scholarly journals Colon capsule endoscopy is a viable alternative to colonoscopy for the investigation of intermediate- and low-risk patients with gastrointestinal symptoms: results of a pilot study

2021 ◽  
Vol 09 (06) ◽  
pp. E965-E970
Author(s):  
Mohd Syafiq Ismail ◽  
Serhiy Semenov ◽  
Sandeep Sihag ◽  
Thilagaraj Manoharan ◽  
Atiyekeogbebe Rita Douglas ◽  
...  
Keyword(s):  
High Risk ◽  
Capsule Endoscopy ◽  
Viable Alternative ◽  
Average Risk ◽  
Positive Finding ◽  
Polyp Detection ◽  
Colon Capsule Endoscopy ◽  
Risk Patients ◽  
Colon Capsule ◽  
Significant Disease

Abstract Background and study aims Colon capsule endoscopy (CCE) is a recommended viable alternative to colonoscopy for colonic visualisation in a variety of clinical settings with proven efficacy in polyp detection, surveillance, screening and Inflammatory Bowel Disease (IBD) assessment. CCE efficacy in an unselected average risk symptomatic cohort has yet to be established. The aim of this study was to determine the feasibility of CCE imaging assessment in average risk symptomatic patients as an alternative to colonoscopy with and without additional biomarker assessment. Patients and methods This was a prospective, single-center comparison study of colonoscopy, CCE and biomarker assessment. Results Of 77 invited subjects, 66 underwent both a CCE and colonoscopy. A fecal immunochemical test (FIT) and fecal calprotectin (FC) were available in 56 and 59 subjects. In all 64 % (n = 42) had any positive finding with 16 (24 %) found to have significant disease (high-risk adenomas, IBD) on colonoscopy. The CCE completion rate was 76 %, five (8 %) had an inadequate preparation, the CCE polyp detection rate was high at 35 %. The sensitivity, specificity, positive and negative predictive values of CCE for significant disease were 81 %, 98 %, 93 % and 94 % respectively. In addition, three (5 %) significant small bowel diagnoses were made on CCE. FC and FIT were frequently elevated in patients with both colitis (5/7, 71 %) and high-risk adenomas (4/7 57 %). While both had a low positive predictive value for clinically significant disease, FIT 32 % and FC 26 %. Conclusions CCE is a safe and effective alternative to colonoscopy in symptomatic average risk patients with or without the addition of biomarker screening.

scholarly journals Colon Capsule Endoscopy vs. CT Colonography Following Incomplete Colonoscopy: A Systematic Review with Meta-Analysis

Cancers ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3367
Author(s):  
Ulrik Deding ◽  
Lasse Kaalby ◽  
Henrik Bøggild ◽  
Eva Plantener ◽  
Mie Kruse Wollesen ◽  
...  
Keyword(s):  
Capsule Endoscopy ◽  
Diagnostic Yield ◽  
Meta Analysis ◽  
Rate Sensitivity ◽  
Completion Rate ◽  
Polyp Detection ◽  
Proximal Point ◽  
Incomplete Colonoscopy ◽  
Colon Capsule Endoscopy ◽  
Colon Capsule

Following incomplete colonoscopy (IC) patients often undergo computed tomography colonography (CTC), but colon capsule endoscopy (CCE) may be an alternative. We compared the completion rate, sensitivity and diagnostic yield for polyp detection from CCE and CTC following IC. A systematic literature search resulted in twenty-six studies. Extracted data included inter alia, complete/incomplete investigations and polyp findings. Pooled estimates of completion rates of CCE and CTC and complete colonic view rates (CCE reaching the most proximal point of IC) of CCE were calculated. Per patient diagnostic yields of CCE and CTC were calculated stratified by polyp sizes. CCE completion rate and complete colonic view rate were 76% (CI 95% 68–84%) and 90% (CI 95% 83–95%). CTC completion rate was 98% (CI 95% 96–100%). Diagnostic yields of CTC and CCE were 10% (CI 95% 7–15%) and 37% (CI 95% 30–43%) for any size, 13% (CI 95% 9–18%) and 21% (CI 95% 12–32%) for >5-mm and 4% (CI 95% 2–7%) and 9% (CI 95% 3–17%) for >9-mm polyps. No study performed a reference standard follow-up after CCE/CTC in individuals without findings, rendering sensitivity calculations unfeasible. The increased diagnostic yield of CCE could outweigh its slightly lower complete colonic view rate compared to the superior CTC completion rate. Hence, CCE following IC appears feasible for an introduction to clinical practice. Therefore, randomized studies investigating CCE and/or CTC following incomplete colonoscopy with a golden standard reference for the entire population enabling estimates for sensitivity and specificity are needed.

scholarly journals Colon capsule endoscopy in clinical practice: lessons from a national 5-year observational prospective cohort

2021 ◽  
Vol 09 (10) ◽  
pp. E1542-E1548
Author(s):  
Nicolas Benech ◽  
Olivier Vinet ◽  
Jean-Louis Gaudin ◽  
Robert Benamouzig ◽  
Xavier Dray ◽  
...  
Keyword(s):  
Capsule Endoscopy ◽  
Real Life ◽  
Average Risk ◽  
Advanced Neoplasia ◽  
Medical Centers ◽  
Colon Capsule Endoscopy ◽  
Bowel Cleansing ◽  
National Cohort ◽  
Colon Capsule ◽  
Technical Issues

