P.02.4 DIAGNOSTIC YIELD, PRACTICAL ISSUES AND SAFETY OF SMALL BOWEL CAPSULE ENDOSCOPY IN CLINICAL PRACTICE: PROSPECTIVE DATA FROM A REGIONAL REGISTRY

Background: Video capsule endoscopy (VCE) revolutionized the diagnosis and management of obscure gastrointestinal bleeding, though the rate of detection of small bowel lesions by the physician is still disappointing. Our group developed a novel algorithm (CMEMS-Uminho) to automatically detect angioectasias which display greater accuracy in VCE static frames than other methods previously published. We aimed to evaluate the algorithm overall performance and assess its diagnostic yield and usability in clinical practice. Methods: Algorithm overall performance was determined using 54 full-length VCE recordings. To assess its diagnostic yield and usability in clinical practice, 38 VCE examinations with the clinical diagnosis of angioectasias consecutively performed (2017–2018) were evaluated by three physicians with different experiences. The CMEMS-Uminho algorithm was also applied. The performance of the CMEMS-Uminho algorithm was defined by a positive concordance between a frame automatically selected by the software and a study independent capsule endoscopist. Results: Overall performance in complete VCE recordings was 77.7%, and diagnostic yield was 94.7%. There were significant differences between physicians in regard to global detection rate (p < 0.001), detection rate per capsule (p < 0.001), diagnostic yield (p = 0.007), true positive rate (p < 0.001), time (p < 0.001), and speed viewing (p < 0.001). The application of CMEMS-Uminho algorithm significantly enhanced all readers’ global detection rate (p < 0.001) and the differences between them were no longer observed. Conclusion: The CMEMS-Uminho algorithm detained a good overall performance and was able to enhance physicians’ performance, suggesting a potential usability of this tool in clinical practice.

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ID: 3519521 FEASIBILITY AND DIAGNOSTIC YIELD OF SMALL BOWEL CAPSULE ENDOSCOPY IN PATIENTS WITH SURGICALLY ALTERED GASTRIC ANATOMY

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2021.03.898 ◽

2021 ◽

Vol 93 (6) ◽

pp. AB354

Author(s):

Xavier Dray ◽

Maria Elena Riccioni ◽

Gabriele W. Johansson ◽

Martin Keuchel ◽

Guillaume Perrod ◽

...

Keyword(s):

Small Bowel ◽

Capsule Endoscopy ◽

Diagnostic Yield

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The Use Of Bowel Preparation to Improve Diagnostic Yield in Small Bowel Capsule Endoscopy. A Prospective Randomised Nested Case Control Study Of Moviprep Versus Dietary Measures

10.1055/s-0041-1724604 ◽

2021 ◽

Author(s):

F O’Hara ◽

S Seminov ◽

D McNamara

Keyword(s):

Small Bowel ◽

Capsule Endoscopy ◽

Bowel Preparation ◽

Case Control Study ◽

Diagnostic Yield ◽

Case Control ◽

Nested Case Control ◽

Control Study

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Rendimiento diagnóstico de la videocápsula endoscópica en el sangrado del intestino delgado manifiesto

Acta gastroenterológica latinoamericana ◽

10.52787/dzvw9801 ◽

2020 ◽

Vol 50 (4) ◽

Author(s):

María Alejandra Arriola ◽

Diana Valencia ◽

Carolina Olano

Keyword(s):

Small Bowel ◽

Capsule Endoscopy ◽

Diagnostic Yield ◽

Laboratory Data ◽

Increased Risk ◽

Frequent Finding ◽

Male Sex ◽

Lower Endoscopy ◽

Small Bowel Bleeding ◽

Nonspecific Inflammation

Introduction. The small bowel capsule endoscopy is the first line procedure in patients with suspected small bowel bleeding. Data regarding overt suspected small bowel bleeding and its predictive factors remain still limited. Aim. To assess the diagnostic yield of the capsule endoscopy and the factors predicting positive findings in patients with overt suspected small bowel bleeding. Methods. Patients with overt suspected small bowel bleeding (melena or enterorrhagia) and negative upper and lower endoscopy were included. A positive diagnostic yield was considered when the capsule endoscopy diagnosed one or more P2 or P3 type lesions (Modified Saurin Classification) Demographic and laboratory data were recorded. Results. 79 patients were included (mean age 62.92 (15-89); F:M 46:33). The diagnostic yield of the capsule endoscopy was 62%. The most frequent finding was angioectasia (44.8%), followed by nonspecific inflammation/ulceration (20.4%). The multivariate analysis found that age older than 50 years and male sex were independent variables that were associated with an increased risk of positive findings and angioectasia. Conclusions. In this group of patients with overt suspected small bowel bleeding, the capsule endoscopy was useful (with a diagnostic yield of 62%). The most frequent lesions were the vascular ones. Age over 50 and male sex were independent predictors of finding lesions and angioectasia.

