Diagnostic Yields and Clinical Impacts of Capsule Endoscopy

Observing the entire small bowel is difficult due to the presence of complex loops and a long length. Capsule endoscopy (CE) provides a noninvasive and patient-friendly method for visualizing the small bowel and colon. Small bowel capsule endoscopy (SBCE) has a critical role in the diagnosis of small bowel disorders through the direct observation of the entire small bowel mucosa and is becoming the primary diagnostic tool for small bowel diseases. Recently, colon capsule endoscopy (CCE) was also considered safe and feasible for obtaining sufficient colonic images in patients with incomplete colonoscopy, in the absence of bowel obstruction. This review article assesses the current status of CE in terms of the diagnostic yield and the clinical impact of SBCE in patients with obscure gastrointestinal bleeding, who have known or suspected Crohn’s disease, small bowel tumor and inherited polyposis syndrome, celiac disease, and those who have undergone CCE.

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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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Diagnostic yield of colon capsule endoscopy for Crohn’s disease lesions in the whole gastrointestinal tract

BMC Gastroenterology ◽

10.1186/s12876-021-01657-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Keisaku Yamada ◽

Masanao Nakamura ◽

Takeshi Yamamura ◽

Keiko Maeda ◽

Tsunaki Sawada ◽

...

Keyword(s):

Crohn’S Disease ◽

Small Bowel ◽

Crohn's Disease ◽

Capsule Endoscopy ◽

Large Bowel ◽

Diagnostic Yield ◽

Gi Tract ◽

Colon Capsule Endoscopy ◽

Colon Capsule ◽

Bowel Segments

Abstract Background Crohn’s disease (CD) can involve the upper gastrointestinal (GI) tract as well as the small and large bowel. PillCam colon capsule endoscopy (PCCE-2) enables observation of the whole GI tract, but its diagnostic yield for CD lesions in the whole GI tract remains unknown. Aim To elucidate the diagnostic yield of PCCE-2 in patients with CD. Methods Patients with CD who underwent PCCE-2 and double-balloon endoscopy (DBE) using oral and anal approaches were evaluated for CD lesions in the whole GI tract. We divided the small bowel into three segments (jejunum, ileum, and terminal ileum), and the large bowel into four segments (right colon, transverse colon, left colon, rectum). Detection of ulcer scars, erosion, ulcers, bamboo joint-like appearance, and notch-like appearance was assessed in each segment. The diagnostic yield of PCCE-2 was analyzed based on the DBE results as the gold standard. Results Of the total 124 segments, the sensitivities of PCCE-2 for ulcer scars, erosion, and ulcers were 83.3%, 93.8%, and 88.5%, respectively, and the specificities were 76.0%, 78.3%, and 81.6%, respectively. For the 60 small bowel segments, the sensitivities were 84.2%, 95.5%, and 90.0%, respectively, and the specificities were 63.4%, 86.8%, and 87.5%, respectively. For the 64 large bowel segments, the sensitivities were 80.0%, 90.0%, and 83.3%, respectively, and the specificities were 84.7%, 72.2%, and 77.6%, respectively. Conclusion PCCE-2 provides a high diagnostic yield for lesions in the whole GI tract of patients with CD. Thus, we recommend its use as a pan-enteric tool in clinical settings.

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Diagnostic Yield of Colon Capsule Endoscopy for Crohn’s Disease Lesions in the Whole Gastrointestinal Tract

10.21203/rs.3.rs-119671/v1 ◽

2020 ◽

Author(s):

Keisaku Yamada ◽

Masanao Nakamura ◽

Takeshi Yamamura ◽

Keiko Maeda ◽

Tsunaki Sawada ◽

...

Keyword(s):

Small Bowel ◽

Capsule Endoscopy ◽

Large Bowel ◽

Diagnostic Yield ◽

Clinical Settings ◽

Gi Tract ◽

Colon Capsule Endoscopy ◽

Colon Capsule ◽

Bowel Segments ◽

Upper Gastrointestinal

Abstract BACKGROUNDCrohn’s disease (CD) can involve the upper gastrointestinal (GI) tract as well as the small and large bowel. PillCam colon capsule endoscopy (PCCE-2) enables to observe the whole GI tract, but its diagnostic yield for CD lesions in the whole GI tract remains unknown. AIMTo elucidate the diagnostic yield of PCCE-2 in patients with CD.METHODSPatients with CD who underwent PCCE-2 and double-balloon endoscopy (DBE) using oral and anal approaches were evaluated for CD lesions in the whole GI tract. We divided the small bowel into three segments (jejunum, ileum, and terminal ileum), and the large bowel into four segments (right colon, transverse colon, left colon, rectum). Detection of ulcer scars, erosion, ulcers, bamboo joint-like appearance, and notch-like appearance was assessed in each segment. The diagnostic yield of PCCE-2 was analyzed based on the DBE results as the gold standard.RESULTSOf the total 124 segments, the sensitivities of PCCE-2 for ulcer scars, erosion, and ulcers were 83.3%, 93.8%, and 88.5%, respectively, and the specificities were 76.0%, 78.3%, and 81.6%, respectively. For the 60 small bowel segments, the sensitivities were 84.2%, 95.5%, and 90.0%, respectively, and the specificities were 63.4%, 86.8%, and 87.5%, respectively. For the 64 large bowel segments, the sensitivities were 80.0%, 90.0%, and 83.3%, respectively, and the specificities were 84.7%, 72.2%, and 77.6%, respectively.CONCLUSIONPCCE-2 provides a high diagnostic yield for lesions in the whole GI tract of patients with CD. Thus, we recommend its use as a pan-enteric tool in clinical settings.