Abstract Background and study aims Colon capsule endoscopy (CCE) has been proposed as an alternative to colonoscopy for screening patients at average risk of colorectal cancer (CRC). A prospective national cohort was developed to assess relevance of CCE in real-life practice and its short- and long-term impacts on clinical management. Patients and methods All patients who underwent a CCE in France were prospectively enrolled from January 2011 to May 2016 and reached annually by phone until May 2017. All CCE and colonoscopy reports were systematically collected. Results During the study period, 689 CCEs were analyzed from 14 medical centers. Median follow-up time was 35 months [IQR: 12–50]. Indication for CCE was mainly for elderly patients (median age: 70 years, IQR: [61–79]) due to anesthetic or colonoscopy contraindication (n = 307; 44.6 %). Only 337 CCEs (48.9 %) were both complete and with adequate bowel preparation. Advanced neoplasia (adenoma with high-grade dysplasia or CRC) was diagnosed following 32 CCEs (4.6 %). Among patients who underwent colonoscopy or therapeutic surgery following CCE, 18.8 % of all advanced neoplasias (6/32) had not been diagnosed by CCE mainly due to technical issues. Performing a colonoscopy in the case of significant polyps or insufficient bowel cleansing or after an incomplete CCE allowed the diagnosis of 96.9 % of all identified advanced neoplasias (31/32). Conclusions Outside the scope of academic trials, improvement is needed to increase the reliability of CCE as less than half were considered optimal i. e. complete with adequate bowel cleansing. Most of missed colonic advanced neoplasia were due to incomplete CCE with distal neoplasia location.

Time-saving polyp detection in colon capsule endoscopy: evaluation of a novel software algorithm

2019 ◽  
Vol 34 (11) ◽  
pp. 1857-1863
Author(s):  
Johannes Hausmann ◽  
Jan-Peter Linke ◽  
Jörg G. Albert ◽  
Johannes Masseli ◽  
Andrea Tal ◽  
...  
Keyword(s):  
Capsule Endoscopy ◽  
Polyp Detection ◽  
Time Saving ◽  
Colon Capsule Endoscopy ◽  
Colon Capsule

scholarly journals Intra and inter‐observer agreement on polyp detection in colon capsule endoscopy evaluations

2018 ◽  
Vol 6 (10) ◽  
pp. 1563-1568 ◽  
Author(s):  
Maria Magdalena Buijs ◽  
Rasmus Kroijer ◽  
Morten Kobaek-Larsen ◽  
Cristiano Spada ◽  
Ignacio Fernandez-Urien ◽  
...  
Keyword(s):  
Capsule Endoscopy ◽  
Observer Agreement ◽  
Polyp Detection ◽  
Colon Capsule Endoscopy ◽  
Colon Capsule

scholarly journals Automated Polyp Detection in Colon Capsule Endoscopy

2014 ◽  
Vol 33 (7) ◽  
pp. 1488-1502 ◽  
Author(s):  
Alexander V. Mamonov ◽  
Isabel N. Figueiredo ◽  
Pedro N. Figueiredo ◽  
Yen-Hsi Richard Tsai
Keyword(s):  
Capsule Endoscopy ◽  
Polyp Detection ◽  
Colon Capsule Endoscopy ◽  
Colon Capsule

scholarly journals Colon Capsule Endoscopy: Detection of Colonic Polyps Compared with Conventional Colonoscopy and Visualization of Extracolonic Pathologies

2014 ◽  
Vol 28 (2) ◽  
pp. 77-82 ◽  
Author(s):  
Alexander F Hagel ◽  
Erwin Gäbele ◽  
Martin Raithel ◽  
Wolfgang H Hagel ◽  
Heinz Albrecht ◽  
...  
Keyword(s):  
Capsule Endoscopy ◽  
Bowel Preparation ◽  
Colonic Polyps ◽  
Conventional Colonoscopy ◽  
Colonic Disease ◽  
Polyp Detection ◽  
Colon Capsule Endoscopy ◽  
Extracolonic Findings ◽  
Colon Capsule ◽  
Technical Failures

BACKGROUND: Conventional colonoscopy (CC) is the gold standard for diagnostic examination of the colon. However, the overall acceptance of this procedure is low due to patient fears of complications or embarrassment. Colon capsule endoscopy (CCE) represents a minimally invasive, patient-friendly procedure that offers complete visualization of the entire intestine.OBJECTIVE: To assess the PillCam Colon 2 (Given Imaging Ltd, Israel) capsule with regard to feasibility, sensitivity and specificity for the detection of colonic pathologies and additional recorded extracolonic findings.METHODS: CCE was performed before CC in patients indicated for CC for known or suspected colonic disease. The results of both techniques were compared with regard to polyp detection. Additionally, bowel preparation and extracolonic pathologies were analyzed.RESULTS: Twenty-four patients (mean age 51.1 years) were included in the analysis. Visualization of the colon was complete in 23 CCs and 17 CCEs. No adverse events or major technical failures occurred. CC detected 47 polyps and CCE detected 43 polyps of any size (per-finding sensitivity 90.9%, specificity 67.6%). The accuracy of CCE in detecting polyp carriers was 81.5% (per-patient analysis). On average, the colon was adequately cleansed in 90.1% of patients. CCE identified esophageal, gastric and small bowel pathologies in seven (24%), nine (38%) and 14 (58%) patients, respectively.CONCLUSIONS: CCE proved to be technically feasible and safe. Acceptable sensitivity and moderate specificity levels in polyp detection were recorded. Bowel preparation was adequate in most patients. Because extracolonic pathologies were effectively visualized, new indications for the PillCam Colon 2 may be defined.

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