Capsule endoscopy (CE) is a novel technology that facilitates highly effective and noninvasive imaging of the small bowel. Although its effi cacy in the evaluation of obscure gastrointestinal bleeding (OGIB) has been ...Capsule endoscopy (CE) is a novel technology that facilitates highly effective and noninvasive imaging of the small bowel. Although its effi cacy in the evaluation of obscure gastrointestinal bleeding (OGIB) has been proven in several trials, data on uses of CE in different small bowel diseases are rapidly accumulating in the literature, and it has been found to be superior to alternative diagnostic tools in a range of such diseases. Based on literature evidence, CE is recommended as a first-line investigation for OGIB after negative bi-directional endoscopy. CE has gained an important role in the diagnosis and follow-up of Crohn's disease and celiac disease and in the surveillance of small bowel tumors and polyps in selected patients. Capsule retention is the major complication, with a frequency of 1%-2%. The purpose of this review was to discuss the procedure, indications, contraindications and adverse effects associated with CE. We also review and share our five-year experience with CE in various small bowel diseases. The recently developed balloon-assisted enteroscopies have both diagnostic and therapeutic capability. At the present time, CE and balloon-assisted enteroscopies are complementary techniques in the diagnosis and management of small bowel diseases.展开更多
Objective： To assess the diagnostic efficiency of OMOM capsule endoscopy （CE） in a group of patients with different indications. Methods： Data from 89 consecutive patients （49 males, 40 females） with suspected s...Objective： To assess the diagnostic efficiency of OMOM capsule endoscopy （CE） in a group of patients with different indications. Methods： Data from 89 consecutive patients （49 males, 40 females） with suspected small bowel disease who underwent OMOM CE （Jinshan Science and Technology Company, review. The patients＇ indications of the disease consisted of the Chongqing, China） examination were obtained by retrospective following： obscure gastrointestinal bleeding （OGIB）, abdominal pain or diarrhea, partial intestinal obstruction, suspected inflammatory bowel disease, tumor of unknown origin, hypoproteinemia, constipation, weight loss, and elevated tumor markers. Results： CE failed in one patient. Visualization of the entire small bowel was achieved in 75.0%. Capsules were naturally excreted by all patients. The detection rate of abnormalities was 70.5% for patients with suspected small bowel disease, and the diagnostic yield for patients with OGIB was higher than that for patients with abdominal pain or diarrhea （85.7% vs 53.3%, P〈0.005）. Angiodysplasia was the most common small bowel finding. Active bleeding sites were noted in the small intestine in 11 cases. Conclusion： OMOM CE is a useful diagnostic tool for the diagnosis of variably suspected small bowel disease, whose diagnostic efficiency is similar to that of the Pillcam SB （small bowel） CE （Given Imaging, Yoqneam, Israel）.展开更多
AIM： To investigate whether the small bowel transit time （SBTT） influences the diagnostic yield of capsule endoscopy （CE）. METHODS： Six hundred and ninety-one consecutive CE procedures collected in a database we...AIM： To investigate whether the small bowel transit time （SBTT） influences the diagnostic yield of capsule endoscopy （CE）. METHODS： Six hundred and ninety-one consecutive CE procedures collected in a database were analyzed. SBTT and CE findings were recorded. A running mean for the SBl-I- was calculated and correlated to the diagnostic yield with a Spearman＇s correlation test. Subgroup anal- yses were performed for the various indications for the procedure. RESULTS： There was a positive correlation between the diagnostic yield and SBT1- （Spearman＇s rho 0.58, P 〈 0.01）. Positive correlations between diagnostic yield and SB-FI-were found for the indication obscure gastro- intestinal bleeding （r = 0.54, P 〈 0.01）, for polyposis and carcinoid combined （r = 0.56, P 〈 0.01） and for the other indications （r = 0.90, P 〈0.01）, but not for suspected Crohn＇s disease （r = -0.40） CONCLUSION： The diagnostic yield in small bowel capsule endoscopy is positively correlated with the small bowel transit time. This is true for all indications except for suspected Crohn＇s disease.展开更多
