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Diagnostics
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Capsule Endoscopy: Clinical Impacts and Innovation since 2001
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Capsule Endoscopy: Clinical Impacts and Innovation since 2001

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (31 December 2021) | Viewed by 63904

Special Issue Editor

Dr. Yun Jeong Lim

E-Mail Website
Guest Editor
Division of Gastroenterology, Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Republic of Korea
Interests: artificial intelligence; capsule endoscopy; deep learning; lesion detection
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Since its introduction in 2001, capsule endoscopy (CE) has shown great progress over the past 19 years, and has now established itself as the first-line diagnostic modality for evaluation of the small intestine. It is also minimally invasive and does not require sedation; moreover, clinical applications have expanded to the large intestine and stomach. In recent years, innovative advances in CE have been made in terms of external locomotion using magnetic force, artificial intelligence-based automated interpretation, and image-enhancing technologies. The ultimate goal of these technological efforts is to improve the diagnostic yield of CE. The forthcoming Special Issue focuses on several key elements that are essential for an understanding of CE, recent advances and their clinical impact. Invited topics may include:

  1. Diagnostic yields and clinical impacts of capsule endoscopy (CE);
  2. CE and AI (artificial intelligence);
  3. Active locomotion of CE;
  4. Image enhancement of CE;
  5. Quality control for CE;
  6. Colon and gastric CE.

Dr. Yun Jeong Lim
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Capsule endoscopy
  • Diagnostic yield
  • Clinical impact
  • Artificial intelligence
  • Locomotion
  • Magnetic
  • Image interpretation
  • Quality control
  • Deep learning

Related Special Issue

Published Papers (21 papers)

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Editorial

Jump to: Research, Review

5 pages, 345 KiB  
Editorial
Colon Capsule Endoscopy as a Diagnostic Adjunct in Patients with Symptoms from the Lower Gastrointestinal Tract
by Thomas Bjørsum-Meyer, Gunnar Baatrup and Anastasios Koulaouzidis
Diagnostics 2021, 11(9), 1671; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091671 - 13 Sep 2021
Cited by 6 | Viewed by 1467
Abstract
Prompted by the core idea of wireless capsule endoscopy as a painless gastrointestinal examination, and the easy adoption of small bowel capsule endoscopy, the armamentarium of the capsule-based imaging platforms has grown to include colon capsule devices as well [...] Full article
(This article belongs to the Special Issue Capsule Endoscopy: Clinical Impacts and Innovation since 2001)
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Research

