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Gastrointest Endosc. 2014 Oct;80(4):642-651. doi: 10.1016/j.gie.2014.04.057. Epub 2014 Jul 3.

Utility of 3-dimensional image reconstruction in the diagnosis of small-bowel masses in capsule endoscopy (with video).

Author information

1
Gastroenterology Unit, Valduce Hospital, Como, Italy.
2
Endoscopy Unit, Centre for Liver & Digestive Disorders, The Royal Infirmary of Edinburgh, Edinburgh, Scotland, UK.
3
National Library of Medicine, National Institutes of Health, Bethesda, Maryland, USA.
4
Faculty of Economics & Management, Open University of Cyprus, Nicosia, Cyprus.
5
Department of Internal Medicine, Gastroenterology and Digestive Endoscopy Unit, Busto Arsizio Hospital, Busto Arsizio, Italy.
6
Department of Internal Medicine, Gastroenterology Unit, San Carlo Borromeo Hospital, Milan, Italy.
7
Division of Gastroenterology, Department of Medicine, San Giovanni Battista University Teaching Hospital, Turin, Italy.

Abstract

BACKGROUND:

In small-bowel capsule endoscopy (SBCE), differentiating masses (ie, lesions of higher probability for neoplasia) requiring more aggressive intervention from bulges (essentially, false-positive findings) is a challenging task; recently, software that enables 3-dimensional (3D) reconstruction has become available.

OBJECTIVE:

To evaluate whether "coupling" 3D reconstructed video clips with the standard 2-dimensional (s2D) counterparts helps in distinguishing masses from bulges.

DESIGN:

Three expert and 3 novice SBCE readers, blind to others and in a random order, reviewed the s2D video clips and subsequently the s2D clips coupled with their 3D reconstruction (2D+3D).

SETTING:

Multicenter study in 3 community hospitals in Italy and a university hospital in Scotland.

PATIENTS:

Thirty-two deidentified 5-minute video clips, containing mucosal bulging (19) or masses (13).

INTERVENTION:

3D reconstruction of s2D SBCE video clips.

MAIN OUTCOME MEASURE:

Differentiation of masses from bulges with s2D and 2D+3D video clips, estimated by the area under the receiver operating characteristic curve (AUC); interobserver agreement.

RESULTS:

AUC for experts and novices for s2D video clips was .74 and .5, respectively (P = .0053). AUC for experts and novices with 2D+3D was .70 (compared with s2D: P = .245) and .57 (compared s2D: P = .049), respectively. AUC for experts and novices with 2D+3D was similar (P = .1846). The interobserver agreement was good for both experts and novices with the s2D (k = .71 and .54, respectively) and the 2D+3D video clips (k = .58 in both groups).

LIMITATIONS:

Few, short video clips; fixed angle of 3D reconstruction.

CONCLUSIONS:

The adjunction of a 3D reconstruction to the s2D video reading platform does not improve the performance of expert SBCE readers, although it significantly increases the performance of novices in distinguishing masses from bulging.

PMID:
24998466
DOI:
10.1016/j.gie.2014.04.057
[Indexed for MEDLINE]

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