Magnetically guided capsule versus conventional gastroscopy for upper abdominal complaints

A prospective blinded study

Ulrike W. Denzer, Thomas Rösch, Bilal Hoytat, Mohammed Abdel-Hamid, Xavier Hebuterne, Geoffroy Vanbiervielt, Jérôme Filippi, Haruhiko Ogata, Naoki Hosoe, Kazuo Ohtsuka, Noriyuki Ogata, Keiichi Ikeda, Hiroyuki Aihara, Shin Ei Kudo, Hisao Tajiri, Andras Treszl, Karl Wegscheider, Michel Greff, Jean Francois Rey

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

OBJECTIVES:: Upper gastrointestinal endoscopy is mostly performed under sedation and has a low yield of relevant gastric lesions in patients without alarm symptoms. Simpler screening tests such as capsule endoscopy could be helpful, but gastric visualization is insufficient with the current passive capsules. A magnetically guided gastric capsule was prospectively evaluated in patients with routine indications for gastroscopy. METHODS:: A total of 189 symptomatic patients (105 male; mean age 53 y) from 2 French centers subsequently and blindly underwent capsule and conventional gastroscopy by 9 and 6 examiners, respectively. The final gold standard was unblinded conventional gastroscopy with biopsy under propofol sedation. Main outcome was accuracy (sensitivity/specificity) of capsule gastroscopy for diagnosis of major gastric lesions, defined as those lesions requiring conventional gastroscopy for biopsy or removal. RESULTS:: Twenty-three major lesions were found in 21 patients. Capsule accuracy was 90.5% [95% confidence interval (CI), 85.4%-94.3%] with a specificity of 94.1% (95% CI, 89.3%-97.1%) and a sensitivity of 61.9% (95% CI, 38%-82%). Accuracy did not correlate with lesion location, gastric luminal visibility, examiner case volume, or examination time. Of the remaining 168 patients, 94% had minor and mostly multiple lesions; the capsule made a correct diagnosis in 88.1% (95% CI, 82.2%-92.6%), with gastric visibility and lesion location in the proximal stomach having significant influence. All patients preferred capsule gastroscopy. CONCLUSIONS:: In a prospective and strictly blinded study, magnetically guided capsule gastroscopy was shown to be feasible in clinical practice and was clearly preferred by patients. Improvements in capsule technology may render this technique a future alternative to gastroscopy.

Original languageEnglish
Pages (from-to)101-107
Number of pages7
JournalJournal of Clinical Gastroenterology
Volume49
Issue number2
DOIs
Publication statusPublished - 2015 Feb 21

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Gastroscopy
Capsules
Prospective Studies
Stomach
Confidence Intervals
Capsule Endoscopy
Biopsy
Gastrointestinal Endoscopy
Propofol
Technology
Sensitivity and Specificity

Keywords

  • capsule endoscopy
  • gastric cancer screening
  • gastroscopy

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Magnetically guided capsule versus conventional gastroscopy for upper abdominal complaints : A prospective blinded study. / Denzer, Ulrike W.; Rösch, Thomas; Hoytat, Bilal; Abdel-Hamid, Mohammed; Hebuterne, Xavier; Vanbiervielt, Geoffroy; Filippi, Jérôme; Ogata, Haruhiko; Hosoe, Naoki; Ohtsuka, Kazuo; Ogata, Noriyuki; Ikeda, Keiichi; Aihara, Hiroyuki; Kudo, Shin Ei; Tajiri, Hisao; Treszl, Andras; Wegscheider, Karl; Greff, Michel; Rey, Jean Francois.

In: Journal of Clinical Gastroenterology, Vol. 49, No. 2, 21.02.2015, p. 101-107.

