Diagnostic Yield of Spiral Enteroscopy When Performed for the Evaluation of Abnormal Capsule Endoscopy Findings

Background & Aims: Neuroendocrine tumors (NETs) are a heterogeneous group of neoplasms with unclear etiology that may show functioning or non-functioning features. Primary tumor localization often requires integrated imaging. The European Neuroendocrine Tumors Society (ENETS) guidelines proposed wireless-capsule endoscopy (WCE) as a possible diagnostic tool for NETs, if intestinal origin is suspected. However, its impact on therapeutic management is debated. We aimed to evaluate the yield of WCE in detecting intestinal primary tumor in patients showing liver NET metastases when first-line investigations are inconclusive.Method: Twenty-four patients with histological diagnosis of metastatic NET from liver biopsy and no evidence of primary lesions at first-line investigations were prospectively studied in an ENETS-certified tertiary care center. Wireless-capsule endoscopy was requested before explorative laparotomy and intra-operative ultrasound. The diagnostic yield of WCE was compared to the surgical exploration.Results: Sixteen subjects underwent surgery; 11/16 had positive WCE identifying 16 bulging lesions. Mini-laparotomy found 13 NETs in 11/16 patients (9 small bowel, 3 pancreas, 1 bile ducts). Agreement between WCE and laparotomy was recorded in 9 patients (Sensitivity=75%; Specificity=37.5%; PPV=55%; NPV=60%). Correspondence assessed per-lesions produced similar results (Sensitivity=70%; Specificity=25%; PPV=44%; NPV=50%). No capsule retentions were recorded.Conclusions: Wireless-capsule endoscopy is not indicated as second-line investigation for patients with gastro-entero-pancreatic NETs. In the setting of a referral center, it might provide additional information when conventional investigations are inconclusive about the primary site.Abbreviations: DBE: double balloon enteroscopy; GEP-NET: gastro-entero-pancreatic neuroendocrine tumor; GI: gastrointestinal; ENETS: European Neuroendocrine Tumor Society; NET: neuroendocrine tumor; SSRS: somatostatin receptor scintigraphy; WCE: wireless capsule endoscopy.

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Diagnostic Yield of Capsule Endoscopy in Elderly Patients with Obscure GI Bleeding and Predictive Factors of Rebleeding: A Prospective Multicenter Study of the ANGH Group

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2008.03.703 ◽

2008 ◽

Vol 67 (5) ◽

pp. AB259

Author(s):

StéPhane Nahon ◽

Antoine Fleury ◽

Emmanuel Cuillerier ◽

Gilles D'Abrigeon ◽

Anne Courillon-Mallet ◽

...

Keyword(s):

Elderly Patients ◽

Predictive Factors ◽

Capsule Endoscopy ◽

Multicenter Study ◽

Diagnostic Yield ◽

Gi Bleeding ◽

Prospective Multicenter Study

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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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KID Project: an internet-based digital video atlas of capsule endoscopy for research purposes

Endoscopy International Open ◽

10.1055/s-0043-105488 ◽

2017 ◽

Vol 05 (06) ◽

pp. E477-E483 ◽

Cited By ~ 22

Author(s):

Anastasios Koulaouzidis ◽

Dimitris Iakovidis ◽

Diana Yung ◽

Emanuele Rondonotti ◽

Uri Kopylov ◽

...

Keyword(s):

Open Source ◽

Open Source Software ◽

Capsule Endoscopy ◽

Diagnostic Yield ◽

Jaccard Index ◽

Machine Learning Algorithms ◽

Medical Decision ◽

Annotation Tool ◽

Medical Decision Support ◽

Medical Decision Support Systems

Abstract Background and aims Capsule endoscopy (CE) has revolutionized small-bowel (SB) investigation. Computational methods can enhance diagnostic yield (DY); however, incorporating machine learning algorithms (MLAs) into CE reading is difficult as large amounts of image annotations are required for training. Current databases lack graphic annotations of pathologies and cannot be used. A novel database, KID, aims to provide a reference for research and development of medical decision support systems (MDSS) for CE. Methods Open-source software was used for the KID database. Clinicians contribute anonymized, annotated CE images and videos. Graphic annotations are supported by an open-access annotation tool (Ratsnake). We detail an experiment based on the KID database, examining differences in SB lesion measurement between human readers and a MLA. The Jaccard Index (JI) was used to evaluate similarity between annotations by the MLA and human readers. Results The MLA performed best in measuring lymphangiectasias with a JI of 81 ± 6 %. The other lesion types were: angioectasias (JI 64 ± 11 %), aphthae (JI 64 ± 8 %), chylous cysts (JI 70 ± 14 %), polypoid lesions (JI 75 ± 21 %), and ulcers (JI 56 ± 9 %). Conclusion MLA can perform as well as human readers in the measurement of SB angioectasias in white light (WL). Automated lesion measurement is therefore feasible. KID is currently the only open-source CE database developed specifically to aid development of MDSS. Our experiment demonstrates this potential.

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