AIM： TO evaluate the effectiveness and safety of capsule endoscopy （CE） in patients with recurrent subacute small bowel obstruction.METHODS： The study was a retrospective analysis of 31 patients referred to hospit...AIM： TO evaluate the effectiveness and safety of capsule endoscopy （CE） in patients with recurrent subacute small bowel obstruction.METHODS： The study was a retrospective analysis of 31 patients referred to hospital from January 2003 to August 2008 for the investigation of subacute small bowel obstruction, who underwent CE. The patients were aged 9-81 years, and all of them had undergone gastroscopy and colonoscopy previously. Some of them received abdominal computed tomography or small bowel follow-through.RESULTS： CE made a definitive diagnosis in 12 （38.7%） of 31 cases： four Crohn＇s disease （CD）, two carcinomas, one intestinal tuberculosis, one ischemic enteritis, one abdominal cocoon, one duplication of the intestine,one diverticulum and one ileal polypoid tumor. Capsule retention occurred in three （9.7%） of 31 patients, and was caused by CD （2） or tumor （1）. Two with retained capsules were retrieved at surgery, and the other one of the capsules was spontaneously passed the stricture by medical treatment in 6 too. No case had an acute small bowel obstruction caused by performance of CE.CONCLUSION： CE provided safe and effective visualization to identify the etiology of a subacute small bowel obstruction, especially in patients with suspected intestinal tumors or CD, which are not identified by routine examinations.展开更多
AIM:To review the literature on capsule endoscopy(CE) for detecting esophageal varices using conventional esophagogas troduodenoscopy(EGD)as the standard. METHODS:A strict literature search of studies comparing the yi...AIM:To review the literature on capsule endoscopy(CE) for detecting esophageal varices using conventional esophagogas troduodenoscopy(EGD)as the standard. METHODS:A strict literature search of studies comparing the yield of CE and EGD in patients diagnosed or suspected as having esophageal varices was conducted by both computer search and manual search.Data were extracted to estimate the pooled diagnostic sensitivity and specificity. RESULTS:There were seven studies appropriate for meta-analysis in our study,involving 446 patients. The pooled sensitivity and specificity of CE for detecting esophageal varices were 85.8%and 80.5%, respectively.In subgroup analysis,the pooled sensitivity and specificity were 82.7%and 54.8%in screened patients,and 87.3%and 84.7%in the screened/ patients under surveillance,respectively. CONCLUSION:CE appears to have acceptable sensitivity and specificity in detecting esophageal varices.However,data are insufficient to determine the accurate diagnostic value of CE in the screen/ surveillance of patients alone.展开更多
The proposed deep learning algorithm will be integrated as a binary classifier under the umbrella of a multi-class classification tool to facilitate the automated detection of non-healthy deformities, anatomical landm...The proposed deep learning algorithm will be integrated as a binary classifier under the umbrella of a multi-class classification tool to facilitate the automated detection of non-healthy deformities, anatomical landmarks, pathological findings, other anomalies and normal cases, by examining medical endoscopic images of GI tract. Each binary classifier is trained to detect one specific non-healthy condition. The algorithm analyzed in the present work expands the ability of detection of this tool by classifying GI tract image snapshots into two classes, depicting haemorrhage and non-haemorrhage state. The proposed algorithm is the result of the collaboration between interdisciplinary specialists on AI and Data Analysis, Computer Vision, Gastroenterologists of four University Gastroenterology Departments of Greek Medical Schools. The data used are 195 videos (177 from non-healthy cases and 18 from healthy cases) videos captured from the PillCam<sup>(R)</sup> Medronics