Jump to: Editorial, Review

11 pages, 8309 KiB  
Article
Sequential Models for Endoluminal Image Classification
by Joana Reuss, Guillem Pascual, Hagen Wenzek and Santi Seguí
Diagnostics 2022, 12(2), 501; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12020501 - 15 Feb 2022
Cited by 2 | Viewed by 1916
Abstract
Wireless Capsule Endoscopy (WCE) is a procedure to examine the human digestive system for potential mucosal polyps, tumours, or bleedings using an encapsulated camera. This work focuses on polyp detection within WCE videos through Machine Learning. When using Machine Learning in the medical [...] Read more.
Wireless Capsule Endoscopy (WCE) is a procedure to examine the human digestive system for potential mucosal polyps, tumours, or bleedings using an encapsulated camera. This work focuses on polyp detection within WCE videos through Machine Learning. When using Machine Learning in the medical field, scarce and unbalanced datasets often make it hard to receive a satisfying performance. We claim that using Sequential Models in order to take the temporal nature of the data into account improves the performance of previous approaches. Thus, we present a bidirectional Long Short-Term Memory Network (BLSTM), a sequential network that is particularly designed for temporal data. We find the BLSTM Network outperforms non-sequential architectures and other previous models, receiving a final Area under the Curve of 93.83%. Experiments show that our method of extracting spatial and temporal features yields better performance and could be a possible method to decrease the time needed by physicians to analyse the video material. Full article
(This article belongs to the Special Issue Capsule Endoscopy: Clinical Impacts and Innovation since 2001)
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10 pages, 1543 KiB  
Article
Predictors of Positive Video Capsule Endoscopy Findings for Chronic Unexplained Abdominal Pain: Single-Center Retrospective Study and Meta-Analysis
by Wonshik Kim, Beomjae Lee, Ahyoung Yoo, Seunghan Kim, Moonkyung Joo and Jong-Jae Park
Diagnostics 2021, 11(11), 2123; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11112123 - 16 Nov 2021
Cited by 1 | Viewed by 1441
Abstract
Video capsule endoscopy (VCE) is an effective diagnostic modality for detecting small bowel lesions. However, the value of VCE for patients with chronic recurrent abdominal pain (CAP) of unknown etiology remains obscure. We retrospectively analyzed factors that could predict enteropathy based on the [...] Read more.
Video capsule endoscopy (VCE) is an effective diagnostic modality for detecting small bowel lesions. However, the value of VCE for patients with chronic recurrent abdominal pain (CAP) of unknown etiology remains obscure. We retrospectively analyzed factors that could predict enteropathy based on the medical records of 65 patients with unexplained chronic recurrent abdominal pain (CAP) who were assessed using VCE between 2001 and 2021. We also conducted a systematic review and meta-analysis of the literature to validate our results. The positive findings of 27 (41.5%) of the 65 patients were mostly ulcerative lesions including stricture (n = 14, 60.9%) and erosion (n = 8, 29.7%). Multivariate analysis identified elevated ESR (OR, 1.06, 95% CI, 1.02–1.1, p = 0.004) as a significant risk factor for enteropathy predicted by VCE. Three eligible studies in the meta-analysis included 523 patients with CAP. Elevated C-reactive protein (CRP) (OR, 14.09; 95% CI, 2.81–70.60; p = 0.001) and erythrocyte sedimentation rate (ESR) (OR, 14.45; 95% CI, 0.92–227.33; p = 0.06) indicated VCE-positive findings in patients with unexplained abdominal pain. Elevated levels of the inflammatory markers ESR and CRP can thus predict positive VCE findings in patients with CAP. Full article
(This article belongs to the Special Issue Capsule Endoscopy: Clinical Impacts and Innovation since 2001)
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16 pages, 7894 KiB  
Article
Automated Bowel Polyp Detection Based on Actively Controlled Capsule Endoscopy: Feasibility Study
by Manh Cuong Hoang, Kim Tien Nguyen, Jayoung Kim, Jong-Oh Park and Chang-Sei Kim
Diagnostics 2021, 11(10), 1878; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11101878 - 12 Oct 2021
Cited by 10 | Viewed by 2159
Abstract
This paper presents an active locomotion capsule endoscope system with 5D position sensing and real-time automated polyp detection for small-bowel and colon applications. An electromagnetic actuation system (EMA) consisting of stationary electromagnets is utilized to remotely control a magnetic capsule endoscope with multi-degree-of-freedom [...] Read more.
This paper presents an active locomotion capsule endoscope system with 5D position sensing and real-time automated polyp detection for small-bowel and colon applications. An electromagnetic actuation system (EMA) consisting of stationary electromagnets is utilized to remotely control a magnetic capsule endoscope with multi-degree-of-freedom locomotion. For position sensing, an electronic system using a magnetic sensor array is built to track the position and orientation of the magnetic capsule during movement. The system is integrated with a deep learning model, named YOLOv3, which can automatically identify colorectal polyps in real-time with an average precision of 85%. The feasibility of the proposed method concerning active locomotion and localization is validated and demonstrated through in vitro experiments in a phantom duodenum. This study provides a high-potential solution for automatic diagnostics of the bowel and colon using an active locomotion capsule endoscope, which can be applied for a clinical site in the future. Full article
(This article belongs to the Special Issue Capsule Endoscopy: Clinical Impacts and Innovation since 2001)
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10 pages, 2626 KiB  
Article
Development and Verification of a Deep Learning Algorithm to Evaluate Small-Bowel Preparation Quality
by Ji Hyung Nam, Dong Jun Oh, Sumin Lee, Hyun Joo Song and Yun Jeong Lim
Diagnostics 2021, 11(6), 1127; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11061127 - 20 Jun 2021
Cited by 11 | Viewed by 1873
Abstract
Capsule endoscopy (CE) quality control requires an objective scoring system to evaluate the preparation of the small bowel (SB). We propose a deep learning algorithm to calculate SB cleansing scores and verify the algorithm’s performance. A 5-point scoring system based on clarity of [...] Read more.
