Comparison of Capsule Endoscopy and Magnetic Resonance Imaging for the Detection of Polyps of the Small Intestine in Patients with Familial Adenomatous Polyposis or with Peutz-Jeghers’ Syndrome

Abstract

Polyps bigger than 15 mm were detected similarly with capsule endoscopy and MRI, whereas smaller polyps were seen much more often with capsule endoscopy. Polyps smaller than 5 mm were exclusively seen with capsule endoscopy. However, location of the detected polyps and determination of their exact sizes was more accurate by MRI.

Five years’ experience with capsule endoscopy in a single center

“…Several studies comparing the yield of CE to other imaging modalities in patients with polyposis syndromes have shown that CE is accurate in the detection of polyps. The same studies also emphasized that CE is not reliable for sizing and determining localization of polyps [57][58][59][60] . The duodenum is a potential blind point of CE because the capsule passes quickly with tumble and results in inadequate examination.…”

Videocapsule Endoscopy of the Small Bowel

“…However, CE provided incomplete data regarding large polyps, while MRI provided a better estimation of their site and size. (Caspari R et al, 2004) Recent data suggests that CE may be used as a replacement for enteroclysis for surveillance of Peutz-Heghers syndrome patients; however this is not accurate in all cases, as it has low sensitivity for identifying the major papilla, also being inaccurate in distinguishing between periampullar and ampullary regions. (Ladas et al, 2009) …”

Capsule endoscopy in non-steroidal anti-inflammatory drugs-enteropathy and miscellaneous, rare intestinal diseases

“…Intussusception of the polyps may cause intestinal obstruction, while ulcerated lesions may be responsible for acute or chronic gastrointestinal bleeding. CE can detect polyps in the entire length of the small intestines, with a higher diagnostic yield compared to CT scan and MRI with enteroclysis, particularly for lesions < 1 cm in diameter [18] . The role of CE has recently been established in the initial workup, as well as for the follow-up of patients with PeutzJeghers syndrome [18] .…”

“…CE can detect polyps in the entire length of the small intestines, with a higher diagnostic yield compared to CT scan and MRI with enteroclysis, particularly for lesions < 1 cm in diameter [18] . The role of CE has recently been established in the initial workup, as well as for the follow-up of patients with PeutzJeghers syndrome [18] . However, it is difficult to determine the size of the polyps on capsule recordings, which is an important factor in selecting patients for removal by DBE.…”