device, originated from 195 patients, all diagnosed with different forms of angioectasia, haemorrhages and other diseases from different sites of the gastrointestinal (GI), mainly including difficult cases of diagnosis. Our AI algorithm is based on convolutional neural network (CNN) trained on annotated images at image level, using a semantic tag indicating whether the image contains angioectasia and haemorrhage traces or not. At least 22 CNN architectures were created and evaluated some of which pre-trained applying transfer learning on ImageNet data. All the CNN variations were introduced, trained to a prevalence dataset of 50%, and evaluated of unseen data. On test data, the best results were obtained from our CNN architectures which do not utilize backbone of transfer learning. Across a balanced dataset from no-healthy images and healthy images from 39 videos from different patients, identified correct diagnosis with sensitivity 90%, specificity 92%, precision 91.8%, FPR 8%, FNR 10%. Besides, we compared the performance of our best CNN algorithm v展开更多
Objective： Small intestinal tumors （SBTs） were difficult to be discovered before surgery. The emergence of dou- ble-balloon enteroscopy （DBE） and capsule endoscopy （CE） have greatly improved the evaluation of S...Objective： Small intestinal tumors （SBTs） were difficult to be discovered before surgery. The emergence of dou- ble-balloon enteroscopy （DBE） and capsule endoscopy （CE） have greatly improved the evaluation of SBTs and facilitated a more precise preoperative diagnosis. Yet little data exist in China regarding clinical efficacy of DBE and clinical characteristics of SBTs. The aim of our study was to clarify the clinical characteristics of SBTs and analyze the efficacy of DBE examination in the detection and diagnosis of SBTs. Methods： We retrospectively reviewed patients who underwent DBE in our hospital between June 2011 and July 2014. Patients who were diagnosed with SBTs by DBE were included in the study. Results： A total of 316 patients underwent 321 DBE procedures, 80 （25.3%） of whom were suspected to have an SBT. And 59 of the 80 subjects were diagnosed with SBT finally. The majorities （59.3%, 35/59） of the patients diagnosed with SBT were males, whose average age was 61.8 years （SD _＋11.0 years）. DBE were frequently performed in patients with obscure gastrointes- tinal bleeding （66.1%）, abdominal pain （16.9%）. The common SBTs identified were： gastrointestinal stromal tumors （GISTs） （24/59, 40.7%）, adenocarcinomas （13/59, 22.0%）, lymphomas （6/59, 10.2%） and benign polyps （6/59, 10.2%）. Jejunum had the highest detection rate （47.5%, 29/61）. During the follow-up period （3 months to 3 years）, 14 patients were submitted to chemotherapy and two patients died of tumor. Conclusion： The most high frequency type and location of SBTs detected in our hospital were different from western countries. DBE is a valuable and safe examination for SBIs.展开更多
文摘Capsule endoscopy (CE) is a novel technology that facilitates highly effective and noninvasive imaging of the small bowel. Although its effi cacy in the evaluation of obscure gastrointestinal bleeding (OGIB) has been proven in several trials, data on uses of CE in different small bowel diseases are rapidly accumulating in the literature, and it has been found to be superior to alternative diagnostic tools in a range of such diseases. Based on literature evidence, CE is recommended as a first-line investigation for OGIB after negative bi-directional endoscopy. CE has gained an important role in the diagnosis and follow-up of Crohn's disease and celiac disease and in the surveillance of small bowel tumors and polyps in selected patients. Capsule retention is the major complication, with a frequency of 1%-2%. The purpose of this review was to discuss the procedure, indications, contraindications and adverse effects associated with CE. We also review and share our five-year experience with CE in various small bowel diseases. The recently developed balloon-assisted enteroscopies have both diagnostic and therapeutic capability. At the present time, CE and balloon-assisted enteroscopies are complementary techniques in the diagnosis and management of small bowel diseases.