Capsule endoscopy (CE) quality control requires an objective scoring system to evaluate the preparation of the small bowel (SB). We propose a deep learning algorithm to calculate SB cleansing scores and verify the algorithm’s performance. A 5-point scoring system based on clarity of mucosal visualization was used to develop the deep learning algorithm (400,000 frames; 280,000 for training and 120,000 for testing). External validation was performed using additional CE cases (n = 50), and average cleansing scores (1.0 to 5.0) calculated using the algorithm were compared to clinical grades (A to C) assigned by clinicians. Test results obtained using 120,000 frames exhibited 93% accuracy. The separate CE case exhibited substantial agreement between the deep learning algorithm scores and clinicians’ assessments (Cohen’s kappa: 0.672). In the external validation, the cleansing score decreased with worsening clinical grade (scores of 3.9, 3.2, and 2.5 for grades A, B, and C, respectively, p < 0.001). Receiver operating characteristic curve analysis revealed that a cleansing score cut-off of 2.95 indicated clinically adequate preparation. This algorithm provides an objective and automated cleansing score for evaluating SB preparation for CE. The results of this study will serve as clinical evidence supporting the practical use of deep learning algorithms for evaluating SB preparation quality. Full article
(This article belongs to the Special Issue Capsule Endoscopy: Clinical Impacts and Innovation since 2001)
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11 pages, 1136 KiB  
Article
Clinical Outcomes between P1 and P0 Lesions for Obscure Gastrointestinal Bleeding with Negative Computed Tomography and Capsule Endoscopy
by Young Kyu Cho, Heesu Park, Jung Rock Moon, Seong Ran Jeon, Hyun Gun Kim, Tae Hee Lee, Junseok Park, Jin-Oh Kim, Joon Seong Lee, Hyeon Jeong Goong, Bong Min Ko and Suyeon Park
Diagnostics 2021, 11(4), 657; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11040657 - 06 Apr 2021
Cited by 5 | Viewed by 1705
Abstract
Background: A simple classification for the relevance of lesions (P0, P1, and P2; no bleeding potential, less likely to bleed, and more likely to bleed, respectively) based on capsule endoscopy (CE) findings has been used. This study aimed at investigating rebleeding rates and [...] Read more.
Background: A simple classification for the relevance of lesions (P0, P1, and P2; no bleeding potential, less likely to bleed, and more likely to bleed, respectively) based on capsule endoscopy (CE) findings has been used. This study aimed at investigating rebleeding rates and predictive factors of P0 and P1 lesions after obtaining negative findings in both, CE and computed tomography (CT), for patients with obscure gastrointestinal bleeding (OGIB). Methods: Among 193 patients resulted in negative CE findings defined as P0 or P1 lesions, 84 patients with negative results on CT images were enrolled in this study. The rebleeding rates and predictive factors were assessed in the P0 and P1 groups. Results: Overall rebleeding rate in patients with negative CT and CE was 17.9%; 18.4% in the P0 group; 17.4% in the P1 group within a median follow-up duration of 18.5 months. In the P0 and P1 groups, the cumulative rebleeding rates were 9.2%, 25.4%, and 25.4%, and 6.9%, 11.8%, and 18.6% at 12, 24, and 60 months, respectively (p = 0.97). There were no independent rebleeding associated factors in the P0 group, whereas Charlson comorbidity index (CCI) (hazard ratio (HR) = 2.019, 95% confidence interval (CI): 1.158–3.519, p = 0.013), and initial low hemoglobin (Hb) level (<8 g/dL) (HR = 15.085, 95% CI: 1.182–192.514, p = 0.037) were independent predictive factors responsible for rebleeding in the P1 group. Conclusions: Despite having negative findings on CT and CE, patients with OGIB have a significant potential rebleeding risk. Although there was no significant difference in rebleeding rates between the P0 and P1 groups on CE, the P1 group, with CCI or low initial Hb level, should be cautiously observed after the first bleeding episode. Full article
(This article belongs to the Special Issue Capsule Endoscopy: Clinical Impacts and Innovation since 2001)
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12 pages, 4806 KiB  
Article
The Entire Intestinal Tract Surveillance Using Capsule Endoscopy after Immune Checkpoint Inhibitor Administration: A Prospective Observational Study
by Keitaro Shimozaki, Kenro Hirata, Sara Horie, Akihiko Chida, Kai Tsugaru, Yukie Hayashi, Kenta Kawasaki, Ryoichi Miyanaga, Hideyuki Hayashi, Ryuichi Mizuno, Takeru Funakoshi, Naoki Hosoe, Yasuo Hamamoto and Takanori Kanai
Diagnostics 2021, 11(3), 543; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11030543 - 18 Mar 2021
Cited by 3 | Viewed by 2262
Abstract
Background: Despite the proven efficacy of immune checkpoint inhibitors (ICIs) against various types of malignancies, they have been found to induce immune-related adverse events, such as enterocolitis; however, the clinical features of ICI-induced enterocolitis remain to be sufficiently elucidated, which is significant, considering [...] Read more.
Background: Despite the proven efficacy of immune checkpoint inhibitors (ICIs) against various types of malignancies, they have been found to induce immune-related adverse events, such as enterocolitis; however, the clinical features of ICI-induced enterocolitis remain to be sufficiently elucidated, which is significant, considering the importance of early detection in the appropriate management and treatment of ICI-induced enterocolitis. Therefore, the current study aimed to determine the utility of capsule endoscopy as a screening tool for ICI-induced enterocolitis. Methods: This single-center, prospective, observational study was conducted on patients with malignancy who received any ICI between April 2016 and July 2020 at Keio University Hospital. Next, second-generation capsule endoscopy (CCE-2) was performed on day 60 after ICI initiation to explore the entire gastrointestinal tract. Results: Among the 30 patients enrolled herein, 23 underwent CCE-2. Accordingly, a total of 23 findings were observed in 14 (60.8%) patients at any portion of the gastrointestinal tract (7 patients in the colon, 4 patients in the small intestine, 2 patients in both the colon and the small intestine, and 1 patient in the stomach). After capsule endoscopy, 2 patients (8.7%) developed ICI-induced enterocolitis: both had significantly higher Capsule Scoring of Ulcerative Colitis than those who had not developed ICI-induced enterocolitis (p = 0.0455). No adverse events related to CCE-2 were observed. Conclusions: CCE-2 might be a safe and useful entire intestinal tract screening method for the early detection of ICI-induced enterocolitis in patients with malignancies. Full article
(This article belongs to the Special Issue Capsule Endoscopy: Clinical Impacts and Innovation since 2001)
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Review

