Virtual colonoscopy as a new diagnostic tool in cancer colon

Virtual reality imaging is a new technology that combines helical computed tomography and magnetic resonance [MR] data and advanced three-dimensional graphics software to generate endoluminal perspective images of hollow organs. Computed tomography colonography [Virtual colonoscopy] is an imaging procedure in which a series of helical CT scans of the patient's colon are rendered by computer into slices that can be visualized as serially combined images to provide a three-dimentional tour of the colon. So, this technique has been evaluated, mostly conducted in diagnostic [rather than screening] setting in higher-risk patients. In this work, we try to evaluate the sensitivity and accuracy of virtual colonoscopy as a new modality for colorectal evaluation in patients subjected to traditional colonoscopy and double-contrast barium enema study who are diagnosed as having cancer colon and to correlate the findings of virtual colonoscopy with those of conventional colonoscopy and barium study. This work was conducted on twenty [20] patients, selected among 91 patients of different colonic illness admitted in Mansoura and Banha Gastroenterology Centers. They were thirteen [13] males and seven [7] females with age ranging form 49-75 years; mean age [59.5 +/- 8.6] years. All patients were subjected to complete medical history, thorough clinical examination, routine laboratory tests and special laboratory investigations as carcino-embryonic antigen [CEA] and occult blood in stool. Abdominal ultrasonography, barium double-contrast enema, traditional colonoscopy and virtual colonoscopy were done for all patients. Colonoscopic biopsies were obtained as routine in every case in addition to biopsy from any suspected areas or detected masses. Histopathological examination was done also for every sample. From this study, we concluded that CT colonography [Virtual Colonoscopy] is feasible for the detection of colorectal cancer with high success in sizes more than 10mm and further technical advances will improve the performance of CT colonoscopy and will allow patients available imaging modality for full structural examination of the colon

diagnostic value of circulating tumor necrosis factor alpha [TNF-alpha] versus alpha fetoprotein [AFP] in patients with hepatocellular carcinoma

The aim of the present work is to assess the level of serum tumor necrosis factor alpha [TNF-alpha] in patients with hepatocellular carcinoma [HCC] and compare the sensitivity of this marker with conventional used marker, alpha-fetoprotein [AFP]. This study was done on sixty five patients attending the Gastroenterology Surgical Center, Mansoura University. 25 patients with HCC, 20 patients with liver cirrhosis, 20 patients with chronic hepatitis in addition to 15 apparently healthy controls [both patients and controls were age and sex matched]. Serum AFP was estimated by an immunoenzymatic assay. Serum TNF-alpha was assayed by a solid phase enzyme amplified sensitivity immunoassay. Results show that serum AFP and TNF-alpha levels were significantly elevated in hepatocelluar carcinoma, cirrhosis and chronic hepatitis groups in comparison to control group. AFP and TNF-alpha showed no significant difference in cirrhosis group in comparison to chronic hepatitis group. No significant correlation was found between HCC stages and both AFP and TNF-alpha. TNF-alpha had a higher sensitivity [100%] than AFP [80%] and lower specificity [40% for TNF-alpha and 64% for AFP] in patients with HCC. In conclusions, serum TNF-alpha is nonspecific marker as it increases in different and stage of liver diseases. TNF-alpha could be used in association with APF in diagnosis of HCC cases. TNF-alpha has higher sensitivity than AFP, but lower specificity as it was elevated in benign inflammatory diseases. TNF-alpha could be used as a marker for early detection of HCC by following up of its level in patients with cirrhosis and chronic hepatitis

Virtual colonoscopy in ulcerative colitis: a comparative study

Ulcerative colitis [UC] is an inflammatory disease of the colon and rectum. Many investigations are put for diagnosis and follow up of its course and complications. Virtual reality imaging is a new technology that combines helical computed tomography, magnetic resonance [MR] data and advanced three-dimensional graphics software to generate endoluminal perspective images of hollow organs.Computed tomography colonography [Virtual colonoscopy] is an imaging procedure in which a series of helical CT scans of the patient's colon are rendered by computer into slices that can be visualized as serially combined images to provide a three-dimensional tour of the colon. In this work, we try to evaluate the sensitivity and accuracy of virtual colonoscopy as a new modality for colorectal evaluation in patients who had been subjected to traditional colonoscopy and double-contrast barium enema study and who were diagnosed as having a chronic intermittent ulcerative colitis disease and to correlate the findings of virtual colonoscopy with those of conventional colonoscopy and barium study. This work was conducted on eighteen [18] patients admitted to Banha Gastroenterology unit. They were ten [10] males and eight [8] females with age ranging form 19-41 years; mean age [28.1 +/- 11.5] years. All patients were subjected to complete medical history, thorough clinical examination, routine laboratory tests and special laboratory investigations as carcinoembryonic antigen [CEA] and occult blood in stool. Abdominal ultrasonography, barium double-contrast enema, traditional colonoscopy and virtual colonoscopy were clone for all patients. Colonoscopic biopsies were obtained as a routine in every case. In our study, traditional colonoscopy gave positive data in 100.0%, while virtual colonoscopy gave positive results in 61.1% and barium enema gave positivity in 55.6%. Characteristic features of ulcerative colitis were evident on the 2-D images and the 3-D endoluminal and extraluminal images obtained by virtual colonoscope. From this study, we concluded that CT colonography [Virtual Colonoscopy] is a non invasive procedure feasible lor follow up of ulcerative colitis and could be used to monitor the extent of intestinal inflammations as well as possible complications such as malignant changes, strictures or stenosis in most patients. Further technical advances will improve the performance of CT colonoscopy and will allow patients available imaging modality for full structural changes of the colon