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To the Editor: I am concerned that Dr Cotton and colleagues¹ primarily used 2-dimensional images for polyp detection, with only sporadic 3-dimensional correlation. My colleagues and I have found that state-of-the-art 3-dimensional endoluminal virtual colonoscopy (VC) fly-through colonography (with requisite 2-dimensional confirmation) is comparable to conventional colonoscopy for detection of clinically relevant polyps.² The retrospective addition of 3-dimensional endoluminal VC fly-throughs also improved polyp detection for Dr Cotton et al. Furthermore, the software system used for interpretation is critical because of the significant differences that exist in 3-dimensional capabilities.³ Therefore, the fact that the VC fly-through system(s) used in this trial was not reported is an important omission. The lack of oral contrast for tagging residual colonic fluid and stool may have further decreased VC fly-through performance. We have reported that barium and water-soluble contrast are valuable for the purposes of stool tagging and fluid opacification, respectively.^{2, 4} Additional shortcomings include . . . [Full Text of this Article]

Perry J. Pickhardt, MD
ppickhardt@mail.radiology.wisc.edu
Department of Radiology
University of Wisconsin Medical School
Madison

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