The book Virtual Colonoscopy. A practical guide, P. Lefere and S. Gryspeerdt editors, is now at its second edition. This is the evidence of the success of this manual, which is the perfect starting point for those who would approach Virtual Colonoscopy (VC). And, at the same time, this is the demonstration of the increasing interest for this technique, now replacing barium enema in more and more radiological centers, and the consequent demand for education on this topic.
Thanks to the efforts of the editors, well renowned “Virtual Colonoscopists”, most of the leading experts from all over the world (Europe, USA and Australia) are among the contributors.

The approach is very practical. Following few initial chapters explaining the reasons for performing VC and the performances of this technique derived from literature data, the book emphasizes how to start a VC program and all the steps necessary to perform an optimal examination: bowel preparation, faecal tagging, colon distention, scanning parameters, data interpretation. In this second edition, all chapters have been completely rewritten, because of the fast evolution of the technique. This is especially true for bowel preparation and faecal tagging where the most recently developed “reduced” preparations are explained; or, for example, scanning parameters where the protocols optimized for the new multidetector scanners are presented together with the systems available for dose reduction.

Of particular interest for novices the chapters on image interpretation and pitfalls, the latter a real gem of the book, possible only because of the enormous experience of the Authors.
In this second edition, a new chapter is entirely dedicated to “flat” lesions, always scaring Radiologists interpreting VC examinations. Numerous figures, including correlations between VC and endoscopic and histological images, will help Radiologists to be aware of the presence of this type of lesions and how to recognize them.

Definition, prevalence and economical impact of extra-colonic findings is another “hot topic” extensively discussed in the book, together with quality and consistency of VC reporting.
Looking ahead are the chapters dedicated to Computer-Aided Detection (CAD) and to the use of VC for diseases different from polyps and colo-rectal cancer (i.e., Inflammatory Bowel Diseases).
The book is completed by a pictorial overview of normal anatomy and typical and atypical findings.
In my personal opinion, this book offers a comprehensive and update view of VC and I strongly recommend it to Radiologists or Residents who are willing to start practicing VC.