Detection of Lesions During Capsule Endoscopy: Physician Performance Is Disappointing

Zheng, YuanPu; Hawkins, Lauren; Wolff, J M; Goloubeva, Olga; Goldberg, Eric

doi:10.1038/ajg.2011.461

Cited by 93 publications

(66 citation statements)

References 15 publications

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“…1,2,6 Furthermore, the accuracy of VCE is heavily dependent on accurate interpretation that is not influenced by the reviewer's experience. 7,8 Historically, the VCE miss rates for vascular lesions, ulcers and neoplasms were 5.9%, 0.5% and 18.9%, respectively. 9 Computational methods, which are integral to the reviewing software of the VCE devices, could contribute to the reduction of both the time required by the reviewers and errors in human interpretation.…”

Section: Introductionmentioning

confidence: 99%

Software for enhanced video capsule endoscopy: challenges for essential progress

Iakovidis

Koulaouzidis

2015

Nat Rev Gastroenterol Hepatol

189

113

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Video capsule endoscopy (VCE) has revolutionized the diagnostic work-up in the field of small bowel diseases. Furthermore, VCE has the potential to become the leading screening technique for the entire gastrointestinal tract. Computational methods that can be implemented in software can enhance the diagnostic yield of VCE both in terms of efficiency and diagnostic accuracy. Since the appearance of the first capsule endoscope in clinical practice in 2001, information technology (IT) research groups have proposed a variety of such methods, including algorithms for detecting haemorrhage and lesions, reducing the reviewing time, localizing the capsule or lesion, assessing intestinal motility, enhancing the video quality and managing the data. Even though research is prolific (as measured by publication activity), the progress made during the past 5 years can only be considered as marginal with respect to clinically significant outcomes. One thing is clear-parallel pathways of medical and IT scientists exist, each publishing in their own area, but where do these research pathways meet? Could the proposed IT plans have any clinical effect and do clinicians really understand the limitations of VCE software? In this Review, we present an in-depth critical analysis that aims to inspire and align the agendas of the two scientific groups.

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Section: Introductionmentioning

confidence: 99%

Software for enhanced video capsule endoscopy: challenges for essential progress

Iakovidis

Koulaouzidis

2015

Nat Rev Gastroenterol Hepatol

189

113

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“…The limitations of our study include its retrospective design, interobserver variability in community based VCE interpretation [21] , reliance on capsule directed deep enteroscopy rather than attempting complete enteroscopy in all patients and the likelihood of false positive and false negative results at DBE. Correlation of VCE findings with pre-procedure preparation was not assessed since the effect of preparation on diagnostic yield remains controversial [10][11][12] .…”

mentioning

confidence: 99%

Accuracy of community based video capsule endoscopy in patients undergoing follow up double balloon enteroscopy

Tenembaum

Sison²,

Rubin³

2013

WJGE

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AIM:To determine the test characteristics of community based video capsule endoscopy (VCE) in patients undergoing sequential VCE and double balloon enteroscopy (DBE). METHODS:Eighty-nine patients (34 females, 55 males, mean age 66) who underwent both VCE and DBE from 2008-2010 were retrospectively reviewed. Lesions detected at VCE were categorized. Capsule directed DBE followed and included 44 antegrade, 11 retrograde and 34 combined antegrade and retrograde procedures. Lesions detected were compared utilizing the McNemar's test. RESULTS:Angioectasia detection with VCE was 25% and with DBE 35% (P < 0.03) with a calculated sensitivity and specificity of 58% and 93% respectively. Polyps were detected by VCE in 22% and in DBE 20%, (P = 0.6), with a sensitivity and specificity for VCE of 61% and 87%. Small bowel diverticula were only seen in 1% of VCE but in 12% of DBE patients (P < 0.002) with a calculated sensitivity and specificity of VCE of 9% and 100%.CONCLUSION: VCE would be moderately sensitive and specific overall with considerable variation by lesion. Furthermore, VCE cannot be relied upon to diagnose small bowel diverticula.© 2013 Baishideng. All rights reserved.Key words: Video capsule endoscopy; Double balloon enteroscopy; Angioectasia; Diverticulosis; Obscure gastrointestinal bleeding Core tip: Advances in endoscopic technology have revolutionized the evaluation of small intestinal disorders. Non-invasive imaging utilizing video capsule endoscopy (VCE) offers the potential to safely visualize the entire small bowel with a high diagnostic yield. It is limited by a lack of therapeutic ability, imprecise localization, failure to reach the colon in all cases and inconsistent visualization of the entire small bowel. Deep enteroscopy, utilizing double balloon enteroscopy (DBE), enables diagnostic and therapeutic endoscopy of the small bowel. Although total enteroscopy can be accomplished, it typically requires antegrade and retrograde approaches. In most clinical situations, VCE is performed initially. By using DBE as the criterion (gold) standard, the sensitivity and specificity of community based VCE can be assessed for individual lesions, offering a more informative comparison than diagnostic yield.

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“…In a survey including 530 members of the American College of Gastroenterology, SingleView, DualView, and QuadView were used by 23.7%, 40.4%, and 54.5%, respectively [65]. QuadView has a theoretical advantage of longer single frame exposure time compared to SingleView, helping interpreters in detecting more lesions [63,66] However, QuadView might have a drawback of making readers rely on their peripheral vision because of simultaneous focusing on several images [66]. …”

Section: Postprocedural Quality Indicatorsmentioning

confidence: 99%

Quality Indicators for Small Bowel Capsule Endoscopy

et al. 2017

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Capsule endoscopy (CE) enables evaluation of the entire mucosal surface of the small bowel (SB), which is one of the most important steps for evaluating obscure gastrointestinal bleeding. Although the diagnostic yield of SB CE depends on many clinical factors, there are no reports on quality indicators. Thus, the Korean Gut Image Study Group (KGISG) publishes an article titled, “Quality Indicators for Small Bowel Capsule Endoscopy” under approval from the Korean Society of Gastrointestinal Endoscopy (KSGE). Herein, we initially identified process quality indicators, while the structural and outcome indicators are reserved until sufficient clinical data are accumulated. We believe that outcomes of SB CE can be improved by trying to meet our proposed quality indicators.

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Detection of Lesions During Capsule Endoscopy: Physician Performance Is Disappointing

Cited by 93 publications

References 15 publications

Software for enhanced video capsule endoscopy: challenges for essential progress

Software for enhanced video capsule endoscopy: challenges for essential progress

Accuracy of community based video capsule endoscopy in patients undergoing follow up double balloon enteroscopy

Quality Indicators for Small Bowel Capsule Endoscopy

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