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Video capsule endoscopy and histology for small-bowel mucosa evaluation: a comparison performed by blinded observers.
Clin Gastroenterol Hepatol. 2006 Aug; 4(8):998-1003.CG

Abstract

BACKGROUND & AIMS

In view of the excellent quality of the images obtained and its magnification capability, videocapsule endoscopy was proposed as a promising tool to evaluate the degree of duodenal villous atrophy. We studied whether the capsule can discriminate different degrees of mucosal damage caused by different conditions; we also evaluated interobserver and intraobserver variability in the assessment of villous atrophy with the capsule.

METHODS

Thirty-two patients underwent both gastroscopy with multiple duodenal biopsies and videocapsule endoscopy. Twenty-six had different forms of celiac disease with different stages of villous atrophy; 5 patients had irritable bowel syndrome and 1 had Crohn's disease. Videocapsule findings were evaluated blindly by 3 observers. Histologic Marsh criteria and a specifically developed classification of videocapsule mucosal patterns were used to compare videocapsule findings and histology.

RESULTS

The study of the correlation between videocapsule and histologic findings showed a Kappa statistic of .45, .49, and .51 for observers 1, 2, and 3, respectively. The sensitivity was 90.5% for observer 1 and 95.2% for observers 2 and 3; the specificity was 63.6% for all observers.

CONCLUSIONS

Videocapsule findings regarding the degree of intestinal mucosal atrophy show only moderate agreement with the histologic pattern; they have a very high sensitivity but a disappointing specificity. This method therefore cannot be proposed as an alternative to traditional biopsy examinations, but it suggests that a duodenal biopsy examination should be performed when an atrophic mucosal pattern is observed in patients undergoing videocapsule examination for other reasons.

Authors+Show Affiliations

First Department of Internal Medicine, IRCCS Policlinico San Matteo, University of Pavia, Italy. f.biagi@smatteo.pv.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

16814612

Citation

Biagi, Federico, et al. "Video Capsule Endoscopy and Histology for Small-bowel Mucosa Evaluation: a Comparison Performed By Blinded Observers." Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, vol. 4, no. 8, 2006, pp. 998-1003.
Biagi F, Rondonotti E, Campanella J, et al. Video capsule endoscopy and histology for small-bowel mucosa evaluation: a comparison performed by blinded observers. Clin Gastroenterol Hepatol. 2006;4(8):998-1003.
Biagi, F., Rondonotti, E., Campanella, J., Villa, F., Bianchi, P. I., Klersy, C., De Franchis, R., & Corazza, G. R. (2006). Video capsule endoscopy and histology for small-bowel mucosa evaluation: a comparison performed by blinded observers. Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, 4(8), 998-1003.
Biagi F, et al. Video Capsule Endoscopy and Histology for Small-bowel Mucosa Evaluation: a Comparison Performed By Blinded Observers. Clin Gastroenterol Hepatol. 2006;4(8):998-1003. PubMed PMID: 16814612.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Video capsule endoscopy and histology for small-bowel mucosa evaluation: a comparison performed by blinded observers. AU - Biagi,Federico, AU - Rondonotti,Emanuele, AU - Campanella,Jonia, AU - Villa,Federica, AU - Bianchi,Paola Ilaria, AU - Klersy,Catherine, AU - De Franchis,Roberto, AU - Corazza,Gino Roberto, Y1 - 2006/06/30/ PY - 2006/7/4/pubmed PY - 2006/11/11/medline PY - 2006/7/4/entrez SP - 998 EP - 1003 JF - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association JO - Clin Gastroenterol Hepatol VL - 4 IS - 8 N2 - BACKGROUND & AIMS: In view of the excellent quality of the images obtained and its magnification capability, videocapsule endoscopy was proposed as a promising tool to evaluate the degree of duodenal villous atrophy. We studied whether the capsule can discriminate different degrees of mucosal damage caused by different conditions; we also evaluated interobserver and intraobserver variability in the assessment of villous atrophy with the capsule. METHODS: Thirty-two patients underwent both gastroscopy with multiple duodenal biopsies and videocapsule endoscopy. Twenty-six had different forms of celiac disease with different stages of villous atrophy; 5 patients had irritable bowel syndrome and 1 had Crohn's disease. Videocapsule findings were evaluated blindly by 3 observers. Histologic Marsh criteria and a specifically developed classification of videocapsule mucosal patterns were used to compare videocapsule findings and histology. RESULTS: The study of the correlation between videocapsule and histologic findings showed a Kappa statistic of .45, .49, and .51 for observers 1, 2, and 3, respectively. The sensitivity was 90.5% for observer 1 and 95.2% for observers 2 and 3; the specificity was 63.6% for all observers. CONCLUSIONS: Videocapsule findings regarding the degree of intestinal mucosal atrophy show only moderate agreement with the histologic pattern; they have a very high sensitivity but a disappointing specificity. This method therefore cannot be proposed as an alternative to traditional biopsy examinations, but it suggests that a duodenal biopsy examination should be performed when an atrophic mucosal pattern is observed in patients undergoing videocapsule examination for other reasons. SN - 1542-3565 UR - https://www.unboundmedicine.com/medline/citation/16814612/Video_capsule_endoscopy_and_histology_for_small_bowel_mucosa_evaluation:_a_comparison_performed_by_blinded_observers_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1542-3565(06)00421-6 DB - PRIME DP - Unbound Medicine ER -