Head or Tail: The Orientation of the Small Bowel Capsule Endoscope Movement in the Small Bowel

Kopylov, Uri; Papageorgiou, Neofytos; Nadler, Moshe; Eliakim, Rami; Ben‐Horin, Shomron

doi:10.1007/s10620-011-1913-6

Cited by 6 publications

(4 citation statements)

References 7 publications

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“…The total transit time for the WMC was longer compared with the SBCE, which could be attributed to the differences in the capsules’ specifications as detailed in Table 2 1 5 6 and the difference in capsule density, Fig. 5 7 8 . The distribution of WGTT, FC and LS for those study subjects for whom the data were available is presented in Fig.…”

Section: Methodsmentioning

confidence: 99%

Morpho-functional evaluation of small bowel using wireless motility capsule and video capsule endoscopy in patients with known or suspected Crohn’s disease: pilot study

et al. 2016

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Background and study aims: SmartPill® (Given Imaging Corp.,Yoqneam,Israel) is an ingestible, non-imaging capsule that records physiological data including contractions and pH throughout the gastrointestinal tract. There are scarce data looking at SmartPill® assessment of patients with known/suspected small-bowel Crohn’s Disease (CD). This pilot study aims to investigate feasibility and safety of SmartPill® to assess gut motility in this group. Patients and methods: Over 1 year, patients with known/suspected CD, referred for small-bowel capsule endoscopy (SBCE), were invited to participate and 12 were recruited (7 female, 5 male, mean age 44.2 ± 16.6 years). They underwent hydrogen breath test to exclude small-bowel bacterial overgrowth, patency capsule (Agile®), and provided stool samples for fecal calprotectin (FC). Patients ingested PillCam®SB2 and SmartPill® 4 hours apart. Using unpublished data, 33 healthy controls also were identified for the study. P < 0.05 was considered statistically significant. Results: Of the 12 patients enrolled, 10 underwent complete Smartpill® examination (1 stomach retention, 1 dropout). Pillcam® was complete in 10 (1 dropout, 1 stomach retention). Mean fecal calprotectin was 340 ± 307.71 mcg/g. The study group had longer transit times and lower gut motility index than did the controls. The difference in motility appears to be statistically significant (P < 0.05). Longer transit times for SmartPill® (not statistically significant) may have been due to different specifications between the capsules. Limitations included transient Smartpill® signal loss (5/10 studies). Conclusions: This is the first pilot to attempt combining SBCE and SmartPill® to assess small-bowel CD. Data on motility in CD are scarce. Multimodal information can provide a clearer clinical picture. Despite concerns about capsule retention in CD patients, SmartPill® seems safe for use if a patency capsule is employed beforehand.

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Section: Methodsmentioning

confidence: 99%

Morpho-functional evaluation of small bowel using wireless motility capsule and video capsule endoscopy in patients with known or suspected Crohn’s disease: pilot study

et al. 2016

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“…The tumbling movements of the capsule (oblique-forward, oblique-reverse, perpendicular movements) often result in temporary visual interference that may render the images unsuitable for diagnostic purposes [15]. Furthermore, it is already known that even expert reviewers have a limited ability to recognize the vector of capsule movement in the small-bowel lumen or through anatomical sphincters [16][17][18].…”

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confidence: 99%

Optimizing lesion detection in small-bowel capsule endoscopy: from present problems to future solutions

Koulaouzidis

Iakovidis

Karargyris

et al. 2014

Expert Review of Gastroenterology & Hepatology

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This review presents issues pertaining to lesion detection in small-bowel capsule endoscopy (SBCE). The use of prokinetics, chromoendoscopy, diagnostic yield indicators, localization issues and the use of 3D reconstruction are presented. The authors also review the current status (and future expectations) in automatic lesion detection software development. Automatic lesion detection and reporting, and development of an accurate lesion localization system are the main software challenges of our time. The 'smart', selective and judicious use (before as well as during SBCE) of prokinetics in combination with other modalities (such as real time and/or purge) improves the completion rate of SBCE. The tracking of the capsule within the body is important for the localization of abnormal findings and planning of further therapeutic interventions. Currently, localization is based on transit time. Recently proposed software and hardware solutions are proposed herein. Moreover, the feasibility of software-based 3D representation (attempt for 3D reconstruction) is examined.