Jump to: Editorial, Research

12 pages, 627 KiB  
Review
Review: Colon Capsule Endoscopy in Inflammatory Bowel Disease
by Writaja Halder, Faidon-Marios Laskaratos, Hanan El-Mileik, Sergio Coda, Stevan Fox, Saswata Banerjee and Owen Epstein
Diagnostics 2022, 12(1), 149; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12010149 - 08 Jan 2022
Cited by 4 | Viewed by 4216
Abstract
The COVID-19 pandemic has caused considerable disruption in healthcare services and has had a substantial impact on the care of patients with chronic diseases, such as inflammatory bowel disease. Endoscopy services were significantly restricted, resulting in long waiting lists. There has been a [...] Read more.
The COVID-19 pandemic has caused considerable disruption in healthcare services and has had a substantial impact on the care of patients with chronic diseases, such as inflammatory bowel disease. Endoscopy services were significantly restricted, resulting in long waiting lists. There has been a growing interest in the use of capsule endoscopy in the diagnostic pathway and management of these patients. This review explores the published literature on the role of colon capsule endoscopy in ulcerative colitis and Crohn’s disease as a method for mucosal assessment of extent, severity, and response to treatment. Colon capsule preparation regimens and scoring systems are reported. The studies indicate that, despite inherent limitations of minimally invasive capsule endoscopy, there is increasing evidence to support the use of the second-generation colon capsule in inflammatory bowel disease evaluation, providing an additional pathway to expedite investigation of appropriate patients especially during and after the pandemic. Full article
(This article belongs to the Special Issue Capsule Endoscopy: Clinical Impacts and Innovation since 2001)
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11 pages, 1031 KiB  
Review
Small Bowel Malignancies in Patients Undergoing Capsule Endoscopy for Iron Deficiency Anemia
by Su Hwan Kim and Ji Won Kim
Diagnostics 2022, 12(1), 91; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12010091 - 31 Dec 2021
Cited by 2 | Viewed by 3715
Abstract
Small bowel malignancies are rare and usually asymptomatic or symptoms are nonspecific. Therefore, small bowel tumors are difficult to diagnose. In patients with iron deficiency anemia (IDA) who have negative bidirectional endoscopy results, the small bowel may be considered the source of bleeding. [...] Read more.
Small bowel malignancies are rare and usually asymptomatic or symptoms are nonspecific. Therefore, small bowel tumors are difficult to diagnose. In patients with iron deficiency anemia (IDA) who have negative bidirectional endoscopy results, the small bowel may be considered the source of bleeding. However, in asymptomatic IDA patients with negative bidirectional endoscopy results, evidence supporting the routine use of capsule endoscopy (CE) is insufficient. CE can be considered in selected patients with recurrent or persistent IDA. The frequency of small bowel malignancies is low in patients undergoing CE for IDA, but the usefulness of CE for the diagnosis of small bowel malignancies in younger age groups with IDA has been reported. For patients with risk factors for small bowel malignancy, investigation of the small bowel should be considered. Efforts should be made to prevent adverse events, such as capsule retention or capsule aspiration, through meticulous history taking and endoscopic capsule delivery as necessary. Full article
(This article belongs to the Special Issue Capsule Endoscopy: Clinical Impacts and Innovation since 2001)
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17 pages, 1621 KiB  
Review
Capsule Endoscopy in Inflammatory Bowel Disease: When? To Whom?
by Soo-Young Na and Yun-Jeong Lim
Diagnostics 2021, 11(12), 2240; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11122240 - 30 Nov 2021
Cited by 4 | Viewed by 5292
Abstract
Capsule endoscopy (CE) has proven to be a valuable diagnostic modality for small bowel diseases over the past 20 years, particularly Crohn’s disease (CD), which can affect the entire gastrointestinal tract from the mouth to the anus. CE is not only used for [...] Read more.
Capsule endoscopy (CE) has proven to be a valuable diagnostic modality for small bowel diseases over the past 20 years, particularly Crohn’s disease (CD), which can affect the entire gastrointestinal tract from the mouth to the anus. CE is not only used for the diagnosis of patients with suspected small bowel CD, but can also be used to assess disease activity, treat-to-target, and postoperative recurrence in patients with established small bowel CD. As CE can detect even mildly non-specific small bowel lesions, a high diagnostic yield is not necessarily indicative of high diagnostic accuracy. Moreover, the cost effectiveness of CE as a third diagnostic test employed usually after ileocolonoscopy and MR or CT enterography is an important consideration. Recently, new developments in colon capsule endoscopy (CCE) have increased the utility of CE in patients with ulcerative colitis (UC) and pan-enteric CD. Although deflation of the colon during the examination and the inability to evaluate dysplasia-associated lesion or mass results in an inherent risk of overestimation or underestimation, the convenience of CCE examination and the risk of flare-up after colonoscopy suggest that CCE could be used more actively in patients with UC. Full article
