Screening of Barrett's esophagus with string-capsule endoscopy: a prospective blinded study of 100 consecutive patients using histology as the criterion standard

String esophageal capsule endoscopy with real-time viewing improves visualization of the distal esophageal Z-line

“…First, the passage of the PillCam ESO wireless CE along the esophagus is entirely passive and the examiner cannot control visualization in a real-time manner to improve the imaging quality of the areas of interest [8,14]. Second, the presence of an air bubble or saliva usually impairs the clarity of the Z-line view and results in an insufficient view of the Z-line [15,16].…”

“…Previous studies have shown that attachment of a string prolongs the transit time of the PillCam SB capsule endoscope and improves the diagnostic accuracy of esophageal diseases [8,9]. However, the PillCam SB capsule endoscope is normally designated for small bowel examination, but is not suitable for viewing esophageal mucosa because of a limited shooting frequency of 2 frames/s.…”

“…String capsule endoscopy, a modified capsule endoscopy reported by Ramirez et al [8], is operator, but not physiology, dependent and allows a longer esophageal transit time, thus providing more esophageal images. The attachment of a string to ECE, namely, string esophageal capsule endoscopy (SECE), is considered to improve the operability and diagnostic yield in the identification of esophageal pathology.…”

Developing a Nonendoscopic Screening Test for Barrett‘s Esophagus

“…This technique has eliminated the previous drawback of fast esophageal transit time and yielded a promising sensitivity and specificity of 93.5 and 78.7%. However, this approach has the same major drawback that it cannot take tissue biopsies [55].…”

Is it time to consider other options for Barrett's esophagus screening?

“…In a prospective, blinded study in which string capsule endoscopy was followed by standard endoscopy in 100 patients with chronic GERD, only 4 capsule endoscopes were required (a magnet was used to turn off the capsule between subjects) and the sensitivity and specificity for BE were 94% and 78%, respectively, when the histologic confirmation of BE was assessed as the comparator. 15 Another option, an ingestible esophageal sampling device (Cytosponge) coupled with an immunohistochemical marker, demonstrated excellent sensitivity and specificity compared with standard EGD for BE detection in more than 500 participants in the United Kingdom. 16 Compared with standard EGD, the sensitivity was 94% for any circumferential segments of 1 cm or greater, and 90% for any segments 2 cm or greater in length.…”