Accuracy of Magnetically Controlled Capsule Endoscopy, Compared With Conventional Gastroscopy, in Detection of Gastric Diseases.
Diseases of the stomach, including gastric cancer and peptic ulcer, are the most common digestive diseases. It is impossible to visualize the entire stomach with the passive capsule currently used in practice because of the large size of the gastric cavity. A magnetically controlled capsule endoscopy (MCE) system has been designed to explore the stomach. We performed a prospective study to compare the accuracy of detection of gastric focal lesions by MCE vs conventional gastroscopy (the standard method).
We performed a multicenter blinded study comparing MCE with conventional gastroscopy in 350 patients (mean age, 46.6 y), with upper abdominal complaints scheduled to undergo gastroscopy at a tertiary center in China from August 2014 through December 2014. All patients underwent MCE, followed by conventional gastroscopy 2 hours later, without sedation. We calculated the sensitivity, specificity, positive predictive value, and negative predictive value of detection of gastric focal lesions by MCE, using gastroscopy as the standard.
MCE detected gastric focal lesions in the whole stomach with 90.4% sensitivity (95% confidence interval [CI], 84.7%-96.1%), 94.7% specificity (95% CI, 91.9%-97.5%), a positive predictive value of 87.9% (95% CI, 81.7%-94.0%), a negative predictive value of 95.9% (95% CI, 93.4%-98.4%), and 93.4% accuracy (95% CI, 90.83%-96.02%). MCE detected focal lesions in the upper stomach (cardia, fundus, and body) with 90.2% sensitivity (95% CI, 82.0%-98.4%) and 96.7% specificity (95% CI, 94.4%-98.9%). MCE detected focal lesions in the lower stomach (angulus, antrum, and pylorus) with 90.6% sensitivity (95% CI, 82.7%-98.4%) and 97.9% specificity (95% CI, 96.1%-99.7%). MCE detected 1 advanced gastric carcinoma, 2 malignant lymphomas, and 1 early stage gastric tumor. MCE did not miss any lesions of significance (including tumors or large ulcers). Among the 350 patients, 5 reported 9 adverse events (1.4%) and 335 preferred MCE over gastroscopy (95.7%).
MCE detects focal lesions in the upper and lower stomach with comparable accuracy with conventional gastroscopy. MCE is preferred by almost all patients, compared with gastroscopy, and can be used to screen gastric diseases without sedation. Clinicaltrials.gov number: NCT02219529.
Liao Z
，Hou X
，Lin-Hu EQ
，Sheng JQ
，Ge ZZ
，Jiang B
，Hou XH
，Liu JY
，Li Z
，Huang QY
，Zhao XJ
，Li N
，Gao YJ
，Zhang Y
，Zhou JQ
，Wang XY
，Liu J
，Xie XP
，Yang CM
，Liu HL
，Sun XT
，Zou WB
，Li ZS
... -
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Blinded nonrandomized comparative study of gastric examination with a magnetically guided capsule endoscope and standard videoendoscope.
Passive video capsule endoscopy is the criterion standard for small-bowel exploration but cannot be used for the large gastric cavity. We report the first blinded comparative clinical trial in humans comparing a magnetically guided capsule endoscope (MGCE) and a conventional high-definition gastroscope.
To assess the potential of gastric examination with a guided capsule.
Blinded, nonrandomized comparative study.
Single endoscopy center.
The trial involved 61 patients included in a blinded capsule and gastroscopy comparative study. MGCE examination was performed 24 hours after patients had undergone gastroscopy. To remove food residue or mucus, patients drank 900 mL of water in 2 portions. Then to provide the air-water interface required by the guidance system, they drank 400 mL of water at 35°C.
Visualization of the gastric pylorus, antrum, body, fundus, and cardia was evaluated as complete in 88.5%, 86.9%, 93.4%, 85.2%, and 88.5% of patients, respectively. Of gastric lesions, 58.3% were detected by both gastroscopy and MGCE at immediate assessment and review of recorded data. Capsule examination missed 14 findings and gastroscopy missed 31 findings seen with MGCE. Overall diagnostic yield was similar for both modalities.
Pilot study.
Diagnostic results were similar for the 2 methods. After some technical difficulties related to gastric expansion or presence of mucus had been overcome, this study opened a new field for noninvasive gastric examination in countries where high gastric cancer incidence demands a screening tool.
Rey JF
，Ogata H
，Hosoe N
，Ohtsuka K
，Ogata N
，Ikeda K
，Aihara H
，Pangtay I
，Hibi T
，Kudo SE
，Tajiri H
... -
《-》
Standing-type magnetically guided capsule endoscopy versus gastroscopy for gastric examination: multicenter blinded comparative trial.
To compare feasibility and safety after gastrointestinal checkup by standing-type magnetically controlled capsule endoscopy (SMCE) and conventional gastroscopy.
This was a prospective multicenter, blinded study that compared SMCE with gastroscopy in patients from April 2018 to July 2018. All patients first underwent SMCE and then subsequently had gastroscopy with i.v. anesthesia. We calculated the compliance rates of gastric lesion detection by SMCE using gastroscopy as the standard. Capsule retention rate, incidence of adverse events, and patient satisfaction were documented throughout the study.
One hundred and sixty-one patients who completed SMCE and gastroscopy were included in the analysis. Positive compliance rate among SMCE and gastroscopy was 92.0% (95% CI: 80.77%-97.78%). Negative compliance rate was 95.5% (89.80%, 98.52%). Moreover, overall compliance rate was 94.41% (89.65%, 97.41%). Sixty-four pathological outcomes were identified. Of these 64 outcomes, 50 were detected by both procedures. The gastroscopy method neglected seven findings (such as five erosions, one polyp, and one ulcer). Furthermore, SMCE also overlooked seven lesions (i.e. one erosion, two polyps, one atrophy, and three submucosal tumors). Capsule retention or related adverse events were not reported.
Standing-type magnetically controlled capsule endoscopy provides equivalent agreement with gastroscopy and may be useful for screening of gastric illnesses without any anesthesia.
Lai HS
，Wang XK
，Cai JQ
，Zhao XM
，Han ZL
，Zhang J
，Chen ZY
，Lin ZZ
，Zhou PH
，Hu B
，Li AM
，Liu SD
... -
《-》
Efficacy and safety of magnetic guided capsule gastroscopy in gastric diseases.
The current mainstay of screening and diagnosis for gastric diseases is conventional standard gastroscopy. However, it is invasive and uncomfortable procedure for the patients especially in case of non-sedative procedures and other adverse effects related to conscious sedation anesthesia. Recently, a magnetic guided capsule gastroscopy (MGCG) was introduced to overcome these challenges. It is a safe and pleasant procedure with no involvement of sedation and no risks of cross-infection between patients. In addition, this method is anticipated to be an alternative tool for screening and diagnosis of gastric diseases with similar gastric visualization as one achieved through standard gastroscopy. In this narrative review, we focused on the recent advances in MGCG including technical issues, ideal gastric preparation, indications and contraindications, available evidences regarding the use of magnetic guided capsule gastroscopy in clinical practice and highlighted further technical advancements which are needed to make MGCG as a potential diagnostic tool. After reviewing the literature, we concluded that the magnetic guided capsule gastroscopy is a safe tool and would be a promising alternative examination equipment for gastric diseases.
Rauya E
，Sha O
，Darwazeh R
，Zhang BQ
... -
《ACTA GASTRO-ENTEROLOGICA BELGICA》
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