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Yano T, Yamamoto H. Endoscopic Diagnosis of Small Bowel Tumor. Cancers (Basel) 2024; 16:1704. [PMID: 38730658 PMCID: PMC11083951 DOI: 10.3390/cancers16091704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 04/22/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024] Open
Abstract
Recent technological advances, including capsule endoscopy (CE) and balloon-assisted endoscopy (BAE), have revealed that small intestinal disease is more common than previously thought. CE has advantages, including a high diagnostic yield, discomfort-free, outpatient basis, and physiological images. BAE enabled endoscopic diagnosis and treatment in the deep small bowel. Computed tomography (CT) enterography with negative oral contrast can evaluate masses, wall thickening, and narrowing of the small intestine. In addition, enhanced CT can detect abnormalities outside the gastrointestinal tract that endoscopy cannot evaluate. Each modality has its advantages and disadvantages, and a good combination of multiple modalities leads to an accurate diagnosis. As a first-line modality, three-phase enhanced CT is preferred. If CT shows a mass, stenosis, or wall thickening, a BAE should be selected. If there are no abnormal findings on CT and no obstructive symptoms, CE should be selected. If there are significant findings in the CE, determine the indication for BAE and its insertion route based on these findings. Early diagnosis of small intestinal tumors is essential for favorable outcomes. For early diagnosis, the possibility of small bowel lesions should be considered in patients with unexplained symptoms and signs after examination of the upper and lower gastrointestinal tract.
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Affiliation(s)
| | - Hironori Yamamoto
- Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke 329-0498, Japan;
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2
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Musha A, Hasnat R, Mamun AA, Ping EP, Ghosh T. Computer-Aided Bleeding Detection Algorithms for Capsule Endoscopy: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2023; 23:7170. [PMID: 37631707 PMCID: PMC10459126 DOI: 10.3390/s23167170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023]
Abstract
Capsule endoscopy (CE) is a widely used medical imaging tool for the diagnosis of gastrointestinal tract abnormalities like bleeding. However, CE captures a huge number of image frames, constituting a time-consuming and tedious task for medical experts to manually inspect. To address this issue, researchers have focused on computer-aided bleeding detection systems to automatically identify bleeding in real time. This paper presents a systematic review of the available state-of-the-art computer-aided bleeding detection algorithms for capsule endoscopy. The review was carried out by searching five different repositories (Scopus, PubMed, IEEE Xplore, ACM Digital Library, and ScienceDirect) for all original publications on computer-aided bleeding detection published between 2001 and 2023. The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) methodology was used to perform the review, and 147 full texts of scientific papers were reviewed. The contributions of this paper are: (I) a taxonomy for computer-aided bleeding detection algorithms for capsule endoscopy is identified; (II) the available state-of-the-art computer-aided bleeding detection algorithms, including various color spaces (RGB, HSV, etc.), feature extraction techniques, and classifiers, are discussed; and (III) the most effective algorithms for practical use are identified. Finally, the paper is concluded by providing future direction for computer-aided bleeding detection research.
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Affiliation(s)
- Ahmmad Musha
- Department of Electrical and Electronic Engineering, Pabna University of Science and Technology, Pabna 6600, Bangladesh; (A.M.); (R.H.)
| | - Rehnuma Hasnat
- Department of Electrical and Electronic Engineering, Pabna University of Science and Technology, Pabna 6600, Bangladesh; (A.M.); (R.H.)
| | - Abdullah Al Mamun
- Faculty of Engineering and Technology, Multimedia University, Melaka 75450, Malaysia;
| | - Em Poh Ping
- Faculty of Engineering and Technology, Multimedia University, Melaka 75450, Malaysia;
| | - Tonmoy Ghosh
- Department of Electrical and Computer Engineering, The University of Alabama, Tuscaloosa, AL 35487, USA;
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Horovistiz A, Oliveira M, Araújo H. Computer vision-based solutions to overcome the limitations of wireless capsule endoscopy. J Med Eng Technol 2023; 47:242-261. [PMID: 38231042 DOI: 10.1080/03091902.2024.2302025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 12/28/2023] [Indexed: 01/18/2024]
Abstract
Endoscopic investigation plays a critical role in the diagnosis of gastrointestinal (GI) diseases. Since 2001, Wireless Capsule Endoscopy (WCE) has been available for small bowel exploration and is in continuous development. Over the last decade, WCE has achieved impressive improvements in areas such as miniaturisation, image quality and battery life. As a result, WCE is currently a very useful alternative to wired enteroscopy in the investigation of various small bowel abnormalities and has the potential to become the leading screening technique for the entire gastrointestinal tract. However, commercial solutions still have several limitations, namely incomplete examination and limited diagnostic capacity. These deficiencies are related to technical issues, such as image quality, motion estimation and power consumption management. Computational methods, based on image processing and analysis, can help to overcome these challenges and reduce both the time required by reviewers and human interpretation errors. Research groups have proposed a series of methods including algorithms for locating the capsule or lesion, assessing intestinal motility and improving image quality.In this work, we provide a critical review of computational vision-based methods for WCE image analysis aimed at overcoming the technological challenges of capsules. This article also reviews several representative public datasets used to evaluate the performance of WCE techniques and methods. Finally, some promising solutions of computational methods based on the analysis of multiple-camera endoscopic images are presented.
