Uri Kopylov1, Diana E Yung2, Tal Engel3, Sanju Vijayan2, Ofir Har-Noy3, Lior Katz3, Salvatore Oliva4, Tomer Avni5, Robert Battat6, Rami Eliakim3, Shomron Ben-Horin3, Anastasios Koulaouzidis2. 1. Gastroenterology Department, Sheba Medical Center, Ramat-Gan, and Sackler School of Medicine, Tel-Aviv University, Israel. Electronic address: ukopylov@gmail.com. 2. Centre for Liver & Digestive Disorders, The Royal Infirmary of Edinburgh, Edinburgh, United Kingdom. 3. Gastroenterology Department, Sheba Medical Center, Ramat-Gan, and Sackler School of Medicine, Tel-Aviv University, Israel. 4. Pediatric Gastroenterology and Liver Unit, Sapienza University of Rome, Italy. 5. Department of Medicine E, Davidoff Cancer Center, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, and Sackler School of Medicine, Tel-Aviv University, Israel. 6. McGill University Health Center, McGill University, Montreal, QC, Canada.
Abstract
BACKGROUND AND AIMS: Capsule endoscopy (CE), magnetic resonance enterography (MRE) and small bowel (SB) intestinal contrast ultrasound (SICUS) are the modalities of choice for SB evaluation. This study aimed to compare the diagnostic yield (DY) of CE to MRE and SICUS in detection and monitoring of SB CD through meta-analysis of the available literature. METHODS: We performed a systematic literature search for trials comparing the accuracy of CE, MRE and SICUS for detection of active SB inflammation in patients with suspected and/or established CD. Only prospective studies comparing CE with another additional diagnostic modality were included in the final analysis. Pooled odds ratios (ORs) for the DY of the three modalities were calculated. RESULTS: A total of 112 studies were retrieved; following selection, 13 studies were eligible for analysis. The DY of CE for detection of active SB CD was similar to that of MRE (10 studies, 400 patients, OR 1.17; 95% CI 0.83-1.67) and SICUS (5 studies, 142 patients, OR 0.88; 95% CI 0.51-1.53). The outcomes were similar for the subgroups of suspected versus established CD and adult versus pediatric patients. CE was superior to MRE for proximal SB CD (7 studies, 251 patients, OR 2.79; 95% CI 1.2-6.48); the difference vs SICUS was not significant. CONCLUSION: CE, MRE and SICUS have similar DY for detection of SB CD in both suspected and established CD. CE is superior to MRE for detection of proximal SB disease, however the risk of capsule retention should be considered.
BACKGROUND AND AIMS: Capsule endoscopy (CE), magnetic resonance enterography (MRE) and small bowel (SB) intestinal contrast ultrasound (SICUS) are the modalities of choice for SB evaluation. This study aimed to compare the diagnostic yield (DY) of CE to MRE and SICUS in detection and monitoring of SB CD through meta-analysis of the available literature. METHODS: We performed a systematic literature search for trials comparing the accuracy of CE, MRE and SICUS for detection of active SB inflammation in patients with suspected and/or established CD. Only prospective studies comparing CE with another additional diagnostic modality were included in the final analysis. Pooled odds ratios (ORs) for the DY of the three modalities were calculated. RESULTS: A total of 112 studies were retrieved; following selection, 13 studies were eligible for analysis. The DY of CE for detection of active SB CD was similar to that of MRE (10 studies, 400 patients, OR 1.17; 95% CI 0.83-1.67) and SICUS (5 studies, 142 patients, OR 0.88; 95% CI 0.51-1.53). The outcomes were similar for the subgroups of suspected versus established CD and adult versus pediatric patients. CE was superior to MRE for proximal SB CD (7 studies, 251 patients, OR 2.79; 95% CI 1.2-6.48); the difference vs SICUS was not significant. CONCLUSION: CE, MRE and SICUS have similar DY for detection of SB CD in both suspected and established CD. CE is superior to MRE for detection of proximal SB disease, however the risk of capsule retention should be considered.
Authors: G Pellino; D S Keller; G M Sampietro; V Annese; M Carvello; V Celentano; C Coco; F Colombo; N Cracco; F Di Candido; M Franceschi; S Laureti; G Mattioli; L Pio; G Sciaudone; G Sica; V Villanacci; R Zinicola; S Leone; S Danese; A Spinelli; G Delaini; F Selvaggi Journal: Tech Coloproctol Date: 2020-01-25 Impact factor: 3.781
Authors: Bella Ungar; Zohar Ben-Shatach; Limor Selinger; Alona Malik; Ahmad Albshesh; Shomron Ben-Horin; Rami Eliakim; Uri Kopylov; Dan Carter Journal: United European Gastroenterol J Date: 2019-09-19 Impact factor: 4.623
Authors: Alan Lobo; Rafael Torrejon Torres; Mark McAlindon; Simon Panter; Catherine Leonard; Nancy van Lent; Rhodri Saunders Journal: Int J Qual Health Care Date: 2020-06-17 Impact factor: 2.038