Diagnostic Yield of Colon Capsule Endoscopy in Detection of Superficial Colorectal Lesions

Digestion. 2020;101(3):262-269. doi: 10.1159/000499332. Epub 2019 Mar 27.

Abstract

Background: The efficacy of second-generation PillCam -COLON2 capsule endoscopy (CCE2) in detecting colorectal superficial lesions remains unclear.

Objective: We sought to determine the diagnostic yield of CCE2 in the detection of colorectal superficial lesions.

Methods: We performed CCE2 in 60 consecutive patients between April 2011 and -December 2017. Lesions ≥6 mm in size were detected in 34 patients (25 males, average age: 60.5 years). We performed endoscopic resection and histopathological analysis of all resected lesions within 3 months after CCE2. We considered the optical colonoscopy (OC) findings as the gold standard and evaluated CCE2 sensitivity.

Results: Sixty-seven lesions (≥6 mm) were detected via OC, with 27 colorectal superficial lesions and 40 protruded lesions. CCE2 sensitivity for ≥6-mm-sized, superficial, and protruded lesions was 84, 78, and 88%, respectively. No significant intergroup differences were observed. CCE2 false-negative colorectal superficial lesions accounted for 31% of right-sided colon lesions and 50% of sessile serrated adenomas/polyps (SSA/Ps). The CCE2 false-negative protruded lesions accounted for 17% of right-sided colon lesions.

Conclusion: CCE2 sensitivities for colorectal superficial and protruded lesions were not significantly different. However, flat-type SSA/Ps in the right colon, especially when the transit time is fast, have a risk of demonstrating CCE2 false-negative results.

Keywords: Colon capsule endoscopy; Colorectal superficial lesions; Sessile serrated adenoma/polyp.

Publication types

  • Evaluation Study

MeSH terms

  • Adenoma / diagnosis*
  • Adenoma / pathology
  • Adenoma / surgery
  • Aged
  • Capsule Endoscopy / statistics & numerical data*
  • Colon / diagnostic imaging
  • Colon / pathology
  • Colonic Polyps / diagnosis*
  • Colonic Polyps / pathology
  • Colonic Polyps / surgery
  • Colonoscopy / methods
  • Colonoscopy / statistics & numerical data*
  • Colorectal Neoplasms / diagnosis*
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / surgery
  • False Negative Reactions
  • Female
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Retrospective Studies
  • Sensitivity and Specificity