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Affiliation(s)
- Ana Horovistiz
- Institute of Systems and Robotics, University of Coimbra, Coimbra, Portugal
| | - Marina Oliveira
- Institute of Systems and Robotics, University of Coimbra, Coimbra, Portugal
- Department of Electrical and Computer Engineering (DEEC), Faculty of Sciences and Technology, University of Coimbra, Coimbra, Portugal
| | - Helder Araújo
- Institute of Systems and Robotics, University of Coimbra, Coimbra, Portugal
- Department of Electrical and Computer Engineering (DEEC), Faculty of Sciences and Technology, University of Coimbra, Coimbra, Portugal
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4
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Odeyinka O, Alhashimi R, Thoota S, Ashok T, Palyam V, Azam AT, Sange I. The Role of Capsule Endoscopy in Crohn's Disease: A Review. Cureus 2022; 14:e27242. [PMID: 36039259 PMCID: PMC9401636 DOI: 10.7759/cureus.27242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2022] [Indexed: 12/09/2022] Open
Abstract
Crohn’s disease (CD) is a chronic inflammatory disorder with a predilection for the small bowel. Although awareness of this disorder has increased over the years, it remains a diagnostic challenge for many physicians. This is exacerbated by the rising incidence and high recurrence rate following therapy in certain individuals. It is currently agreed that a multimodality approach is the best one, but with the advent of new modalities, that could be changing. Furthermore, given its impact on the mental health of patients and the cost of treatment, it is pertinent that we arrive at not only convenient but accurate modalities in its diagnosis and management. Among these investigative modalities is the relatively novel capsule endoscopy (CE) that not only provides a more patient-friendly alternative but avoids the need for invasiveness. Asides from its diagnostic capability, its influence on therapy and monitoring of known CD patients following treatment has been shown. This article has reviewed the current literature comparing the relevance of CE with other available modalities in diagnosing CD patients. We explored its therapeutic impact and how it influences monitoring post-treatment in CD. This article also discusses the complications of CE and the possible solutions to these complications in the future.
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Hirata I, Tsuboi A, Oka S, Sumioka A, Iio S, Hiyama Y, Kotachi T, Yuge R, Hayashi R, Urabe Y, Tanaka S. Diagnostic yield of proximal jejunal lesions with third-generation capsule endoscopy. DEN OPEN 2022; 3:e134. [PMID: 35898830 PMCID: PMC9307735 DOI: 10.1002/deo2.134] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/13/2022] [Accepted: 05/15/2022] [Indexed: 12/09/2022]
Abstract
Objectives Capsule endoscopy (CE) has been shown to have poor diagnostic performance when the capsule passes quickly through the small bowel, especially the proximal jejunum. This study aimed to evaluate the diagnostic yield of proximal jejunal lesions with third-generation CE technology. Methods We retrospectively examined 138 consecutive patients, 76 (55.0%) of whom were men. The patients' median age was 70 years, and proximal jejunal lesions were detected by CE and/or double-balloon endoscopy at Hiroshima University Hospital between January 2011 and June 2021. We analyzed the diagnostic accuracy of CE for proximal jejunal lesions and compared the characteristics of the discrepancy between the use of CE and double-balloon endoscopy with Pillcam SB 2 (SB2) and Pillcam SB 3 (SB3). Results SB2 and SB3 were used in 48 (35%) and 90 (65%) patients, respectively. There was no difference in baseline characteristics between these groups. Small-bowel lesions in the proximal jejunum comprised 75 tumors (54%), 50 vascular lesions (36%), and 13 inflammatory lesions (9%). The diagnostic rate was significantly higher in the SB3 group than in the SB2 group for tumors (91% vs. 72%, p < 0.05) and vascular lesions (97% vs. 69%, p < 0.01). For vascular lesions, in particular, the diagnostic rate of angioectasia improved in the SB3 group (100%) compared with that in the SB2 group (69%). Conclusions SB3 use improved the detection of proximal jejunal tumors and vascular lesions compared with SB2 use.
