Su2011 Magnetic Resonance Enterography, Small-Bowel Contrast Ultrasonography and Capsule Endoscopy to Evaluate Small Bowel in Pediatric Crohn's Disease: A Prospective, Blinded, Comparison Trial

IntroductionCrohn’s disease diagnosis and monitoring remains a great clinical challenge and often requires multiple testing modalities. Assessing Crohn’s disease activity in the entire gastrointestinal (GI) tract using a panenteric capsule endoscopy (CE) system could be used as an alternative to colonoscopy and cross-sectional imaging. This study assessed the accuracy and safety of panenteric CE in Crohn’s disease as compared with ileocolonoscopy (IC) and/or magnetic resonance enterography (MRE).MethodsA prospective, multicentre study was performed in subjects with established Crohn’s disease. Individuals with proven small bowel patency underwent a standardised bowel preparation, followed by CE ingestion and IC either the same or following day. MRE, IC, and CE interpretations were performed by blinded central readers using validated scoring systems. The primary endpoint was the overall sensitivity of CE vs MRE and/or IC in Crohn’s disease subjects.ResultsStudy enrolment included 158 subjects from 21 sites in the USA, Austria, and Israel. Of those, 99 were included in the analysis. Imaging modality scores indicated none to mild inflammation in the proximal small bowel and colon, but discrepant levels of inflammation in the terminal ileum. Overall sensitivity for active enteric inflammation (CE vs MRE and/or IC) was 94% vs 100% (p=0.125) and specificity was 74% vs 22% (p=0.001). Sensitivity of CE was superior to MRE for enteric inflammation in the proximal small bowel (97% vs 71%, p=0.021), and similar to MRE and/or IC in the terminal ileum and colon (p=0.500–0.625). There were seven serious adverse advents of which three were related to the CE device.ConclusionPanenteric CE is a reliable tool for assessing Crohn’s disease mucosal activity and extent compared with more invasive methods. This study demonstrates high performance of the panenteric CE as compared to MRE and/or IC without the need for multiple tests in non-stricturing Crohn’s disease.Trial registration numberClinicalTrials.gov NCT03241368

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P160 Diagnostic yield of capsule endoscopy versus magnetic resonance enterography and small bowel contrast ultrasound for evaluation of small bowel Crohn's disease: a systematic review and meta-analysis

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjx002.286 ◽

2017 ◽

Vol 11 (suppl_1) ◽

pp. S158-S159

Author(s):

U. Kopylov ◽

D. Young ◽

T. Engel ◽

S. Vijayan ◽

O. Har-Noy ◽

...

Keyword(s):

Systematic Review ◽

Crohn’S Disease ◽

Magnetic Resonance ◽

Small Bowel ◽

Crohn's Disease ◽

Capsule Endoscopy ◽

Diagnostic Yield ◽

Meta Analysis ◽

Magnetic Resonance Enterography ◽

Contrast Ultrasound

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Magnetic resonance enterography versus capsule endoscopy activity indices for quantification of small bowel inflammation in Crohn’s disease

Therapeutic Advances in Gastroenterology ◽

10.1177/1756283x16649143 ◽

2016 ◽

Vol 9 (5) ◽

pp. 655-663 ◽

Cited By ~ 25

Author(s):

Uri Kopylov ◽

Eyal Klang ◽

Doron Yablecovitch ◽

Adi Lahat ◽

Benjamin Avidan ◽

...

Keyword(s):

Crohn’S Disease ◽

Magnetic Resonance ◽

Small Bowel ◽

Crohn's Disease ◽

Capsule Endoscopy ◽

Magnetic Resonance Enterography ◽

Activity Indices

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Capsule Endoscopy Complements Magnetic Resonance Enterography and Endoscopy in Evaluating Small Bowel Crohn’s Disease

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwz028 ◽

2019 ◽

Author(s):

David O Prichard ◽

Zachary Hamilton ◽

Thomas Savage ◽

Matthew Smyth ◽

Carlie Penner ◽

...

Keyword(s):

Crohn’S Disease ◽

Magnetic Resonance ◽

Small Bowel ◽

Crohn's Disease ◽

Capsule Endoscopy ◽

Magnetic Resonance Enterography ◽

Newly Diagnosed ◽

Paris Classification ◽

Active Inflammation ◽

Wireless Capsule

Abstract Aims Wireless capsule endoscopy (WCE) and magnetic resonance enterography (MRE) are increasingly utilized to evaluate the small bowel (SB) in Crohn’s disease (CD). The primary aims were to compare the ability of WCE and MRE to detect SB inflammation in children with newly diagnosed CD, and in the terminal ileum (TI) to compare them to ileo-colonoscopy. Secondary aims were to compare diagnostic accuracy of WCE and MRE and changes in Paris classification after each study. Methods Patients (10 to 17 years of age) requiring ileo-colonoscopy for suspected CD were invited to participate. Only patients with endoscopic/histologic evidence of CD underwent MRE and WCE. SB inflammation and extent were documented and comparative analyses performed. Results Of 38 initially recruited subjects, 20 completed the study. WCE and MRE were similarly sensitive in identifying active TI inflammation (16 [80%] versus 12 [60%]) and any SB inflammation (17 [85%] versus 16 [80%]). However, WCE detected more extensive SB disease than MRE with active inflammation throughout the SB in 15 [75%] versus 1 [5%] patient (P < 0.001). Moreover, WCE was more likely to detect proximal SB disease (jejunum and ileum) compared to MRE (85% versus 50%, P = 0.04). Overall, the Paris classification changed in 65% and 85% of patients following MRE and WCE, respectively. Conclusions WCE is as sensitive as MRE for identifying active TI inflammation, but appears more sensitive in identifying more proximal SB inflammation. In the absence of concern regarding stricturing or extra-luminal disease WCE can be considered for the evaluation of suspected SB CD.

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