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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First, their technology appears to be outdated.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 Since their study was conducted between April 17, 2000, and October 3, 2001, the software was likely outdated compared with that currently available.

Second, quality control was unclear. The authors did not describe the quality of colon preparation or air distension, which are important elements in the overall success of CTC.

Third, it appears that some readers were inexperienced. Several . . . [Full Text of this Article]

Joseph Ferrucci, MD
joseph.ferrucci@BMC.org
Boston University Medical Center
For the Working Group on Virtual Colonoscopy

Matthew Barish, MD
Boston, Mass

Richard Choi, MD
Washington, DC

Abraham Dachman, MD
Chicago, Ill

Helen Fenlon, MD
Dublin, Ireland

Seth Glick, MD
Philadelphia, Pa

Andrea Laghi, MD
Rome, Italy

Michael Macari, MD
New York, NY

Martina Morrin, MD
Boston, Mass

Erik Paulson, MD
Durham, NC

Perry J. Pickhardt, MD
Madison, Wis

Jorge Soto, MD
Boston, Mass

Judy Yee, MD
San Francisco, Calif

Michael Zalis, MD
Boston, Mass

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