Flat Colorectal Lesions in Asymptomatic Adults:Implications for Screening with CT Virtual Colonoscopy

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Abstract
OBJECTIVE. The clinical significance of flat lesions in colorectal cancer screening remains uncertain. The purpose of this study was to investigate the frequency, histology, and virtual colonoscopy detection of flat lesions in an asymptomatic screening population.SUBJECTS AND METHODS. The morphology of all detected polyps was prospectively recorded as flat or polypoid (sessile or pedunculated) in 1,233 consecutive asymptomatic adults who underwent same-day virtual colonoscopy and optical colonoscopy. A flat morphology was defined as a shallow plaquelike broad-based lesion with a height of less than one half of its width.RESULTS. Of 344 polyps of 6 mm or greater confirmed at optical colonoscopy, 17 (4.9%) were labeled as flat at both virtual colonoscopy and optical colonoscopy; 17 (4.9%), at optical colonoscopy only; and 25 (7.3%), at virtual colonoscopy only, yielding 59 total lesions in 52 (4.2%) of 1,233 patients. Twenty-nine (49.2%) of 59 flat lesions were adenomatous, of which four measured 10 mm or g...