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“…We read with great interest the article by Kopylov et al [1] on the orientation of the small-bowel capsule endoscope's (CE) movement in the small bowel. Although factors determining the orientation of a CE during a small-bowel study-and thus the diagnostic yield-are complex and largely due to random chance, this study represents an important attempt to highlight the importance of capsule passage orientation when imaging the small-bowel.…”

mentioning

confidence: 99%

“…Both reviewers (AK, reviewer 1 and SD, reviewer 2) have extensive experience with CE. We re-examined the SBCE aiming to detect the direction (head-or tail-first) of each CE system through the pylorus and the ileocecal valve as suggested by Kopylov et al [1]. In the PillCam Ò cohort, the pylorus was entered head-first in 13/20 (65%) and 14/20 (70%) examinations, for reviewer 1 and 2, respectively.…”

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confidence: 99%

Heads or Tail Orientation in Small-Bowel Capsule Endoscopy: 2 Capsule Models with 2 Reviewers

2012

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We read with great interest the article by Kopylov et al. [1] on the orientation of the small-bowel capsule endoscope's (CE) movement in the small bowel. Although factors determining the orientation of a CE during a small-bowel study-and thus the diagnostic yield-are complex and largely due to random chance, this study represents an important attempt to highlight the importance of capsule passage orientation when imaging the small-bowel.The authors have also clearly demonstrated (using submersion testing) that the PillCam Ò SB2 capsule has its center of gravity closer to the antenna dome due to the heavier battery compartment.In our center, we use two CE systems, i.e., Given Ò Imaging PillCam Ò and Intromedic Ò Ltd MiroCam Ò . We aimed to determine how the MiroCam Ò capsules compared to PillCam Ò in orientation of small-bowel movement.We therefore repeated the submersion experiment by immersing a PillCam Ò SB2 and a MiroCam Ò in a glass of plain tap water. It was noted that the PillCam Ò replicated the previous experiment by orientating its antenna's dome first. However, the MiroCam Ò lay horizontally on the bottom of the glass (Fig. 1).As Kopylov et al. point out, previous data suggest that that the vector of CE small-bowel transit impacts on the CE diagnostic yield [2]. It has been shown that single-headed CE may have limitations when compared to double-headed CE [3,4], in the detection of anatomical landmarks, i.e., ampulla of Vater.We have recently reported our center's experience with two different small-bowel capsule endoscopy systems [5]. Review of our dual system small-bowel capsule endoscopy (SBCE) patient database was performed and all SBCE with either suboptimal image quality due to poor preparation or technical failures, i.e., inability to retrieve video-sequences stored in compact disks due to time corruption and/or incomplete recording were excluded. The remaining 17 patients have been investigated multiple times with both CE systems at different points in their diagnostic work-up totaling 20 PillCam Ò procedures and 18 MiroCam Ò procedures. The indications for SBCE were: obscure (overt/ occult) gastrointestinal bleeding (n = 13), Crohn's (known/suspected) disease assessment (n = 4). Both reviewers (AK, reviewer 1 and SD, reviewer 2) have extensive experience with CE. We re-examined the SBCE aiming to detect the direction (head-or tail-first) of each CE system through the pylorus and the ileocecal valve as suggested by Kopylov et al. [1]. In the PillCam Ò cohort, the pylorus was entered head-first in 13/20 (65%) and 14/20 (70%) examinations, for reviewer 1 and 2, respectively. The head-first direction of transit through the IC valve was seen in 14/20 (70%) and 15/20 (75%) examinations, for reviewer 1 and 2, respectively. In the MiroCam Ò group, the head-first pyloric entry was recorded in 13/18 (72%) and 14/18 (78%) examinations, for reviewer 1 and 2, respectively. For the IC head-first transit, the values were 14/18 (78%) and 11/18 (61%), respectively (Fig. 2).The interobserver variability was qu...

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Head or Tail: The Orientation of the Small Bowel Capsule Endoscope Movement in the Small Bowel

Cited by 6 publications

References 7 publications

Morpho-functional evaluation of small bowel using wireless motility capsule and video capsule endoscopy in patients with known or suspected Crohn’s disease: pilot study

Morpho-functional evaluation of small bowel using wireless motility capsule and video capsule endoscopy in patients with known or suspected Crohn’s disease: pilot study

Optimizing lesion detection in small-bowel capsule endoscopy: from present problems to future solutions

Heads or Tail Orientation in Small-Bowel Capsule Endoscopy: 2 Capsule Models with 2 Reviewers

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