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Affiliation(s)
- Issei Hirata
- Department of Gastroenterology and MetabolismHiroshima University HospitalHiroshimaJapan
| | - Akiyoshi Tsuboi
- Department of EndoscopyHiroshima University HospitalHiroshimaJapan
| | - Shiro Oka
- Department of Gastroenterology and MetabolismHiroshima University HospitalHiroshimaJapan
| | - Akihiko Sumioka
- Department of Gastroenterology and MetabolismHiroshima University HospitalHiroshimaJapan
| | - Sumio Iio
- Department of Gastroenterology and MetabolismHiroshima University HospitalHiroshimaJapan
| | - Yuichi Hiyama
- Department of Center for Integrated Medical ResearchHiroshima University HospitalHiroshimaJapan
| | - Takahiro Kotachi
- Department of EndoscopyHiroshima University HospitalHiroshimaJapan
| | - Ryo Yuge
- Department of EndoscopyHiroshima University HospitalHiroshimaJapan
| | - Ryohei Hayashi
- Department of EndoscopyHiroshima University HospitalHiroshimaJapan
| | - Yuji Urabe
- Division of Regeneration and Medicine Center for Translational and Clinical ResearchHiroshima University HospitalHiroshimaJapan
| | - Shinji Tanaka
- Department of EndoscopyHiroshima University HospitalHiroshimaJapan
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Capsule Endoscopy in Inflammatory Bowel Disease: When? To Whom? Diagnostics (Basel) 2021; 11:diagnostics11122240. [PMID: 34943477 PMCID: PMC8700081 DOI: 10.3390/diagnostics11122240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 11/24/2021] [Accepted: 11/28/2021] [Indexed: 11/16/2022] Open
Abstract
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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Caroppo A, Leone A, Siciliano P. Deep transfer learning approaches for bleeding detection in endoscopy images. Comput Med Imaging Graph 2021; 88:101852. [PMID: 33493998 DOI: 10.1016/j.compmedimag.2020.101852] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 12/17/2020] [Accepted: 12/18/2020] [Indexed: 12/17/2022]
Abstract
Wireless capsule endoscopy is a non-invasive, wireless imaging tool that has developed rapidly over the last several years. One of the main limiting factors using this technology is that it produces a huge number of images, whose analysis, to be done by a doctor, is an extremely time-consuming process. In this research area, the management of this problem has been addressed with the development of Computer-aided Diagnosis systems thanks to which the automatic inspection and analysis of images acquired by the capsule has clearly improved. Recently, a big advance in classification of endoscopic images is achieved with the emergence of deep learning methods. The proposed expert system employs three pre-trained deep convolutional neural networks for feature extraction. In order to construct efficient feature sets, the features from VGG19, InceptionV3 and ResNet50 models are then selected and fused using the minimum Redundancy Maximum Relevance method and different fusion rules. Finally, supervised machine learning algorithms are employed to classify the images using the extracted features into two categories: bleeding and nonbleeding images. For performance evaluation a series of experiments are performed on two standard benchmark datasets. It has been observed that the proposed architecture outclass the single deep learning architectures, with an average accuracy in detection bleeding regions of 97.65 % and 95.70 % on well-known state-of-the-art datasets considering three different fusion rules, with the best combination in terms of accuracy and training time obtained using mean value pooling as fusion rule and Support Vector Machine as classifier.
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Affiliation(s)
- Andrea Caroppo
- Institute for Microelectronics and Microsystems, National Research Council of Italy, Lecce 73100, Italy.
| | - Alessandro Leone
- Institute for Microelectronics and Microsystems, National Research Council of Italy, Lecce 73100, Italy.
| | - Pietro Siciliano
- Institute for Microelectronics and Microsystems, National Research Council of Italy, Lecce 73100, Italy.
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Meher D, Gogoi M, Bharali P, Anirvan P, Singh SP. Artificial Intelligence in Small Bowel Endoscopy: Current Perspectives and Future Directions. JOURNAL OF DIGESTIVE ENDOSCOPY 2020. [DOI: 10.1055/s-0040-1717824] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
AbstractArtificial intelligence (AI) is a computer system that is able to perform tasks which normally require human intelligence. The role of AI in the field of gastroenterology has been gradually evolving since its inception in the 1950s. Discovery of wireless capsule endoscopy (WCE) and balloon enteroscopy (BE) has revolutionized small gut imaging. While WCE is a relatively patient-friendly and noninvasive mode to examine the nonobstructed small gut, it is limited by a lengthy examination time and the need for expertise in reading images acquired by the capsule. Similarly, BE, despite having the advantage of therapeutic intervention, is costly, invasive, and requires general sedation. Incorporation of concepts like machine learning and deep learning has been used to handle large amounts of data and images in gastroenterology. Interestingly, in small gut imaging, the application of AI has been limited to WCE only. This review was planned to examine and summarize available published data on various AI-based approaches applied to small bowel disease.
We conducted an extensive literature search using Google search engine, Google Scholar, and PubMed database for published literature in English on the application of different AI techniques in small bowel endoscopy, and have summarized the outcome and benefits of these applications of AI in small bowel endoscopy. Incorporation of AI in WCE has resulted in significant advancements in the detection of various lesions starting from dysplastic mucosa, inflammatory and nonmalignant lesions to the detection of bleeding with increasing accuracy and has shortened the lengthy review time in image analysis. As most of the studies to evaluate AI are retrospective, the presence of inherent selection bias cannot be excluded. Besides, the interpretability (black-box nature) of AI models remains a cause for concern. Finally, issues related to medical ethics and AI need to be judiciously addressed to enable its seamless use in future.