文摘Objective： To assess the diagnostic efficiency of OMOM capsule endoscopy （CE） in a group of patients with different indications. Methods： Data from 89 consecutive patients （49 males, 40 females） with suspected small bowel disease who underwent OMOM CE （Jinshan Science and Technology Company, review. The patients＇ indications of the disease consisted of the Chongqing, China） examination were obtained by retrospective following： obscure gastrointestinal bleeding （OGIB）, abdominal pain or diarrhea, partial intestinal obstruction, suspected inflammatory bowel disease, tumor of unknown origin, hypoproteinemia, constipation, weight loss, and elevated tumor markers. Results： CE failed in one patient. Visualization of the entire small bowel was achieved in 75.0%. Capsules were naturally excreted by all patients. The detection rate of abnormalities was 70.5% for patients with suspected small bowel disease, and the diagnostic yield for patients with OGIB was higher than that for patients with abdominal pain or diarrhea （85.7% vs 53.3%, P〈0.005）. Angiodysplasia was the most common small bowel finding. Active bleeding sites were noted in the small intestine in 11 cases. Conclusion： OMOM CE is a useful diagnostic tool for the diagnosis of variably suspected small bowel disease, whose diagnostic efficiency is similar to that of the Pillcam SB （small bowel） CE （Given Imaging, Yoqneam, Israel）.
基金Supported by A clinical fellow grant(90700281)from the Netherlands Organization for Scientific Research(NWO)
文摘AIM： To investigate whether the small bowel transit time （SBTT） influences the diagnostic yield of capsule endoscopy （CE）. METHODS： Six hundred and ninety-one consecutive CE procedures collected in a database were analyzed. SBTT and CE findings were recorded. A running mean for the SBl-I- was calculated and correlated to the diagnostic yield with a Spearman＇s correlation test. Subgroup anal- yses were performed for the various indications for the procedure. RESULTS： There was a positive correlation between the diagnostic yield and SBT1- （Spearman＇s rho 0.58, P 〈 0.01）. Positive correlations between diagnostic yield and SB-FI-were found for the indication obscure gastro- intestinal bleeding （r = 0.54, P 〈 0.01）, for polyposis and carcinoid combined （r = 0.56, P 〈 0.01） and for the other indications （r = 0.90, P 〈0.01）, but not for suspected Crohn＇s disease （r = -0.40） CONCLUSION： The diagnostic yield in small bowel capsule endoscopy is positively correlated with the small bowel transit time. This is true for all indications except for suspected Crohn＇s disease.
文摘AIM： TO evaluate the effectiveness and safety of capsule endoscopy （CE） in patients with recurrent subacute small bowel obstruction.METHODS： The study was a retrospective analysis of 31 patients referred to hospital from January 2003 to August 2008 for the investigation of subacute small bowel obstruction, who underwent CE. The patients were aged 9-81 years, and all of them had undergone gastroscopy and colonoscopy previously. Some of them received abdominal computed tomography or small bowel follow-through.RESULTS： CE made a definitive diagnosis in 12 （38.7%） of 31 cases： four Crohn＇s disease （CD）, two carcinomas, one intestinal tuberculosis, one ischemic enteritis, one abdominal cocoon, one duplication of the intestine,one diverticulum and one ileal polypoid tumor. Capsule retention occurred in three （9.7%） of 31 patients, and was caused by CD （2） or tumor （1）. Two with retained capsules were retrieved at surgery, and the other one of the capsules was spontaneously passed the stricture by medical treatment in 6 too. No case had an acute small bowel obstruction caused by performance of CE.CONCLUSION： CE provided safe and effective visualization to identify the etiology of a subacute small bowel obstruction, especially in patients with suspected intestinal tumors or CD, which are not identified by routine examinations.