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International core curriculum for capsule endoscopy training courses

Endoscopy International Open ◽

10.1055/s-0043-106181 ◽

2017 ◽

Vol 05 (06) ◽

pp. E526-E538 ◽

Cited By ~ 6

Author(s):

Ignacio Fernandez-Urien ◽

Simon Panter ◽

Cristina Carretero ◽

Carolyn Davison ◽

Xavier Dray ◽

...

Keyword(s):

Small Bowel ◽

Capsule Endoscopy ◽

Core Curriculum ◽

Endoscopy Training ◽

Colon Capsule Endoscopy ◽

Hands On ◽

Bowel Diseases ◽

Colon Capsule ◽

Training Courses ◽

Inflammatory Bowel

AbstractCapsule endoscopy (CE) has become a first-line noninvasive tool for visualisation of the small bowel (SB) and is being increasingly used for investigation of the colon. The European Society of Gastrointestinal Endoscopy (ESGE) guidelines have specified requirements for the clinical applications of CE. However, there are no standardized recommendations yet for CE training courses in Europe. The following suggestions in this curriculum are based on the experience of European CE training courses directors. It is suggested that 12 hours be dedicated for either a small bowel capsule endoscopy (SBCE) or a colon capsule endoscopy (CCE) course with 4 hours for an introductory CCE course delivered in conjunction with SBCE courses. SBCE courses should include state-of-the-art lectures on indications, contraindications, complications, patient management and hardware and software use. Procedural issues require approximately 2 hours. For CCE courses 2.5 hours for theoretical lessons and 3.5 hours for procedural issued are considered appropriate. Hands-on training on reading and interpretation of CE cases using a personal computer (PC) for 1 or 2 delegates is recommended for both SBCE and CCE courses. A total of 6 hours hands-on session- time should be allocated. Cases in a SBCE course should cover SB bleeding, inflammatory bowel diseases (IBD), tumors and variants of normal and cases with various types of polyps covered in CCE courses. Standardization of the description of findings and generation of high-quality reports should be essential parts of the training. Courses should be followed by an assessment of traineesʼ skills in order to certify readers’ competency.

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Colon Capsule Endoscopy in Inflammatory Bowel Disorders

Video Capsule Endoscopy ◽

10.1007/978-3-662-44062-9_48 ◽

2014 ◽

pp. 507-511

Author(s):

Joseph J. Y. Sung ◽

Jörg G. Albert

Keyword(s):

Capsule Endoscopy ◽

Colon Capsule Endoscopy ◽

Colon Capsule ◽

Bowel Disorders ◽

Inflammatory Bowel ◽

Inflammatory Bowel Disorders

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

Cancers ◽

10.3390/cancers12113367 ◽

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.

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Current status of colon capsule endoscopy

Digestive Endoscopy ◽

10.1111/den.13769 ◽

2020 ◽

Cited By ~ 1

Author(s):

Naoki Hosoe ◽

Kenji J. L. Limpias Kamiya ◽

Yukie Hayashi ◽

Tomohisa Sujino ◽

Haruhiko Ogata ◽

...

Keyword(s):

Capsule Endoscopy ◽

Current Status ◽

Colon Capsule Endoscopy ◽

Colon Capsule

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Colon Capsule Endoscopy: Review and Perspectives

Gastroenterology Research and Practice ◽

10.1155/2016/9643162 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 12

Author(s):

David Friedel ◽

Rani Modayil ◽

Stavros Stavropoulos

Keyword(s):

Capsule Endoscopy ◽

Prior Experience ◽

Current Status ◽

Entire Colon ◽

Optical Colonoscopy ◽

Colon Capsule Endoscopy ◽

Colon Capsule

Colon capsule endoscopy utilizing PillCam COLON 2 capsule allows for visualization potentially of the entire colon and is currently approved for patients who cannot withstand the rigors of traditional optical colonoscopy (OC) and associated sedation as well as those that had an OC that was incomplete for technical reasons other than a poor preparation. We will then describe the prior experience and current status of colon capsule endoscopy.

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