(This article belongs to the Special Issue Capsule Endoscopy: Clinical Impacts and Innovation since 2001)
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11 pages, 256 KiB  
Review
Small-Bowel Capsule Endoscopy—Optimizing Capsule Endoscopy in Clinical Practice
by Fintan O’Hara and Deirdre McNamara
Diagnostics 2021, 11(11), 2139; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11112139 - 18 Nov 2021
Cited by 3 | Viewed by 2091
Abstract
The small bowel is the longest organ within the gastrointestinal tract. The emergence of small bowel capsule endoscopy (SBCE) over the last 20 years has revolutionized the investigation and diagnosis of small bowel pathology. Its utility as a non-invasive and well-tolerated procedure, which [...] Read more.
The small bowel is the longest organ within the gastrointestinal tract. The emergence of small bowel capsule endoscopy (SBCE) over the last 20 years has revolutionized the investigation and diagnosis of small bowel pathology. Its utility as a non-invasive and well-tolerated procedure, which can be performed in an outpatient setting, has made it a valuable diagnostic tool. The indications for SBCE include obscure gastrointestinal bleeding, small bowel Crohn’s disease, and, less frequently for screening in polyposis syndromes, celiac disease, or other small bowel pathology. Currently, there are several small bowel capsules on the market from different manufacturers; however, they share many technological features. The European Society of Gastrointestinal Endoscopy (ESGE) only recently developed a set of key quality indicators to guide quality standards in this area. Many of the technical aspects of capsule endoscopy still feature a degree of uncertainty in terms of optimal performance. Incomplete studies due to slow transit through the bowel, poor imaging secondary to poor preparation, and the risk of capsule retention remain frustrations in its clinical utility. Capsule review is a time-consuming process; however, artificial intelligence and machine learning offer opportunities to improve this. This narrative review examines our current standing in a number of these aspects and the potential to further the application of SBCE in order to maximize its diagnostic utility. Full article
(This article belongs to the Special Issue Capsule Endoscopy: Clinical Impacts and Innovation since 2001)
14 pages, 3574 KiB  
Review
Image-Enhanced Capsule Endoscopy Improves the Identification of Small Intestinal Lesions
by Noriyuki Ogata, Kazuo Ohtsuka, Masataka Ogawa, Yasuharu Maeda, Fumio Ishida and Shin-ei Kudo
Diagnostics 2021, 11(11), 2122; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11112122 - 15 Nov 2021
Cited by 5 | Viewed by 2543
Abstract
Image-enhanced endoscopy is useful for diagnosing and identifying lesions in the gastrointestinal tract. Recently, image-enhanced endoscopy has become a breakthrough technology that has attracted significant attention. This image enhancing technology is available for capsule endoscopy, which is an effective tool for small intestinal [...] Read more.
Image-enhanced endoscopy is useful for diagnosing and identifying lesions in the gastrointestinal tract. Recently, image-enhanced endoscopy has become a breakthrough technology that has attracted significant attention. This image enhancing technology is available for capsule endoscopy, which is an effective tool for small intestinal lesions and has been applied in flexible spectral color enhancement technology and in contrast capsule like narrow-band imaging. In this field, most researchers focus on improving the visibility and detection of small intestinal lesions. This review summarizes previous studies on image-enhanced capsule endoscopy and aims to evaluate the efficacy of this technology. Full article
(This article belongs to the Special Issue Capsule Endoscopy: Clinical Impacts and Innovation since 2001)
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16 pages, 340 KiB  
Review
Diagnostic Yields and Clinical Impacts of Capsule Endoscopy
by Seung Min Hong, Sung Hoon Jung and Dong Hoon Baek
Diagnostics 2021, 11(10), 1842; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11101842 - 05 Oct 2021
Cited by 6 | Viewed by 2243
Abstract
Observing the entire small bowel is difficult due to the presence of complex loops and a long length. Capsule endoscopy (CE) provides a noninvasive and patient-friendly method for visualizing the small bowel and colon. Small bowel capsule endoscopy (SBCE) has a critical role [...] Read more.
Observing the entire small bowel is difficult due to the presence of complex loops and a long length. Capsule endoscopy (CE) provides a noninvasive and patient-friendly method for visualizing the small bowel and colon. Small bowel capsule endoscopy (SBCE) has a critical role in the diagnosis of small bowel disorders through the direct observation of the entire small bowel mucosa and is becoming the primary diagnostic tool for small bowel diseases. Recently, colon capsule endoscopy (CCE) was also considered safe and feasible for obtaining sufficient colonic images in patients with incomplete colonoscopy, in the absence of bowel obstruction. This review article assesses the current status of CE in terms of the diagnostic yield and the clinical impact of SBCE in patients with obscure gastrointestinal bleeding, who have known or suspected Crohn’s disease, small bowel tumor and inherited polyposis syndrome, celiac disease, and those who have undergone CCE. Full article
