Consensus on current clinical practice of virtual colonoscopy

OBJECTIVE. The purpose of our study was to determine the current opinions regarding the performance, interpretation, reporting, and clinical role of virtual colonoscopy among a group of selected experts to develop a consensus statement. MATERIALS AND METHODS. A questionnaire was sent to 33 selected experts in virtual colonoscopy. Responses were tabulated and results were used to develop a consensus statement. The results of the questionnaire and consensus statement were sent to respondents for comment and approval. RESULTS. Thirty-one (93.9%) of 33 surveys were returned. Eighty-seven percent (27/31) of respondents believe virtual colonoscopy is a credible screening method. Oral sodium phosphate solution is the laxative preferred by more than 66% (18/27), whereas 62% (13/21) do not believe fecal tagging is necessary. All respondents (25/25) think that both prone and supine imaging is required, with most (81%, 21/26) believing IV contrast material is not necessary. The routine use of spasmolytics is suggested by only 15% (4/26). The largest acceptable slice thickness of 3 mm is agreed on by 88% (22/25). All respondents believe screening virtual colonoscopy should be performed at a lower dose per slice than conventional CT. Most (80%, 20/25) believe the optimum method of interpreting virtual colonoscopy should be primary axial review, with 3D used for problem solving. All but one respondent (96%, 26/27) agree there is a threshold size below which polyps are not clinically important. When reporting virtual colonoscopy results, 59% (16/27) believe polyps less than 4 mm need not be reported. CONCLUSION. A consensus is developing among experts as to the appropriate manner in which virtual colonoscopy should be performed, interpreted, and reported.