Dear AuntMinnie Insider,
Most large-scale virtual colonoscopy screening programs are set up in academic centers, where researchers often benefit from the latest equipment, generous staffing levels, and teams of statisticians to compile the data. Unfortunately, the results of these groups' painstaking efforts can be subject to criticism that their work isn't representative of "real world" constraints that can be expected as virtual colonoscopy expands to the community setting.
Now comes evidence that a high-volume VC practice can be quite successful in a nonacademic setting. Dr. Danielle Hock and colleagues in Belgium have screened nearly 5,000 patients, generating impressive results after rolling over a few bumps in the road. Of course, steady reimbursement at the level of an abdominal CT hasn't hurt. Find out how they did it in this issue's Insider Exclusive story.
Also in your Virtual Colonoscopy Digital Community, a new report from the Agency for Healthcare Research and Quality reminds us that most Americans forego colonoscopy screening, and offers some interesting details on the ethnicity of those who avoid the conventional exam.
Meanwhile, a pair of new studies has reopened the debate over 2D versus primary 3D reading of VC results. Find out what the researchers found (and what they still don't know) here.
From the recent RSNA meeting in Chicago, Italian researchers are doing well with a minimal-prep VC program for the elderly. And from a story by staff writer Erik L. Ridley, examining regions or "patches" of interest has improved the sensitivity of VC computer-aided detection (CAD) results beyond what was achieved when the algorithm picked the most important findings. Another CAD scheme actually beat the human readers.
Meanwhile, a study from Minnesota found that elevated glucose and insulin levels raised the risk of polyp recurrence. Similarly, fasting insulin levels were higher in patients with colorectal adenomas, Italian researchers reported. It's food for thought in this season of culinary excess. May your holidays be happy and low in sugar.
![Axial images from unenhanced calcium score cardiac CT (left) and curved planar reformation images from CT angiography (right) show that higher long-term exposure to air pollution is associated with greater coronary artery calcium and more obstructive coronary artery disease (CAD). Top row: Images in a 68-year-old male patient with higher 10-year mean ambient air pollution exposure (7.9 μg/m3 for particulate matter measuring ≤2.5 μm in diameter [PM2.5] and 17.4 parts per billion [ppb] for NO2) with extensive CAD (coronary artery calcium score [CACS] >1,000 and obstructive CAD [≥70% diameter stenosis]). Bottom row: Images in a 57-year-old female patient with lower 10-year mean ambient air pollution exposure (6.3 μg/m3 for PM2.5 and 4.6 ppb for NO2) with no CAD (CACS = 0 and no obstructive stenosis).](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/06/hanneman.r6SMLzkezo.png?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
