Virtual colonoscopy and teleradiology bring colorectal cancer screening to patients in rural areas

Computed tomography colonography (CTC) -- otherwise known as virtual colonoscopy -- is feasible in remote health centers where optimal colonoscopy is limited, according to a study in the November issue of the American Journal of Roentgenology.

The study was performed at Fort Defiance Indian Hospital in Fort Defiance, AZ, and Tuba City Regional Health Care Center in Tuba City, AZ, both of which are rural medical centers serving Native American, mainly Navajo, populations. After brief on-site instruction, including performing a CTC examination on a volunteer to train the CT technologists, both sites began performing CTC.

"A total of 321 studies were transferred to the University of Arizona Hospital for assessment, with reports returned via a teleradiology information system. Overall image quality assessment of stool, fluid and distention revealed that about 92 percent of patients had diagnostic quality examinations with respect to each image quality parameter," said Arnold C. Friedman, MD, lead author of the study.

"Optical colonoscopy in many rural areas is limited. Availability of CTC permits access to a robust method of colorectal screening for rural patients," said Friedman.

"Our results show that CTC can be introduced with minimal effort to rural undeserved communities, adequately performed locally, and then interpreted remotely. However, important aspects of implementation should include technologist training, referring physician education, careful attention to image transmission and clearly defined methods of communication with patients and referring providers," he said.