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CT Colonography Screening Gets Qualified Yes

September 13, 2013
Written by: , Filed in: Abdominal Imaging, Gastrointestinal Imaging
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“FDA Panel Reaffirms Role of CT Colonography,” says the headline on an American College of Radiology news release from Wednesday. Well, sort of.

David Pittman, the Washington correspondent for MedPage Today, painted a more nuanced picture with his Monday story, which began:

An FDA advisory panel generally backed greater use of CT colonography in screening asymptomatic patients for colon cancer but did question certain aspects of the test.

The Food and Drug Administration’s Gastroenterology-Urology Panel and Radiological Devices Panel met jointly on Monday. Both are part of the FDA’s Medical Devices Advisory Committee. Congress had required the meeting in its reauthorization bill for the FDA’s user fee.

The panels took no formal vote. However, according to the FDA, the presentations made at the meeting “will assist FDA’s consideration of evolving research on this topic and inform the Agency’s continuing regulation of these devices.”

In general, the panels discussed whether CT colonography, also known as virtual colonoscopy, could be used instead of conventional colonoscopy. The U.S. Preventive Services Task Force in 2008 determined that “the evidence is insufficient to assess the benefits and harms of computed tomographic colonography and fecal DNA testing as screening modalities for colorectal cancer.” Medicare has declined to cover CT colonography for such screening because studies have indicated that it is less sensitive for smaller lesions and because a positive test requires confirmation from a conventional colonoscopy.

Panelists at Monday’s meeting did mention concerns about detection of smaller polyps and “flat” or serrated polyps. Others said CT colonography would be useful for patients who should not be or prefer not to be sedated or who are on anticoagulants. Panelists agreed that the radiation exposure was not a significant problem.

For all of the juicy, or dry, details, you can read the FDA’s summary of the meeting by clicking here.

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A New Zealand radiation technologist who exposed a 15-year-old patient to excess radiation and failed to report the incident has been awarded $3,000 (about $2,444 in U.S. dollars) for being fired unjustly. For details, see our Facebook page.

Related CME seminar (up to 11.25 AMA PRA Category 1 credits™): UCSF Abdominal & Pelvic Imaging: CT/MR/US


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