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Affiliation(s)
- Dinesh Meher
- Department of Gastroenterology, S.C.B. Medical College, Cuttack, Odisha, India
| | - Mrinal Gogoi
- Department of Gastroenterology, S.C.B. Medical College, Cuttack, Odisha, India
| | - Pankaj Bharali
- Department of Gastroenterology, S.C.B. Medical College, Cuttack, Odisha, India
| | - Prajna Anirvan
- Department of Gastroenterology, S.C.B. Medical College, Cuttack, Odisha, India
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Yung DE, Plevris JN, Leenhardt R, Dray X, Koulaouzidis A. Poor Quality of Small Bowel Capsule Endoscopy Images Has a Significant Negative Effect in the Diagnosis of Small Bowel Malignancy. Clin Exp Gastroenterol 2020; 13:475-484. [PMID: 33116745 PMCID: PMC7586059 DOI: 10.2147/ceg.s260906] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 09/14/2020] [Indexed: 12/22/2022] Open
Abstract
Background and Aims Capsule endoscopy (CE) is a visual modality; hence, diagnosis relies on image quality. We studied the contribution of image parameters to visualization quality and their effect on diagnostic certainty of small bowel (SB) lesions. Methods Five clear CE images of common SB pathology – two vascular lesions, two inflammatory, one polyp – were processed for three image parameters to simulate poor SB conditions: opacity (color-matched to luminal content; 10–90%, 10% increments); blurriness (radius 1–10 pixels; one pixel increments); and contrast (−50-50%; 10% increments). Nine expert readers evaluated whether images were adequate for diagnosis. Points where perception of image quality changed significantly were determined for each parameter. Three further sets of SBCE images (vascular, inflammatory, and neoplastic lesions; nine images/set) were processed for four points/parameters. Twenty experienced/expert CE readers reviewed these images. Results The negative effects of opacity in diagnostic certainty were mostly evident in images of neoplasia; images of vascular and inflammatory lesions were less affected. Similar results were observed with increasing blur radius, simulating movement, and poor focus. The proportions of readers finding vascular and inflammatory images adequate for diagnosis did not drop significantly at wider blur radii, while images of neoplasia were quickly deemed inadequate. Low contrast had a greater negative effect than high, most consistently in neoplastic lesions. Conclusion Poor visualization quality in all parameters affected mostly neoplastic lesions. Software to increase contrast and sharpen images can improve visualization quality; smart frame rate adaptation could improve the number of high-quality frames obtained. Thoroughness in SB cleansing is most important when there is a suspicion of neoplasia.
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Affiliation(s)
- Diana E Yung
- Centre for Liver and Digestive Disorders, The Royal Infirmary of Edinburgh, Edinburgh, UK
| | - John N Plevris
- Centre for Liver and Digestive Disorders, The Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Romain Leenhardt
- Sorbonne University, Endoscopy Unit, APHP Saint-Antoine Hospital, Paris, France
| | - Xavier Dray
- Sorbonne University, Endoscopy Unit, APHP Saint-Antoine Hospital, Paris, France
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Second-generation magnetically controlled capsule gastroscopy with improved image resolution and frame rate: a randomized controlled clinical trial (with video). Gastrointest Endosc 2020; 91:1379-1387. [PMID: 31981648 DOI: 10.1016/j.gie.2020.01.027] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 01/11/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Compared with conventional endoscopy, magnetically controlled capsule gastroscopy (MCCG) can be further optimized in gastric examination time and complete visualization of upper GI (UGI) mucosa. The second-generation MCCG (MCCG-2) was developed with higher image resolution and adaptive frame rate, and we aimed to evaluate its clinical availability for UGI examination in this study. METHODS Consecutive patients undergoing MCCG examination between May to June 2019 were prospectively enrolled and randomized to swallow the first-generation MCCG (MCCG-1) or MCCG-2 in a 1:1 ratio. The main outcomes included visualization of the esophagus and duodenum, operation-related parameters, image quality, maneuverability, detection of lesions, and safety evaluation. RESULTS Eighty patients were enrolled. In the MCCG-2 group, frames captured for esophageal mucosa and Z-line were 171.00 and 2.00, significantly increased from those in the MCCG-1 group (97.00 [P = .002] and .00 [P = .028], respectively). The gastric examination time was shortened from 7.78 ± .97 minutes to 5.27 ± .74 minutes (P < .001), with the total running time of the capsule extended from 702.83 minutes to 1001.99 minutes (P < .001). MCCG-2 also greatly improved the image quality (P < .001) and maneuverability (P < .01). No statistical difference existed in the detection of lesions between the 2 groups, and no adverse events occurred. CONCLUSIONS MCCG-2 showed better performance in mucosal visualization, examination duration, and maneuverability, making better diagnosis of UGI diseases a possibility. (Clinical trial registration number: NCT03977935.).
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Blanco-Velasco G, Solórzano-Pineda O, Mendoza-Segura C, Hernández-Mondragón O. PillCam SB3 vs. PillCam SB2: Can technologic advances in capsule endoscopy improve diagnostic yield in patients with small bowel bleeding? REVISTA DE GASTROENTEROLOGÍA DE MÉXICO (ENGLISH EDITION) 2019. [DOI: 10.1016/j.rgmxen.2018.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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Affiliation(s)
- Jihong Min
- Andrew and Peggy Cherng Department of Medical EngineeringDivision of Engineering and Applied ScienceCalifornia Institute of Technology Pasadena CA 91125 USA
| | - Yiran Yang
- Andrew and Peggy Cherng Department of Medical EngineeringDivision of Engineering and Applied ScienceCalifornia Institute of Technology Pasadena CA 91125 USA
| | - Zhiguang Wu
- Andrew and Peggy Cherng Department of Medical EngineeringDivision of Engineering and Applied ScienceCalifornia Institute of Technology Pasadena CA 91125 USA
| | - Wei Gao
- Andrew and Peggy Cherng Department of Medical EngineeringDivision of Engineering and Applied ScienceCalifornia Institute of Technology Pasadena CA 91125 USA
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13
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McGoran JJ, McAlindon ME, Iyer PG, Seibel EJ, Haidry R, Lovat LB, Sami SS. Miniature gastrointestinal endoscopy: Now and the future. World J Gastroenterol 2019; 25:4051-4060. [PMID: 31435163 PMCID: PMC6700702 DOI: 10.3748/wjg.v25.i30.4051] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 06/22/2019] [Accepted: 07/03/2019] [Indexed: 02/06/2023] Open
Abstract
Since its original application, gastrointestinal (GI) endoscopy has undergone many innovative transformations aimed at expanding the scope, safety, accuracy, acceptability and cost-effectiveness of this area of clinical practice. One method of achieving this has been to reduce the caliber of endoscopic devices. We propose the collective term “Miniature GI Endoscopy”. In this Opinion Review, the innovations in this field are explored and discussed. The progress and clinical use of the three main areas of miniature GI endoscopy (ultrathin endoscopy, wireless endoscopy and scanning fiber endoscopy) are described. The opportunities presented by these technologies are set out in a clinical context, as are their current limitations. Many of the positive aspects of miniature endoscopy are clear, in that smaller devices provide access to potentially all of the alimentary canal, while conferring high patient acceptability. This must be balanced with the costs of new technologies and recognition of device specific challenges. Perspectives on future application are also considered and the efforts being made to bring new innovations to a clinical platform are outlined. Current devices demonstrate that miniature GI endoscopy has a valuable place in investigation of symptoms, therapeutic intervention and screening. Newer technologies give promise that the potential for enhancing the investigation and management of GI complaints is significant.