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Diagnostic yield of magnetically assisted capsule endoscopy versus gastroscopy in recurrent and refractory iron deficiency anemia

Endoscopy ◽

10.1055/a-0750-5682 ◽

2018 ◽

Vol 51 (05) ◽

pp. 409-418 ◽

Cited By ~ 10

Author(s):

Hey-Long Ching ◽

Melissa F. Hale ◽

Matthew Kurien ◽

Jennifer A. Campbell ◽

Stefania Chetcuti Zammit ◽

...

Keyword(s):

Small Bowel ◽

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Capsule Endoscopy ◽

Diagnostic Yield ◽

Deficiency Anemia ◽

Gi Tract ◽

Upper Gi ◽

Upper Gi Tract ◽

Magnetically Assisted

Abstract Background Small-bowel capsule endoscopy is advocated and repeat upper gastrointestinal (GI) endoscopy should be considered for evaluation of recurrent or refractory iron deficiency anemia (IDA). A new device that allows magnetic steering of the capsule around the stomach (magnetically assisted capsule endoscopy [MACE]), followed by passive small-bowel examination might satisfy both requirements in a single procedure. Methods In this prospective cohort study, MACE and esophagogastroduodenoscopy (EGD) were performed in patients with recurrent or refractory IDA. Comparisons of total (upper GI and small bowel) and upper GI diagnostic yields, gastric mucosal visibility, and patient comfort scores were the primary end points. Results 49 patients were recruited (median age 64 years; 39 % male). Combined upper and small-bowel examination using the new capsule yielded more pathology than EGD alone (113 vs. 52; P < 0.001). In upper GI examination (proximal to the second part of the duodenum, D2), MACE identified more total lesions than EGD (88 vs. 52; P < 0.001). There was also a difference if only IDA-associated lesions (esophagitis, altered/fresh blood, angioectasia, ulcers, and villous atrophy) were included (20 vs. 10; P = 0.04). Pathology distal to D2 was identified in 17 patients (34.7 %). Median scores (0 – 10 for none – extreme) for pain (0 vs. 2), discomfort (0 vs. 3), and distress (0 vs. 4) were lower for MACE than for EGD (P < 0.001). Conclusion Combined examination of the upper GI tract and small bowel using the MACE capsule detected more pathology than EGD alone in patients with recurrent or refractory IDA. MACE also had a higher diagnostic yield than EGD in the upper GI tract and was better tolerated by patients.

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Capsule Endoscopy in Inflammatory Bowel Disease: When? To Whom?

Diagnostics ◽

10.3390/diagnostics11122240 ◽

2021 ◽

Vol 11 (12) ◽

pp. 2240

Author(s):

Soo-Young Na ◽

Yun-Jeong Lim

Keyword(s):

Small Bowel ◽

Capsule Endoscopy ◽

Diagnostic Yield ◽

Postoperative Recurrence ◽

Treat To Target ◽

Diagnostic Modality ◽

Colon Capsule Endoscopy ◽

Bowel Diseases ◽

Colon Capsule ◽

The Cost

Capsule endoscopy (CE) has proven to be a valuable diagnostic modality for small bowel diseases over the past 20 years, particularly Crohn’s disease (CD), which can affect the entire gastrointestinal tract from the mouth to the anus. CE is not only used for the diagnosis of patients with suspected small bowel CD, but can also be used to assess disease activity, treat-to-target, and postoperative recurrence in patients with established small bowel CD. As CE can detect even mildly non-specific small bowel lesions, a high diagnostic yield is not necessarily indicative of high diagnostic accuracy. Moreover, the cost effectiveness of CE as a third diagnostic test employed usually after ileocolonoscopy and MR or CT enterography is an important consideration. Recently, new developments in colon capsule endoscopy (CCE) have increased the utility of CE in patients with ulcerative colitis (UC) and pan-enteric CD. Although deflation of the colon during the examination and the inability to evaluate dysplasia-associated lesion or mass results in an inherent risk of overestimation or underestimation, the convenience of CCE examination and the risk of flare-up after colonoscopy suggest that CCE could be used more actively in patients with UC.

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