(This article belongs to the Special Issue Capsule Endoscopy: Clinical Impacts and Innovation since 2001)
15 pages, 476 KiB  
Review
Capsule Endoscopy for Gastric Evaluation
by Ji-Hyun Kim and Seung-Joo Nam
Diagnostics 2021, 11(10), 1792; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11101792 - 28 Sep 2021
Cited by 12 | Viewed by 2703
Abstract
Wireless capsule endoscopy was first developed to observe the small intestine. A small capsule can be swallowed and images of gastrointestinal tract are taken with natural movement of peristalsis. Application of capsule endoscopy for observing the stomach has also received much attention as [...] Read more.
Wireless capsule endoscopy was first developed to observe the small intestine. A small capsule can be swallowed and images of gastrointestinal tract are taken with natural movement of peristalsis. Application of capsule endoscopy for observing the stomach has also received much attention as a useful alternative to esophagogastroduodenoscopy, but anatomical characteristics of the stomach have demanded technical obstacles that need to be tackled: clear visualization and active movements that could be controlled. Different methods of controlling the capsule within stomach have been studied and magnetic manipulation is the only system that is currently used in clinical settings. Magnets within the capsule can be controlled with a hand-held magnet paddle, robotic arm, and electromagnetic coil system. Studies on healthy volunteers and patients with upper gastrointestinal symptoms have shown that it is a safe and effective alternative method of observing the stomach. This work reviews different magnetic locomotion systems that have been used for observation of the stomach as an emerging new application of wireless capsule endoscopy. Full article
(This article belongs to the Special Issue Capsule Endoscopy: Clinical Impacts and Innovation since 2001)
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16 pages, 8628 KiB  
Review
Capsule Endoscopy: Pitfalls and Approaches to Overcome
by Seung Han Kim and Hoon Jai Chun
Diagnostics 2021, 11(10), 1765; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11101765 - 25 Sep 2021
Cited by 14 | Viewed by 8844
Abstract
Capsule endoscopy of the gastrointestinal tract is an innovative technology that serves to replace conventional endoscopy. Wireless capsule endoscopy, which is mainly used for small bowel examination, has recently been used to examine the entire gastrointestinal tract. This method is promising for its [...] Read more.
Capsule endoscopy of the gastrointestinal tract is an innovative technology that serves to replace conventional endoscopy. Wireless capsule endoscopy, which is mainly used for small bowel examination, has recently been used to examine the entire gastrointestinal tract. This method is promising for its usefulness and development potential and enhances convenience by reducing the side effects and discomfort that may occur during conventional endoscopy. However, capsule endoscopy has fundamental limitations, including passive movement via bowel peristalsis and space restriction. This article reviews the current scientific aspects of capsule endoscopy and discusses the pitfalls and approaches to overcome its limitations. This review includes the latest research results on the role and potential of capsule endoscopy as a non-invasive diagnostic and therapeutic device. Full article
(This article belongs to the Special Issue Capsule Endoscopy: Clinical Impacts and Innovation since 2001)
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13 pages, 22612 KiB  
Review
Capsule Endoscopy in Crohn’s Disease—From a Relative Contraindication to Habitual Monitoring Tool
by Adi Lahat and Ido Veisman
Diagnostics 2021, 11(10), 1737; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11101737 - 22 Sep 2021
Cited by 4 | Viewed by 2673
Abstract
Crohn’s disease (CD) is a chronic inflammatory disorder that may involve the gastrointestinal tract from the mouth to the anus. Habitual disease monitoring is highly important during disease management, aiming to identify and treat disease exacerbations, in order to avoid immediate and future [...] Read more.
Crohn’s disease (CD) is a chronic inflammatory disorder that may involve the gastrointestinal tract from the mouth to the anus. Habitual disease monitoring is highly important during disease management, aiming to identify and treat disease exacerbations, in order to avoid immediate and future complications. Currently, ilio-clonoscopy is the gold standard for mucosal assessment. However, the procedure is invasive, involves sedation and allows for visualization of the colon and only a small part of the terminal ileum, while most of the small bowel is not visualized. Since CD may involve the whole length of the small bowel, the disease extent might be underestimated. Capsule endoscopy (CE) provides a technology that can screen the entire bowel in a non-invasive procedure, with minimal side effects. In recent years, this technique has gained in popularity for CD evaluation and monitoring. When CE was first introduced, two decades ago, the fear of possible capsule retention in the narrowed inflamed bowel lumen limited its use in CD patients, and a known CD located at the small bowel was even regarded as a relative contraindication for capsule examination. However, at present, as experience using CE in CD patients has accumulated, this procedure has become one of the accepted tools for disease diagnosis and monitoring. In our current review, we summarize the historic change in the indications and contraindications for the usage of capsule endoscopy for the evaluation of CD, and discuss international recommendations regarding CE’s role in CD diagnosis and monitoring. Full article
