Diagnostic capability of colon capsule endoscopy for advanced colorectal cancer: A pilot study

Ota, Yutaka; Yamada, Atsuo; Kobayashi, Yuka; Niikura, Ryota; Shimpoh, Takayuki; Narita, Atsushi; Yoshida, Shuntaro; Suzuki, Nobumi; Watabe, Hirotsugu; Hirata, Yoshihiro; Ishihara, Soichiro; Sunami, Eiji; Watanabe, Toshiaki; Koike, Kazuhiko

doi:10.1111/den.12862

Cited by 8 publications

(7 citation statements)

References 24 publications

(39 reference statements)

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“…Six studies [13][14][15][16][17][18] had a low risk of bias in relation to patient selection, as either random or consecutive sample of patients were used. Two studies [19,20] were classified with high risk of bias in relation to the index test (CCE), as descriptions of the blinding process were insufficient. Because of the unproven capability of colonoscopy as a true gold standard, the reference standard (colonoscopy) was classified as high risk of bias in all studies but one [16], which used a segmental unblinding during the colonoscopy procedure.…”

Section: Literature Search and Quality Assessmentmentioning

confidence: 99%

“…Only the study by Ota et al [20] reported sensitivity and specificity for detection of cancer. However, as all included patients were CRC positive on inclusion, only sensitivity was re-ported.…”

Section: Diagnostic Yield Of Other Findingsmentioning

confidence: 99%

“…The literature search and update resulted in 1338 hits, of which 261 were duplicates. After abstract and title screening, 86 fulltext papers were retrieved and read thoroughly, and ultimately 12 studies were included in the current review [13][14][15][16][17][18][19][20][21][22][23][24]. The flowchart is presented in Fig.…”

Section: Literature Search and Quality Assessmentmentioning

confidence: 99%

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Diagnostic accuracy of capsule endoscopy compared with colonoscopy for polyp detection: systematic review and meta-analyses

et al. 2020

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Background: Colon capsule endoscopy (CCE) is a technology that might contribute to colorectal cancer (CRC) screening programs as a filter test between fecal immunological test and standard colonoscopies (SC). The aim was to systematically review the literature for studies investigating the diagnostic yield of 2nd generation CCE compared to SC. Methods: A systematic literature search was performed in PubMed, Embase and Web of Science. Study characteristics including quality of bowel preparation and completeness of CCE transits were extracted. Per-patient sensitivity and specificity were extracted for polyps (any size; ≥ 10mm, ≥6 mm) and lesion characteristics. Meta-analyses of diagnostic yield were performed. Results: The literature search revealed 1077 unique papers and 12 studies were included. These included 2199 in total of which 1898 patients were available for analyses. The rate of patients with adequate quality of the bowel preparation varied from 40% to 100%. The rates of complete CCE transits varied from 57% to 100%. Our meta-analyses demonstrated that mean [95% confidence interval] sensitivity, specificity and diagnostic odds ratio was 0.85 [0.73;0.92], 0.85 [0.70;0.93] and 30.5 [16.2;57.2], respectively for polyps of any size, 0.87 [0.82;0.90], 0.95 [0.92;0.97] and 136.0 [70.6;262.1], respectively for polyps ≥ 10mm and 0.87 [0.83;0.90], 0.88 [0.75;0.95] and 51.1 [19.8;131.8], respectively for polyps ≥ 6mm. No serious adverse events were reported for CCE. Conclusion: In conclusion, CCE has a high sensitivity and specificity for per-patient polyps compared to SC. However, the relatively high rate of incomplete investigations limits the application of CCE in a CRC-screening setting.

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Section: Literature Search and Quality Assessmentmentioning

confidence: 99%

Section: Diagnostic Yield Of Other Findingsmentioning

confidence: 99%

Section: Literature Search and Quality Assessmentmentioning

confidence: 99%

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Diagnostic accuracy of capsule endoscopy compared with colonoscopy for polyp detection: systematic review and meta-analyses

et al. 2020

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“…CTC has high patient acceptability and high sensitivity for polypoid lesions [8,9], whereas CCE has higher sen- sitivity for non-polypoid tumours as demonstrated in the present study. Even advanced colon cancers can be missed in failed CCE studies [32], but CTC can depict advanced colon cancers in almost 100% [8,9]. The combination of CCE and CTC might be useful as a colon screening test.…”