基金Supported by Shanghai Educational Development Foundation Shanghai Chenguang Project,No.2007CG49
文摘AIM:To review the literature on capsule endoscopy(CE) for detecting esophageal varices using conventional esophagogas troduodenoscopy(EGD)as the standard. METHODS:A strict literature search of studies comparing the yield of CE and EGD in patients diagnosed or suspected as having esophageal varices was conducted by both computer search and manual search.Data were extracted to estimate the pooled diagnostic sensitivity and specificity. RESULTS:There were seven studies appropriate for meta-analysis in our study,involving 446 patients. The pooled sensitivity and specificity of CE for detecting esophageal varices were 85.8%and 80.5%, respectively.In subgroup analysis,the pooled sensitivity and specificity were 82.7%and 54.8%in screened patients,and 87.3%and 84.7%in the screened/ patients under surveillance,respectively. CONCLUSION:CE appears to have acceptable sensitivity and specificity in detecting esophageal varices.However,data are insufficient to determine the accurate diagnostic value of CE in the screen/ surveillance of patients alone.
文摘The proposed deep learning algorithm will be integrated as a binary classifier under the umbrella of a multi-class classification tool to facilitate the automated detection of non-healthy deformities, anatomical landmarks, pathological findings, other anomalies and normal cases, by examining medical endoscopic images of GI tract. Each binary classifier is trained to detect one specific non-healthy condition. The algorithm analyzed in the present work expands the ability of detection of this tool by classifying GI tract image snapshots into two classes, depicting haemorrhage and non-haemorrhage state. The proposed algorithm is the result of the collaboration between interdisciplinary specialists on AI and Data Analysis, Computer Vision, Gastroenterologists of four University Gastroenterology Departments of Greek Medical Schools. The data used are 195 videos (177 from non-healthy cases and 18 from healthy cases) videos captured from the PillCam<sup>(R)</sup> Medronics device, originated from 195 patients, all diagnosed with different forms of angioectasia, haemorrhages and other diseases from different sites of the gastrointestinal (GI), mainly including difficult cases of diagnosis. Our AI algorithm is based on convolutional neural network (CNN) trained on annotated images at image level, using a semantic tag indicating whether the image contains angioectasia and haemorrhage traces or not. At least 22 CNN architectures were created and evaluated some of which pre-trained applying transfer learning on ImageNet data. All the CNN variations were introduced, trained to a prevalence dataset of 50%, and evaluated of unseen data. On test data, the best results were obtained from our CNN architectures which do not utilize backbone of transfer learning. Across a balanced dataset from no-healthy images and healthy images from 39 videos from different patients, identified correct diagnosis with sensitivity 90%, specificity 92%, precision 91.8%, FPR 8%, FNR 10%. Besides, we compared the performance of our best CNN algorithm v
文摘Objective： Small intestinal tumors （SBTs） were difficult to be discovered before surgery. The emergence of dou- ble-balloon enteroscopy （DBE） and capsule endoscopy （CE） have greatly improved the evaluation of SBTs and facilitated a more precise preoperative diagnosis. Yet little data exist in China regarding clinical efficacy of DBE and clinical characteristics of SBTs. The aim of our study was to clarify the clinical characteristics of SBTs and analyze the efficacy of DBE examination in the detection and diagnosis of SBTs. Methods： We retrospectively reviewed patients who underwent DBE in our hospital between June 2011 and July 2014. Patients who were diagnosed with SBTs by DBE were included in the study. Results： A total of 316 patients underwent 321 DBE procedures, 80 （25.3%） of whom were suspected to have an SBT. And 59 of the 80 subjects were diagnosed with SBT finally. The majorities （59.3%, 35/59） of the patients diagnosed with SBT were males, whose average age was 61.8 years （SD _＋11.0 years）. DBE were frequently performed in patients with obscure gastrointes- tinal bleeding （66.1%）, abdominal pain （16.9%）. The common SBTs identified were： gastrointestinal stromal tumors （GISTs） （24/59, 40.7%）, adenocarcinomas （13/59, 22.0%）, lymphomas （6/59, 10.2%） and benign polyps （6/59, 10.2%）. Jejunum had the highest detection rate （47.5%, 29/61）. During the follow-up period （3 months to 3 years）, 14 patients were submitted to chemotherapy and two patients died of tumor. Conclusion： The most high frequency type and location of SBTs detected in our hospital were different from western countries. DBE is a valuable and safe examination for SBIs.