(This article belongs to the Special Issue Capsule Endoscopy: Clinical Impacts and Innovation since 2001)
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13 pages, 1790 KiB  
Review
Patient-Reported Outcomes and Preferences for Colon Capsule Endoscopy and Colonoscopy: A Systematic Review with Meta-Analysis
by Ulrik Deding, Pablo Cortegoso Valdivia, Anastasios Koulaouzidis, Gunnar Baatrup, Ervin Toth, Cristiano Spada, Ignacio Fernández-Urién, Marco Pennazio and Thomas Bjørsum-Meyer
Diagnostics 2021, 11(9), 1730; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091730 - 20 Sep 2021
Cited by 18 | Viewed by 2670
Abstract
Colon capsule endoscopy as an alternative to colonoscopy for the diagnosis of colonic disease may serve as a less invasive and more tolerable investigation for patients. Our aim was to examine patient-reported outcomes for colon capsule endoscopy compared to conventional optical colonoscopy including [...] Read more.
Colon capsule endoscopy as an alternative to colonoscopy for the diagnosis of colonic disease may serve as a less invasive and more tolerable investigation for patients. Our aim was to examine patient-reported outcomes for colon capsule endoscopy compared to conventional optical colonoscopy including preference of investigation modality, tolerability and adverse events. A systematic literature search was conducted in Web of Science, PubMed and Embase. Search results were thoroughly screened for in- and exclusion criteria. Included studies underwent assessment of transparency and completeness, after which, data for meta-analysis were extracted. Pooled estimates of patient preference were calculated and heterogeneity was examined including univariate meta-regressions. Patient-reported tolerability and adverse events were reviewed. Out of fourteen included studies, twelve had investigated patient-reported outcomes in patients who had undergone both investigations, whereas in two the patients were randomized between investigations. Pooled patient preferences were estimated to be 52% (CI 95%: 41–63%) for colon capsule endoscopy and 45% (CI 95%: 33–57%) for conventional colonoscopy: not indicating a significant difference. Procedural adverse events were rarely reported by patients for either investigation. The tolerability was high for both colon capsule endoscopy and conventional colonoscopy. Patient preferences for conventional colonoscopy and colon capsule endoscopy were not significantly different. Procedural adverse events were rare and the tolerability for colon capsule endoscopy was consistently reported higher or equal to that of conventional colonoscopy. Full article
(This article belongs to the Special Issue Capsule Endoscopy: Clinical Impacts and Innovation since 2001)
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12 pages, 1666 KiB  
Review
Artificial Intelligence in Capsule Endoscopy: A Practical Guide to Its Past and Future Challenges
by Sang Hoon Kim and Yun Jeong Lim
Diagnostics 2021, 11(9), 1722; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091722 - 20 Sep 2021
Cited by 24 | Viewed by 3281
Abstract
Artificial intelligence (AI) has revolutionized the medical diagnostic process of various diseases. Since the manual reading of capsule endoscopy videos is a time-intensive, error-prone process, computerized algorithms have been introduced to automate this process. Over the past decade, the evolution of convolutional neural [...] Read more.
Artificial intelligence (AI) has revolutionized the medical diagnostic process of various diseases. Since the manual reading of capsule endoscopy videos is a time-intensive, error-prone process, computerized algorithms have been introduced to automate this process. Over the past decade, the evolution of convolutional neural network (CNN) enabled AI to detect multiple lesions simultaneously with increasing accuracy and sensitivity. Difficulty in validating CNN performance and unique characteristics of capsule endoscopy images make computer-aided reading systems in capsule endoscopy still on a preclinical level. Although AI technology can be used as an auxiliary second observer in capsule endoscopy, it is expected that in the near future, it will effectively reduce the reading time and ultimately become an independent, integrated reading system. Full article
(This article belongs to the Special Issue Capsule Endoscopy: Clinical Impacts and Innovation since 2001)
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18 pages, 5710 KiB  
Review
Lavage, Simethicone, and Prokinetics—What to Swallow with a Video Capsule
by Martin Keuchel, Niehls Kurniawan, Marc Bota and Peter Baltes
