Reading of Capsule Endoscopy Images Significantly Improved

Capsule endoscopy (Given Imaging, Yoqneam, Israel) allows for small-bowel assessment with little discomfort for the patient. However, evaluation is still a challenge for the investigator. Unlike flexible endoscopy where the examiner is actively involved in maneuvering the instruments, browsing more than 50 000 images in capsule endoscopy can be a monotonous procedure. We added a “jog/shuttle” control, which is a well-established tool in professional video editing, to the Given Imaging capsule endoscopy reading system.

Figure 1 Configuration of the jog/shuttle control.

Figure 2 Placing the jog/shuttle control on the left and the mouse on the right side appeared to be the most practical solution.

The jog/shuttle control (Contour Design, Inc. Windham, New Hampshire, USA) was connected to the USB port. The inner ring or “jog” rotates through 360° and provides precision frame-by-frame control. The outer ring or “shuttle” is rubberized and spring-loaded, and was configured to control browsing speed; seven different frame speeds could be obtained, according to the torque applied. Turning right or left moved the video forward and backward. Additional buttons were configured as shown in Figure [1].

Volunteer doctors evaluated two training videos for 5 : 30 minutes each, with randomization of the order of the two videos and the order of evaluation with and without the jog/shuttle control.

Preliminary evaluation of the first 12 volunteers did not show improvement in the detection rate with use of the jog/shuttle control. However, overall, 25 % more images were reviewed. In a questionnaire examiners reported that they found capsule endoscopy evaluation significantly easier with the jog/shuttle control (P = 0.005), they felt significantly more actively involved (P = 0.002), and preferred the addition of the jog/shuttle control significantly (P = 0.002).

Using the jog/shuttle control with the left hand and the mouse with the right hand (Figure [2]) was found to be the most practical solution in the evaluation of three complete cases.

Our preliminary results indicate an advantage in the use of a jog/shuttle control for capsule endoscopy evaluation.

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