Obama gets virtual colonoscopy, keeps presidential powers

As part of his first annual comprehensive physical exam as chief executive, U.S. President Barack Obama underwent a virtual colonoscopy exam (also known as CT colonography or CTC) that found him free of colorectal polyps or cancer, chief White House physician and Navy Captain Dr. Jeffrey Kuhlman told reporters Sunday.

The virtual colon exam requires no sedation, which allowed the president to resume normal activities immediately following the scan at the National Naval Medical Center in Bethesda, MD.

The choice of VC rather than conventional colonoscopy stands in contrast to that of former President George W. Bush, who famously transferred presidential authority to Vice President Dick Cheney for two hours on July 21, 2007, to undergo optical colonoscopy under monitored anesthesia care.

During that procedure, Bush's physicians removed five polyps, all smaller than 5 mm. These lesions, considered clinically insignificant under the C-RADS criteria used to guide virtual colonoscopy reporting, would have been too small to report had they been found at virtual colonoscopy.

Obama, who is 48 years old, was advised to return in five years for another colon cancer screening exam, Kuhlman said in a statement released on Sunday.

"The fact that President Obama and his medical advisors chose for him to have CT colonography over conventional colonoscopy speaks to the safety and effectiveness of this exam," Dr. Perry Pickhardt, professor of radiology at the University of Wisconsin in Madison, commented in an e-mail to AuntMinnie.com.

Obama's CT images were acquired using 1.5-mm collimation on a 64-detector-row scanner (Brilliance 64, Philips Healthcare, Andover, MA), primary 3D interpretation software (V3D Colon, Viatronix, Stony Brook, NY), and automated CO2 insufflation (ProtoCO2l, Bracco Diagnostics, Princeton, NJ), healthcare personnel familiar with the case told AuntMinnie.com by telephone Monday morning.

The decision to go with virtual colonoscopy was also noteworthy in light of a decision last year by the U.S. Centers for Medicare and Medicaid Services (CMS) to deny Medicare reimbursement for the noninvasive exam.

"The lack of sedation and pain medication allowed the president to maintain control and also avoid the potential for serious complications from colonoscopy," Pickhardt said. "This should serve as a model for his emphasis on preventive medicine -- CMS should also take note of this decision."

In other exam results, the president still uses nicotine gum to avoid smoking, takes anti-inflammatory medication for chronic tendonitis in his left knee, and needs to modify his diet further to lower his cholesterol. However, the results show that Obama is otherwise in excellent health, his physicians concluded.

By Eric Barnes
AuntMinnie.com staff writer
March 1, 2010

Related Reading

Editorial: CMS unfairly held VC to higher standard, February 5, 2010

VC CAD application does well alone and as reader aid, February 15, 2010

VC screening maintains performance in Medicare population, November 9, 2009

MedCAC panel members question VC's effectiveness, November 20, 2008

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