Z Gastroenterol 2010; 48 - A21
DOI: 10.1055/s-0030-1254759

Colon capsule endoscopy: the importance of double sided video camera system for the detection of localized colonic pathology

A Gaál 1, G Balogh 1, A Székely 1, L Madácsy 1
  • 1First Dept. of Internal Medicine and Gastroenterology, Fejer County Szent György Hospital, Székesfehérvár, Hungary

Background and Aims: Colonoscopy is the gold standard for evaluating pathologies of the large bowel, including screening for colorectal cancer. The PillCam™ Colon capsule endoscopy (CCE) with a double sided video camera system was developed as a non-invasive modality to visualize the colonic mucosa. The aims of our present study were to separately analyse the CCE pictures captured from each camera direction, and to compare the sensitivity of uni- and bidirectional analysis for the detection of localized colorectal lesions.

Methods: In the last year 28 CCE investigations were accomplished in our center. During the analysis of these CCE records we described 16 solitary colonic lesions, including polyps, diverticulas and localized mucosal inflammation. After the selection of these positive CCE recordings, two independent observer were re-evaluated the video recordings captured from left and right video camera, but without the knowledge of the other sided pictures. The appearance of the positive findings and the exact number of positive CCE pictures were calculated at each camera direction and then the results were compared. The CCE pictures depicted the Bauchin valve were also counted.

Results: We detected only 10 out of 16 solitary colonic lesions with the left, and 14 out of 16 lesions with the right sided video camera of the CCE. Only 8 of the 16 positive colonic findings were visible on both camera directions, therefore we calculated the possible drop of sensitivity up to 50% with a colonic application of a capsule endoscope with single sided camera system. We also demonstrated a significant difference between the mean of the positive picture counts captured from left versus right camera direction: 116 vs. 57 (p=0.0048).

Conclusions: The application of capsule endoscope equipped with a double sided video camera system is mandatory for the detection of localised colonic lesions. The possibility of a third, perpendicularly angled video camera and an increase of the captured picture numbers might further improve the sensitivity of CCE.