Meta-Analysis of the Yield of Capsule Endoscopy in Patients with Crohn's Disease

Erber, William F.; Erber, Jonathan A.

doi:10.1111/j.1572-0241.2006.00809_8.x

Cited by 6 publications

(3 citation statements)

References 3 publications

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“…The utility of a clinical score system has been questioned and it provides only limited information about the GI segment affected (1). Numerous other techniques are clinically used to assess disease activity including computed tomography (CT), ultrasound, ileocolonoscopy, capsule endoscopy, and/or surgical techniques in conjunction with tissue biopsy (2)(3)(4)(5). However, these techniques are either associated with low diagnostic accuracy (ultrasound), ionizing radiation (CT), are invasive (endoscopy), or may have contraindications in the setting of obstruction (capsule endoscopy).…”

mentioning

confidence: 99%

Role of spectral presaturation attenuated inversion‐recovery fat‐suppressed T2‐weighted MR imaging in active inflammatory bowel disease

Udayasankar

Martín

Lauenstein

et al. 2008

Magnetic Resonance Imaging

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Purpose:To retrospectively evaluate the efficacy of spectral presaturation attenuated inversion-recovery (SPAIR) fatsuppressed (FS) partial Fourier single shot (SSH) T2-weighted (T2W) and gadolinium-enhanced (Gd) FS 3D-gradient echo (3DGRE) T1-weighted (T1W) delayed phase MRI to differentiate active bowel inflammation from fibrotic disease in patients with Crohn's disease (CD). Materials and Methods:MRI studies of 81 patients (mean age, 43 years; range, 22-77 years; M:F ratio 33:48) had T2W and T1W imaging including SPAIR-SSH and delayed Gd-3DGRE. The ability to assess disease activity in bowel segments affected were retrospectively evaluated by a grading scheme based on subjective analysis of signal intensities. These results were compared against the standard clinical parameters of disease activity.Results: SPAIR-SSH images correlated better (r ϭ 0.74, P Ͻ 0.0001) with activity than delayed Gd-3DGRE (r ϭ 0.39, P ϭ 0.0003), with a significant difference between the two techniques (P Ͻ 0.0001). SPAIR-SSH images showed higher specificity in detection of severely active disease in per patient (98%) and segmental (98%) analysis compared to Gd-3DGRE (57%, 70%). Gd-3DGRE technique showed significantly higher sensitivity (P ϭ 0.01) in identifying active disease in per patient (83%) and segmental (85%) analysis compared to SPAIR-SSH (70%, 64%).Conclusion: SPAIR-SSH detects actively diseased CD bowel segments with a high level of specificity. Noninflammatory bowel fibrosis corresponds to abnormal uptake on delayed phase Gd-3DGRE images but without associated elevated abnormal signal on SPAIR-SSH.

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mentioning

confidence: 99%

Role of spectral presaturation attenuated inversion‐recovery fat‐suppressed T2‐weighted MR imaging in active inflammatory bowel disease

Udayasankar

Martín

Lauenstein

et al. 2008

Magnetic Resonance Imaging

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“…The type of endoscopic assessment should be determined by known sites of involvement and clinical presentation (level D). Capsule endoscopy or enteroscopy may be considered in patients with negative ileocolonoscopy and imaging evaluations (level D) [24,98,99,100,101]. …”

Section: Monitoring In Symptomatic Patientsmentioning

confidence: 99%

Monitoring Disease Activity and Progression in Crohn's Disease. A Swiss Perspective on the IBD Ahead ‘Optimised Monitoring' Recommendations

Sauter

Beglinger²,

Girardin³

et al. 2014

Digestion

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Background and Aims: The structured IBD Ahead ‘Optimised Monitoring' programme was designed to obtain the opinion, insight and advice of gastroenterologists on optimising the monitoring of Crohn's disease activity in four settings: (1) assessment at diagnosis, (2) monitoring in symptomatic patients, (3) monitoring in asymptomatic patients, and (4) the postoperative follow-up. For each of these settings, four monitoring methods were discussed: (a) symptom assessment, (b) endoscopy, (c) laboratory markers, and (d) imaging. Based on literature search and expert opinion compiled during an international consensus meeting, recommendations were given to answer the question ‘which diagnostic method, when, and how often'. The International IBD Ahead Expert Panel advised to tailor this guidance to the healthcare system and the special prerequisites of each country. The IBD Ahead Swiss National Steering Committee proposes best-practice recommendations adapted for Switzerland. Methods: The IBD Ahead Steering Committee identified key questions and provided the Swiss Expert Panel with a structured literature research. The expert panel agreed on a set of statements. During an international expert meeting the consolidated outcome of the national meetings was merged into final statements agreed by the participating International and National Steering Committee members - the IBD Ahead ‘Optimized Monitoring' Consensus. Results: A systematic assessment of symptoms, endoscopy findings, and laboratory markers with special emphasis on faecal calprotectin is deemed necessary even in symptom-free patients. The choice of recommended imaging methods is adapted to the specific situation in Switzerland and highlights the importance of ultrasonography and magnetic resonance imaging besides endoscopy. Conclusion: The recommendations stress the importance of monitoring disease activity on a regular basis and by objective parameters, such as faecal calprotectin and endoscopy with detailed documentation of findings. Physicians should not rely on symptoms only and adapt the monitoring schedule and choice of options to individual situations.

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“…Techniques used to assess disease activity include endoscopy, capsule endoscopy, and/or surgical techniques in conjunction with tissue biopsy (29)(30)(31)(32). However, these techniques are invasive (endoscopy) or may have contraindications (capsule endoscopy) in the setting of suspected bowel stenosis and obstruction.…”

Section: Clinical Use Of Small Bowel Mrementioning

confidence: 99%

Magnetic resonance enterography in crohn’s disease: techniques, interpretation, and utilization for clinical management

Martín

Kalb

Sauer

et al. 2011

Diagn Interv Radiol

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Meta-Analysis of the Yield of Capsule Endoscopy in Patients with Crohn's Disease

Cited by 6 publications

References 3 publications

Role of spectral presaturation attenuated inversion‐recovery fat‐suppressed T2‐weighted MR imaging in active inflammatory bowel disease

Role of spectral presaturation attenuated inversion‐recovery fat‐suppressed T2‐weighted MR imaging in active inflammatory bowel disease

Monitoring Disease Activity and Progression in Crohn's Disease. A Swiss Perspective on the IBD Ahead ‘Optimised Monitoring' Recommendations

Magnetic resonance enterography in crohn’s disease: techniques, interpretation, and utilization for clinical management

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