Research output: Contribution to journalArticle

Denzer, UW, Rösch, T, Hoytat, B, Abdel-Hamid, M, Hebuterne, X, Vanbiervielt, G, Filippi, J, Ogata, H, Hosoe, N, Ohtsuka, K, Ogata, N, Ikeda, K, Aihara, H, Kudo, SE, Tajiri, H, Treszl, A, Wegscheider, K, Greff, M & Rey, JF 2015, 'Magnetically guided capsule versus conventional gastroscopy for upper abdominal complaints: A prospective blinded study', Journal of Clinical Gastroenterology, vol. 49, no. 2, pp. 101-107. https://doi.org/10.1097/MCG.0000000000000110
Denzer, Ulrike W. ; Rösch, Thomas ; Hoytat, Bilal ; Abdel-Hamid, Mohammed ; Hebuterne, Xavier ; Vanbiervielt, Geoffroy ; Filippi, Jérôme ; Ogata, Haruhiko ; Hosoe, Naoki ; Ohtsuka, Kazuo ; Ogata, Noriyuki ; Ikeda, Keiichi ; Aihara, Hiroyuki ; Kudo, Shin Ei ; Tajiri, Hisao ; Treszl, Andras ; Wegscheider, Karl ; Greff, Michel ; Rey, Jean Francois. / Magnetically guided capsule versus conventional gastroscopy for upper abdominal complaints : A prospective blinded study. In: Journal of Clinical Gastroenterology. 2015 ; Vol. 49, No. 2. pp. 101-107.
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abstract = "OBJECTIVES:: Upper gastrointestinal endoscopy is mostly performed under sedation and has a low yield of relevant gastric lesions in patients without alarm symptoms. Simpler screening tests such as capsule endoscopy could be helpful, but gastric visualization is insufficient with the current passive capsules. A magnetically guided gastric capsule was prospectively evaluated in patients with routine indications for gastroscopy. METHODS:: A total of 189 symptomatic patients (105 male; mean age 53 y) from 2 French centers subsequently and blindly underwent capsule and conventional gastroscopy by 9 and 6 examiners, respectively. The final gold standard was unblinded conventional gastroscopy with biopsy under propofol sedation. Main outcome was accuracy (sensitivity/specificity) of capsule gastroscopy for diagnosis of major gastric lesions, defined as those lesions requiring conventional gastroscopy for biopsy or removal. RESULTS:: Twenty-three major lesions were found in 21 patients. Capsule accuracy was 90.5{\%} [95{\%} confidence interval (CI), 85.4{\%}-94.3{\%}] with a specificity of 94.1{\%} (95{\%} CI, 89.3{\%}-97.1{\%}) and a sensitivity of 61.9{\%} (95{\%} CI, 38{\%}-82{\%}). Accuracy did not correlate with lesion location, gastric luminal visibility, examiner case volume, or examination time. Of the remaining 168 patients, 94{\%} had minor and mostly multiple lesions; the capsule made a correct diagnosis in 88.1{\%} (95{\%} CI, 82.2{\%}-92.6{\%}), with gastric visibility and lesion location in the proximal stomach having significant influence. All patients preferred capsule gastroscopy. CONCLUSIONS:: In a prospective and strictly blinded study, magnetically guided capsule gastroscopy was shown to be feasible in clinical practice and was clearly preferred by patients. Improvements in capsule technology may render this technique a future alternative to gastroscopy.",
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AU - Rösch, Thomas

AU - Hoytat, Bilal

AU - Abdel-Hamid, Mohammed

AU - Hebuterne, Xavier

AU - Vanbiervielt, Geoffroy

AU - Filippi, Jérôme

AU - Ogata, Haruhiko

AU - Hosoe, Naoki

AU - Ohtsuka, Kazuo

AU - Ogata, Noriyuki

AU - Ikeda, Keiichi

AU - Aihara, Hiroyuki

AU - Kudo, Shin Ei

AU - Tajiri, Hisao

AU - Treszl, Andras

AU - Wegscheider, Karl

AU - Greff, Michel

AU - Rey, Jean Francois

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N2 - OBJECTIVES:: Upper gastrointestinal endoscopy is mostly performed under sedation and has a low yield of relevant gastric lesions in patients without alarm symptoms. Simpler screening tests such as capsule endoscopy could be helpful, but gastric visualization is insufficient with the current passive capsules. A magnetically guided gastric capsule was prospectively evaluated in patients with routine indications for gastroscopy. METHODS:: A total of 189 symptomatic patients (105 male; mean age 53 y) from 2 French centers subsequently and blindly underwent capsule and conventional gastroscopy by 9 and 6 examiners, respectively. The final gold standard was unblinded conventional gastroscopy with biopsy under propofol sedation. Main outcome was accuracy (sensitivity/specificity) of capsule gastroscopy for diagnosis of major gastric lesions, defined as those lesions requiring conventional gastroscopy for biopsy or removal. RESULTS:: Twenty-three major lesions were found in 21 patients. Capsule accuracy was 90.5% [95% confidence interval (CI), 85.4%-94.3%] with a specificity of 94.1% (95% CI, 89.3%-97.1%) and a sensitivity of 61.9% (95% CI, 38%-82%). Accuracy did not correlate with lesion location, gastric luminal visibility, examiner case volume, or examination time. Of the remaining 168 patients, 94% had minor and mostly multiple lesions; the capsule made a correct diagnosis in 88.1% (95% CI, 82.2%-92.6%), with gastric visibility and lesion location in the proximal stomach having significant influence. All patients preferred capsule gastroscopy. CONCLUSIONS:: In a prospective and strictly blinded study, magnetically guided capsule gastroscopy was shown to be feasible in clinical practice and was clearly preferred by patients. Improvements in capsule technology may render this technique a future alternative to gastroscopy.

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