure. The effect of radiation will be difficult to estimate until the intervals for performing Virtual Colonoscopy are determined.
Common Symptoms of Colorectal Cancer
- Change in bowel habits
- Diarrhea, constipation, or feeling that the bowel does not empty completely
- Blood (either bright red or very dark) in the fecal stool
- Fecal stools that is narrower than usual
- General abdominal discomfort (frequent gas pains, bloating, fullness, and/or cramps)
- Weight loss with no known reason
- Constant fatigue
- Nausea and vomiting
InView Imaging offers payment plan options for this procedure. Please contact us for pricing information at (510) 490-0961
Preparing for Your Virtual Colonoscopy
Please follow instructions carefully.
Obtain two (2) 1 1/2 fl. oz. Bottles of Fleet Phospho-soda (Ginger-Lemon flavor or unflavored) at any pharmacy.
Day Before the Exam:
You may have a clear liquid breakfast. Clear liquids include: water, tea, coffee (no milk), strained fruit juice. Do not eat any solid food throughout the day.
Between 11am and 1pm, eat a clear liquid lunch (ex- broth, jello, or popsicle).
Between 2pm and 5pm, drink the first bottle Fleet Phospho-soda (1 1/2 fluid ounces or 3 tbsp) mixed in a half glass (4 oz) of water. This should be followed by drinking an additional 3 or 4 glasses of plain water. Five hours after drinking the first Fleet Phospho soda (i.e. between 7pm and 10pm) drink the second bottle Fleet Phospho-soda (1 1/2 ounces or 3 tbsp) mixed in a half glass (4 oz) of water. The solution will cause you to have repeated loose stools (diarrhea), which is the expected result. It typically works within 30 minutes but may take as long as 3 hours to have an effect. During the remainder of the evening you may drink clear liquids if desired but do not eat solid foods until the procedure is completed the following day. Do not exceed the recommended Fleet Phospho-soda dosage as serious side-effects may occur.
Morning of Exam:
You should take your regular medications with water, unless otherwise instructed by your physician. If you have an afternoon procedure, you may have clear liquids until 10am (If you are diabetic, take 1/2 your usual dose) of insulin on the morning of the procedure. If you take a "diabetes pill" you may skip it on the morning of the procedure unless instructed otherwise. If you have any other questions regarding your medications please call your primary care physician.
 Download and print the Inview Virtual Colonoscopy Patient Brochure
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