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Affiliation(s)
- John J McGoran
- Digestive Diseases Centre, Leicester Royal Infirmary, Leicester LE1 5WW, United Kingdom
| | - Mark E McAlindon
- Department of Gastroenterology, Royal Hallamshire Hospital, Sheffield S10 2JF, United Kingdom
| | - Prasad G Iyer
- Division of Gastroenterology and Hepatology, Mayo Clinic Rochester, MN 55905, United States
| | - Eric J Seibel
- Department of Mechanical Engineering, University of Washington, 4000 Mason St, Seattle, WA 98195, United States
| | - Rehan Haidry
- Division of Surgery and Interventional Science, University College London, London WC1E 6BT, United Kingdom
| | - Laurence B Lovat
- Division of Surgery and Interventional Science, University College London, London WC1E 6BT, United Kingdom
| | - Sarmed S Sami
- Division of Surgery and Interventional Science, University College London, London WC1E 6BT, United Kingdom
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14
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Tsuboi A, Oka S, Tanaka S, Iio S, Otani I, Kunihara S, Chayama K. The Clinical Usefulness of the PillCam Progress Indicator for Route Selection in Double Balloon Endoscopy. Intern Med 2019; 58:1375-1381. [PMID: 30626833 PMCID: PMC6548919 DOI: 10.2169/internalmedicine.2043-18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Objective The utility of capsule endoscopy (CE) findings in the route selection for double balloon endoscopy (DBE) has not been adequately discussed. The PillCam Progress Indicator in the RAPID 6.5 software program graphically demonstrates the progress of the capsule endoscope through the small-bowel. This study aimed to clarify the usefulness of the PillCam Progress Indicator in choosing the initial DBE route. Methods We retrospectively examined 50 consecutive patients with 50 target lesions detected on both CE and DBE at Hiroshima University Hospital from January 2011 to February 2018. In this study, we selected antegrade DBE on the basis of % Capsule Progress <50% as a clinical trial. The association between the PillCam Progress Indicator data and the DBE route to the target lesion was analyzed. Results The target lesion was reached via the initial DBE route in 96% (48/50) of cases. The cutoff values for selecting an antegrade route for DBE were 50% for % Capsule Progress and 42% for % SB Time. At the cutoff value, the sensitivity, specificity, and positive and negative predictive values for route selection were 100%, 91%, 93%, and 100% for % Capsule Progress and 96%, 91%, 93%, and 95% for % SB Time. Conclusion The PillCam Progress Indicator was useful for determining the appropriate initial DBE route.
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Affiliation(s)
- Akiyoshi Tsuboi
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Japan
| | - Shiro Oka
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Japan
| | - Shinji Tanaka
- Department of Endoscopy and Medicine, Hiroshima University Hospital, Japan
| | - Sumio Iio
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Japan
| | - Ichiro Otani
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Japan
| | - Sayoko Kunihara
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Japan
| | - Kazuaki Chayama
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Japan
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15
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Blanco-Velasco G, Solórzano-Pineda OM, Mendoza-Segura C, Hernández-Mondragón O. PillCam SB3 vs. PillCam SB2: Can technologic advances in capsule endoscopy improve diagnostic yield in patients with small bowel bleeding? REVISTA DE GASTROENTEROLOGÍA DE MÉXICO 2019; 84:467-471. [PMID: 31000460 DOI: 10.1016/j.rgmx.2018.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 09/24/2018] [Accepted: 11/02/2018] [Indexed: 12/22/2022]
Abstract
INTRODUCTION AND OBJECTIVE The SB3 capsule endoscopy system has better image resolution and the capacity to increase the number of images from 2 to 6 frames per second. Small bowel bleeding is the most common indication. The aim To determine if the advances in capsule endoscopy technology increase diagnostic yield in cases of small bowel bleeding, according to the Saurin classification. MATERIAL AND METHODS A retrospective, observational, analytic, cross-sectional study included 100 SB2 capsule endoscopies and 100 SB3 capsule endoscopies in patients that presented with small bowel bleeding. The findings obtained with both systems were evaluated. The lesions identified by the two capsules were categorized using the Saurin classification. The relation between the lesions identified with the SB3 and those found with the SB2 was identified through a logistic regression analysis. RESULTS In the SB2 capsule endoscopy group, 60% were women, patient age was 59 years (42.2, 73), and intestinal transit time was 271min (182, 353). In the SB3 group, 57% were women, patient age was 60 years (42.5, 73), and intestinal transit time was 277min (182, 352). There were no significant differences in the identification of P0 and P2 lesions between the two systems. The SB3 capsule endoscope identified more P1 lesions (p=0.020, OR: 2.35, 95% CI:1.12-4.90). There was no significant difference in relation to location of the lesions in the small bowel. CONCLUSIONS A greater number of P1 lesions were detected through the technologic advances made in SB3 capsule endoscopy, but the diagnostic yield for P2 lesions was not modified.