Section: Cce Versus Ctc For Non-polypoid Tumoursmentioning

confidence: 99%

Colon Capsule Endoscopy versus CT Colonography in Patients with Large Non-Polypoid Tumours: A Multicentre Prospective Comparative Study (4CN Study)

Utano

Katsuki

Matsuda³

et al. 2019

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Background/Aims: Non-polypoid colon lesions compared with polypoid lesions has a high malignant potential. The diagnostic performance of colon capsule endoscopy (CCE) and CT colonography (CTC) for large colorectal non-polypoid tumours, that is, laterally spreading tumours is still unclear. The aim of this study is to evaluate the performance of CCE and CTC for the diagnosis of large non-polypoid tumours. Methods: Thirty patients referred for endoscopic submucosal dissection of non-polypoid tumours measuring ≥20 mm were enrolled. Patients first underwent CCE, then colonoscopy (without resection) and CTC on the same day. An experienced gastroenterologist in a third hospital evaluated the CCE and recorded the location, size and morphology of all lesions detected, blinded to the colonoscopic findings. An experienced radiologist read the CTC under the same conditions. Colonoscopic findings were defined as the reference. Results: A total of 30 lesions (T1 cancer: 3, Tis cancer: 7, adenoma: 14, sessile serrated adenoma/polyp: 6) in 27 patients were observed for evaluation. The capsule excretion rate within 8 h was 85% (23/27), and all capsules went beyond the target lesions. Non-polypoid tumours tend to be depicted as polypoid on CCE. Per patient sensitivities were 0.89 (24/27) by CCE and 0.70 (19/27) by CTC (p = 0.0253, McNemar), and per lesion sensitivities were 0.87 (26/30) and 0.67 (20/30) respectively (p = 0.0143). Most lesions missed by both modalities were located in the proximal colon. Conclusion: Eighty-seven per cent of non-polypoid tumours were detected by CCE, and the sensitivity using CCE was higher than that obtained using CTC (UMIN0000014772).

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“…Recently, a minimally invasive method, colon capsule endoscopy (CCE), has been used to investigate these neoplasms [2,3]. However, it is time-consuming to review 50 000 images per patient (requiring approximately 1 hour) [4].…”

Section: Introductionmentioning

confidence: 99%

Automatic detection of colorectal neoplasia in wireless colon capsule endoscopic images using a deep convolutional neural network

et al. 2020

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Background and Aims: Although colorectal neoplasias are the most common abnormalities found in colon capsule endoscopy (CCE), no computer-aided detection method is yet available. We developed an artificial intelligence (AI) system that uses deep learning to automatically detect such lesions in CCE images. Methods: We trained a deep convolutional neural network system based on a Single Shot Multibox Detector using 15,933 CCE images of colorectal neoplasias such as polyps and cancers. We assessed performance by calculating areas under the receiver operating characteristic curves and sensitivities, specificities, and accuracies using an independent test set of 4,784 images including 1,850 images of colorectal neoplasias and 2,934 normal colon images. Results: The area under the curve for detection by the AI model of colorectal neoplasias was 0.902. The sensitivity, specificity, and accuracy were 79.0%, 87.0%, and 83.9%, respectively, at a probability cutoff of 0.348. Conclusions: We developed and validated a new AI-based system that automatically detects colorectal neoplasias in CCE images.

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Diagnostic capability of colon capsule endoscopy for advanced colorectal cancer: A pilot study

Abstract: The diagnostic capability of CCE in detecting advanced CRC was limited in cases of procedure incompletion. Refining procedures to increase CCE procedure completion rates are required to enhance CRC detection.

Cited by 8 publications

References 24 publications

Diagnostic accuracy of capsule endoscopy compared with colonoscopy for polyp detection: systematic review and meta-analyses

Diagnostic accuracy of capsule endoscopy compared with colonoscopy for polyp detection: systematic review and meta-analyses

Colon Capsule Endoscopy versus CT Colonography in Patients with Large Non-Polypoid Tumours: A Multicentre Prospective Comparative Study (4CN Study)

Automatic detection of colorectal neoplasia in wireless colon capsule endoscopic images using a deep convolutional neural network

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