Oesophageal capsule endoscopy; preliminary results of a prospective comparative study

Background: Oesophageal capsule endoscopy (OCE) is a novel, non-invasive method for the visualization of the oesophagus, the gastro-oesophageal junction and the Z-line.

Methods and aims: The aim of this prospective study was to compare OCE images and flexibile oesophago-gastroscopy (FOG) findings with respects to erosive reflux oesophagitis alterations, presence of hiatal hernia and suspected Barrett's oesophagus. OCE investigations were performed with the PillCam ESO 1 first generation device (Given Imaging). The capsule camera flashed 14 times per second to capture images from both ends of the capsule. A total of 18 patients with reflux symptoms underwent FOG followed by OCE within two days. The OCE recordings were red and evaluated by experienced endoscopiests two times: first blinded (unaware of FOG reports), then unblinded (informed about the previous FOG reports). The blinded and unblinded OCE readings were compared to the identical FOG reports accepted as true positive results.

Results: The gastro-oesophageal junction was visible by OCE in all the 18 cases with 82% and 86% appearance of the whole Z-line circumference according to blinded and unblinded readings. With blinded OCE readings 9 out of 10 suspected Barrett's and 2 out of 3 LA-D oesophagitis cases were detectable.

	Susp. Barrett's	Hiatal Hernia	Reflux oesophagitis
			LA-A	LA-B	LA-C	LA-D
FOG	10	9	1	5	7	3
OCE blind.	9	0	1	10	2	2
OCE unblind.	7	3	2	4	7	2

Conclusion: Oesophageal capsule endoscopy even with the first generation device offers quite high diagnostic yield in cases with suspected Barrett's oesophagus and severe erosive oesophagitis. Learning curve investigation period experiences are essentially important.