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Affiliation(s)
- G Blanco-Velasco
- Servicio de Endoscopia, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México.
| | - O M Solórzano-Pineda
- Servicio de Endoscopia, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - C Mendoza-Segura
- Servicio de Endoscopia, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - O Hernández-Mondragón
- Servicio de Endoscopia, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
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Color masking improves classification of celiac disease in videocapsule endoscopy images. Comput Biol Med 2019; 106:150-156. [DOI: 10.1016/j.compbiomed.2018.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 12/10/2018] [Accepted: 12/18/2018] [Indexed: 02/06/2023]
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Aasen TD, Wilhoite D, Rahman A, Devani K, Young M, Swenson J. No significant difference in clinically relevant findings between Pillcam ® SB3 and Pillcam ® SB2 capsules in a United States veteran population. World J Gastrointest Endosc 2019; 11:124-132. [PMID: 30788031 PMCID: PMC6379749 DOI: 10.4253/wjge.v11.i2.124] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 01/20/2019] [Accepted: 01/26/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Capsule endoscopy (CE) allows for a non-invasive small bowel evaluation for a wide range of gastrointestinal (GI) symptoms and diseases. Capsule technology has been rapidly advancing over recent years, often improving image frequency and quality. The Pillcam® SB3 (SB3) capsule is one such technology that offers an adaptive frame rate advantage over the previous versions of the capsule the Pillcam® SB2 (SB2). Some have proposed that this improvement in capsule technology may lead to increased diagnostic yields; however, real world clinical data is currently lacking.
AIM To evaluate the clinically relevant findings of SB3 and SB2 capsules in a population of United States veterans.
METHODS A retrospective analysis of 260 consecutive CE studies was performed including 130 SB3 and 130 SB2 capsule studies. Recorded variables included: age, gender, type of capsule, body mass index, exam completion, inpatient status, opioid use, diabetes, quality of preparation, gastric transit time, small bowel transit time, indication, finding, and if the exam resulted in a change in clinical management. The primary outcome measured was the detection of clinically relevant findings between SB3 and SB2 capsules.
RESULTS Mean age of the study population was 67.1 ± 10.4 years and 94.2% of patients were male. Of these 28.1% were on opioid users. The most common indications for capsule procedure were occult GI bleeding (74.6%) and overt GI bleeding (14.6%). Rates of incomplete exam were similar between SB3 and SB2 groups (16.9% vs 9.2%, P = 0.066). The overall rate of clinically relevant finding was 48.9% in our study. No significant difference was observed in SB3 vs SB2 capsules for clinically relevant findings (46.2% vs 51.5%, P = 0.385) or change in clinical management (40.8% vs 50.0%, P = 0.135).
CONCLUSION Our study found no significant difference in clinically relevant findings between SB3 and SB2 capsules.
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Affiliation(s)
- Tyler D Aasen
- Gastroenterology Section, East Tennessee State University Quillen College of Medicine, Johnson City, TN 37604, United States
| | - David Wilhoite
- Gastroenterology Section, East Tennessee State University Quillen College of Medicine, Johnson City, TN 37604, United States
| | - Aynur Rahman
- Gastroenterology Section, East Tennessee State University Quillen College of Medicine, Johnson City, TN 37604, United States
| | - Kalpit Devani
- Gastroenterology Section, East Tennessee State University Quillen College of Medicine, Johnson City, TN 37604, United States
| | - Mark Young
- Gastroenterology Section, East Tennessee State University Quillen College of Medicine, Johnson City, TN 37604, United States
| | - James Swenson
- Gastroenterology Section, Mountain Home Veterans Affairs Healthcare System, Mountain Home, TN 37684, United States
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Nam SJ, Kim JH, Park SC. The Usefulness of New-Generation Capsule Endoscopy in Patients with Portal Hypertensive Enteropathy. Clin Endosc 2018; 51:505-507. [PMID: 30449077 PMCID: PMC6283760 DOI: 10.5946/ce.2018.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 10/31/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- Seung-Joo Nam
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Ji Hyun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Sung Chul Park
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
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Goenka MK, Shah BB, Rai VK, Jajodia S, Goenka U. Mucosal Changes in the Small Intestines in Portal Hypertension: First Study Using the Pillcam SB3 Capsule Endoscopy System. Clin Endosc 2018; 51:563-569. [PMID: 30300988 PMCID: PMC6283757 DOI: 10.5946/ce.2018.041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 07/18/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND/AIMS To evaluate patients with portal hypertension (PH) of varied etiologies for portal hypertensive enteropathy (PHE) using the PillCam SB3 capsule endoscopy (CE) system. METHODS Consecutive patients with PH presenting with unexplained anemia and/or occult gastrointestinal bleeding were evaluated using the PillCam SB3 CE system. Abnormal findings were categorized as vascular or non-vascular. The patients with ongoing bleeding caused by PHE were treated. The correlation of the CE scores of PHE with the clinical, laboratory, and endoscopic features was determined. RESULTS Of the 43 patients included in the study, 41 (95.3%) showed PHE findings. These included varices (67.4%), red spots (60.5%), erythema (44.2%), villous edema (46.5%), telangiectasia (16.3%), and polyps (16.3%). The CE scores varied from 0 to 8 (mean±standard deviation, 4.09±1.8). Five patients (11.6%) showed evidence of ongoing or recent bleeding due to PHE. Three of these five patients underwent endotherapy, and one patient underwent radiological coil placement. CONCLUSION The PillCam SB3 CE system revealed a high prevalence of PHE in the patients with PH. Using this system, evidence of bleeding due to PHE was found in a small but definite proportion of the patients.
