Comparison of CT virtual endoscopy with electronic colonoscopy in 30 colonic carcinoma patients

Objective: To evaluate the clinical application of CT virtual endoscopy (CTVE) in the diagnosis and treatment of colonic carcinoma. Methods: We collected 30 patients pathologically proven to have colonic carcinomas as examined by CTVE and electronic colonoscopy (EC), correlating the CTVE and EC images respectively with surgical pathology in three aspects: tumor morphological features, degree of circumferential bowel wall involvement and longitudinal extent of tumor. Results: CTVE imaging of colonic carcinomas showed morphological features: polypoid pattern (11 patients), ulcerative pattern (11), and infiltrative pattern (8); degree of circumferential bowel wall involvement: less than 1/2 (4 patients), from 1/2 to 3/4 (6), and more than 3/4 (20); and their longitudinal extent: 1.0-3.0 cm (7 patients), 31-5.0 cm (10), and 5.1-11.0 cm (13). Correlation of CTVE and EC with surgical pathology was found. Comparison of CTVE with surgical pathology showed tumor morphological features: concordant (26 patients), and disconcordant (4); degree of circumferential bowel wall involvement: concordant (25), disconcordant (5); and longitudinal extent of the tumor: concordant (23), disconcordant (7). Comparison of EC with surgical pathology showed tumor morphological features: concordant (22 patients), disconcordant (8); degree of circumferential bowel wall involvement: concordant (28), disconcordant (2); and longitudinal extent of the tumor: concordant (14), disconcordant (3), and undefined by EC (13). Conclusions: The images obtained by CTVE in colonic carcinoma are similar to those obtained by EC. CTVE is an excellent alternative to EC for patients who cannot tolerate EC and for cases with incomplete EC.