Diagnostics 2021, 11(9), 1711; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091711 - 18 Sep 2021
Cited by 6 | Viewed by 4521
Abstract
The development of new capsules now allows endoscopic diagnosis in all segments of the gastrointestinal tract and comes with new needs for differentiated preparation regimens. Although the literature is steadily increasing, the results of the conducted trials on preparation are sometimes conflicting. The [...] Read more.
The development of new capsules now allows endoscopic diagnosis in all segments of the gastrointestinal tract and comes with new needs for differentiated preparation regimens. Although the literature is steadily increasing, the results of the conducted trials on preparation are sometimes conflicting. The ingestion of simethicone before gastric and small bowel capsule endoscopy for prevention of air bubbles is established. The value of a lavage before small bowel capsule endoscopy (SBCE) is recommended, although not supported by all studies. Ingestion in the morning before the procedure seems useful for the improvement of mucosa visualization. Lavage after swallowing of the capsule seems to improve image quality, and in some studies also diagnostic yield. Prokinetics has been used with first generation capsules to shorten gastric transit time and increase the rate of complete small bowel visualization. With the massively prolonged battery capacity of the new generation small bowel capsules, prokinetics are only necessary in significantly delayed gastric emptying as documented by a real-time viewer. Lavage is crucial for an effective colon capsule or pan-intestinal capsule endoscopy. Mainly high or low volume polyethylene glycol (PEG) is used. Apart from achieving optimal cleanliness, propulsion of the capsule by ingested boosts is required to obtain a complete passage through the colon within the battery lifetime. Boosts with low volume sodium picosulfate (NaP) or diatrizoate (gastrografin) seem most effective, but potentially have more side effects than PEG. Future research is needed for more patient friendly but effective preparations, especially for colon capsule and pan-intestinal capsule endoscopy. Full article
(This article belongs to the Special Issue Capsule Endoscopy: Clinical Impacts and Innovation since 2001)
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10 pages, 534 KiB  
Review
Examination of Entire Gastrointestinal Tract: A Perspective of Mouth to Anus (M2A) Capsule Endoscopy
by Ji Hyung Nam, Kwang Hoon Lee and Yun Jeong Lim
Diagnostics 2021, 11(8), 1367; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11081367 - 29 Jul 2021
Cited by 5 | Viewed by 2014
Abstract
Capsule endoscopy (CE) is the only non-invasive diagnostic tool that enables the direct visualization of the gastrointestinal (GI) tract. Even though CE was initially developed for small-bowel investigation, its clinical application is expanding, and technological advances continue. The final iteration of CE will [...] Read more.
Capsule endoscopy (CE) is the only non-invasive diagnostic tool that enables the direct visualization of the gastrointestinal (GI) tract. Even though CE was initially developed for small-bowel investigation, its clinical application is expanding, and technological advances continue. The final iteration of CE will be a mouth to anus (M2A) capsule that investigates the entire GI tract by the ingestion of a single capsule. This narrative review describes the current developmental status of CE and discusses the possibility of realizing an M2A capsule and what needs to be overcome in the future. Full article
(This article belongs to the Special Issue Capsule Endoscopy: Clinical Impacts and Innovation since 2001)
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9 pages, 734 KiB  
Review
A Current and Newly Proposed Artificial Intelligence Algorithm for Reading Small Bowel Capsule Endoscopy
by Dong Jun Oh, Youngbae Hwang and Yun Jeong Lim
Diagnostics 2021, 11(7), 1183; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11071183 - 29 Jun 2021
Cited by 8 | Viewed by 2007
Abstract
Small bowel capsule endoscopy (SBCE) is one of the most useful methods for diagnosing small bowel mucosal lesions. However, it takes a long time to interpret the capsule images. To solve this problem, artificial intelligence (AI) algorithms for SBCE readings are being actively [...] Read more.
Small bowel capsule endoscopy (SBCE) is one of the most useful methods for diagnosing small bowel mucosal lesions. However, it takes a long time to interpret the capsule images. To solve this problem, artificial intelligence (AI) algorithms for SBCE readings are being actively studied. In this article, we analyzed several studies that applied AI algorithms to SBCE readings, such as automatic lesion detection, automatic classification of bowel cleanliness, and automatic compartmentalization of small bowels. In addition to automatic lesion detection using AI algorithms, a new direction of AI algorithms related to shorter reading times and improved lesion detection accuracy should be considered. Therefore, it is necessary to develop an integrated AI algorithm composed of algorithms with various functions in order to be used in clinical practice. Full article
(This article belongs to the Special Issue Capsule Endoscopy: Clinical Impacts and Innovation since 2001)
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