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Affiliation(s)
| | - Bhavik Bharat Shah
- Institute of Gastro-Sciences, Apollo Gleneagles Hospitals, Kolkata, India
| | - Vijay Kumar Rai
- Institute of Gastro-Sciences, Apollo Gleneagles Hospitals, Kolkata, India
| | - Surabhi Jajodia
- Department of Clinical Imaging and Interventional Radiology, Apollo Gleneagles Hospitals, Kolkata, India
| | - Usha Goenka
- Department of Clinical Imaging and Interventional Radiology, Apollo Gleneagles Hospitals, Kolkata, India
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Impact of magnetic steering on gastric transit time of a capsule endoscopy (with video). Gastrointest Endosc 2018; 88:746-754. [PMID: 30005825 DOI: 10.1016/j.gie.2018.06.031] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 06/29/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUNDS AND AIMS Delayed gastric transit of the capsule may lead to incomplete small bowel examination, reducing the diagnostic yield. Thus, this study was designed to determine if magnetic steering could enhance capsule gastric emptying and mucosal visualization within the duodenum. METHODS The intervention group comprised 100 patients undergoing magnetic-controlled capsule endoscopy between May to September 2017 in whom magnetic control was used to assist transpyloric passage of the capsule and duodenal inspection. A cohort of 100 patients who had undergone the procedure before May 2017 was randomly selected from the database as an historic control group in whom transpyloric movement of the capsule occurred spontaneously (without magnetic assistance). The difference in the pyloric transit time (PTT) and duodenal papilla detection rate (DPDR) between the 2 groups were compared, and related factors were also investigated. RESULTS Transpyloric passage of the capsule under magnetic control was successfully performed in 59 patients (59%). Median PTT was greatly reduced in the intervention group from 58.38 minutes (range, 13.45-87.47) to 4.69 minutes (range, 1.56-55.00; P < .001), and DPDR was also greatly improved with magnetic steering (30.5% vs 9%, P < .001). Magnetic steering, male gender, and higher body mass index were independently associated with reduced gastric transit time and magnetic steering with an enhanced DPDR. CONCLUSIONS Magnetic steering of the capsule can enhance gastric emptying of the capsule and may prove useful in nonobese and female patients who appeared to have longer gastric transit time and achieved a better DPDR than that under the action of peristalsis alone. (Clinical trial registration number: NCT03441945.).
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Spiceland CM, Lodhia N. Endoscopy in inflammatory bowel disease: Role in diagnosis, management, and treatment. World J Gastroenterol 2018; 24:4014-4020. [PMID: 30254405 PMCID: PMC6148432 DOI: 10.3748/wjg.v24.i35.4014] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 07/29/2018] [Accepted: 08/01/2018] [Indexed: 02/06/2023] Open
Abstract
Endoscopy plays a fundamental role in the diagnosis, management, and treatment of inflammatory bowel disease (IBD). Colonoscopy, flexible sigmoidoscopy, and esophagogastroduodenoscopy have long been used in the care of patients with IBD. As endoscopic technologies have progressed, tools such as endoscopic ultrasound, capsule endoscopy, and balloon-assisted enteroscopy have expanded the role of endoscopy in IBD. Furthermore, chromoendoscopy has enhanced our ability to detect dysplasia in IBD. In this review article, we will focus on the roles, indications, and limitations of these tools in IBD. We will also discuss the most commonly used endoscopic scoring systems, as well as special considerations in post-surgical patients. Lastly, we will discuss the role of endoscopy in the diagnosis and management of fistulae and strictures.
