TY - JOUR
T1 - Capsule endoscopy versus colonoscopy for the detection of polyps and cancer
AU - Van Gossum, André
AU - Navas, Miguel Munoz
AU - Fernandez-Urien, Iñaqui
AU - Carretero, Cristina
AU - Gay, Gérard
AU - Delvaux, Michel
AU - Lapalus, Marie Georges
AU - Ponchon, Thierry
AU - Neuhaus, Horst
AU - Philipper, Michael
AU - Costamagna, Guido
AU - Riccioni, Maria Elena
AU - Spada, Cristiano
AU - Petruzziello, Lucio
AU - Fraser, Chris
AU - Postgate, Aymer
AU - Fitzpatrick, Aine
AU - Hagenmuller, Friedrich
AU - Keuchel, Martin
AU - Schoofs, Nathalie
AU - Devière, Jacques
PY - 2009
Y1 - 2009
N2 - Background: An ingestible capsule consisting of an endoscope equipped with a video camera at both ends was designed to explore the colon. This study compared capsule endoscopy with optical colonoscopy for the detection of colorectal polyps and cancer. Methods: We performed a prospective, multicenter study comparing capsule endoscopy with optical colonoscopy (the standard for comparison) in a cohort of patients with known or suspected colonic disease for the detection of colorectal polyps or cancer. Patients underwent an adapted colon preparation, and colon cleanliness was graded from poor to excellent. We computed the sensitivity and specificity of capsule endoscopy for polyps, advanced adenoma, and cancer. Results: A total of 328 patients (mean age, 58.6 years) were included in the study. The capsule was excreted within 10 hours after ingestion and before the end of the lifetime of the battery in 92.8% of the patients. The sensitivity and specificity of capsule endoscopy for detecting polyps that were 6 mm in size or bigger were 64% (95% confidence interval [CI], 59 to 72) and 84% (95% CI, 81 to 87), respectively, and for detecting advanced adenoma, the sensitivity and specificity were 73% (95% CI, 61 to 83) and 79% (95% CI, 77 to 81), respectively. Of 19 cancers detected by colonoscopy, 14 were detected by capsule endoscopy (sensitivity, 74%; 95% CI, 52 to 88). For all lesions, the sensitivity of capsule endoscopy was higher in patients with good or excellent colon cleanliness than in those with fair or poor colon cleanliness. Mild-to-moderate adverse events were reported in 26 patients (7.9%) and were mostly related to the colon preparation. Conclusions: The use of capsule endoscopy of the colon allows visualization of the colonic mucosa in most patients, but its sensitivity for detecting colonic lesions is low as compared with the use of optical colonoscopy. (ClinicalTrials.gov number, NCT00604162.) Copyright © 2009 Massachusetts Medical Society. All rights reserved.
AB - Background: An ingestible capsule consisting of an endoscope equipped with a video camera at both ends was designed to explore the colon. This study compared capsule endoscopy with optical colonoscopy for the detection of colorectal polyps and cancer. Methods: We performed a prospective, multicenter study comparing capsule endoscopy with optical colonoscopy (the standard for comparison) in a cohort of patients with known or suspected colonic disease for the detection of colorectal polyps or cancer. Patients underwent an adapted colon preparation, and colon cleanliness was graded from poor to excellent. We computed the sensitivity and specificity of capsule endoscopy for polyps, advanced adenoma, and cancer. Results: A total of 328 patients (mean age, 58.6 years) were included in the study. The capsule was excreted within 10 hours after ingestion and before the end of the lifetime of the battery in 92.8% of the patients. The sensitivity and specificity of capsule endoscopy for detecting polyps that were 6 mm in size or bigger were 64% (95% confidence interval [CI], 59 to 72) and 84% (95% CI, 81 to 87), respectively, and for detecting advanced adenoma, the sensitivity and specificity were 73% (95% CI, 61 to 83) and 79% (95% CI, 77 to 81), respectively. Of 19 cancers detected by colonoscopy, 14 were detected by capsule endoscopy (sensitivity, 74%; 95% CI, 52 to 88). For all lesions, the sensitivity of capsule endoscopy was higher in patients with good or excellent colon cleanliness than in those with fair or poor colon cleanliness. Mild-to-moderate adverse events were reported in 26 patients (7.9%) and were mostly related to the colon preparation. Conclusions: The use of capsule endoscopy of the colon allows visualization of the colonic mucosa in most patients, but its sensitivity for detecting colonic lesions is low as compared with the use of optical colonoscopy. (ClinicalTrials.gov number, NCT00604162.) Copyright © 2009 Massachusetts Medical Society. All rights reserved.
KW - Capsule endoscopydetection of polyps
KW - Capsule endoscopydetection of polyps
UR - http://hdl.handle.net/10807/250771
U2 - 10.1056/NEJMoa0806347
DO - 10.1056/NEJMoa0806347
M3 - Article
SN - 0028-4793
VL - 361
SP - 264
EP - 270
JO - THE NEW ENGLAND JOURNAL OF MEDICINE
JF - THE NEW ENGLAND JOURNAL OF MEDICINE
ER -
