Colon cancer prevention goes virtual using low radiation electron beam tomography

Denver 18 March 2002A Southern California disease prevention centre has introduced a new colon cancer screening test that may someday replace the dreaded colonoscopy. Two of the United States' top experts in preventive imaging, Dr. Michael Wright of San Diego, California, and Dr. James Ehrlich of Denver, Colorado, are touting the use of the FDA-approved "ultrafast", low radiation electron beam tomography (EBT) combined with advanced workstations to visualise the large intestine simply, safely, and non-invasively.


The new virtual colonoscopy screening test has been introduced by LifeScore Disease Prevention Center of La Jolla, California, as part of its ColonScore programme for the early detection and prevention of colon cancer. Dr. Wright and Dr. Ehrlich operate imaging centres that offer the new technology, which they say will pave the way for more effectively dealing with one of the nation's deadliest, yet most preventable, forms of cancer.

Less than 30 percent of "at risk" Americans are getting any type of colon screening while colon cancer is the second leading cause of cancer death in the United States. In 2002, 130.000 new cases of colorectal cancer will be diagnosed. Men and women are at equal risk and 90 percent of colon cancers occur over age 50.

Traditional colonoscopy is unpleasant and embarrassing. Each year, hundreds of thousands avoid the colon cancer screening test. This year, about 50.000 people will succumb to a disease that has more than a 90 percent cure rate if detected early. "Early detection is the key to prevention, and ColonScore's high-speed virtual colonoscopy makes that possible", stated Dr. Michael Wright, president and chief medical officer of LifeScore. "Our virtual colonoscopy is a less threatening, non-invasive alternative to colonoscopy, which is the current gold standard for colon cancer prevention."

LifeScore of San Diego recently started offering the virtual colonoscopy procedure. Dr. Wright is associate professor in the Preventive Medicine Department at San Diego State University and clinical instructor in the Department of Family and Preventive Medicine at the University of California, San Diego. He believes strongly in the value of this virtual alternative and predicts that insurance companies will eventually cover the procedure under the same guidelines they cover traditional colonoscopy, which is actually more expensive.

In recent studies, appeared in Radiology, Vol. 219, pp. 685-692, 2001, virtual colonoscopy has been shown to detect 91 percent of the polyps that were detected by conventional colonoscopy, a degree of sensitivity considered to be excellent for a screening procedure. "Studies show that about 130.000 new cases of colon or rectal cancer will be diagnosed in 2002 and 56.000 people will die", noted Dr. Wright. "Most of those deaths are preventable, but men and women hate the current colonoscopy procedure, so they avoid the test but not the consequences."

The ColonScore scan requires only a light preparation, and is performed using an innovative Electron Beam CT scanner. No sedation or laxatives are required, and the individual can immediately resume normal activities when the scan is concluded. The procedure is safe without any risk of bowel perforation and very low radiation for the patient. It is also complete: a doctor can see 100 percent of the colon, looking for polyps and other abnormalities, because of the ability to navigate in both directions and the caecum can always be reached.

Unlike many other centres that will soon be offering a similar scan, LifeScore is using a breakthrough enhancement technology from TeraRecon of San Mateo. It makes possible an immediate, 3D, real time "fly-through" review of the colon. This means the physician can be thoroughly reviewing a patient's exam even while the patient is getting dressed.

"Traditional colonoscopy has been a failure of acceptance", added Dr. Ehrlich, medical director and founder of Colorado Heart and Body Imaging in Denver. "It is an important preventive procedure that, tragically, attracts too few people nationwide." In addition to Colorado Heart and Body Imaging in Denver, Dr. Ehrlich serves as medical co-director of similar facilities in Houston and Washington D.C. and performs consulting at imaging centres, both in the United States and in Europe. He is working closely with gastro-enterologists to get more people screened.

Both Dr. Wright and Dr. Ehrlich readily admit that there are circumstances when it is preferable for individuals to undergo traditional colonoscopy: a history of repeated polyps that need to be excised is a prime example. Patients need to be aware that conventional optical colonoscopy offers the capability of immediate excision of discovered polyps, an advantage which its virtual "cousin" cannot claim. Yet, the fact remains that hundreds of thousands of people still avoid screening altogether. Both doctors believe that offering patients the option of a far more agreeable examination represents a tremendous advance and should save lives.

Founded in October 1999, LifeScore is a preventive medicine and imaging company, and has served more than 8000 clients from around the world. LifeScore offers comprehensive, preventive health care management which encompasses full-body diagnostic imaging, lab tests, lifestyle evaluation, lifestyle modification, and periodic re-evaluations. LifeScore's mission is to enhance the quality and length of life through early disease detection and programmes for prevention.

Founded in 1997, Colorado Heart and Body Imaging (CHBI) is a comprehensive, preventive screening centre. It offers lung, heart, colon, total body and bone density imaging for early detection of coronary disease and cancer as well as non-imaging based services and consultation. CHBI uses FDA-approved electron beam tomography (EBT), with its extra-ordinarily fast acquisition speeds. Unlike slower and higher radiation helical mechanical equipment, EBT's usefulness for coronary imaging and cardiac risk assessment has been validated extensively in cardiology literature. CHBI is associated with Colorado Imaging Associates P.C., a group of board certified radiologists serving the Denver area since 1957, with extensive experience and training in all areas of diagnostic imaging.

More news on colon cancer screening and diagnosing methods is available in this VMW issue's articles:

Leslie Versweyveld

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