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Affiliation(s)
- Clayton M Spiceland
- Division of Gastroenterology and Hepatology, Medical University of South Carolina, Charleston, SC 29425, United States
| | - Nilesh Lodhia
- Division of Gastroenterology and Hepatology, University of North Carolina, Charlotte, NC 28204, United States
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Omori T, Hara T, Sakasai S, Kambayashi H, Murasugi S, Ito A, Nakamura S, Tokushige K. Does the PillCam SB3 capsule endoscopy system improve image reading efficiency irrespective of experience? A pilot study. Endosc Int Open 2018; 6:E669-E675. [PMID: 29868632 PMCID: PMC5979195 DOI: 10.1055/a-0599-5852] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 02/20/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND AND STUDY AIMS The aim of this study was tp compare the diagnostic efficiency of the PillCam SB3 capsule endoscopy (CE) system with the older system, PillCam SB2, taking into consideration the experience of the image reader. PATIENTS AND METHODS Small intestinal CE was conducted on 64 patients around May 2014 when the SB3 was introduced in our hospital. Data obtained from 20 patients (SB2: 10 and SB3: 10) based on transit time were assessed by junior (experience: 20 images), intermediate (> 50), and expert readers (> 600). RESULTS Reading time with the CE down to the end of the small intestine was shorter in the SB3 group for each reader (SB2 vs. SB3: junior, 40.2 ± 10.1 vs. 23.7 ± 6.7 [ P = 0.0009]; intermediate, 21.4 ± 4.9 vs. 10.3 ± 2.9 [ P = 0.0003]; expert, 23.2 ± 5.6 vs. 11.1 ± 2.9 min [ P = 0.0002]). Interpretation agreement rates between the findings by junior and intermediate readers and those by the expert reader were 84.6 % and 92.3 %, respectively. For the junior reader, rates of agreement using the SB2 and SB3 systems with those by the expert reader were 85.7 % and 83.3 %, respectively; no significant difference was noted between the two systems. Similarly, for the intermediate reader, the respective agreement rates using the SB2 and SB3 systems were 85.7 % and 100 %, respectively. CONCLUSIONS The PillCam SB3 reduces the time burden on readers irrespective of their experience.
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Affiliation(s)
- Teppei Omori
- Institute of Gastroenterology, Tokyo Women’s University, Tokyo, Japan,Corresponding author Teppei Omori, MD Institute of GastroenterologyTokyo Women’s Medical University8-1 Kawada-choShinjuku-kuTokyo 162-8666Japan+81-3-5269-7507
| | - Toshifumi Hara
- Institute of Gastroenterology, Tokyo Women’s University, Tokyo, Japan
| | - Sachiyo Sakasai
- Central Clinical Laboratory, Tokyo Women’s Medical University, Tokyo, Japan
| | | | - Shun Murasugi
- Institute of Gastroenterology, Tokyo Women’s University, Tokyo, Japan
| | - Ayumi Ito
- Institute of Gastroenterology, Tokyo Women’s University, Tokyo, Japan
| | - Shinichi Nakamura
- Institute of Gastroenterology, Tokyo Women’s University, Tokyo, Japan
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Diagnostic Benefit of Simultaneous Capsule Endoscopy Using Two Different Systems. Gastroenterol Res Pract 2018; 2018:9798546. [PMID: 29997649 PMCID: PMC5994584 DOI: 10.1155/2018/9798546] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 12/24/2017] [Accepted: 01/17/2018] [Indexed: 02/07/2023] Open
Abstract
Background/Aims Capsule endoscopy (CE) is a noninvasive test for diagnosing small bowel disorders. However, several studies reported that the CE-based visualization is suboptimal. This study, the first to use two CEs simultaneously, aimed at evaluating the diagnostic ability of dual CE. Methods Dual CE procedures were prospectively conducted. All patients completed bowel cleansing 2 hours before examination. Subsequently, they simultaneously swallowed two capsules: MiroCam (IntroMedic, Seoul, Korea) and PillCam SB3 (Medtronic, Minneapolis, USA). We assessed the completeness and feasibility of small bowel examination and the detection rate of duodenal papilla and diagnostic yield. Results Twenty consecutive patients who underwent complete small bowel examination with dual CE were enrolled in the study. The mean time of small bowel passage was 245 ± 99 min. Dual CE examination increased the duodenal papilla detection rate to up to 75% (versus PillCam SB3 alone (P = 0.031) and MiroCam alone (P = 0.063)) and overall diagnostic yield to up to 70% (P = 0.063) in comparison to single CE. Adverse events or electrical interference during data transmission between the two capsule endoscopes were not detected. Conclusions In this study, we found that dual CE enhances diagnostic accuracy and could increase the diagnostic power of existing CE systems using simply applicable methods. This trial is registered with KCT0002541.
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Third-Generation Capsule Endoscopy Outperforms Second-Generation Based on the Detectability of Esophageal Varices. Gastroenterol Res Pract 2016; 2016:9671327. [PMID: 27980536 PMCID: PMC5131243 DOI: 10.1155/2016/9671327] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 10/13/2016] [Accepted: 10/20/2016] [Indexed: 12/28/2022] Open
Abstract
Background and Aim. The third-generation capsule endoscopy (SB3) was shown to have better image resolution than that of SB2. The aim of this study was to compare SB2 and SB3 regarding detectability of esophageal varices (EVs). Methods. Seventy-six consecutive liver cirrhosis patients (42 men; mean age: 67 years) received SB3, and 99 (58 men; mean age, 67 years old) received SB2. All patients underwent esophagogastroduodenoscopy within 1 month prior to capsule endoscopy as gold standard for diagnosis. The diagnosis using SB3 and SB2 for EVs was evaluated regarding form (F0–F3), location (Ls, Lm, and Li), and the red color (RC) sign of EVs. Results. SB2 and SB3 did not significantly differ on overall diagnostic rates for EV. Sensitivity, specificity, positive predictive value, and negative predictive value of SB2/SB3 for EV diagnosis were, respectively, 65%/81%, 100%/100%, 100%/100%, and 70%/62%. However, the diagnostic rates for EV form F1 were 81% using SB3 and 52% using SB2 (P = 0.009). Further, the diagnostic rates for Ls/Lm varices were 79% using SB3 and 81% using SB2, and, for Li, varices were 84% using SB3 and 52% using SB2 (P = 0.02). Conclusion. SB3 significantly improved the detectability of EVs compared with SB2.
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