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.

scholarly journals Assessment of bowel cleansing quality in colon capsule endoscopy using machine learning: a pilot study

2018 ◽  
Vol 06 (08) ◽  
pp. E1044-E1050 ◽  
Author(s):  
Maria Magdalena Buijs ◽  
Mohammed Hossain Ramezani ◽  
Jürgen Herp ◽  
Rasmus Kroijer ◽  
Morten Kobaek-Larsen ◽  
...  
Keyword(s):  
Machine Learning ◽  
Pilot Study ◽  
Capsule Endoscopy ◽  
Analysis Model ◽  
Specific Analysis ◽  
Colon Capsule Endoscopy ◽  
Bowel Cleansing ◽  
Colon Capsule ◽  
Pixel Analysis ◽  
Almost All

Abstract Background and study aims The aim of this study was to develop a machine learning-based model to classify bowel cleansing quality and to test this model in comparison to a pixel analysis model and assessments by four colon capsule endoscopy (CCE) readers. Methods A pixel analysis and a machine learning-based model with four cleanliness classes (unacceptable, poor, fair and good) were developed to classify CCE videos. Cleansing assessments by four CCE readers in 41 videos from a previous study were compared to the results both models yielded in this pilot study. Results The machine learning-based model classified 47 % of the videos in agreement with the averaged classification by CCE readers, as compared to 32 % by the pixel analysis model. A difference of more than one class was detected in 12 % of the videos by the machine learning-based model and in 32 % by the pixel analysis model, as the latter tended to overestimate cleansing quality. A specific analysis of unacceptable videos found that the pixel analysis model classified almost all of them as fair or good, whereas the machine learning-based model identified five out of 11 videos in agreement with at least one CCE reader as unacceptable. Conclusions The machine learning-based model was superior to the pixel analysis in classifying bowel cleansing quality, due to a higher sensitivity to unacceptable and poor cleansing quality. The machine learning-based model can be further improved by coming to a consensus on how to classify cleanliness of a complete CCE video, by means of an expert panel.

Accuracy of colon capsule endoscopy for advanced neoplasia

2020 ◽  
Vol 91 (2) ◽  
pp. 406-414.e1 ◽  
Author(s):  
Silvia Pecere ◽  
Carlo Senore ◽  
Cesare Hassan ◽  
Emilia Riggi ◽  
Nereo Segnan ◽  
...  
Keyword(s):  
Capsule Endoscopy ◽  
Advanced Neoplasia ◽  
Colon Capsule Endoscopy ◽  
Colon Capsule

scholarly journals Booster medication to achieve capsule excretion in colon capsule endoscopy: a randomized controlled trial of three regimens

2018 ◽  
Vol 06 (11) ◽  
pp. E1363-E1368 ◽  
Author(s):  
Rasmus Kroijer ◽  
Anne-Kirstine Dyrvig ◽  
Morten Kobaek-Larsen ◽  
Jens Overgaard Støvring ◽  
Niels Qvist ◽  
...  
Keyword(s):  
Polyethylene Glycol ◽  
Capsule Endoscopy ◽  
Completion Rate ◽  
Oral Contrast ◽  
Recording Time ◽  
Colon Capsule Endoscopy ◽  
Bowel Cleansing ◽  
Colon Capsule ◽  
Group A ◽  
Group B

Abstract Background and study aims To achieve a complete colon capsule endoscopy, the entire colon must be visualized, clean and filled with clear fluids. The primary aim was to compare three booster regimens in colon capsule endoscopy in achieving capsule excretion within recording time. Secondary aims were quality of bowel cleansing and completion rate (both adequate cleansing and capsule excretion). Patients and methods Patients scheduled for follow-up colonoscopy due to previous neoplastic findings or familial history of colorectal cancer aged 18 to 70 years were eligible. Bowel preparation was 2-L split doses of polyethylene glycol. Patients were randomized to three booster regimens of either polyethylene glycol (Group A), sulfate-based solution (Group B) or polyethylene glycol with iodine oral contrast (Group C). Results One hundred eighty participants were included and randomized into three groups of 60. Capsule excretion was 70 % (95 % CI: 58 – 80) in Group A, 73 % (95 % CI: 61 – 83) in Group B and in 68 % (95 % CI: 56 – 79) in Group C, no statistically significant differences. Bowel cleansing grade was statistically significant better in Group B compared to Group A (P = 0.03), but there were no statistically significant differences between Groups C and A (P = 0.40). Complete examination rate was 65 % (95 % CI: 53 – 77), 72 % (95 % CI: 61 – 83) and 62 % (95 % CI: 50 – 74) in Group A, B and C respectively, not statistically significant different. Conclusions Sulfate-based solution resulted in statistically significant better bowel cleansing compared to polyethylene glycol. Overall the excretion and completion rate was suboptimal. Achieving a high completion rate using patient-tolerable and low-risk compounds is still a challenge.

Su1563 One-Day Bowel Cleansing for Colon Capsule Endoscopy: A Prospective and Randomized Pilot Study

2011 ◽  
Vol 73 (4) ◽  
pp. AB305-AB306
Author(s):  
Laura Ramos ◽  
Onofre Alarcón-Fernández ◽  
Antonio Z. Gimeno-García ◽  
David Nicolás-Pérez ◽  
Zaida Adrián-De-Ganzo ◽  
...  
Keyword(s):  
Pilot Study ◽  
Capsule Endoscopy ◽  
Colon Capsule Endoscopy ◽  
Bowel Cleansing ◽  
Colon Capsule

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.

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