Scoring Systems for Clinical Colon Capsule Endoscopy—All You Need to Know

Abstract

In the constantly developing era of minimal diagnostic invasiveness, the role of colon capsule endoscopy in colonic examination is being increasingly recognised, especially in the context of curtailed endoscopy services due to the COVID-19 pandemic. It is a safe diagnostic tool with low adverse event rates. As with other endoscopic modalities, various colon capsule endoscopy scores allow the standardisation of reporting and reproducibility. As bowel cleanliness affects CCE’s diagnostic yield, a few operator-dependent scores (Leighton–Rex and CC-CLEAR scores) and a computer-dependent score (CAC score) have been developed to grade bowel cleanliness objectively. CCE can be used to monitor IBD mucosal disease activity through the UCEIS and the panenteric CECDAIic score for UC and CD, respectively. CCE may also have a role in CRC screening, given similar sensitivity and specificity rates to conventional colonoscopy to detect colonic polyps ≥ 10 mm and CRC. Given CCE’s diagnostic yield and reproducible clinical scores with high inter-observer agreements, CCE is fast becoming a suitable alternative to conventional colonoscopy in specific patient populations.

TOP 100 and detection of colorectal lesions in colon capsule endoscopy: more than meets the eye

“…The diagnostic accuracy of CCE in the detection of colorectal lesions, namely colorectal polyps, has been thoroughly studied [23]. In a recent meta-analysis, the mean 95% CI sensitivity and specificity in polyp detection, compared with colonoscopy, was 85% (73–92%) and 85% (70–93%), respectively, for polyps of any size; 87% (83–90%) and 88% (75–95%), respectively, for polyps ≥6 mm; and 87% (82–90%) and 95% (92–97%), respectively, for polyps ≥10 mm [24].…”

Pan-Enteric Capsule Endoscopy: Current Applications and Future Perspectives

“…Whereas most scores have been established for colonoscopy and small bowel CE, their application in PCE to monitor IBD mucosal disease activity has also been proposed [ 13 ]. Niv et al [ 24 ] extended the validated Capsule Endoscopy Crohn’s Disease Activity Index (CECDAI) score to include the colon, introducing the novel CECDAIic score, allowing for an objective pan-enteric assessment of CD inflammatory activity [ 25 ]. In 2019, Arieira et al [ 26 ] applied the CECDAIic score in a cohort of CD patients who underwent PCE and found an excellent interobserver agreement (Kendall’s coefficient 0.94) and strong correlation with inflammatory parameters, especially calprotectin ( r s = 0.82; p = 0.012).…”